Masters Degrees (Health Systems and Public Health)
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Browsing Masters Degrees (Health Systems and Public Health) by browse.metadata.advisor "Esterhuizen, Tonya"
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- ItemPrevalence of unsuppressed viraemia in HIV positive female sex workers on the daily single dose TDF/3TC/EFV tablet for 6 months : PSI-Zimbabwe sex worker cohort(Stellenbosch : Stellenbosch University, 2016-03) Moyo, Brian; Esterhuizen, Tonya; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Community Health.ENGLISH ABSTRACT: Background: Data on viral suppression and adherence patterns of anti-retroviral therapy (ART) naïve HIV positive female sex workers (FSWs) initiated on the Tenofovir/lamivudine/Efavirenz (TDF/3TC/EFV) fixed dose combination are scarce in Zimbabwe. The objectives of this study were to describe the prevalence of and factors associated with unsuppressed viraemia as well as the mean adherence of FSWs on the Efavirenz based fixed dose tablet after 6 months of treatment. Methods: A retrospective record review was done on 77 FSWs who had been initiated on TDF/3TC/EFV and had a 6 months post initiation viral load test result at 2 FSW clinics in Gwanda and Bulawayo, Zimbabwe. Recruitment into the clinics was done between July 2013 and September 2015. Data on monthly adherence per pill count, 6 months viral load test result and possible predictors of unsuppressed viraemia were collected. Results: Prevalence of unsuppressed viraemia after 6 months on TDF/3TC/EFV FDC tablet was 7.78% (95%CI, 1.67-13.92 %) while viral suppression occurred in 92.22% (95%CI 83.8-97.1%). Based on the 35 patients with complete adherence data, the mean adherence was 99.69% (95%CI, 99.48%-99.91%). All 35 had adherence >95% classified as good. Only comorbidity (Adjusted OR 23.31, 95%CI 1.74-310.65, p = 0.017) and baseline CD4 count (Adjusted OR 0.9886; 95%CI 0.9774-0.9998, p= 0.047) showed independent associations with unsuppressed viraemia. Conclusion: In the first 6 months on TDF/3TC/EFV, ART there is a low prevalence of unsuppressed viraemia, high viral suppression rates and high adherence rates in naïve HIV positive FSWs in our setting.
- ItemTrends in mortality and factors associated with mortality and morbidity amongst hospitalized low birth weigth infants at a tertiary level hospital in Cameroon, 2001-2005(Stellenbosch : Stellenbosch University, 2016-12) Wiyeh, Alison Beriliy; Esterhuizen, Tonya; Koum, Danielle Christiane Kedy; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Community Health.ENGLISH SUMMARY : Background: Babies born with a birth weight of less than 2500grams have a low birth weight (LBW) and death amongst them accounts for 80% of all neonatal deaths. At the endpoint of the Millennium Development Goals (MDGs), we evaluate the progress made by Laquintinie hospital, Cameroon in reducing mortality amongst low birth weight babies, and identify factors associated with their morbidity and mortality. Methods: We estimated the mortality rates amongst LBW infants from 2001 to 2015, using a retrospective cohort study. Hospital records from 2001 to 2014, and the medical files for 2015 of LBW infants hospitalized in this hospital were used to evaluate their outcomes and factors associated with their morbidity and mortality. Findings: The overall mortality rate progressively increased from 19·9% in 2001 to 50·7% in 2015, with the greatest increase observed amongst extremely low birth weight infants (ELBW). In time series analysis, ELBW infants Beta 0·49 (95% CI 0.12 - 0.87) and incremental year of birth Beta 1·4 (95% CI 1.04 - 1.81) accounted for the increase in mortality rate. ELBW (OR: 4·3, 95% CI ), VLBW (OR: 2·7, 95% CI ) and apgar <7 at 5 minutes (OR: 25, P=0·022) were risk factors for respiratory morbidity. Apgar <7 at 5 minutes (OR: 5·5, P<0·001) was a risk factor for neurological morbidity. Factors associated with mortality were VLBW (OR: 4·7 P<0·001), respiratory distress (OR: 9·2, P<0·001), apnoea (OR: 4·2, P0·004) and gastrointestinal haemorrhage (OR: 5·839, P<0·001). Interpretation: The mortality rates amongst low birth weight infants hospitalized at Laquintinie Hospital, increased in the period 2001-2015, and negatively impacted its achievement of MDG 4.