Journal Article > ResearchFull Text
Disasters. 2003 June 1; Volume 27 (Issue 2); 141-153.; DOI:10.1111/1467-7717.00225
Van Herp M, Parqué V, Rackley E, Ford NP
Disasters. 2003 June 1; Volume 27 (Issue 2); 141-153.; DOI:10.1111/1467-7717.00225
The people of the Democratic Republic of Congo for decades have been living in a situation of chronic crisis. Violence, population displacement and the destruction of infrastructure and health services have devastated the health of the population. In 2001, Médicins Sans Frontières conducted a survey in five areas of western and central DRC to assess mortality, access to health-care, vaccination coverage and exposure to violence. High mortality rates were found in front-line zones, mainly due to malnutrition and infectious diseases. In Basankusu approximately 10 per cent of the total population and 25 per cent of the under-five population had perished in the year before the survey. Humanitarian needs remain acute across the country, particularly near the front line. Infectious-disease control and treatment are a priority, as is increasing access to health-care. Humanitarian assistance must be increased considerably, especially in rural areas and zones that have been affected directly by conflict.
Journal Article > EditorialFull Text
BMJ Opinion (blog). 2023 September 25; Volume 382; 2205.; DOI:10.1136/bmj.p2205
Bhardwaj V, Philips M
BMJ Opinion (blog). 2023 September 25; Volume 382; 2205.; DOI:10.1136/bmj.p2205
Journal Article > ResearchFull Text
Torture. 2018 August 1; Volume 28 (Issue 2); 38-55.; DOI:10.7146/torture.v28i2.106921
Spissu C, De Maio G, Van der Bergh R, Ali E, Venables E, et al.
Torture. 2018 August 1; Volume 28 (Issue 2); 38-55.; DOI:10.7146/torture.v28i2.106921
BACKGROUND
Access and linkage to care for migrant torture survivors is contingent on their identification and appropriate referral. However, appropriate tools for identification of survivors are not readily available, and the (staff of) reception systems of host countries may not always be equipped for this task. This study explores practices in the identification and case management of torture survivors in the reception structures and in the public health sector in Rome, Italy.
METHOD
Data were analysed manually and codes and themes generated.
RESULTS
A non-homogeneous level of awareness and experience with torture survivors was observed, together with a general lack of knowledge on national and internal procedures for correct identification of torture survivors. Identification and case management of torture survivors was mainly carried out by non-trained staff. Participants expressed the need for training to gain experience in the identification and management of torture survivors’ cases, as well support and increased resources at both the reception and public health system levels.
CONCLUSIONS
The crucial process of identification and prise en charge of survivors of torture among migrant and refugee populations is relegated to nontrained and inexperienced professionals at different levels of the reception system and public health care sector, which may carry a risk of non-identification and possible harm to survivors. Additional resources and structured interventions are urgently needed, in the form of developing procedures, training, and adapted multidisciplinary services.
Access and linkage to care for migrant torture survivors is contingent on their identification and appropriate referral. However, appropriate tools for identification of survivors are not readily available, and the (staff of) reception systems of host countries may not always be equipped for this task. This study explores practices in the identification and case management of torture survivors in the reception structures and in the public health sector in Rome, Italy.
METHOD
Data were analysed manually and codes and themes generated.
RESULTS
A non-homogeneous level of awareness and experience with torture survivors was observed, together with a general lack of knowledge on national and internal procedures for correct identification of torture survivors. Identification and case management of torture survivors was mainly carried out by non-trained staff. Participants expressed the need for training to gain experience in the identification and management of torture survivors’ cases, as well support and increased resources at both the reception and public health system levels.
CONCLUSIONS
The crucial process of identification and prise en charge of survivors of torture among migrant and refugee populations is relegated to nontrained and inexperienced professionals at different levels of the reception system and public health care sector, which may carry a risk of non-identification and possible harm to survivors. Additional resources and structured interventions are urgently needed, in the form of developing procedures, training, and adapted multidisciplinary services.
Journal Article > LetterFull Text
Lancet Diabetes Endocrinol. 2022 February 7; Volume S2213-8587 (Issue 22); 00036-5.; DOI:10.1016/S2213-8587(22)00036-5
Kehlenbrink S, Mahboob O, Al-Zubi S, Boulle P, Aebischer-Perone S, et al.
Lancet Diabetes Endocrinol. 2022 February 7; Volume S2213-8587 (Issue 22); 00036-5.; DOI:10.1016/S2213-8587(22)00036-5
Journal Article > ResearchFull Text
BMC Cancer. 2023 October 13; Volume 23 (Issue 1); 975.; DOI:10.1186/s12885-023-11484-z
Elshami M, Al-Madhoun S, Alser M, Al-Slaibi I, Yaseen A, et al.
BMC Cancer. 2023 October 13; Volume 23 (Issue 1); 975.; DOI:10.1186/s12885-023-11484-z
BACKGROUND
Several factors contribute to delayed presentation with ovarian cancer (OC) symptoms including poor symptom awareness and barriers to seeking help. This study explored the anticipated time to seek medical advice for possible OC symptoms and its association with OC symptom awareness. In addition, it examined perceived barriers that may delay help-seeking among Palestinian women.
METHODS
A cross-sectional study was conducted among adult women (≥ 18 years) recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates. A modified version of the OC awareness measure was used to collect data in face-to-face interviews. The questionnaire comprised three sections: sociodemographic details, awareness of 11 OC symptoms and time to seek medical advice, and barriers to early presentation.
RESULTS
Of 6095 participants approached, 5618 completed the OCAM (response rate = 92.1%). The proportion of participants who would immediately seek medical advice for a possible OC symptom varied based on the symptom’s nature. For OC symptoms with pain, the proportion that reported immediate seeking of medical advice ranged from 7.9% for ‘persistent low back pain’ to 13.6% for ‘persistent pain in the pelvis’. For non-specific potential OC symptoms, the proportion that reported immediate seeking of medical advice ranged from 2.3% for ‘feeling full persistently’ to 15.8% for ‘increased abdominal size on most days’. Good OC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing 10 out of 11 OC symptoms.
Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n = 1512, 52.4%). Displaying good OC symptom awareness was associated with a lower likelihood of reporting ≥ 4 emotional barriers (OR = 0.61, 95% CI: 0.38–0.98).
CONCLUSION
Participants with good OC symptom awareness were more likely to seek medical advice earlier and to display fewer emotional barriers. Establishing educational interventions to raise OC awareness may help in promoting earlier help-seeking and, thus, facilitate earlier diagnosis and improved prognosis.
Several factors contribute to delayed presentation with ovarian cancer (OC) symptoms including poor symptom awareness and barriers to seeking help. This study explored the anticipated time to seek medical advice for possible OC symptoms and its association with OC symptom awareness. In addition, it examined perceived barriers that may delay help-seeking among Palestinian women.
METHODS
A cross-sectional study was conducted among adult women (≥ 18 years) recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates. A modified version of the OC awareness measure was used to collect data in face-to-face interviews. The questionnaire comprised three sections: sociodemographic details, awareness of 11 OC symptoms and time to seek medical advice, and barriers to early presentation.
RESULTS
Of 6095 participants approached, 5618 completed the OCAM (response rate = 92.1%). The proportion of participants who would immediately seek medical advice for a possible OC symptom varied based on the symptom’s nature. For OC symptoms with pain, the proportion that reported immediate seeking of medical advice ranged from 7.9% for ‘persistent low back pain’ to 13.6% for ‘persistent pain in the pelvis’. For non-specific potential OC symptoms, the proportion that reported immediate seeking of medical advice ranged from 2.3% for ‘feeling full persistently’ to 15.8% for ‘increased abdominal size on most days’. Good OC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing 10 out of 11 OC symptoms.
Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n = 1512, 52.4%). Displaying good OC symptom awareness was associated with a lower likelihood of reporting ≥ 4 emotional barriers (OR = 0.61, 95% CI: 0.38–0.98).
CONCLUSION
Participants with good OC symptom awareness were more likely to seek medical advice earlier and to display fewer emotional barriers. Establishing educational interventions to raise OC awareness may help in promoting earlier help-seeking and, thus, facilitate earlier diagnosis and improved prognosis.
Conference Material > Abstract
Mairos Ferreira S, Muthengi K, Mohale M, Mokhameleli S, Mathosi L
MSF Paediatric Days 2024. 2024 May 4; DOI:10.57740/wrwUr6Xhz
BACKGROUND AND OBJECTIVES
This research emerges from Lesotho's diverse landscapes, where children’s stories remain largely unheard in the realm of health policy. The study aims to harness these narratives to drive equity, inclusivity, and human rights in health interventions, positioning youth not just as beneficiaries but as active participants in all health interventions.
METHODS
This research represents a meta-analysis of a larger, cross-sectional, qualitative research project, focused on understanding childrens’ narratives and experiences on their health and wellbeing. The study employed Participatory Learning Approach (PLA) tools, notably Social and Resource Mapping, Body Mapping, and Cause and Effect Analysis, to delve into these narratives. It involved a purposeful sample of 180 children, ranging from 6 to 19 years old, including school-goers, herd boys, children with disabilities, and teenagers. It occurred in diverse regions of Lesotho (Lowlands, Mountains, Foothills, and Senqu River Valley). This comprehensive approach also encompassed 18 Focus Group Discussions, enriched by Key Informant Interviews with local stakeholders.
RESULTS
Key findings from this study highlight significant issues in health, Water, Sanitation and Hygiene (WASH), education, nutrition, and child protection. The study underscores the challenges in accessing general healthcare services, particularly stressing the importance of sexual and reproductive health in high HIV/AIDS prevalence areas. The need for improved water and sanitation infrastructure is critically emphasised. In education, children and youth advocate for greater equity and inclusivity. The impact of climate change on nutrition is evident, leading to food insecurity and malnutrition, with high prevalence of stunting. Participants highlighted key facets of child protection, emphasising the increased vulnerability and exploitation of children and youth, alongside a considerable risk of gender-based and sexual violence.
CONCLUSIONS
Participants powerful testimonies advocate for a paradigm shift towards more inclusive and youth-involved policymaking, challenging the dominance of adult-centric approaches and calling for a holistic integration of their perspectives in programmes and policies.
This research emerges from Lesotho's diverse landscapes, where children’s stories remain largely unheard in the realm of health policy. The study aims to harness these narratives to drive equity, inclusivity, and human rights in health interventions, positioning youth not just as beneficiaries but as active participants in all health interventions.
METHODS
This research represents a meta-analysis of a larger, cross-sectional, qualitative research project, focused on understanding childrens’ narratives and experiences on their health and wellbeing. The study employed Participatory Learning Approach (PLA) tools, notably Social and Resource Mapping, Body Mapping, and Cause and Effect Analysis, to delve into these narratives. It involved a purposeful sample of 180 children, ranging from 6 to 19 years old, including school-goers, herd boys, children with disabilities, and teenagers. It occurred in diverse regions of Lesotho (Lowlands, Mountains, Foothills, and Senqu River Valley). This comprehensive approach also encompassed 18 Focus Group Discussions, enriched by Key Informant Interviews with local stakeholders.
RESULTS
Key findings from this study highlight significant issues in health, Water, Sanitation and Hygiene (WASH), education, nutrition, and child protection. The study underscores the challenges in accessing general healthcare services, particularly stressing the importance of sexual and reproductive health in high HIV/AIDS prevalence areas. The need for improved water and sanitation infrastructure is critically emphasised. In education, children and youth advocate for greater equity and inclusivity. The impact of climate change on nutrition is evident, leading to food insecurity and malnutrition, with high prevalence of stunting. Participants highlighted key facets of child protection, emphasising the increased vulnerability and exploitation of children and youth, alongside a considerable risk of gender-based and sexual violence.
CONCLUSIONS
Participants powerful testimonies advocate for a paradigm shift towards more inclusive and youth-involved policymaking, challenging the dominance of adult-centric approaches and calling for a holistic integration of their perspectives in programmes and policies.
Journal Article > CommentaryAbstract Only
Endocrinology and Metabolism Clinics
ENDOCRINOL METAB CLIN NORTH AM
Endocrinol Metab Clin North Am. 2023 June 18; Volume 52 (Issue 4); 603-615.; DOI:10.1016/j.ecl.2023.05.010
Kehlenbrink S, Jobanputra K, Reddy A, Boulle P, Gomber A, et al.
Endocrinology and Metabolism Clinics
ENDOCRINOL METAB CLIN NORTH AM
Endocrinol Metab Clin North Am. 2023 June 18; Volume 52 (Issue 4); 603-615.; DOI:10.1016/j.ecl.2023.05.010
Despite the increasing prevalence of diabetes in populations experiencing humanitarian crisis, along with evidence that people living with diabetes are at higher risk for poor outcomes in a crisis, diabetes care is not routinely included in humanitarian health interventions. We here describe 4 factors that have contributed to the inequities and lack of diabetes inclusion in humanitarian programmes: (1) evolving paradigms in humanitarian health care, (2) complexities of diabetes service provision in humanitarian settings, (3) social and cultural challenges, and (4) lack of financing. We also outline opportunities and possible interventions to address these challenges and improve diabetes care among crisis-affected populations.
Journal Article > CommentaryFull Text
PLOS Med. 2012 December 18; Volume 9 (Issue 12); e1001357.; DOI:10.1371/journal.pmed.1001357
Karunakara U, Stevenson F
PLOS Med. 2012 December 18; Volume 9 (Issue 12); e1001357.; DOI:10.1371/journal.pmed.1001357
Technical Report > Evidence Brief
Fetters T, Lissouba P, Moore AM, Lagrou D, Pasquier E, et al.
2022 December 1
Journal Article > ResearchFull Text
J Acquir Immune Defic Syndr; JAIDS. 2024 March 1; Online ahead of print; DOI:10.1097/QAI.0000000000003404
Ben Farhat J, TiendrebeogoMD T, Malateste K, Poda A, Minga A, et al.
J Acquir Immune Defic Syndr; JAIDS. 2024 March 1; Online ahead of print; DOI:10.1097/QAI.0000000000003404
OBJECTIVES
Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic’s impact on ART initiation and HIV viral load (VL) monitoring in three West African countries.
METHODS
We used routinely collected data from five clinics contributing to the IeDEA collaboration in Burkina Faso, Côte d'Ivoire and Nigeria. We included ART-naïve adults living with HIV (ALWH) initiating ART from 01/01/2018. We conducted regression discontinuity analysis to estimate changes in the number of ART initiations and VL measures per week, before and during the pandemic period in each country.
RESULTS
In clinics in Burkina Faso and Côte d’Ivoire, ART initiations per week remained constant throughout the studied periods (-0.24 points (p) of ART initiations/week 95%CI -5.5, 5.9, -0.9 p 95%CI -8.5,8.6, respectively), whereas in Nigeria’s clinic, they decreased significantly (-6.3 p, 95% CI -10.8, -1.7) after the beginning of the pandemic. The volume of VL tests performed decreased significantly in all three countries (-17.0 p 95%CI -25.3, -8.6 in Burkina Faso, -118.4 p 95%CI -171.1, -65.8 in Côte d’Ivoire and -169.1p 95%CI-282.6, -55.6 in Nigeria).
CONCLUSIONS
Access to ART was maintained for newly diagnosed ALWH despite pandemic-related physical/social distancing measures. However, VL monitoring was severely disrupted and did not return to pre-pandemic levels approximately one year after the beginning of the pandemic. While HIV services in West Africa appear rather resilient, the impact of disruptions in VL monitoring on virological and clinical outcomes should continue to be monitored.
Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic’s impact on ART initiation and HIV viral load (VL) monitoring in three West African countries.
METHODS
We used routinely collected data from five clinics contributing to the IeDEA collaboration in Burkina Faso, Côte d'Ivoire and Nigeria. We included ART-naïve adults living with HIV (ALWH) initiating ART from 01/01/2018. We conducted regression discontinuity analysis to estimate changes in the number of ART initiations and VL measures per week, before and during the pandemic period in each country.
RESULTS
In clinics in Burkina Faso and Côte d’Ivoire, ART initiations per week remained constant throughout the studied periods (-0.24 points (p) of ART initiations/week 95%CI -5.5, 5.9, -0.9 p 95%CI -8.5,8.6, respectively), whereas in Nigeria’s clinic, they decreased significantly (-6.3 p, 95% CI -10.8, -1.7) after the beginning of the pandemic. The volume of VL tests performed decreased significantly in all three countries (-17.0 p 95%CI -25.3, -8.6 in Burkina Faso, -118.4 p 95%CI -171.1, -65.8 in Côte d’Ivoire and -169.1p 95%CI-282.6, -55.6 in Nigeria).
CONCLUSIONS
Access to ART was maintained for newly diagnosed ALWH despite pandemic-related physical/social distancing measures. However, VL monitoring was severely disrupted and did not return to pre-pandemic levels approximately one year after the beginning of the pandemic. While HIV services in West Africa appear rather resilient, the impact of disruptions in VL monitoring on virological and clinical outcomes should continue to be monitored.