7 research outputs found
Behavioral and cognitive interventions to improve treatment adherence and access to HIV care among older adults in sub-Saharan Africa: an updated systematic review
BACKGROUND: Approximately 14% of Africans infected with HIV are over the age of 50, yet few intervention studies
focus on improving access to care, retention in care, and adherence to antiretroviral therapy (ART) in this
population. A review of the published literature until 2012, found no relevant ART management and care interventions
for older people living with HIV (OPLHIV) in sub-Saharan Africa. The aim of this systematic review is to update the
original systematic review of intervention studies on OPLHIV, with a focus on evidence from sub-Saharan Africa.
METHODS: We conducted a systematic review of the available published literature from 2012 to 2017 to explore
behavioral and cognitive interventions addressing access to ART, retention in HIV care and adherence to ART in
sub-Saharan Africa that include older adults (50+). We searched three databases (MEDLINE, EMBASE, and Education
Resources Information Center) using relevant Medical Subject Headings (MeSH) terms as well as a manual search of the
reference lists. No language restrictions were placed. We identified eight articles which were analyzed using content
analysis with additional information obtained directly from the corresponding authors.
RESULTS AND DISCUSSION: There were no studies that exclusively focused on OPLHIV. Three studies referred only to
participants being over 18 years and did not specify age categories. Therefore, it is unclear whether these studies
actively considered people living with HIV over the age of 50. Although the studies sampled older adults, they lacked
sufficient data to draw conclusions about the relevance of the outcomes of this group.
CONCLUSIONS: These findings underscore the need to increase the evidence-base of which interventions will work for
older Africans on ART
A field tool for prediction of body fat in Sri Lankan women: skinfold thickness equation
Socio-demographic characteristics, maternal and fetal outcome of parturients presenting in second stage labour
Purpose: To document the socio-demographic characteristics, maternal and foetal outcome of booked patients presenting in second stage labour and compare them with those who presented in spontaneous active phase, first stage labour, delivering normally and without oxytocin augmentation. Method: Retrospective case - control study. Result: Women who presented in second stage labour were more likely to book late in pregnancy (23.01±7.55 weeks versus 20.80±7.98, p value 0.014) and attended fewer antenatal care visits (7.22±3.09 versus 8.67±2.98 p value 0.000). Higher parity (p value 0.002), lower female education (p value 0.000) and HIV positive status (10.52% versus 0.66% p value 0.000) were other factors found with late presentation in labour. The commonest reason for presentation in the second stage of labour was transportation problems (31.9%). Perineal tear was the only significant maternal outcome between the cases and control (26.3% versus 13.8%, p value 0.001). There was no significant difference in the foetal outcome between the two groups. Conclusion: Socio-demographic characteristics of patients affect their utilization of available obstetric care. Maternal and foetal outcomes were comparable in the two groups except for increased perineal tear among the cases. A multicentre prospective study is necessary to further evaluate the foetal and maternal outcome in this group of patients.Keywords: Second stage labour, first stage of labour, failed antenatal care, socio-demographic characteristics