Reduced Semen Quality And Risk Behaviour Amongst Men Consulting A Referral STD Clinic

A CAJM article on the reduced semen quality among Zimbabwean men who consult referral STD clinics.Sexually transmitted diseases (STDs) and infertility are public health challenges that continue to represent a high demand and costly adult medical care conditions in most developing countries. Few studies address strategies for prevention of infertility secondary to STDs through behavioural change and early and prompt STD treatment. A prospective cohort design was used to study the effects of urogenital infection on semen quality in consenting consecutive subjects that presented with chronic or recurrent sexually transmitted diseases. Health seeking behavioural correlates and socio-economic variables were compared between index subjects at a genito-urinary referral clinic and those that presented with non-STD conditions at a referral polyclinic

A systematic approach for reviewing research capacity within Zimbabwe’s national blood service

Background Blood services need to undertake research to improve their strategic goals, operational effectiveness and promote evidence-based policies. NBSZ has along history of active research and undertook a systematic review of its research capacity to guide its new research strategy. In the absence of a published approach for research capacity assessment for national blood services, a frame-work to assess research capacity in African universities was used. Methods Semi-structured interviews were conducted with 85 NBSZ internal and external stakeholders. The interview topics were based on eight areas covered by the framework used to assess universities’ research systems. Information was ver-ified through triangulation, and recommended actions emerging from the review were validated at a national stakeholder workshop. The appropriateness of the framework for use in the setting of blood services was also evaluated. Results Synthesis of information from the multi perspective interviews high-lighted key areas of NBSZ’s research capacity for improvement, in particular better dissemination of NBSZ’s research priorities and closer ties with academics and their institutions for preparing research proposals and jointly undertaking research projects. With minor adaptations, the framework was found to be applicable to NBSZ, and no aspects of research capacity were identified which were not covered by the framework. Discussion Our results indicate that it is feasible and useful to apply a structured process to review the research capacity of blood services. However, the frame-work needs to be tested in blood services and other non-university setting to assess its usefulness and transferability

Progress and Research Needs of Plant Biomass Degradation by Basidiomycete Fungi

Peer reviewe

Strengthening primary care for diabetes and hypertension in Eswatini: study protocol for a nationwide cluster-randomized controlled trial

Background: Diabetes and hypertension are increasingly important population health challenges in Eswatini. Prior to this project, healthcare for these conditions was primarily provided through physician-led teams at tertiary care facilities and accessed by only a small fraction of people living with diabetes or hypertension. This trial tests and evaluates two community-based healthcare service models implemented at the national level, which involve health care personnel at primary care facilities and utilize the country’s public sector community health worker cadre (the rural health motivators [RHMs]) to help generate demand for care. Methods: This study is a cluster-randomized controlled trial with two treatment arms and one control arm. The unit of randomization is a primary healthcare facility along with all RHMs (and their corresponding service areas) assigned to the facility. A total of 84 primary healthcare facilities were randomized in a 1:1:1 ratio to the three study arms. The first treatment arm implements differentiated service delivery (DSD) models at the clinic and community levels with the objective of improving treatment uptake and adherence among clients with diabetes or hypertension. In the second treatment arm, community distribution points (CDPs), which previously targeted clients living with human immunodeficiency virus, extend their services to clients with diabetes or hypertension by allowing them to pick up medications and obtain routine nurse-led follow-up visits in their community rather than at the healthcare facility. In both treatment arms, RHMs visit households regularly, screen clients at risk, provide personalized counseling, and refer clients to either primary care clinics or the nearest CDP. In the control arm, primary care clinics provide diabetes and hypertension care services but without the involvement of RHMs and the implementation of DSD models or CDPs. The primary endpoints are mean glycated hemoglobin (HbA1c) and systolic blood pressure among adults aged 40 years and older living with diabetes or hypertension, respectively. These endpoints will be assessed through a household survey in the RHM service areas. In addition to the health impact evaluation, we will conduct studies on cost-effectiveness, syndemics, and the intervention’s implementation processes. Discussion: This study has the ambition to assist the Eswatini government in selecting the most effective delivery model for diabetes and hypertension care. The evidence generated with this national-level cluster-randomized controlled trial may also prove useful to policy makers in the wider Sub-Saharan African region. Trial registration: NCT04183413. Trial registration date: December 3, 201