The significance of HIV and non-communicable diseases in Africa

No AbstractKeywords: Human Immunodeficiency Virus, communicable diseases, non-communicable diseases, Rwanda, sub-Saharan Afric

The impact of educational camp on glycemic control of Rwandan type 1 diabetes youth

In Rwanda, the prevalence of known type 1 diabetes mellitus in seven  districts of the country is 16.4 per 100,000 in young adults under 25 years old. The objective of this study was to compare the glycemic control of type 1 diabetes youth before and after the diabetes camp in Rwanda. A quasi experimental design using a longitudinal approach to compare the glycemic control before and after camp was used; 97 type 1 diabetes youth of both sexes, average age of 21 years were assigned into 8 groups and every group attended 5 days of diabetes education at the camp. Medical records about glycated hemoglobin levels before and 3 months after the camp were extracted from the database of Rwanda Diabetes Association and were analyzed to identify the impact of the educational camp. The mean  difference between the glycemic control before and 3 months after the camp revealed a statistically  significant decrease of 2.1% HbA1c (P-value = 0.02). As conclusion, this study found that diabetes educational camp is an effective strategy to improve Rwandan type 1 diabetes youth’s glycemic control. ________________________________________________________________________Key words: Rwanda, type 1 diabetes, youth, camp, glycemic contro

Safety and effectiveness of combination antiretroviral therapy during the first year of treatment in HIV-1 infected Rwandan children: a prospective study

With increased availability of paediatric combination antiretroviral therapy (cART) in resource limited settings, cART outcomes and factors associated with outcomes should be assessed. HIV-infected children -2, immunological success as CD4 cells ≥500/mm3 and ≥25% for respectively children over 5 years and under 5 years, and virological success as a plasma HIV-1 RNA concentration 1000 c/mL). Older age at cART initiation, poor adherence, and exposure to antiretrovirals around birth were associated with virological failure. A third (33%) of children had side effects (by self-report or clinical assessment), but only 9% experienced a severe side effect requiring a cART regimen change. cART in Rwandan HIV-infected children was successful but success might be improved further by initiating cART as early as possible, optimizing adherence and optimizing management of side effect

Baseline characteristics at cART initiation (n = 123).

<p>*Orphan status was defined as having at least one biological parent vs. none.</p><p>**Caregiver's educational level was categorized as non-educated/few years of primary school vs. completed at least primary school.</p><p>***Distance to the clinic was defined as living in Kigali vs. outside of Kigali.</p><p>Baseline characteristics at cART initiation (n = 123).</p

Clinical and laboratory side effects.

<p>*other included fatigue, anxiety and nightmares.</p><p>Clinical and laboratory side effects.</p

Number of children with virological failure^* over time.

<p>*Virological failure defined as VL≥1000 copies/mL for one measurement;</p><p>**between group comparisons.</p><p><b>P values bold:</b> significant difference at p<0.05.</p><p>Number of children with virological failure^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0111948#nt105" target="_blank">*</a>} over time.</p

Changes of WAZ, HAZ, Hemoglobin, CD4 values and HIV RNA overtime.

<p><b>P values bold:</b> Changes over time for all variables were statistically significant at p<0.05 using a univariate Generalized estimating equation model for categorical, normal and no normal distributed outcomes.</p><p>Changes of WAZ, HAZ, Hemoglobin, CD4 values and HIV RNA overtime.</p