scholarly journals Socio-demographic and behavioral factors associated with HIV testing and HIV seropositivity among women and children in sub-Saharan Africa: A population-based multilevel analysis

2014 ◽  
Author(s):  
Zelalem T. Haile
Keyword(s):  
Hiv Testing ◽  
Multilevel Analysis ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Behavioral Factors ◽  
Hiv Seropositivity ◽  
Factors Associated ◽  
Women And Children ◽  
Sub Saharan

scholarly journals Adherence to Iron Supplementation in 22 Sub-Saharan African Countries and Associated Factors among Pregnant Women: A Large Population-Based Study

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Djibril M Ba ◽  
Paddy Ssentongo ◽  
Kristen H Kjerulff ◽  
Muzi Na ◽  
Guodong Liu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Iron Supplementation ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Deficiency Anemia ◽  
Demographic And Health Surveys ◽  
Factors Associated ◽  
Sub Saharan ◽  
Ssa Countries ◽  
Antenatal Visits

ABSTRACT Background Iron deficiency anemia during pregnancy is a significant public health problem in sub-Saharan Africa (SSA) and is associated with serious adverse health outcomes. Although it is recommended that all women receive iron supplementation during pregnancy, little research has been conducted to measure overall compliance with this recommendation or variation across SSA countries. Objectives To assess prevalence and sociodemographic-economic factors associated with adherence to iron supplementation among pregnant women in SSA. Methods This was a weighted population-based cross-sectional study of 148,528 pregnant women aged 15–49 y in 22 SSA countries that participated in the Demographic and Health Surveys (DHS) in 2013–2018 and measured iron supplementation during pregnancy. Adherence to iron supplementation was defined as using iron supplementation for ≥90 d during pregnancy of the most recent birth. Results The overall prevalence of adherence to ≥90 d of iron supplementation during pregnancy was 28.7%, ranging from 1.4% in Burundi to 73.0% in Senegal. Factors associated with adherence included receiving ≥4 antenatal care visits [adjusted Prevalence Ratio (aPR): 25.73; 95% CI: 22.36, 29.60] compared with no antenatal visits; secondary or higher education (aPR: 1.17; 95% CI: 1.14, 1.19) compared with no education; wealthy (aPR: 1.13; 95% CI: 1.10, 1.16) compared with poor; and older women aged 35–49 y (aPR: 1.07; 95% CI: 1.05, 1.10) compared with younger women aged 15–24 y. Conclusions Adherence to iron supplementation during pregnancy in SSA is low and varies substantially across countries and in relation to factors such as number of antenatal visits, education, and level of family wealth. These results underscore the need for increased efforts to improve the uptake of iron supplementation for pregnant women in SSA.

scholarly journals Trends in knowledge of HIV status and efficiency of HIV testing services in Sub-Saharan Africa (2000-2020): a modelling study of survey and HIV testing program data

2020 ◽  
Author(s):  
Katia Giguère ◽  
Jeffrey W. Eaton ◽  
Kimberly Marsh ◽  
Leigh F. Johnson ◽  
Cheryl C. Johnson ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Median Time ◽  
Credible Interval ◽  
Population Based ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Hiv Testing Services ◽  
Sub Saharan ◽  
First Time

AbstractBackgroundKnowledge of HIV status (KOS) among people living with HIV (PLHIV) is essential for an effective national HIV response. This study estimates progress and gaps in reaching the UNAIDS 2020 target of 90% KOS, and the efficiency of HIV testing services (HTS) in sub-Saharan Africa (SSA), where two thirds of all PLHIV live.MethodsWe used data from 183 population-based surveys (N=2.7 million participants) and national HTS programs (N=315 country-years) from 40 countries as inputs into a mathematical model to examine trends in KOS among PLHIV, median time from HIV infection to diagnosis, HIV testing positivity, and proportion of new diagnoses among all positive tests, adjusting for retesting.FindingsAcross SSA, KOS steadily increased from 6% (95% credible interval [95%CrI]: 5% to 7%) in 2000 to 84% (95%CrI: 82% to 86%) in 2020. Twelve countries and one region, Southern Africa, reached the 90% target. In 2020, KOS was lower among men (79%) than women (87%) across SSA. PLHIV aged 15-24 years were the least likely to know their status (65%), but the largest gap in terms of absolute numbers was among men aged 35-49 years, with over 700,000 left undiagnosed. As KOS increased from 2000 to 2020, the median time to diagnosis decreased from 10 to 3 years, HIV testing positivity declined from 9% to 3%, and the proportion of first-time diagnoses among all positive tests dropped from 89% to 42%.InterpretationOn the path towards the next UNAIDS target of 95% diagnostic coverage by 2030, and in a context of declining positivity and yield of first-time diagnoses, we need to focus on addressing disparities in KOS. Increasing KOS and treatment coverage among older men could be critical to reduce HIV incidence among women in SSA, and by extension, reducing mother-to-child transmission.

scholarly journals Does it really matter where you live? A multilevel analysis of factors associated with missed opportunities for vaccination in sub-Saharan Africa

2018 ◽  
Vol 14 (10) ◽  
pp. 2397-2404 ◽  
Author(s):  
Olalekan A. Uthman ◽  
Evanson Z. Sambala ◽  
Abdu A. Adamu ◽  
Duduzile Ndwandwe ◽  
Alison B. Wiyeh ◽  
...  
Keyword(s):  
Multilevel Analysis ◽  
Sub Saharan Africa ◽  
Missed Opportunities ◽  
Factors Associated ◽  
Sub Saharan

scholarly journals Individual- and Facility-Level Factors Associated with Facility Testing among Men in Malawi: Findings from a Representative Community Survey

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 950
Author(s):  
Kelvin Balakasi ◽  
Brooke E. Nichols ◽  
Misheck Mphande ◽  
Christian Stillson ◽  
Shaukat Khan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sexual Partner ◽  
Secondary Analysis ◽  
Sub Saharan Africa ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Testing Uptake ◽  
Outpatient Departments ◽  
Sub Saharan ◽  
Facility Level

(1) Background: Men frequent outpatient departments (OPD) but are underrepresented in HIV testing services throughout sub-Saharan Africa. (2) Methods: We conducted a secondary analysis on data from a community-based survey with men in rural Malawi to assess factors associated with HIV testing, and being offered testing, during men’s OPD visits. We include OPD visits made by men in-need of testing as our unit of observation. Multilevel mixed-effects logistic regression models were conducted. (3) Results: 782 men were eligible for these analyses, with 1575 OPD visits included (median two visits per man; IQR 1–3). 17% of OPD visits resulted in HIV testing. Being offered testing (aOR 42.45; 95% CI 15.13–119.10) and satisfaction with services received (aOR 3.27; 95% CI 1.28–8.33) were significantly associated with HIV testing. 14% of OPD visits resulted in being offered HIV testing. Being married/steady relationship (aOR 2.53; 95% CI 1.08–5.91) and having a sexual partner living with HIV (aOR 8.22; 95% CI 1.67–40.49) were significantly associated with being offered testing. (4) Conclusion: Being offered HIV testing was the strongest factor associated with testing uptake, while HIV status of sexual partner had the strongest association with being offered testing. Implementation of provider-initiated-testing should be prioritized for male OPD visits.

scholarly journals Time trends in socio-economic inequalities in HIV testing: insights from population-based surveys in 16 sub-Saharan African countries

2019 ◽  
Author(s):  
Pearl Anne Ante-Testard ◽  
Tarik Benmarhnia ◽  
Anne Bekelynck ◽  
Rachel Baggaley ◽  
Eric Ouattara ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Time Trends ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Absolute Difference ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Economic Inequalities

SummaryBackgroundOverall increase in the uptake of HIV testing in the past decades may hide discrepancies across socio-economic groups. We used population-based surveys conducted in sub-Saharan Africa to quantify socio-economic inequalities in recent HIV testing uptake, together with their trends over the two past decades.MethodsWe analyzed the data from Demographic and Health Surveys in sub-Saharan African countries where at least one survey was conducted before and after 2008. Country- and gender-specific proportions of recent (<12 month) HIV testing were assessed across wealth and education groups, and inequalities were quantified using the relative and slope indices of inequalities. Time trends in inequalities were assessed and results were pooled across countries using random-effect meta-analyses.FindingsWe analyzed data from 32 surveys conducted between 2003 and 2016 in 16 countries among 537,784 participants. In pre-2008 surveys, women reported higher HIV testing uptake than men in 8 out of 16 countries, and in 15 out of 16 countries in post-2008 surveys. After 2008, the wealthiest women were on average 2.77 (95% CI 1.42-5.40) times more likely to report recent testing than the poorest; and 3.55 (1.85-6.81) times in men. The averaged absolute difference in recent testing between the richest and poorest was 11.1 (4.6-17.5) percentage points in women and 15.1 (9.6-20.6) in men. Over time, relative inequalities in recent HIV testing decreased in both genders, while absolute inequalities plateaued in women and increased in men.InterpretationsThe overall increase in HIV testing uptake that was stimulated by the impetus to scale up HIV treatment in sub-Saharan Africa led to a decrease in relative inequalities, while absolute inequalities persisted. Within most countries, large inequalities still remained, both in absolute and relative scales, especially in West and Central Africa. A greater focus should be put on equity in monitoring HIV testing programs.A French version of this article is available in the Appendices [Une version française de cet article est disponible en appendice].FundingINSERM-ANRS (France Recherche Nord & Sud Sida-HIV Hépatites), grant number ANRS-12377.

scholarly journals Population-Based Screening and Eradication of Helicobacter pylori in a Resource-Limited Population of Sub-Saharan Africa

2020 ◽  
Author(s):  
Yang Jae Lee ◽  
Ibrahim Ssekalo ◽  
Rauben Kazungu ◽  
Timothy S. Blackwell ◽  
Peter Muwereza ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Significant Risk ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Standard Triple Therapy ◽  
Sub Saharan ◽  
H Pylori ◽  
Antigen Testing

Abstract Background: Helicobacter pylori (H. pylori) infection is a common cause of chronic dyspepsia worldwide. Its prevalence in the developing world remains understudied, however. Given that H. pylori is the most significant risk factor for developing gastric cancer, an accurate assessment of the effectiveness of population-based screening and eradication of H. pylori is warranted. The objectives of this study were to determine the prevalence of H. pylori, to identify risk factors associated with H. pylori colonization, and to assess the efficacy of triple therapy on H. pylori eradication within a region of sub-Saharan Africa.Methods: We administered a dyspepsia questionnaire to 376 randomly selected adult residents of the Namutumba District in Uganda. Participants submitted a stool sample for H. pylori fecal antigen testing. H. pylori-positive participants were given standard triple therapy. The efficacy of triple therapy on H. pylori eradication was established by fecal H. pylori antigen testing and improvement in dyspepsia scores after treatment. Dyspeptic, H. pylori-negative participants were administered daily omeprazole for one month. Logistic regression analyses were used to identify factors associated with H. pylori positivity, chronic dyspepsia, and H. pylori eradication failure.Results: The prevalence of H. pylori within the study population was 48%. A higher level of education was significantly associated with H. pylori positivity. 87% of study participants reported at least one symptom of dyspepsia, with 43% reporting moderate or severe dyspepsia. Dyspepsia severity was independent of H. pylori status. Standard triple therapy resulted in ~90% eradication. Missing four or more doses of the triple therapy regimen was significantly associated with H. pylori eradication failure.Conclusions: Chronic dyspepsia is a common complaint in this sub-Saharan population but is not by itself a defining feature of H. pylori positivity. Clinical suspicion for H. pylori within this population should nonetheless remain high, given the high prevalence of positivity among all those with dyspepsia, including many with relatively mild dyspeptic symptoms. Population-based screening and adherence to standard triple therapy are effective at eradicating H. pylori within this region. Trial Registration: This study was registered in ClinicalTrials.gov (TRN: NCT04525664, registered 24 August 2020 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04525664). This study adheres to CONSORT guidelines.

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