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Institutionalizing research capacity strengthening in LMICs: A systematic review and meta-synthesis. 中低收入国家加强研究能力的制度化:系统回顾和综合。
Q2 Multidisciplinary Pub Date : 2020-09-09 DOI: 10.12688/aasopenres.13116.1
Marta Vicente-Crespo, O. Agunbiade, J. Eyers, M. Thorogood, S. Fonn
Background: Evidence on effective strategies to ensure sustainability of research capacity strengthening interventions in low- and middle-income country (LMIC) institutions is lacking. This systematic review identified publications describing research capacity building programs and noted their effect, their contexts, and the mechanisms, processes and social actors employed in them. Methods: We searched online databases for the period 2011-2018. Inclusion criteria were that the publications 1) described the intervention; 2) were implemented in LMICs; 3) were based in, or relevant to, university staff or post docs; 4) aimed to improve research capacity; 5) aimed to effect change at the institutional level. Two reviewers screened titles, abstracts and full text in consecutive rounds, a third resolved disagreements. Two people extracted the data of each full text using a data extraction tool covering data relevant to our question. Results: In total 4052 citations were identified and 19 papers were included, which referred to 14 interventions. Only three interventions mentioned using a conceptual framework to develop their approach and none described using a theory of change to assess outcomes. The most frequent inputs described were some method of formal training, promotion of a research-conducive environment and establishment of research support systems. A range of outcomes were reported, most frequently an increased number of publications and proportion of staff with PhDs. When factors of success were discussed, this was attributed to a rigorous approach to implementation, adequate funding, and local buy-in. Those who mentioned sustainability linked it to availability of funds and local buy-in. The lack of a common lexicon and a framework against which to report outcomes made comparison between initiatives difficult. Conclusions: The reduced number of interventions that met the inclusion criteria suggests that programs should be well-described, evaluated systematically, and findings published so that the research capacity strengthening community can extract important lessons.
背景:缺乏关于确保中低收入国家机构加强研究能力干预措施可持续性的有效战略的证据。本系统综述确定了描述研究能力建设项目的出版物,并指出了它们的效果、背景、机制、过程和其中使用的社会行动者。方法:检索2011-2018年在线数据库。纳入标准为:出版物1)描述干预;2)在中低收入国家实施;3)在大学工作或与之相关;4)旨在提高科研能力;5)旨在实现体制层面的变革。两位审稿人连续几轮对论文的标题、摘要和全文进行了筛选,第三位审稿人解决了分歧。两个人使用涵盖与我们的问题相关的数据的数据提取工具提取每个全文的数据。结果:共检索到引文4052篇,纳入文献19篇,涉及干预措施14项。只有三个干预措施提到使用概念框架来发展他们的方法,没有一个描述使用变化理论来评估结果。所描述的最常见的投入是某种正式培训方法、促进有利于研究的环境和建立研究支助系统。报告了一系列成果,最常见的是出版物数量和拥有博士学位的工作人员比例的增加。在讨论成功的因素时,人们将其归因于严格的执行方法、充足的资金和当地的支持。那些提到可持续性的人将其与资金的可用性和当地的购买联系起来。由于缺乏共同的词汇和报告结果的框架,因此很难对不同举措进行比较。结论:符合纳入标准的干预措施数量的减少表明,应该对项目进行充分描述,系统评估,并发表研究结果,以便加强研究能力的社区可以从中吸取重要的经验教训。
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引用次数: 6
Recruiting students for the COVID-19 emergency response: lessons from eight African countries 新冠肺炎应急响应招生:来自八个非洲国家的经验教训
Q2 Multidisciplinary Pub Date : 2020-09-04 DOI: 10.12688/aasopenres.13115.1
V. Mkenda, M. Woolhouse, F. Mutapi, Geoffrey Banda
Background: This paper examines how African countries can innovatively use pre-qualified undergraduate and postgraduate students, as well as retired clinical, laboratory and epidemiological technocrats in dealing with medical emergency situations, such as the COVID-19 pandemic. Methods: An online questionnaire was sent to key informants in six universities and two research institutions working with the Tackling Infections to Benefit Africa (TIBA) program eight African countries.  The return rate was 88.9% and data was analysed using the framework method. Results: Students and other personnel trained in the medical and health professions are a valuable resource that can be mobilised by African governments during medical emergency situations. These are found in research, academia, non-governmental organisations, and government.  However, without clear plans and mechanisms for recruiting, supervising and remunerating or reimbursing the costs of engaging someone not employed by the government, the legitimation and authority for such recruitment becomes a challenge. Currently, postgraduate students in the biomedical sciences are the most preferred because of their level of experience and exposure to medical techniques. They also have a degree certificate, which serves as a quality and competence assurance tool. Engagement of postgraduate medical students undergoing their residence programmes also seems a lot easier. While on the other hand, undergraduate students, who are the majority, are considered underexposed and with low technological capabilities. They also lack certificates needed to ensure competence, although we argue that not all tasks during pandemics require specialized skills. Conclusion: As a step towards strengthening national disaster preparedness capacities, African governments need to develop plans that clarify protocols for engaging, training, supervising and protecting students, especially undergraduates and those taking non-biomedical courses. Such plans may form part of the National Pandemic Response Plan, while considering both specialised and non-specialized roles of emergency response.
背景:本文探讨了非洲国家如何创新地利用资格预审的本科生和研究生,以及退休的临床、实验室和流行病学技术专家来应对COVID-19大流行等医疗紧急情况。方法:向参与“应对感染造福非洲”(TIBA)项目的6所大学和2家研究机构的关键线人发送在线问卷。回收率为88.9%,数据采用框架法进行分析。结果:接受过医疗和卫生专业培训的学生和其他人员是非洲各国政府在医疗紧急情况下可以调动的宝贵资源。在研究机构、学术界、非政府组织和政府中都有这种情况。但是,如果没有明确的计划和机制来征聘、监督和支付或偿还雇用非政府人员的费用,这种征聘的合法性和权威性就成为一个挑战。目前,生物医学专业的研究生是最受欢迎的,因为他们的经验水平和对医疗技术的接触。他们还拥有学位证书,这是质量和能力的保证工具。接受住院实习项目的医学研究生的参与似乎也容易得多。而另一方面,本科生占大多数,被认为是暴露不足,技术能力较低。他们也缺乏确保能力所需的证书,尽管我们认为,在大流行期间并非所有任务都需要专业技能。结论:作为加强国家备灾能力的一个步骤,非洲各国政府需要制定计划,明确学生参与、培训、监督和保护的规程,特别是本科生和非生物医学课程的学生。这些计划可构成国家大流行病应对计划的一部分,同时考虑到应急反应的专业和非专业作用。
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引用次数: 3
Validation of self-reported physical activity by accelerometry among primary school children in Kilimanjaro, Tanzania: a pilot study. 在坦桑尼亚乞力马扎罗市小学生中,用加速度计对自我报告的身体活动进行验证:一项试点研究。
Q2 Multidisciplinary Pub Date : 2020-08-21 eCollection Date: 2020-01-01 DOI: 10.12688/aasopenres.13118.1
Mary Vincent Mosha, Elizabeth Kasagama, Philip Ayieko, Jim Todd, Sia E Msuya, Heiner Grosskurth, Suzanne Filteau

Background: Self-reports are commonly used to assess physical activity in children.  Existing self-reports for physical activity have not been validated for use among primary school children in Kilimanjaro, Tanzania. In order to understand if primary school children can accurately report their physical activity, we examined the validity of self-reported physical activity against accelerometer measured physical activity. Methods: A community based cross-sectional study was conducted from May to July, 2018 among four primary schools in Moshi municipal and Moshi rural districts, Kilimanjaro, Tanzania.  A total of 51 primary school children aged 9-11 years were enrolled using a simple random sampling technique. A self-reported questionnaire was used to collect physical activity related variables. In addition, children wore accelerometers for seven consecutive days to capture physical activity movements. Spearman's rank test and Bland Altman plots were used for assessing validity and agreement between self-reports and accelerometer moderate to vigorous physical activity (MVPA). Results: The mean age of the study participants was 10 (SD=0.8) years. Majority of the study participants were female 32 (63%). A moderate, positive correlation was found between self-reports and accelerometer MVPA (rho=0.36, p=0.009). Accelerometer had higher MVPA compared to self-reports. Children who reported walking to school had higher MVPA for both accelerometer and self- reports compared to children who use other means of transport to school, e.g. school buses (p < 0.001). Conclusions: This study found the moderate positive correlation between self-reports and accelerometers. Self-reports are prone to errors due to recall bias, and this interferes their validity.  More research is needed to develop better self-reported measures with specific activities which can easily be recalled by children. Also, researchers have to be aware of self-reports validity limitation.

背景:自我报告通常用于评估儿童的身体活动。现有的身体活动自我报告尚未在坦桑尼亚乞力马扎罗市小学生中得到验证。为了了解小学生是否能准确地报告他们的身体活动,我们检验了自我报告的身体活动与加速度计测量的身体活动的有效性。方法:2018年5 - 7月,对坦桑尼亚乞力马扎罗市莫希市和莫希农村地区的4所小学进行了基于社区的横断面研究。采用简单的随机抽样方法,对51名9-11岁的小学生进行了调查。采用自我报告问卷收集体力活动相关变量。此外,孩子们连续7天佩戴加速度计来记录身体活动。采用Spearman’s rank检验和Bland Altman图来评估自我报告与加速度计中高强度体力活动(MVPA)之间的效度和一致性。结果:研究参与者的平均年龄为10岁(SD=0.8)。大多数研究参与者是32岁的女性(63%)。自我报告与加速度计MVPA之间存在中度正相关(rho=0.36, p=0.009)。与自我报告相比,加速度计的MVPA更高。与使用其他交通工具(如校车)上学的儿童相比,报告步行上学的儿童在加速度计和自我报告中都具有更高的MVPA (p < 0.001)。结论:本研究发现自我报告与加速度计之间存在中度正相关。由于回忆偏差,自我报告容易出错,这干扰了它们的有效性。需要进行更多的研究,以开发更好的自我报告措施,其中包括儿童容易回忆起的具体活动。同时,研究者必须意识到自我报告的效度限制。
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引用次数: 6
Analysis of the MUII-plus mentorship programme: reflections of Fellows’ experiences and lessons for other programmes MUII+导师计划分析:对研究员在其他计划中的经验教训的反思
Q2 Multidisciplinary Pub Date : 2020-08-10 DOI: 10.12688/aasopenres.13091.1
Irene Andia Biraro, Emmanuella Driciru, Rehema Namaganda, Fiona Luboga, Charles Kato Drago, A. Wajja, B. Okech, Mary Gorrethy N. Mboowa, Raymond Muganyizi, Moses Kizza, S. Cose, V. Bukirwa, D. Nakanjako, A. Elliott
Background: The MUII mentorship programme began 11 years ago with a successful group mentorship model. Over the years, the programme has evolved and is presently anchored on the “GROW” approach. This model allows individuals to: set Goals (What I want?); Reflect (Where am I now?); think of Options (What can I do?); What to implement (my actions?). It is intended to help fellows (current, honorary, alumni) herein referred to as mentees achieve their short, medium, and long-term research, career and professional goals. Methods: A mixed methods study combining a cross-sectional survey, one focus group discussion and 11 in-depth key informant interviews were carried out between November 2018 and January 2019 to 1) assess the status of the mentorship programme, 2) perform a strength weakness opportunity and threats (SWOT) analysis, and 3) identify factors relevant for sustainability. Results: An open invitation was made to 52 fellows to participate in the survey, and 23 responded. Among respondents, the largest proportions were male [70% (16/23)], and PhD fellows [35% (8/23)]. The respondents rated the fellowship experience as excellent [65% (15/23)], and most [78% (18/23)] revealed they had benefitted greatly from the programme. The SWOT analysis revealed outstanding strengths of having regular fellows’ meetings for peer support, and availability of international collaborations, linkages and exposure. Opportunities identified included large pool of mentees within MUII-plus and evidence of fellows taking up leadership positions. The biggest threat to the mentorship programme was the busy schedule of mentors. Conclusions: The MUII-plus mentorship programme has strong potential to offer research and career mentorship to its fellows. To promote sustainability of the programme, there is a need for innovative ways to engage mentors; such as digital platforms (e-mentorship) for greater mentor-mentee interactions.
背景:理大师友计划始于11年前,成功推行了团体师友模式。多年来,该方案不断发展,目前以“增长”方法为基础。这种模式允许个人:设定目标(我想要什么?)反思(我现在在哪里?);想想选项(我能做什么?);执行什么(我的行动?)它旨在帮助学员(现任、荣誉、校友)实现他们短期、中期和长期的研究、职业和专业目标。方法:在2018年11月至2019年1月期间进行了一项混合方法研究,包括横断面调查,一次焦点小组讨论和11次深入的关键信息者访谈,以1)评估师徒计划的现状,2)进行优势劣势机会和威胁(SWOT)分析,以及3)确定与可持续性相关的因素。结果:公开邀请52名研究员参与调查,23名研究员回复。在被调查者中,男性所占比例最大[70%(16/23)],博士生所占比例最大[35%(8/23)]。受访者认为奖学金体验非常好[65%(15/23)],大多数[78%(18/23)]表示他们从该项目中受益匪浅。SWOT分析显示,定期召开研究员会议以获得同行支持,以及国际合作、联系和曝光的可用性具有突出优势。确定的机会包括MUII-plus内的大量学员,以及有证据表明研究员担任领导职位。导师计划面临的最大威胁是导师们的繁忙日程。结论:MUII-plus导师计划在为其学员提供研究和职业指导方面具有强大的潜力。为了促进该方案的可持续性,需要以创新的方式聘请导师;例如数字平台(电子指导),以促进导师与学员之间的互动。
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引用次数: 1
The wearing of face masks in African countries under the COVID-19 crisis: luxury or necessity? 新冠肺炎危机下非洲国家戴口罩:奢侈品还是必需品?
Q2 Multidisciplinary Pub Date : 2020-08-05 DOI: 10.12688/aasopenres.13079.1
Zohra Aloui-Zarrouk, Lahcen El Youssfi, K. Badu, Adeniyi Francis Fagbamigbe, D. Matoke-Muhia, C. Ngugi, N. Dukhi, G. Mwaura
The unforeseeable global crisis of the spread of coronavirus disease 2019 (COVID-19) has caused almost all affected countries to adopt a range of protective measures as recommended by the World Health Organization. However, the speed, type and level of adoption of these protective measures have been remarkably different. Social distancing and quarantine were the main measures adopted in addition to observing basic hygiene. Based on the available evidences, WHO continues to recommend wearing of face masks for healthcare workers and for those people caring for COVID-19 patients. However, some countries and organisations have recommended, and some have even made it mandatory, for their citizens to wear face masks. Particularly in low- and middle-income countries, protecting by wearing face masks is viewed as an affordable yet proactive preventive measure to avoid and slow down viral spread based on the experience of other affected countries. However, the wearing of face masks is controversial due to shortages in their stocks and uncertainty around the quality of masks, as well as their efficiency as a protective mechanism. Masks should be used based on appropriate use and management guidelines. This paper discusses the wearing of face masks from the perspective of low- and middle-income countries, particularly in Africa; and then makes some recommendations that will greatly inform policy makers on epidemic mitigation strategies throughout the African continent.
2019冠状病毒病(COVID-19)传播的不可预见的全球危机导致几乎所有受影响的国家都采取了世界卫生组织建议的一系列保护措施。然而,采取这些保护措施的速度、类型和程度却大不相同。除注意基本卫生外,采取的主要措施是保持社会距离和隔离。根据现有证据,世卫组织继续建议卫生保健工作者和照顾COVID-19患者的人佩戴口罩。然而,一些国家和组织建议,有些甚至强制要求其公民佩戴口罩。特别是在低收入和中等收入国家,根据其他受影响国家的经验,通过戴口罩进行保护被视为一种负担得起的主动预防措施,以避免和减缓病毒传播。然而,由于库存短缺、口罩质量的不确定性以及口罩作为一种保护机制的效率,佩戴口罩存在争议。应根据适当的使用和管理指南使用口罩。本文从低收入和中等收入国家,特别是非洲国家的角度讨论了佩戴口罩的问题;然后提出一些建议,这些建议将极大地为整个非洲大陆的流行病缓解战略决策者提供信息。
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引用次数: 15
SNPs in IL4 and IFNG show no protective associations with human African trypanosomiasis in the Democratic Republic of the Congo: a case-control study. IL4和IFNG的SNPs与刚果民主共和国的非洲锥虫病没有保护性关联:一项病例对照研究。
Q2 Multidisciplinary Pub Date : 2020-08-04 eCollection Date: 2020-01-01 DOI: 10.12688/aasopenres.12999.1
Olivier Fataki Asina, Harry Noyes, Bruno Bucheton, Hamidou Ilboudo, Annette MacLeod, Dieudonné Mumba Ngoyi

Background: Human African trypanosomiasis (HAT) is a protozoal disease transmitted by tsetse flies. Infection with trypanosomes can lead directly to active HAT or latent infection with no detectable parasites, which may progress to active HAT or to spontaneous self-cure. Genetic variation could explain these differences in the outcome of infection. To test this hypothesis, polymorphisms in 17 candidate genes were tested ( APOL1 [ G1 and G2], CFH, HLA-A, HPR, HP, IL1B, IL12B, IL12RB1, IL10, IL4R, MIF, TNFA , IL6, IL4, IL8, IFNG, and HLA-G). Methods: Samples were collected in Democratic Republic of the Congo. 233 samples were genotyped: 100 active HAT cases, 33 from subjects with latent infections and 100 negative controls. Commercial service providers genotyped polymorphisms at 96 single nucleotide polymorphisms (SNPs) on 17 genes. Data were analyzed using Plink V1.9 software and R. Loci, with suggestive associations (uncorrected p < 0.05) validated using an additional 594 individuals, including 164 cases and 430 controls. Results: After quality control, 87 SNPs remained in the analysis. Two SNPs in IL4 and two in IFNG were suggestively associated (uncorrected p<0.05) with a differential risk of developing a Trypanosoma brucei gambiense infection in the Congolese population. The IFNG minor allele (rs2430561, rs2069718) SNPs were protective in comparison between latent infections and controls. Carriers of the rs2243258_T and rs2243279_A alleles of IL4 and the rs2069728_T allele of IFNG had a reduced risk of developing illness or latent infection, respectively. None of these associations were significant after Bonferroni correction for multiple testing. A validation study using more samples was run to determine if the absence of significant association was due to lack of power. Conclusions: This study showed no evidence of an association of HAT with IL4 and IFNG SNPs or with APOL1 G1 and G2 alleles, which have been found to be protective in other studies.

背景:人类非洲锥虫病(HAT)是一种由采采蝇传播的原生动物疾病。锥虫感染可直接导致活动性非洲锥虫病,也可导致未检测到寄生虫的潜伏感染,进而发展为活动性非洲锥虫病或自发自愈。基因变异可以解释感染结果的这些差异。为了验证这一假设,我们检测了 17 个候选基因(APOL1 [ G1 和 G2]、CFH、HLA-A、HPR、HP、IL1B、IL12B、IL12RB1、IL10、IL4R、MIF、TNFA、IL6、IL4、IL8、IFNG 和 HLA-G)的多态性。研究方法在刚果民主共和国采集样本。对 233 份样本进行了基因分型:其中 100 例为活动性 HAT 病例,33 例为潜伏感染者,100 例为阴性对照。商业服务提供商对 17 个基因上的 96 个单核苷酸多态性 (SNP) 进行了基因分型。使用 Plink V1.9 软件和 R. Loci 对数据进行分析,并使用另外 594 人(包括 164 例病例和 430 例对照)验证了提示性关联(未校正 p <0.05)。结果显示经过质量控制后,87 个 SNPs 仍在分析中。IL4中的两个SNP和IFNG中的两个SNP与刚果人群中的布氏锥虫感染呈提示性相关(未校正p<0.05)。IFNG 小等位基因(rs2430561、rs2069718)SNPs 在潜伏感染者和对照组之间具有保护作用。IL4的rs2243258_T和rs2243279_A等位基因以及IFNG的rs2069728_T等位基因携带者患病或潜伏感染的风险分别降低。经 Bonferroni 多重检验校正后,这些关联均不显著。我们使用了更多的样本进行了验证研究,以确定是否由于缺乏力量而导致没有显著关联。结论:本研究没有证据表明HAT与IL4和IFNG SNPs或APOL1 G1和G2等位基因有关,而其他研究发现这些基因具有保护作用。
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引用次数: 0
Detection of Mycobacterium tuberculosis DNA in CD34 + peripheral blood mononuclear cells of Ugandan adults with latent infection: a cross-sectional and nested prospective study. 乌干达成人潜伏感染者 CD34 + 外周血单核细胞中结核分枝杆菌 DNA 的检测:一项横断面和巢式前瞻性研究。
Q2 Multidisciplinary Pub Date : 2020-07-29 eCollection Date: 2020-01-01 DOI: 10.12688/aasopenres.13108.1
Jonathan Mayito, Irene Andia Biraro, Stephen T Reece, Adrian R Martineau, David P Kateete

Background: Tuberculin skin test and interferon gamma release assay (IGRA) show limitations in diagnosing latent tuberculosis infection (LTBI) and poorly predict progression to active tuberculosis. This study will explore detection of Mycobacterium tuberculosis ( M.tb) DNA in CD34 + peripheral blood mononuclear cells (PBMCs) as a biomarker for LTBI and monitoring chemoprophylaxis response. Methods: In a cross-sectional study, 120 household contacts (60 HIV positive and 60 HIV negative) will be recruited. Also, 10 patients with sputum positive pulmonary tuberculosis and 10 visitors from low incidence countries with no history of TB treatment will be recruited as positive and negative controls, respectively. Participants will donate 100 ml (50 ml for TB patients) of blood to isolate PBMCs using density gradient centrifugation. Isolated PBMCs will be separated into CD34 + and CD34 - enriched cellular fractions. DNA from each fraction will be purified, quantified and subjected to droplet digital PCR targeting IS6110 (a M.tb Complex multi-copy gene) and rpoB, a single copy gene. Also, 4 ml of blood will be drawn for IGRA. In a nested prospective study, 60 HIV positive participants will be given 300 mg of Isoniazid Preventive Therapy (IPT) daily for six months, after which they will donate a second 100 ml blood sample that will be processed as described above. Data from the cross-sectional study will be analysed to determine the proportion of individuals in whom M.tb DNA is detectable in CD34 + and CD34 - fractions and number of M.tb genomes present. Data from the prospective study will be analysed to compare the proportion of individuals with detectable M.tb DNA in CD34 + and CD34 - fractions, and median M.tb genome copy number, post vs pre-IPT. Discussion: This study will determine whether detection of M.tb DNA in CD34 + PBMCs holds promise as a biomarker for LTBI and monitoring chemoprophylaxis response.

背景:结核菌素皮试和γ干扰素释放测定(IGRA)在诊断潜伏肺结核感染(LTBI)方面存在局限性,而且不能很好地预测活动性肺结核的进展。本研究将探索检测 CD34 + 外周血单核细胞(PBMCs)中的结核分枝杆菌(M.tb)DNA,作为诊断 LTBI 和监测化学预防反应的生物标志物。研究方法在横断面研究中,将招募 120 名家庭接触者(60 名 HIV 阳性,60 名 HIV 阴性)。此外,还将招募 10 名痰液呈阳性的肺结核患者和 10 名来自低发病率国家且无结核病治疗史的访客,分别作为阳性对照和阴性对照。参与者将捐献 100 毫升血液(肺结核病人捐献 50 毫升),利用密度梯度离心法分离出 PBMC。分离出的 PBMC 将分为 CD34 + 和 CD34 - 富集细胞部分。将对每个部分的 DNA 进行纯化、定量,并针对 IS6110(一种 M.tb 复合多拷贝基因)和 rpoB(一种单拷贝基因)进行液滴数字 PCR 检测。此外,还将抽取 4 毫升血液进行 IGRA 检测。在一项巢状前瞻性研究中,60 名艾滋病毒呈阳性的参与者将在 6 个月内每天接受 300 毫克异烟肼预防疗法(IPT),之后他们将捐献第二份 100 毫升血液样本,并按上述方法进行处理。将对横断面研究的数据进行分析,以确定在 CD34 + 和 CD34 - 部分检测到 M.tb DNA 的个体比例以及存在的 M.tb 基因组数量。将对前瞻性研究的数据进行分析,以比较 CD34 + 和 CD34 - 部分中可检测到 M.tb DNA 的患者比例以及 M.tb 基因组拷贝数中位数(IPT 后与 IPT 前)。讨论:这项研究将确定在 CD34 + PBMCs 中检测出 M.tb DNA 是否有望成为治疗 LTBI 和监测化学预防反应的生物标志物。
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引用次数: 0
A Journey of Hope: giving research participants a voice to share their experiences and improve community engagement around advanced HIV disease in Uganda 希望之旅:让研究参与者有机会分享他们的经验,并在乌干达改善社区对晚期艾滋病毒疾病的参与
Q2 Multidisciplinary Pub Date : 2020-07-27 DOI: 10.12688/aasopenres.13104.1
F. Cresswell, J. Kasibante, E. Martyn, L. Tugume, G. Stead, Kenneth Ssembambulidde, M. Rutakingirwa, E. Kagimu, Laura Nsangi, Carol Namuju, J. F. Ndyetukira, C. Ahimbisibwe, Florence Kugonza, Alisat Sadiq, Alice Namudde, Joanna Dobbin, Diksha Srishyla, C. Quinn, Mable Kabahubya, C. Muzoora, Stephen Watiti, D. Meya, A. Elliott
Over the last decade excellent progress has been made globally in HIV management thanks to antiretroviral therapy (ART) rollout and international guidelines now recommending immediate initiation of ART in people living with HIV. Despite this, advanced HIV disease (CD4 less than 200 cells/mL) and opportunistic infections remain a persistent challenge and contribute significantly to HIV-associated mortality, which equates to 23,000 deaths in Uganda in 2018 alone. Our Meningitis Research Team based in Uganda is committed to conducting clinical trials to answer important questions regarding diagnostics and management of HIV-associated opportunistic infections, including tuberculosis and cryptococcal meningitis. However, clinical research is impossible without research participants and results are meaningless unless they are translated into benefits for those affected by the disease. Therefore, we held a series of community engagement events with the aims of 1) giving research participants a voice to share their experiences of clinical research and messages of hope around advanced HIV disease with the community, 2) dispelling myths and stigma around HIV, and 3) raising awareness about the complications of advanced HIV disease and local clinical research and recent scientific advances. The purpose of this Open Letter is to describe our community engagement experience in Uganda, where we aimed to give clinical research participants a greater voice to share their experiences. These activities build upon decades of work in HIV community engagement and lays a platform for future research and engagement activities.
在过去十年中,由于抗逆转录病毒疗法(ART)的推广以及目前建议艾滋病毒感染者立即开始抗逆转录病毒疗法的国际指南,全球在艾滋病毒管理方面取得了巨大进展。尽管如此,晚期艾滋病毒疾病(CD4细胞低于200细胞/mL)和机会性感染仍然是一个持续的挑战,并显著导致艾滋病毒相关死亡率,仅2018年乌干达就有2.3万人死亡。我们在乌干达的脑膜炎研究小组致力于开展临床试验,以回答与艾滋病毒相关的机会性感染(包括结核病和隐球菌性脑膜炎)的诊断和管理方面的重要问题。然而,没有研究参与者的临床研究是不可能的,除非将结果转化为对受疾病影响的人的益处,否则这些结果是没有意义的。因此,我们举办了一系列的社区参与活动,目的是1)让研究参与者有机会与社区分享他们的临床研究经验和关于晚期艾滋病毒疾病的希望信息,2)消除对艾滋病毒的误解和污名,以及3)提高对晚期艾滋病毒疾病并发症和本地临床研究和最新科学进展的认识。这封公开信的目的是描述我们在乌干达的社区参与经验,我们的目标是让临床研究参与者有更大的发言权来分享他们的经验。这些活动建立在数十年来艾滋病毒社区参与工作的基础上,并为未来的研究和参与活动奠定了平台。
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引用次数: 1
Strengthening research management and support services in sub-Saharan African universities and research institutions. 加强撒哈拉以南非洲大学和研究机构的研究管理和支助服务。
Q2 Multidisciplinary Pub Date : 2020-07-20 DOI: 10.12688/aasopenres.13100.1
J. Pulford, Susie Crossman, Sara Begg, Jessica Amegee Quach, P. Abomo, T. El Hajj, I. Bates
Background: International development partners and research councils are increasingly funding research management and support (RMS) capacity strengthening initiatives in sub-Saharan Africa (SSA) as part of a broader investment in strengthening national and regional research systems.  However, the evidence-base to inform RMS capacity strengthening initiatives is limited at present. This research note presents a synthesis of 28 RMS capacity assessments completed in 25 universities/research institutions from across 15 SSA countries between 2014 and 2018.  Methods: All 28 capacity assessments were completed following a standardised methodology consisting of semi-structured interviews conducted with research and research support staff at the respective institution as well as document reviews and observation of onsite facilities. Data were extracted from the 28 reports detailing the findings of each assessment according to a framework synthesis approach. Results: In total, 13 distinct capacity gap categories emerged from across the 28 RMS capacity assessment reports.  Almost all the institutions assessed faced significant gaps in RMS capacity within and across each of these 13 categories. The 13 categories were not independent of each other and were often closely inter-connected. Commonalities were also evident across multiple categories, the two most obvious of which were severe fiscal constraints and the often-complex bureaucracy of the institutional operating environment. Conclusions: The synthesis findings reveal multiple, commonly shared RMS capacity gaps in universities and research institutions across SSA. No single intervention type, or focus, would be sufficient to strengthen capacity across all 13 areas; rather, what is needed to facilitate a significant shift in RMS capacity within such SSA universities and research institutions is a combination of interventions, consisting of differing levels of cost and complexity, variously led (or supported) by both internal and external actors.
背景:国际发展伙伴和研究理事会越来越多地资助撒哈拉以南非洲(SSA)的研究管理和支持(RMS)能力加强倡议,作为加强国家和区域研究系统的更广泛投资的一部分。然而,目前为RMS能力加强举措提供信息的证据基础有限。本研究报告综合了2014年至2018年间在15个SSA国家的25所大学/研究机构完成的28项RMS能力评估。方法:所有28项能力评估均按照标准化方法完成,该方法包括与各自机构的研究和研究支持人员进行半结构化访谈,以及文件审查和现场设施观察。数据摘自28份报告,其中详细介绍了根据框架综合方法进行的每次评估的结果。结果:在28份RMS能力评估报告中,总共出现了13种不同的能力差距类别。几乎所有被评估的机构在这13个类别内和之间都面临着显著的RMS能力差距。这13个类别并不是相互独立的,往往是紧密相连的。在多个类别中也有明显的共性,其中最明显的两个是严重的财政限制和机构运作环境中往往复杂的官僚主义。结论:综合研究结果揭示了整个SSA地区的大学和研究机构存在多重共同的RMS能力差距。任何单一的干预类型或重点都不足以加强所有13个领域的能力;相反,在这些SSA大学和研究机构中,促进RMS能力的重大转变所需要的是由内部和外部行动者不同程度地领导(或支持)的干预措施的组合,这些干预措施由不同水平的成本和复杂性组成。
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引用次数: 4
Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study. 疟疾对加纳阿散蒂地区城市、城郊和农村居民血液学参数的影响:一项横断面研究。
Q2 Multidisciplinary Pub Date : 2020-07-09 eCollection Date: 2019-01-01 DOI: 10.12688/aasopenres.12979.3
Abdul-Hakim Mutala, Kingsley Badu, Christian Owusu, Samuel Kekeli Agordzo, Austine Tweneboah, Dawood Ackom Abbas, Matthew Glover Addo

Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99;  p=4.96*10 -4). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.

背景:我们的目的是调查疟疾对加纳阿散蒂地区不同人口居住区居民血液学参数的影响。疟疾寄生虫会引起某些血液参数的变化,从而导致一系列临床表现。农村、城郊和城市等不同人口居住区的差异也可能影响这些变化,但加纳尚未对此进行广泛研究。研究方法我们于 2018 年 1 月至 12 月在三个不同的居住区开展了一项基于医院的横断面研究。共招募了 598 名参与者。对血液涂片进行检查,以检测和量化疟疾寄生虫血症,同时使用血液分析仪测量血液学参数。结果显示与城市地区(11.8%)和城郊地区(13.3%)相比,农村地区的疟疾感染率最高(21.3%);然而,城郊地区的寄生虫密度中位数最高(568;IQR=190.0-1312.0)。年龄与疟疾阳性几率明显相关(OR:0.97;CI:0.96 - 0.99;P=4.96*10 -4)。与未感染者相比,疟疾检测呈阳性的研究参与者更年轻,血红蛋白和血小板crit水平更低。需要进一步研究,以更准确地阐明疟疾感染、人口统计学和血液学参数之间的关系。
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引用次数: 0
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