Factors associated with childhood diarrhea in Rwanda: a secondary data analysis of the Rwanda demographic and health survey 2014-15

Background: Diarrheal diseases remain an important cause of morbidity among children, particularly in children under five years old, in low- and middle-income countries where it causes nearly 1.7 billion cases every year.Methods: We used a quantitative cross-sectional design. This study aimed to explore the determinants of child diarrhea among under five-year children in Rwanda. A deep analysis of the 2014- 2015 Rwanda Demographic and Health Survey (RDHS), with multivariate logistic regression, using stata13 was performed. The 2014-2015 Survey was the fifth standard national survey, implemented by the National Institute of Statistics of Rwanda (NISR) in a period of six months from November 2014 to April 2015.Results: A sample of 2841 children under five years old were included. Chi-square test and logistic regression were performed. A significance level of 0.05 at 95% CI was considered. Child age and wealth index showed a strong association with diarrhea. Children in the age groups of 6-11, 12-23, 24-35 months were at higher risk of diarrhea than children aged 48-59 months, OR: 5.0 [3.1-8.2], P-value: 0.001; OR: 7.6, CI [4.7-12.2], P-value: 0.001; OR:3.8 [2.3-6.2], P-value: 0.001 respectively. Moreover, children from poorest and poorer families were twice more at risk of diarrhea than children from richest families. OR: 2, CI [1.3-2.9], P-value: 0.001.Conclusion: The study concluded that low wealth index, and child age less than 35 months were important risks for under-five child diarrhea.Keywords: determinants, under five years children, diarrhe

GeoERA Raw Materials Monograph : the past and the future

ABSTRACT: GeoERA Minerals projects have produced data aimed at supporting Europe’s minerals sector and to assist the European Commission to realise its goals for raw materials. Data has been compiled on mineral occurrences and mineral provinces across Europe, in particular, areas with potential to host Critical Raw Materials. Anecdotal evidence from the minerals sector provides an indication of the likelihood of exploration leading to mine development. For every 1,000 mineral showings examined, only 100 may receive further exploration work and of those 100, only 10 may warrant more detailed sampling either through trenching, drilling or other means and of those 10 only 1 may proceed to an evaluation through a full feasibility study which itself has only 50% chance of being positive. Following this, any project for which a mine proposal is made must undergo a full evaluation and permitting by authorities including full public consultation. The proposal may or may not pass this scrutiny. In terms of a schedule, the generally accepted minimum time frame from discovery to production is 10 years and usually much more, up to 20 years.info:eu-repo/semantics/publishedVersio

Identifying Breast Cancer Care Quality Measures for a Cancer Facility in Rural Sub-Saharan Africa: Results of a Systematic Literature Review and Modified Delphi Process

The burden of cancer is growing in low- and middle-income countries (LMICs), including sub-Saharan Africa. Ensuring the delivery of high-quality cancer care in such regions is a pressing concern. There is a need for strategies to identify meaningful and relevant quality measures that are applicable to and usable for quality measurement and improvement in resource-constrained settings. To identify quality measures for breast cancer care at Butaro Cancer Center of Excellence (BCCOE) in Rwanda, we used a modified Delphi process engaging two panels of experts, one with expertise in breast cancer evidence and measures used in high-income countries and one with expertise in cancer care delivery in Rwanda. Our systematic review of the literature yielded no publications describing breast cancer quality measures developed in a low-income country, but it did provide 40 quality measures, which we adapted for relevance to our setting. After two surveys, one conference call, and one in-person meeting, 17 measures were identified as relevant to pathology, staging and treatment planning, surgery, chemotherapy, endocrine therapy, palliative care, and retention in care. Successes of the process included participation by a diverse set of global experts and engagement of the BCCOE community in quality measurement and improvement. Anticipated challenges include the need to continually refine these measures as resources, protocols, and measurement capacity rapidly evolve in Rwanda. A modified Delphi process engaging both global and local expertise was a promising strategy to identify quality measures for breast cancer in Rwanda. The process and resulting measures may also be relevant for other LMIC cancer facilities. Next steps include validation of these measures in a retrospective cohort of patients with breast cancer