Patterns of availability and accuracy of risk factor data for cardiovascular diseases among people initiated on antiretroviral therapy at selected health facilities in Khomas region, Namibia: a retrospective, cross-sectional, quantitative study.

Introduction: quality data is a prerequisite for timely decision-making and measuring health outcomes in public health settings. Comorbidities such as cardiovascular diseases (CVDs) among people living with HIV (PLHIV), require a robust system that ensures credible data at all data-producing levels. The study at determining the level of availability and completeness of CVDs risk factors data of PLHIV. Methods: a quantitative study was conducted to extract CVDs risk factors data retrospectively from 529 patient care booklets (PCBs) between 2004 and 2017. The analysis was done with the Statistical Package for Social Sciences (SPSS) version 25. Pearson Chi-Square was used to test for associations. The level of significance was at p ≤ 0.05. Results: the study revealed that 72.8% of patients are at risk of CVDs due to incomplete demographics (73.72%) and other systemic data (41.18%). A significant association was found (Pearson Chi-Square test 19.907; p-value of 0.001) between average visits per year, accurate data recording, and active status of the patient. Lost to follow-up (15%) and true retention (27.2%) was significantly associated with the last Antiretroviral Therapy (ART) status of a patient (Pearson Chi-Square test 87.754; p-value of 0.001). Conclusion: the study that despite concerted efforts to improve data quality, the availability and completeness of data remain unsatisfactory. Lack of harmonised data screening and analysis efforts for CVDs risk factors is found to be a significant risk factor in ensuring integrated routine measuring of CVDs health outcomes for PLHIV.

Predictors of cardiovascular diseases among people living with HIV initiated on antiretroviral therapy in Khomas region, Namibia: A cross-sectional study.

Cardiovascular diseases (CVDs) have been identified as the leading cause of morbidity and mortality among people living with human immunodeficiency virus (PLHIV). However, it is evident that there is a lack of effective surveillance and monitoring of CVDs. Salient side-effects of antiretroviral therapy (ART) exacerbate pre-existing co-morbidities, hence the need for CVDs and its predictors to be monitored closely to ensure life-long care. Personal health records play a crucial role in the field of health information extraction because of their factuality and reliability. The current study assessed the predictors associated with CVDs among PLHIV initiated on ART in the Khomas health district in Namibia A cross-sectional quantitative descriptive study was conducted to extract CVDs predictors from 529 patient care booklets (PCBs) between 2004 and 2018 at purposely selected health facilities in Khomas health district. Data was matched with the electronic Patient Monitoring System(ePMS) and statistical analyses were performed. The study found that prominent CVDs predictors were found to be greatly prevalent among PLHIV initiated on ART with an adjusted variation (p<0.001). The mean ± SD age of all participants was 38.10, ± range 64 and 55.1% of them were males and 44.9% were females. Data from this study suggest that high blood pressure, obesity, smoking, and alcohol use are greatly prevalent among PLHIV, particularly among males. Systems that provide accurate information, early screening with subsequent treatment for PLHIV, is recommended by this study.

The role of Namibia Field Epidemiology and Laboratory Training Programme in strengthening the public health workforce in Namibia, 2012-2019.

Namibia faces a critical shortage of skilled public health workers to perform emergency response operations, preparedness activities and real-time surveillance. The Namibia Field Epidemiology and Laboratory Training Programme (NamFELTP) increases the number of skilled public health professionals and strengthens the public health system in Namibia. We describe the NamFELTP during its first 7 years, assess its impact on the public health workforce and provide recommendations to further strengthen the workforce. We reviewed disease outbreak investigations and response reports, field projects and epidemiological investigations conducted during 2012-2019. The data were analysed using descriptive methods such as frequencies and rates. Maps representing the geographical distribution of NamFELTP workforce were produced using QGIS software V.3.2. There were no formally trained field epidemiologists working in Namibia before the NamFELTP. In its 7 years of operation, the programme graduated 189 field epidemiologists, of which 28 have completed the Advanced FELTP. The graduates increased epidemiological capacity for surveillance and response in Namibia at the national and provincial levels, and enhanced epidemiologist-led outbreak responses on 35 occasions, including responses to outbreaks of human and zoonotic diseases. Trainees analysed data from 51 surveillance systems and completed 31 epidemiological studies. The NamFELTP improved outcomes in the Namibia's public health systems; including functional and robust public health surveillance systems that timely and effectively respond to public health emergencies. However, the current epidemiological capacity is insufficient and there is a need to continue training and mentorship to fill key leadership and strategic roles in the public health system.

Time series analysis of Nevirapine syrup consumption in prevention of mother-tochild transmission and optimal supply chain model in Oshana region, Namibia.

HIV/AIDS continue to be serious communicable disease whose impact on public health in Namibia is massive. It is estimated that the prevalence rate of HIV in Namibia is 17.2%, ranking the country as the fifth highest in sub-Saharan Africa (SSA). Some improvement in reducing the number of cases of HIV/AIDS has been made in the country, but the sporadic shortage of medicines continues to slow down government efforts to foster the emergence of an HIVfree generation of Namibians. Develop and demonstrate a mathematical supply-chain model, which can establish parameters to prevent stock-outs of NVP suspension. The study adopted retrospective approach to acquire data from 2012-2016. Gamma supply chain model was developed as the optimal model for NVP syrup and forecasted consumption for 2017-2018 was determined. It is a recommendation of this study that new guidelines for implementation of optimal supply-chain models at the regional medical store, health centers and clinics be implemented for Nevirapine syrup.

Factors associated with stock out of malaria test kit in Oshana region, Namibia.

Malaria continues to be a serious communicable disease whose impact on public health in Namibia is massive. Some improvement in reducing the number of malaria cases has been made in the country, but the sporadic availability of malaria diagnostic test kits (mRDT) continues to slow down government efforts to eliminate malaria in the country. Given the nature of current conditions, justification exists for a study to determine the factors associated with stock out of malaria rapid test kit (mRDT) in Namibia. Mixed method approach was employed, whereby in quantitative aspect, the study adopted a descriptive approach to acquire data from a period of five years retrospectively (2012-2016). To gain insight into qualitative aspects of the study, key informants at all levels of the supply chain in Oshana region were interviewed. Pharmaceutical knowledge of ordering mRDT is needed to prevent stock out of mRDT. It is a recommendation of this study that training is needed for staffs who are involved in ordering of pharmaceutical items.

Factors associated with stockout of Nevirapine syrup in Oshana Region, Namibia.

Infants who are born with HIV/AIDS is still a public health concern in developing countries, especially in Sub Saharan Africa. In Namibia, it is estimated that the prevalence rate of HIV pregnant women is around 17.2%, makes it to be among the countries with the highest prevalence rates among HIV women in sub-Saharan Africa (SSA). Some improvement regarding Prevention of Mother to Child Transmission has been made, however, frequent stock out of Nevirapine syrup continues to slow down, government efforts to foster the emergence of an HIV-free generation of Namibians. Given the nature of current conditions, justification exists for a study to determine the factors associated with stock out of Nevirapine (NVP) syrup.Mixed method was employed. In which descriptive approach was employed to acquire data from a period of five years retrospectively (2012-2016) and informants from different levels of supply chain in Oshana region. Initial, order receiving is not a predictor of NVP syrup. Lack of pharmaceutical knowledge is the biggest challenge which leads to sporadic stock out of NVP syrup. Pharmaceutical knowledge of ordering NVP syrup is needed to prevent stock out of NVP syrup. It is a recommendation of this study that training is needed for staffs who are involved in ordering of pharmaceutical items.