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  1. Article ; Online: Spatial distribution and predictive factors of antenatal care in Burundi: A spatial and multilevel baseline analysis for the third burundian demographic and health survey.

    Barankanira, Emmanuel / Iradukunda, Arnaud / Ntakaburimvo, Nestor / Ahishakiye, Willy / Nsavyimana, Jean Claude / Odjidja, Emmanuel Nene

    PloS one

    2023  Volume 18, Issue 1, Page(s) e0272897

    Abstract: Introduction: The use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during ... ...

    Abstract Introduction: The use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during childbirth. To avoid these complications, the World Health Organization (WHO) recommends at least four antenatal visits. Therefore, this study was conducted to identify predictive factors of antenatal care (ANC) among women aged 15 to 49 years and its spatial distribution in Burundi.
    Methods: We used data from the Second Burundi Demographic and Health Survey (DHS). A Spatial analysis of ANC prevalence and Mulitlevel logistic regressions of determinants factors of ANC with a medical doctor were done. The ANC prevalence was mapped by region and by province. In unsampled data points, a cluster based interpolation of ANC prevalence was done using the kernel method with an adaptive window. Predictive factors of ANC were assessed using Mulitlevel logistic regressions. The dependent variable was antenatal care with a medical doctor and the explanatory variables were place of residence, age, education level, religion, marital status of the woman, household wealth index and delivery place of the woman. Data processing and data analysis were done using using Quantum Geographic Information System (QGIS) and R software, version 3. 5. 0.
    Results: The ANC prevalence varied from 0. 0 to 16. 2% with a median of 0. 5%. A highest predicted ANC prevalence was observed at Muyinga and Kirundo provinces' junction. Low prevalence was observed in several locations in all regions and provinces. The woman's education level and delivery place were significantly associated with antenatal care with a medical doctor.
    Conclusion: Globally, the ANC prevalence is low in Burundi. It varies across the country. There is an intra-regional or intra-provincial heterogeneity in term of ANC prevalence. Woman's education level and delivery place are significantly associated antenatal care. There is a need to consider these ANC disparities and factors in the design and strengthening of existing interventions aimed at increasing ANC visits.
    MeSH term(s) Pregnancy ; Female ; Humans ; Prenatal Care ; Burundi/epidemiology ; Parturition ; Pregnant Women ; Socioeconomic Factors ; Demography ; Patient Acceptance of Health Care
    Language English
    Publishing date 2023-01-17
    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.0272897
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effect of health financing reforms on incidence and management of childhood infections in Ghana: a matching difference in differences impact evaluation.

    Odjidja, Emmanuel Nene / Ansah-Akrofi, Ruth / Iradukunda, Arnaud / Kwanin, Charles / Saha, Manika

    BMC public health

    2022  Volume 22, Issue 1, Page(s) 1494

    Abstract: Introduction: In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this ... ...

    Abstract Introduction: In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea.
    Methods: Nigeria was used as the control country with pre-intervention period of 1990 and 2003 and 1993 and 1998 in Ghana. Post-intervention period was 2008 and 2014 in Ghana and 2008 and 2018 in Nigeria. Data was acquired from demographic health surveys in both countries and propensity score matching was calculated based on background socioeconomic covariates. Following matching, difference in difference analysis was conducted to estimate average treatment on the treated effects. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05.
    Results: After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points).
    Conclusions: Introduction of health financing reforms in Ghana had positive effects on childhood infections (malaria and diarrhoea).
    MeSH term(s) Child ; Diarrhea/epidemiology ; Diarrhea/therapy ; Ghana/epidemiology ; Healthcare Financing ; Humans ; Incidence ; Malaria/epidemiology ; Malaria/therapy
    Language English
    Publishing date 2022-08-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041338-5
    ISSN 1471-2458 ; 1471-2458
    ISSN (online) 1471-2458
    ISSN 1471-2458
    DOI 10.1186/s12889-022-13934-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Prevalence and predictive risk factors of hypertension in patients hospitalized in Kamenge Military hospital and Kamenge University teaching hospital in 2019: A fixed effect modelling study in Burundi.

    Iradukunda, Arnaud / Odjidja, Emmanuel Nene / Ndayishima, Stephane Karl / Ngendakumana, Egide / Ndayishimiye, Gabin Pacifique / Sinarinzi, Darlene / Izere, Cheilla / Ntakaburimvo, Nestor / Akimana, Arlene

    PloS one

    2021  Volume 16, Issue 12, Page(s) e0260225

    Abstract: Introduction: Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. ... ...

    Abstract Introduction: Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi.
    Materials and methods: Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software.
    Results: Overall, 16.7% of the patients were found to be hypertensive. This study didn't showed any significant difference of hypertension's prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40-59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors.
    Conclusion: The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.
    MeSH term(s) Adolescent ; Adult ; Age Factors ; Area Under Curve ; Body Mass Index ; Burundi/epidemiology ; Educational Status ; Female ; Hospitals, Military ; Hospitals, Teaching ; Humans ; Hypertension/diagnosis ; Hypertension/epidemiology ; Logistic Models ; Male ; Middle Aged ; Prevalence ; ROC Curve ; Retrospective Studies ; Risk Factors ; Young Adult
    Language English
    Publishing date 2021-12-13
    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.0260225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Key factors influencing multidrug-resistant tuberculosis in patients under anti-tuberculosis treatment in two centres in Burundi: a mixed effect modelling study.

    Iradukunda, Arnaud / Ndayishimiye, Gabin-Pacifique / Sinarinzi, Darlene / Odjidja, Emmanuel Nene / Ntakaburimvo, Nestor / Nshimirimana, Innocent / Izere, Cheilla

    BMC public health

    2021  Volume 21, Issue 1, Page(s) 2142

    Abstract: Background: Despite the World Health Organization efforts to expand access to the tuberculosis treatment, multidrug resistant tuberculosis (MDR-TB) remains a major threat. MDR-TB represents a challenge for clinicians and staff operating in national ... ...

    Abstract Background: Despite the World Health Organization efforts to expand access to the tuberculosis treatment, multidrug resistant tuberculosis (MDR-TB) remains a major threat. MDR-TB represents a challenge for clinicians and staff operating in national tuberculosis (TB) programmes/centres. In sub-Saharan African countries including Burundi, MDR-TB coexists with high burden of other communicable and non-communicable diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence which well defines the at-risk population. In this study, using data from two referral anti-tuberculosis in Burundi, we model the key factors associated with MDR-TB in Burundi.
    Methods: A case-control study was conducted from 1
    Results: MDR-TB was more identified among patients who lived in rural areas (51.3%), in patients' residence (69.2%) and among those with a household size of six or more family members (59.5%). Most of the MDR-TB cases had already been under TB treatment (86.4%), had previous contact with an MDR-TR case (85.0%), consumed tobacco (55.5%) and were diabetic (66.6 %). HIV prevalence was 32.3 % in controls and 67.7 % among cases. After modelling using mixed effects, Residence of patients (aOR= 1.31, 95%C: 1.12-1.80), living in houses with more than 6 family members (aOR= 4.15, 95% C: 3.06-5.39), previous close contact with MDR-TB (aOR= 6.03, 95% C: 4.01-8.12), history of TB treatment (aOR= 2.16, 95% C: 1.06-3.42), tobacco consumption (aOR = 3.17 ,95% C: 2.06-5.45) and underlying diabetes' ( aOR= 4.09,95% CI = 2.01-16.79) were significantly associated with MDR-TB. With 2000 stratified bootstrap replicates, the model had an excellent predictive performance, accurately predicting 88.15% (95% C: 82.06%-92.8%) of all observations. The coexistence of risk factors to the same patients increases the risk of MDR-TB occurrence. TB patients with no any risk factors had 17.6% of risk to become MDR-TB. That probability was respectively three times and five times higher among diabetic and close contact MDR-TB patients.
    Conclusion: The relatively high TB's prevalence and MDR-TB occurrence in Burundi raises a cause for concern especially in this context where there exist an equally high burden of chronic diseases including malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.
    MeSH term(s) Antitubercular Agents/therapeutic use ; Burundi/epidemiology ; Case-Control Studies ; Humans ; Risk Factors ; Tuberculosis/drug therapy ; Tuberculosis, Multidrug-Resistant/drug therapy ; Tuberculosis, Multidrug-Resistant/epidemiology
    Chemical Substances Antitubercular Agents
    Language English
    Publishing date 2021-11-23
    Publishing country England
    Document type Journal Article
    ISSN 1471-2458
    ISSN (online) 1471-2458
    DOI 10.1186/s12889-021-12233-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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