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  1. Article: Childhood stunting is highly clustered in Northern Province of Rwanda: A spatial analysis of a population-based study.

    Ndagijimana, Albert / Nduwayezu, Gilbert / Kagoyire, Clarisse / Elfving, Kristina / Umubyeyi, Aline / Mansourian, Ali / Lind, Torbjörn

    Heliyon

    2024  Volume 10, Issue 2, Page(s) e24922

    Abstract: Background: In Northern Province, Rwanda, stunting is common among children aged under 5 years. However, previous studies on spatial analysis of childhood stunting in Rwanda did not assess its randomness and clustering, and none were conducted in ... ...

    Abstract Background: In Northern Province, Rwanda, stunting is common among children aged under 5 years. However, previous studies on spatial analysis of childhood stunting in Rwanda did not assess its randomness and clustering, and none were conducted in Northern Province. We conducted a spatial-pattern analysis of childhood undernutrition to identify stunting clusters and hotspots for targeted interventions in Northern Province.
    Methods: Using a household population-based questionnaire survey of the characteristics and causes of undernutrition in households with biological mothers of children aged 1-36 months, we collected anthropometric measurements of the children and their mothers and captured the coordinates of the households. Descriptive statistics were computed for the sociodemographic characteristics and anthropometric measurements. Spatial patterns of childhood stunting were determined using global and local Moran's I and Getis-Ord Gi* statistics, and the corresponding maps were produced.
    Results: The z-scores of the three anthropometric measurements were normally distributed, but the z-scores of height-for-age were generally lower than those of weight-for-age and weight-for-height, prompting us to focus on height-for-age for the spatial analysis. The estimated incidence of stunting among 601 children aged 1-36 months was 27.1 %. The sample points were interpolated to the administrative level of the sector. The global Moran's I was positive and significant (Moran's I = 0.403, p < 0.001, z-score = 7.813), indicating clustering of childhood stunting across different sectors of Northern Province. The local Moran's I and hotspot analysis based on the Getis-Ord Gi* statistic showed statistically significant hotspots, which were strongest within Musanze district, followed by Gakenke and Gicumbi districts.
    Conclusion: Childhood stunting in Northern Province showed statistically significant hotspots in Musanze, Gakenke, and Gicumbi districts. Factors associated with such clusters and hotspots should be assessed to identify possible geographically targeted interventions.
    Language English
    Publishing date 2024-01-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2024.e24922
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Perceptions and attitudes of midwives on respectful maternity care during childbirth: a qualitative study in three district hospitals of Kigali City of Rwanda.

    Uwamahoro, Valentine / Semasaka, Jean Paul Sengoma / Ndagijimana, Albert / Humuza, James

    The Pan African medical journal

    2023  Volume 46, Page(s) 110

    Abstract: Introduction: Respectful Maternity Care (RMC) is "a universal human right for every childbearing woman". In Rwanda, few studies conducted on RMC assessed how women perceive care provided during childbirth, yet little is known about providers' ... ...

    Abstract Introduction: Respectful Maternity Care (RMC) is "a universal human right for every childbearing woman". In Rwanda, few studies conducted on RMC assessed how women perceive care provided during childbirth, yet little is known about providers' perspectives. We investigated the perceptions and attitudes of midwives towards the provision of RMC to complement women's viewpoints.
    Methods: this qualitative study used individual in-depth interviews in Kinyarwanda language. A purposive sampling method was used to reach out to twenty-eight midwives from three district hospitals in Kigali City. Transcribed interviews were translated into English and thematic content analysis was performed using Atlas Ti, version 7. The University of Rwanda College of Medicine and Health Sciences Institutional Review Board (Ref: 363/CHMS/IRB/2019) ethically approved this study before data collection.
    Results: the majority of participants revealed that they have knowledge on RMC and perceive that they provide maternal health care based on women´s rights. Positive attitudes towards providing RMC were reported by midwives, however, a considerable number of participants reported the existence of abusive practices. The majority of midwives reported facing many challenges affecting their ability to provide respectful maternal care.
    Conclusion: midwives understand the seven rights of women and have a positive attitude towards providing RMC. However, abusive practices still exist while providing RMC with considerable challenges, including overload and lack of labour monitoring materials. The adjustment of the ratio of midwives to clients and the availability of essential materials in labour monitoring is recommended to improve the quality of healthcare received by women during childbirth.
    MeSH term(s) Pregnancy ; Female ; Humans ; Midwifery ; Rwanda ; Hospitals, District ; Maternal Health Services ; Obstetrics
    Language English
    Publishing date 2023-12-19
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.2023.46.110.40764
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Factors Associated With Oral Cancer Adverse Outcome at the Rwanda Military Hospital, a Retrospective Cross-Sectional Study.

    Ndayisabye, Halifa / Ndagijimana, Albert / Biracyaza, Emmanuel / Umubyeyi, Aline

    Frontiers in oral health

    2022  Volume 3, Page(s) 844254

    Abstract: Oral cancer (OC) is one of the most common cancers that remain global public health concerns in low- and middle-income countries. The epidemiology of OC in Africa endures uncertain. Earlier reports suggested a relatively low incidence of OC among ... ...

    Abstract Oral cancer (OC) is one of the most common cancers that remain global public health concerns in low- and middle-income countries. The epidemiology of OC in Africa endures uncertain. Earlier reports suggested a relatively low incidence of OC among Africans. Acting on behavioral factors and setting early diagnosis and treatments of OC can tremendously reduce morbidity and mortality related to it. This study determined factors associated with the OC adverse outcome and death in the Rwanda Military Hospital. A cross-sectional study was conducted among 311 medical records of patients who consulted in the Oral and Maxilla Facial Department between January 1, 2007 and December 31, 2019. Associated factors were estimated by use of odds ratios (OR) with their 95% confidence intervals (CI) in bivariate and multivariate logistic regression analyses to estimate predictors of an OC adverse outcome and death. Almost three quarters of the participants were from rural areas (
    Language English
    Publishing date 2022-03-18
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-4842
    ISSN (online) 2673-4842
    DOI 10.3389/froh.2022.844254
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  4. Article ; Online: Prevalence and factors associated with sputum smear non-conversion after two months of tuberculosis treatment among smear-positive pulmonary tuberculosis patients in Rwanda: a cross-sectional study.

    Gatete, Gaetan / Njunwa, Kato J / Migambi, Patrick / Ntaganira, Joseph / Ndagijimana, Albert

    BMC infectious diseases

    2023  Volume 23, Issue 1, Page(s) 408

    Abstract: Background: Non-conversion of sputum smear prolongs the infectivity of pulmonary tuberculosis patients and has been associated with unfavorable tuberculosis (TB) treatment outcomes. Nevertheless, there is a limited evidence on predictors of sputum smear ...

    Abstract Background: Non-conversion of sputum smear prolongs the infectivity of pulmonary tuberculosis patients and has been associated with unfavorable tuberculosis (TB) treatment outcomes. Nevertheless, there is a limited evidence on predictors of sputum smear non-conversion among smear-positive PTB (SPPTB) patients in Rwanda. Therefore, this study aimed to determine the factors associated with sputum smear non-conversion after two months of treatment among SPPTB patients in Rwanda.
    Methods: A cross-sectional study was conducted among SPPTB patients registered in the national electronic TB reporting system by all health facilities countrywide (Rwanda) from July 2019 to June 2021. Eligible patients who had completed the first two months of anti-TB treatment and with smear results at the end of the second month of treatment were included in the study. Bivariate and multivariate logistic regression analyses were done using STATA version 16 to determine the factors associated with sputum smear non-conversion. Adjusted odds ratio (OR), 95% confidence interval (CI), and p-value < 0.05 was considered statistically significant.
    Results: This study included 7,211 patients. Of them, 632 (9%) patients had sputum smear non-conversion at the end of the second month of treatment. In multivariate logistic regression analysis, age groups of 20-39 years (AOR = 1.7, 95% CI: 1.0-2.8) and 40-59 years (AOR:2, 95% CI: 1.1-3.3), history of first-line TB treatment failure (AOR = 2, 95% CI: 1.1-3.6), follow-up by community health workers(CHWs) (AOR = 1.2, 95% CI: 1.0-1.5), BMI < 18.5 at TB treatment initiation (AOR = 1.5, 95% CI: 1.2-1.8), and living in Northern Province of Rwanda (AOR = 1.4, 95% CI: 1.0-2.0), were found to be significantly associated with sputum smear non-conversion after two months of treatment.
    Conclusion: Sputum smear non-conversion among SPPTB patients remains low in Rwanda compared to countries of similar health care setting. Identified risk factors for sputum smear non-conversion among SPPTB patients in Rwanda were age (20-39 years, 40-59 years), history of first-line TB treatment failure, follow up by CHWs, BMI < 18.5 at TB treatment initiation and residence (Northern province).
    MeSH term(s) Humans ; Young Adult ; Adult ; Cross-Sectional Studies ; Antitubercular Agents/therapeutic use ; Sputum ; Rwanda/epidemiology ; Prevalence ; Tuberculosis, Pulmonary/drug therapy ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis/drug therapy ; Mycobacterium tuberculosis
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2023-06-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041550-3
    ISSN 1471-2334 ; 1471-2334
    ISSN (online) 1471-2334
    ISSN 1471-2334
    DOI 10.1186/s12879-023-08395-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Non-adherence to medication and associated factors among type 2 diabetes patients at Clinique Medicale Fraternite, Rwanda: a cross-sectional study.

    Murwanashyaka, Jean de Dieu / Ndagijimana, Albert / Biracyaza, Emmanuel / Sunday, François Xavier / Umugwaneza, Maryse

    BMC endocrine disorders

    2022  Volume 22, Issue 1, Page(s) 219

    Abstract: Background: Type 2 Diabetes Miletus (T2DM) is a public health burdens that alarmingly increases and leads to morbidity and mortality over the last decades globally. Its management is multifaceted and adherence to diabetic medications plays great roles ... ...

    Abstract Background: Type 2 Diabetes Miletus (T2DM) is a public health burdens that alarmingly increases and leads to morbidity and mortality over the last decades globally. Its management is multifaceted and adherence to diabetic medications plays great roles in life of T2DM patients. But epidemiology on adherence and its associated factors remain unknown in Rwanda. Therefore, this study determined the extent of non-adherence and its predictors among T2DM patients seeking healthcare services at the Clinique Medicale la Fraternite.
    Methods: A cross-sectional study among 200 adults' patients with T2DM receiving care in the Medicale la Fraternite clinic was investigated. Bivariate and multivariate logistic regression models were performed based on odds ratio employed to examine associated predictors of non-adherence. The cut-off value for all statistical significances tests were considered at p < 0.05 with 95% for the confidence intervals.
    Results: Overall, more than a half of T2DM patients (53.5%) had poor medication adherence. Being females [OR = 2.1, 95%CI(1.13-3.71), p = 0.002], consuming anti-diabetic drugs for 4-10 years [OR = 2.18, 95%CI(1.09-4.34), p = 0.027], experiencing poor communication with healthcare providers [OR = 2.4; 95%CI (1.36-4.25), p = 0.003] and being perceived as burden of the family [OR = 5.8; 95%CI(1.3-25.7), p < 0.021] had higher odds of non-adherence to anti-diabetic medications. Those with poor HbA1C [OR = 4.26; 95%CI(1.7-10.67), p = 0.002] had 4.26 times higher odds to be non-adherent compared to those with good HbA1C. Respondents with primary [OR = 3.56; 95%CI (1.12-11.28), p = 0.031] and secondary education [OR = 2.96; 95%CI (1.11-7.87), p = 0.03] were more likely to be non-adherent than those with informal education respectively. Those with normal BMI [OR = 5.17; 95%CI(1.63-16.37), p = 0.005] and those with overweight or obese [OR = 3.6; 95%CI (1.04-9.1), p < 0.02] had higher odds of being non-adherent than those with underweight.
    Conclusion: Sex, glycaemia, communication with healthcare providers, education and gycosylated hemoglobin were the major predictors of non-adherence. Interventions for tackling this problem through bringing together efforts to stem this epidemic and controlling predictors of non-adherence are urgently recommended.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/drug therapy ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Glycated Hemoglobin A ; Humans ; Hypoglycemic Agents/therapeutic use ; Male ; Medication Adherence ; Rwanda/epidemiology
    Chemical Substances Glycated Hemoglobin A ; Hypoglycemic Agents
    Language English
    Publishing date 2022-08-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 2091323-0
    ISSN 1472-6823 ; 1472-6823
    ISSN (online) 1472-6823
    ISSN 1472-6823
    DOI 10.1186/s12902-022-01133-0
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  6. Article ; Online: Baseline knowledge and attitudes on COVID-19 among hotels' staff: A cross-sectional study in Kigali, Rwanda.

    Hagabimana, Aphrodis / Omolo, Jared / El-Khatib, Ziad / Rwagasore, Edson / Benemariya, Noella / Nsekuye, Olivier / Kabeja, Adeline / Balisanga, Helene / Umutoni, Angela / Musafili, Aimable / Ndagijimana, Albert

    PloS one

    2021  Volume 16, Issue 12, Page(s) e0261744

    Abstract: Background: The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff ... ...

    Abstract Background: The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and strengthening of Infection Prevention and Control (IPC) practices in such settings are important interventions. This study assessed the baseline knowledge and attitudes on COVID-19 among hotels' representatives in Kigali, Rwanda.
    Methods: A cross-sectional study was conducted among hotels' staff in Kigali in July 2020. A structured questionnaire was self-administered to 104 participants. Baseline knowledge and attitudes were assessed using a number of pre-test questions and mean scores were used to dichotomise the participants' responses as satisfactory or unsatisfactory.
    Results: All of the 104 hotels' staff completed the self-administered questionnaires. Sixty-seven percent (n = 70) were male and 58% (n = 60) were aged between 30 and 44 years. The satisfactory rate of correct answers was 63%±2.4 (n = 66) on knowledge and 68%±1.7 (n = 71) on attitudes evaluation. Participants with University education were more likely to have satisfactory knowledge (AOR: 2.6, 95% C.I: 1.07-6.58) than those with secondary education or less. The staff working in the front-office (AOR: 0.05; 95% CI 0.01-0.54) and housekeeping (AOR: 0.09; 95% C.I: 0.01-0.87) were less likely to have satisfactory attitudes than those working in the administration.
    Conclusions: Hotels' staff based in the capital of Rwanda have shown satisfactory knowledge and attitudes regarding appropriate IPC practices for preventing the COVID-19 transmission. Educational interventions are needed to improve their knowledge and attitudes for better prevention in this setting.
    MeSH term(s) Adolescent ; Adult ; COVID-19/prevention & control ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Pandemics/prevention & control ; Rwanda ; Surveys and Questionnaires ; Young Adult
    Language English
    Publishing date 2021-12-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0261744
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Baseline knowledge and attitudes on COVID-19 among hotels' staff

    Aphrodis Hagabimana / Jared Omolo / Ziad El-Khatib / Edson Rwagasore / Noella Benemariya / Olivier Nsekuye / Adeline Kabeja / Helene Balisanga / Angela Umutoni / Aimable Musafili / Albert Ndagijimana

    PLoS ONE, Vol 16, Iss 12, p e

    A cross-sectional study in Kigali, Rwanda.

    2021  Volume 0261744

    Abstract: Background The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and ... ...

    Abstract Background The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and strengthening of Infection Prevention and Control (IPC) practices in such settings are important interventions. This study assessed the baseline knowledge and attitudes on COVID-19 among hotels' representatives in Kigali, Rwanda. Methods A cross-sectional study was conducted among hotels' staff in Kigali in July 2020. A structured questionnaire was self-administered to 104 participants. Baseline knowledge and attitudes were assessed using a number of pre-test questions and mean scores were used to dichotomise the participants' responses as satisfactory or unsatisfactory. Results All of the 104 hotels' staff completed the self-administered questionnaires. Sixty-seven percent (n = 70) were male and 58% (n = 60) were aged between 30 and 44 years. The satisfactory rate of correct answers was 63%±2.4 (n = 66) on knowledge and 68%±1.7 (n = 71) on attitudes evaluation. Participants with University education were more likely to have satisfactory knowledge (AOR: 2.6, 95% C.I: 1.07-6.58) than those with secondary education or less. The staff working in the front-office (AOR: 0.05; 95% CI 0.01-0.54) and housekeeping (AOR: 0.09; 95% C.I: 0.01-0.87) were less likely to have satisfactory attitudes than those working in the administration. Conclusions Hotels' staff based in the capital of Rwanda have shown satisfactory knowledge and attitudes regarding appropriate IPC practices for preventing the COVID-19 transmission. Educational interventions are needed to improve their knowledge and attitudes for better prevention in this setting.
    Keywords Medicine ; R ; Science ; Q
    Subject code 910
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Baseline knowledge and attitudes on COVID-19 among hotels’ staff

    Aphrodis Hagabimana / Jared Omolo / Ziad El-Khatib / Edson Rwagasore / Noella Benemariya / Olivier Nsekuye / Adeline Kabeja / Helene Balisanga / Angela Umutoni / Aimable Musafili / Albert Ndagijimana

    PLoS ONE, Vol 16, Iss

    A cross-sectional study in Kigali, Rwanda

    2021  Volume 12

    Abstract: Background The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and ... ...

    Abstract Background The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and strengthening of Infection Prevention and Control (IPC) practices in such settings are important interventions. This study assessed the baseline knowledge and attitudes on COVID-19 among hotels’ representatives in Kigali, Rwanda. Methods A cross-sectional study was conducted among hotels’ staff in Kigali in July 2020. A structured questionnaire was self-administered to 104 participants. Baseline knowledge and attitudes were assessed using a number of pre-test questions and mean scores were used to dichotomise the participants’ responses as satisfactory or unsatisfactory. Results All of the 104 hotels’ staff completed the self-administered questionnaires. Sixty-seven percent (n = 70) were male and 58% (n = 60) were aged between 30 and 44 years. The satisfactory rate of correct answers was 63%±2.4 (n = 66) on knowledge and 68%±1.7 (n = 71) on attitudes evaluation. Participants with University education were more likely to have satisfactory knowledge (AOR: 2.6, 95% C.I: 1.07–6.58) than those with secondary education or less. The staff working in the front-office (AOR: 0.05; 95% CI 0.01–0.54) and housekeeping (AOR: 0.09; 95% C.I: 0.01–0.87) were less likely to have satisfactory attitudes than those working in the administration. Conclusions Hotels’ staff based in the capital of Rwanda have shown satisfactory knowledge and attitudes regarding appropriate IPC practices for preventing the COVID-19 transmission. Educational interventions are needed to improve their knowledge and attitudes for better prevention in this setting.
    Keywords Medicine ; R ; Science ; Q
    Subject code 910
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: PrePex Male Circumcision: Follow-Up and Outcomes during the First Two Years of Implementation at the Rwanda Military Hospital.

    Ndagijimana, Albert / Mugenzi, Pacifique / Thomson, Dana R / Hedt-Gauthier, Bethany / Condo, Jeanine U / Ngoga, Eugene

    PloS one

    2015  Volume 10, Issue 9, Page(s) e0138287

    Abstract: Background: PrePex Male Circumcision (MC) has been demonstrated as an effective and scalable strategy to prevent HIV infection in low- and middle-income countries. This study describes the follow-up and outcomes of clients who underwent PrePex MC ... ...

    Abstract Background: PrePex Male Circumcision (MC) has been demonstrated as an effective and scalable strategy to prevent HIV infection in low- and middle-income countries. This study describes the follow-up and outcomes of clients who underwent PrePex MC between January 2011 and December 2012 with weekly follow-up at the Rwanda Military Hospital, the first national hospital in Rwanda to adopt PrePex.
    Methods: Data on 570 clients age 21 to 54 were extracted from patient records. We compared socio-demographic and clinical characteristics, the operator's qualification, HIV status, pain before and after device removal, urological status, device size and follow-up time between clients who were formally discharged and those who defaulted. We reported bivariate associations between each covariate and discharge status, number of people with adverse events by discharge status, and time to formal discharge or defaulting using life table methods. Data were entered into Epidata and analyzed with Stata v 13.
    Results: Among study participants, 96.5% were circumcised by non-physician operators, 85.4%were under 30 years, 98.9% were HIV-negative and 97.9% were without any urological problems that could delay the healing time. Most (70.7%) defaulted before formal discharge. Pain before (p<0.001) and after PrePex device removal (p = 0.001) were associated with discharge status, although very few cases were reported, and pain was more commonly missing among defaulters. Twenty-seven adverse events were reported (7 formally discharged, 20 defaulters). Median follow-up time was seven weeks among formally discharged and six weeks among defaulters (p<0.001).
    Conclusion: Given that all socio-demographic and most clinical characteristics were not associated with defaulting, we hypothesize that clients stopped returning once they determined they were healed. We recommend less frequent follow-up protocols to encourage clinical visits until formal discharge. Based on these results and recommendations, we believe PrePex MC is a practical circumcision strategy in Rwanda and in sub-Saharan Africa.
    MeSH term(s) Circumcision, Male/adverse effects ; Demography ; Follow-Up Studies ; Health Plan Implementation ; Hospitals, Military ; Humans ; Male ; Probability ; Rwanda ; Time Factors ; Treatment Outcome ; Wound Healing ; Young Adult
    Language English
    Publishing date 2015
    Publishing country United States
    Document type Journal Article
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0138287
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: PrePex Male Circumcision

    Albert Ndagijimana / Pacifique Mugenzi / Dana R Thomson / Bethany Hedt-Gauthier / Jeanine U Condo / Eugene Ngoga

    PLoS ONE, Vol 10, Iss 9, p e

    Follow-Up and Outcomes during the First Two Years of Implementation at the Rwanda Military Hospital.

    2015  Volume 0138287

    Abstract: PrePex Male Circumcision (MC) has been demonstrated as an effective and scalable strategy to prevent HIV infection in low- and middle-income countries. This study describes the follow-up and outcomes of clients who underwent PrePex MC between January ... ...

    Abstract PrePex Male Circumcision (MC) has been demonstrated as an effective and scalable strategy to prevent HIV infection in low- and middle-income countries. This study describes the follow-up and outcomes of clients who underwent PrePex MC between January 2011 and December 2012 with weekly follow-up at the Rwanda Military Hospital, the first national hospital in Rwanda to adopt PrePex.Data on 570 clients age 21 to 54 were extracted from patient records. We compared socio-demographic and clinical characteristics, the operator's qualification, HIV status, pain before and after device removal, urological status, device size and follow-up time between clients who were formally discharged and those who defaulted. We reported bivariate associations between each covariate and discharge status, number of people with adverse events by discharge status, and time to formal discharge or defaulting using life table methods. Data were entered into Epidata and analyzed with Stata v 13.Among study participants, 96.5% were circumcised by non-physician operators, 85.4%were under 30 years, 98.9% were HIV-negative and 97.9% were without any urological problems that could delay the healing time. Most (70.7%) defaulted before formal discharge. Pain before (p<0.001) and after PrePex device removal (p = 0.001) were associated with discharge status, although very few cases were reported, and pain was more commonly missing among defaulters. Twenty-seven adverse events were reported (7 formally discharged, 20 defaulters). Median follow-up time was seven weeks among formally discharged and six weeks among defaulters (p<0.001).Given that all socio-demographic and most clinical characteristics were not associated with defaulting, we hypothesize that clients stopped returning once they determined they were healed. We recommend less frequent follow-up protocols to encourage clinical visits until formal discharge. Based on these results and recommendations, we believe PrePex MC is a practical circumcision strategy in Rwanda and in sub-Saharan ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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