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Objectives: The number needed to test (NNT) to identify a child infected with HIV remains high in the context of the implementation of the blanket provider-initiated testing and counselling (bPITC) strategy. This study assessed the predictors of HIV seropositivity among outpatient children/adolescents (6 weeks-19 years) in Cameroon. This information is needed to improve the yield of bPITC and reduce the current gap in pediatric and adolescent ART coverage in this country and beyond. Study design: Cross-sectional study conducted in 3 hospitals in Cameroon. Methods: Through biological parents and guardians we systematically invited children and adolescents visiting the outpatient departments for any reason to test for HIV (bPITC) in a 6-month period. Children and adolescents were tested for HIV following the national guidelines and the predictors of HIV seropositivity were assessed using multivariate logistic regression at 5% significant level. Results: A total of 2729 eligible children/adolescents were enrolled. Among these, 90.3% (2465/2729) were tested for HIV. Out of these, 1.6% (40/2465) tested HIV-positive, corresponding to a NNT of 62. In multivariate analysis, HIV seropositivity was 2.5, 3.3, and 5 times more likely to be reported among children/adolescents of the female sex [aOR â= â0.4 (0.2-0.8), p â= â0.008]; whose fathers had no formal school education [aOR â= â0.3 (0.1-0.6), p â= â0.004] and those whose mothers had died [aOR â= â0.2 (0.0-0.9), p â= â0.041], respectively. Conclusions: Focusing HIV testing among female children/adolescents, whose fathers had no education level and whose mothers had died could reduce the NNT, improve the yield of bPITC and increase the pediatric and adolescent ART coverage.
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Both the academic and the policy community are calling for wider application of mixed methods research, suggesting that combined use of quantitative and qualitative methods is most suitable to assess and understand the complexities of health interventions. In spite of recent growth in mixed methods studies, limited efforts have been directed towards appraising and synthetizing to what extent and how mixed methods have been applied specifically to Health Policy and Systems Research (HPSR) in low- and middle-income countries (LMICs). We aimed at filling this gap in knowledge, by exploring the scope and quality of mixed methods research in the African context. We conducted a scoping review applying the framework developed by Arksey and O'Malley and modified by Levac et al. to identify and extract data from relevant studies published between 1950 and 2013. We limited our search to peer-reviewed HPSR publications in English, which combined at least one qualitative and one quantitative method and focused on Africa. Among the 105 studies that were retained for data extraction, over 60% were published after 2010. Nearly 50% of all studies addressed topics relevant to Health Systems, while Health Policy and Health Outcomes studies accounted respectively for 40% and 10% of all publications. The quality of the application of mixed methods varied greatly across studies, with a relatively small proportion of studies stating clearly defined research questions and differentiating quantitative and qualitative elements, including sample sizes and analytical approaches. The methodological weaknesses observed could be linked to the paucity of specific training opportunities available to people interested in applying mixed methods to HPSR in LMICs as well as to the limitations on word limit, scope and peer-review processes at the journals levels. Increasing training opportunities and enhancing journal flexibility may result in more and better quality mixed methods publications.
Assuntos
Atenção à Saúde , Países em Desenvolvimento , Política de Saúde , Pesquisa sobre Serviços de Saúde , África , Humanos , PobrezaRESUMO
Introduction : Les maladies diarrhéiques sont une importante cause de morbidité et mortalité chez les nourrissons et les jeunes enfants dans les pays en voie de développement. Le district de santé de Bamendjou, à l'ouest Cameroun, n'en est pas épargné.Objectif : Principalement, il était question de mesurer l'association entre la qualité de l'eau de boisson, assainissement dans les ménages et les cas de diarrhées chez les enfants de moins de cinq ans.Matériel et méthode : Il s'agissait d'une étude cas-témoins. La population cible était les enfants de moins cinq ans résidant dans le district de santé de Bamendjou. Une approche adaptée de l'autopsie verbale en communauté était utilisée pour diagnostiquer les cas de diarrhées. Chaque cas était apparié à deux témoins. L'analyse des données s'est faite par régression et test de Khi2 à l'aide de l'outil Epi-info 7.1.4.0. Une valeur de P inférieure à 5% était considérée comme significative.Résultats : Sur 99 enfants (33 cas et 66 témoins), 38,71% des cas de maladies diarrhéiques, issus des ménages n'utilisant pas une source d'eau améliorée contre 30,8% des ménages utilisant une source d'eau améliorée (OR = 1.4535 ; IC = 0,582- 3,432). Sur les 33 cas diarrhéiques, 63,6% étaient issus des ménages n'utilisant pas de toilettes améliorées contre 36,3% issus ménages utilisant les toilettes améliorées (OR = 7,1346 ; CI = 2,805- 18,142).Conclusion : Les cas diarrhéiques sont attribuables à un accès limité à l'assainissement. Nous recommandons la mise en place d'un projet de promotion d'hygiène et assainissement dans le district de santé de Bamendjou
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Camarões , Centros Comunitários de Saúde , Diarreia , Diarreia InfantilRESUMO
BACKGROUND AND AIMS: The impact of acne upon quality of life (QOL) among affected patients had not previously been investigated in Cameroon. The present study therefore sought to assess the QOL of patients with acne and related psychiatric comorbidities in this country. PATIENTS AND METHODS: This was a cross-sectional study conducted in three hospitals in Yaoundé, Cameroon. We included patients diagnosed with acne after a consultation with a dermatologist, and who consented to participate in the study. The ECLA scale was used for the clinical evaluation of acne and the CADI score was used to assess QOL. PHQ-9 and GAD-7 questionnaires were used for the respective screening of depression and anxiety. RESULTS: We enrolled 181 patients aged between 13 and 56years. According to the ECLA table, the acne global severity score ranged from 3 to 26 points. Impairment was observed in all patients' QOL, which ranged from 1 to 15 points. We noted 11 cases of depression (6.1%) and 14 cases of anxiety (7.7%). There was a positive and significant correlation between the severity of acne and impairment of patients' QOL (r=0.46; P<0.001). Likewise, the severity of acne and of depression and anxiety scores were positively and significantly correlated with one other: r=0.347 (P<0.001) and r=0.291 (P<0.001), respectively. CONCLUSION: Acne negatively impacts the QOL of patients presenting acne in Cameroon and is associated with depression and anxiety, which must therefore be taken into account when treating these patients.
