Browsing by Author "Young, T."
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- ItemAchieving the millennium development goals in sub-Saharan Africa(Health and Medical Publishing Group (HMPG), 2007-09) Wiysonge, Charles S.; Young, T.; Volmink, J.To the Editor: The UN has released a mid-term report on progress towards achieving the Millennium Development Goals (MDG), eight pro-poor goals contained in the Millennium Declaration of 2000, to be achieved by 2015. It paints a gloomy picture of health in sub-Saharan Africa. Child mortality rates declined globally, but the improvement was uneven, with sub-Saharan Africa recording the highest rate and the slowest pace of progress. In 1990 and 2005 in sub-Saharan Africa, 185 and 166 children respectively died, mainly from preventable causes, before their 5th birthday for every 1 000 live births, a mere 10% reduction in 16 years.
- ItemBuilding capacity for development and implementation of clinical practice guidelines(Health and Medical Publishing Group, 2017) Louw, Q.; Dizon, J. M.; Grimmer, K.; McCaul, M.; Kredo, T.; Young, T.Robust, reliable and transparent methodologies are necessary to ensure that clinical practice guidelines (CPGs) meet international criteria. In South Africa (SA) and other low- and middle-income countries, upskilling and training of individuals in the processes of CPG development is needed. Since de novo CPG development is time-consuming and expensive, new emerging CPG-development approaches (adopting, contextualising, adapting and updating existing good-quality CPGs) are potentially more appropriate for our context. These emerging CPG-development methods are either not included or sparsely covered in existing training opportunities. The SA Guidelines Excellence (SAGE) team has responded innovatively to the need for CPG training in SA. We have revised an existing SA course and developed an online, open-access CPG-development toolkit. This Guideline Toolkit is a comprehensive guideline resource designed to assist individuals who are interested in knowing how to develop CPGs. Findings from the SAGE project can now be implemented with this innovative CPG training programme. This level of CPG capacity development has the potential to influence CPG knowledge, development, practices and uptake by clinicians, managers, academics and policy-makers around the country.
- ItemCo-trimoxazole prophylaxis in HIV : the evidence(Health and Medical Publishing Group (HMPG), 2008-04) Oliphant, C. E. M.; Young, T.; Araoyinbo, I.; Volmink, J.Human immunodeficiency virus (HIV) damages the body’s immune system, making secondary (or opportunistic) infections more common. Treatment and prevention of such infections is integral to the management of patients with HIV infection. Co-trimoxazole is a prophylactic treatment that has a wide range of action against common bacteria, parasites, fungi and yeasts. As part of a minimum care package, UNAIDS/ WHO recommends co-trimoxazole prophylaxis for HIVinfected adults with symptomatic disease (WHO stage II, III or IV), or asymptomatic individuals with CD4 counts ≤500 cells/μl, and for all HIV-positive pregnant women after the first trimester.1 Co-trimoxazole is also recommended for use in children with proven HIV infection and infants exposed to HIV (from 4 - 6 weeks of age until infection with HIV is ruled out).2 The object of this report is to summarise the effects of co-trimoxazole prophylaxis on morbidity and mortality among HIV-infected individuals.
- ItemEvidence insufficient to confirm the value of population screening for diabetes and hypertension in low- and-middle-income settings(Health & Medical Publishing Group, 2015) Durao, S.; Ajumobi, O.; Kredo, T.; Naude, C.; Levitt, N. S.; Steyn, K.; Bradshaw, D.; Young, T.To assess the evidence from systematic reviews on the effect on morbidity and mortality of blanket screening for hypertension or diabetes mellitus compared with targeted, opportunistic or no screening, we searched for relevant systematic reviews and conducted duplicate study selection, data extraction and quality appraisal. Results were summarised narratively. We included two completed reviews of moderate quality and one ongoing Cochrane review. In one completed review, general health checks had no effect on total morbidity or mortality or on healthcare services compared with no health checks. In the other, intensive hypertension screening methods were ineffective in increasing screening uptake or detecting new cases compared with less intensive methods. Both reviews included studies in high-income settings. There is insufficient evidence from currently available systematic reviews to confirm a beneficial effect of blanket screening for hypertension and/or diabetes compared with other types of screening methods in low- and middle-income settings. Scarce resources are being mobilised to implement mass screening intervention for diabetes and hypertension without adequate evidence of its effects. A systematic review is needed to assess clinical effectiveness, cost-effectiveness and overall impact on the health system of screening strategies, especially in low- and middle-income settings such as exist in South Africa. Robust evaluation of these outcomes would then be necessary to inform secondary prevention strategies.
- ItemInterventions for improving childhood vaccination coverage in low- and middle-income countries(Health & Medical Publishing Group, 2015) Wiysonge, Charles S.; Young, T.; Kredo, T.; McCaul, M.; Volmink, J.Cochrane Corner’ in the November SAMJ highlights a Cochrane review that evaluated the effects of interventions for improving childhood vaccination coverage in low- and middle-income countries. Question: Which interventions increase the uptake of childhood vaccines in low and middle-income countries? Bottom line: Health education, home visits, and reminders probably increase the uptake of childhood vaccines in low and middle-income countries.
- ItemOutput from the CIHR Canadian HIV Trials Network international postdoctoral fellowship for capacity building in HIV clinical trials(Dove Medical Press, 2018) Mbuagbaw, L.; Slogrove, Amy L.; Sas, J.; Lengwe, Kunda J.; Morfaw, F.; Mukonzo, J. K.; Cao, W.; Ngomba-Kadima, G.; Zunza, Moleen; Ongolo-Zogo, P.; Nana, P. N.; Cockcroft, A.; Andersson, N.; Sewankambo, N; Cotton, M. F.; Li, T.; Young, T.; Singer, J.; Routy, J. P.; Ross, C. J. D.; Thin, K.; Thabane, L.; Anis, A. H.ENGLISH ABSTRACT: As a response to the human immunodeficiency virus (HIV) epidemic and part of Canadian Institutes for Health Research’s mandate to support international health research capacity building, the Canadian Institutes for Health Research Canadian HIV Trial Network (CTN) developed an international postdoctoral fellowship award under the CTN’s Postdoctoral Fellowship Awards Program to support and train young HIV researchers in resource-limited settings. Since 2010, the fellowship has been awarded to eight fellows in Cameroon, China, Lesotho, South Africa, Uganda and Zambia. These fellows have conducted research on a wide variety of topics and have built a strong network of collaboration and scientific productivity, with 40 peer-reviewed publications produced by six fellows during their fellowships. They delivered two workshops at international conferences and have continued to secure funding for their research, using the fellowship as a stepping stone. The CTN has been successful in building local HIV research capacity and forming a strong network of like-minded junior low- and middle-income country researchers with high levels of research productivity. They have developed into mentors, supervisors and faculty members, who, in turn, build local capacity. The sustainability of this international fellowship award relies on the recognition of its strengths and the involvement of other stakeholders for additional resources.
- ItemTaking stock of evidence-based healthcare in the undergraduate medical curriculum at Stellenbosch University : combining a review of curriculum documents and input from recent graduates(Health and Medical Publishing Group, 2015) Rohwer, A.l.; Willems, B.; Young, T.ENGLISH SUMMARY : Background: The Stellenbosch University Rural Medical Educational Partnership Initiative (SURMEPI) aims to increase the quality and retention of medical doctors, and regionally relevant research. Strengthening evidence-based healthcare (EBHC) knowledge and skills at an undergraduate level is important within this context. Objectives: To assess and describe the current undergraduate medical EBHC curriculum in order to identify opportunities to enhance EBHC teaching, and to explore challenges related to EBHC experienced by recently graduated doctors. Methods: We used methodological triangulation to assess current EBHC teaching and learning through a document review and a survey of recent graduates. We extracted learning outcomes from module guides that related to prespecified EBHC competencies. Our electronic survey collected quantitative data, which were analysed with SPSS, and qualitative data, which were coded with ATLAS.ti and grouped into emerging themes. Results: EBHC teaching was fragmented and concentrated in the first and last phase of the medical curriculum. Most survey respondents agreed that it was important to learn EBHC at undergraduate level, and that there was a need for increased teaching of certain EBHC competencies. Recently graduated doctors identified lack of access to literature as the main challenge when practising EBHC. Other challenges included time constraints, work overload, lack of EBHC skills, lack of self-motivation, applicability of the evidence and the work environment. Conclusion: Recent graduates felt that they needed more EBHC learning opportunities within the undergraduate medical curriculum. Existing EBHC teaching and learning for undergraduate medical students need to be enhanced by integrating EBHC into clinical modules and scaffolding it throughout all the phases of the curriculum.