Perspective on Opportunities for Research and Interventions provided by Community Based Health Information System illustrated by the Potential use of Motivational Interviewing Intervention

Background: With the growth of Community-Based Health Information (CBHIS) for decision making and service provision in the low income settings, innovative models of addressing Maternal and Newborn Health (MNH) morbidity and mortality are necessary. World Health Organization (WHO) estimates that five hundred thousand mothers and about three million newborns die each year in middle and low income countries. Objectives: To stimulate interest in utilisation CBHIS for research and interventions, with an illustration of potential using on Motivational Interviewing intervention. Data Source: Literature searched electronically, discussion with behavioural experts, health system researchers, and maternal and Newborn Health (MNH) experts, and book reviews. Study Selection: Broad selection criteria including all current literature relevantsubjects including CBHIS, behaviour change methods and Community MNH. Data Extraction: A checklist for relevance was used to identify the relevant behaviour change intervention to use in the illustration. Data Synthesis: A method that met the criteria was identified, and based on a discussion with behavioural experts, the decision to use it the illustration was reached. Conclusion: Motivational Interviewing Intervention (MII) should be considered for implementation and study on near-term Pregnant women in a setting where these mothers can be identified and a targeted intervention instituted

Evaluation of a measles vaccine campaign by oral-fluid surveys in a rural Kenyan district: interpretation of antibody prevalence data using mixture models

We evaluated the effectiveness of a measles vaccine campaign in rural Kenya, based on oral-fluid surveys and mixture-modelling analysis. Specimens were collected from 886 children aged 9 months to 14 years pre-campaign and from a comparison sample of 598 children aged 6 months post-campaign. Quantitative measles-specific antibody data were obtained by commercial kit. The estimated proportions of measles-specific antibody negative in children aged 0–4, 5–9 and 10–14 years were 51%, 42% and 27%, respectively, pre- campaign and 18%, 14% and 6%, respectively, post-campaign. We estimate a reduction in the proportion susceptible of 65–78%, with ~85% of the population recorded to have received vaccine. The proportion of ‘weak’ positive individuals rose from 35% pre-campaign to 54% post-campaign. Our results confirm the effectiveness of the campaign in reducing susceptibility to measles and demonstrate the potential of oral-fluid studies to monitor the impact of measles vaccination campaigns

Socio-Economic and Health Consequences of Drugs and Substance Use in Gachie: : A Peri-Urban Town on the Outskirts of Nairobi

Drug and substance abuse is a major socioeconomic and health problem to the drug users, family and society and is reported to be on a steady global rise. In Kenya, drug abuse is a major societal problem especially in many cosmopolitan cities such as Nairobi and Mombasa and the surrounding immediate environs. The objective of this study was to evaluate the types of drugs, the socio-economic and health consequences of drug abuse among the inhabitants of Gachie Sub-Location, Kiambu County a town within the Nairobi suburbs. A snowballing sampling method was used to recruit a total of 246 study participants aged between 15-65years recruited into the study after consenting and meeting drug and substance use and dependence clinical evaluation according to UNCOPE criteria. Data on the type of drugs abused, socio-economic and health implications of drug use on both drug abusers and the community was captured using a structured questionnaire and the resulting data analysed using SPSS version 21. Over-the counter prescription drugs including, benzodiazepine, Cozepam (“ma-cc”), rohypnol (“ma-blue”), and benzhexol (“ma-white”) as well as the traditional heroine were the major abused drugs reported in the study. Approximately 85% of the sampled drug abusers were men abusing mainly the licit over- the counter prescription drugs and heroine as a result of their easy affordability and accessibility. Failed marriages, conflictual family and communal relationships, unemployment, life of destitution and poverty were the main socioeconomic consequences of drug abuse reported in the study, corroborating reports of some previous studies. Participants’s self-reported feeling of hyperactiveness and euphoria was the major health consequence repoted. This study thus indicates that drug use is slowly creeping into rural areas in the vicinity of major towns with prescription over the counter drugs taking a centre stage than the traditional hard drugs due to the associated low costs, availability and accessibility and can result in myriad socioeconomic consequences in the society. This data provides an insight of the spread of drugs from the traditional cities to the surrounding town environments as these areas provide a safe haven for drug peddlers and thus should be of great focus by drug law enforcers as they strategize and seek to curb drug abuse problem. Future similar studies involving larger area are recommended to acquire more dynamics of this proble

Localization in Strongly Chaotic Systems

We show that, in the semiclassical limit and whenever the elements of the Hamiltonian matrix are random enough, the eigenvectors of strongly chaotic time-independent systems in ordered bases can on average be exponentially localized across the energy shell and decay faster than exponentially outside the energy shell. Typically however, matrix elements are strongly correlated leading to deviations from such behavior.Comment: RevTeX, 5 pages + 3 postscript figures, submitted to Phys. Rev. Let

HIV Serostatus and Tumor Differentiation Among Patients with Cervical Cancer at Bugando Medical Centre.

Evidence for the association between Human immunodeficiency virus infection and cervical cancer has been contrasting, with some studies reporting increased risk of cervical cancer among HIV positive women while others report no association. Similar evidence from Tanzania is scarce as HIV seroprevalence among cervical cancer patients has not been rigorously evaluated. The purpose of this study was to determine the association between HIV and tumor differentiation among patients with cervical cancer at Bugando Medical Centre and Teaching Hospital in Mwanza, North-Western Tanzania. This was a descriptive analytical study involving suspected cervical cancer patients seen at the gynaecology outpatient clinic and in the gynaecological ward from November 2010 to March 2011. A total of 91 suspected cervical cancer patients were seen during the study period and 74 patients were histologically confirmed with cervical cancer. The mean age of those confirmed of cervical cancer was 50.5 ± 12.5 years. Most patients (39 of the total 74-52.7%) were in early disease stages (stages IA-IIA). HIV infection was diagnosed in 22 (29.7%) patients. On average, HIV positive women with early cervical cancer disease had significantly more CD4+ cells than those with advanced disease (385.8 ± 170.4 95% CI 354.8-516.7 and 266.2 ± 87.5, 95% CI 213.3-319.0 respectively p = 0.042). In a binary logistic regression model, factors associated with HIV seropositivity were ever use of hormonal contraception (OR 5.79 95% CI 1.99-16.83 p = 0.001), aged over 50 years (OR 0.09 95% CI 0.02-0.36 p = 0.001), previous history of STI (OR 3.43 95% CI 1.10-10.80 p = 0.035) and multiple sexual partners OR 5.56 95% CI 1.18-26.25 p = 0.030). Of these factors, only ever use of hormonal contraception was associated with tumor cell differentiation (OR 0.16 95% CI 0.06-0.49 p = 0.001). HIV seropositivity was weakly associated with tumor cell differentiation in an unadjusted analysis (OR 0.21 95% CI 0.04-1.02 p = 0.053), but strong evidence for the association was found after adjusting for ever use of hormonal contraception with approximately six times more likelihood of HIV infection among women with poorly differentiated tumor cells compared to those with moderately and well differentiated cells (OR 5.62 95% CI 1.76-17.94 p = 0.004).\ud Results from this study setting suggest that HIV is common among cervical cancer patients and that HIV seropositivity may be associated with poor tumour differentiation. Larger studies in this and similar settings with high HIV prevalence and high burden of cervical cancer are required to document this relationship