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Kolié D, Guillard E, Sow A, Manet H, Camara BS, Bigirimana T, Harouna M, Delamou A. Exploring experiences of HIV care to optimize patient-centred care in Conakry, Guinea: a qualitative study. Front Reprod Health 2024; 6:1134404. [PMID: 38655091 PMCID: PMC11035823 DOI: 10.3389/frph.2024.1134404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Studies on the organisation of care and the power dynamic between providers and patients with HIV in sub-Saharan Africa are rare. This study aims to describe the patient-provider relationship and explore the challenges to optimal and patient-centred care for HIV patients. Methods This was a qualitative exploratory descriptive study using in-depth individual interviews and focus group discussions. In total, 17 individual interviews and 5 focus group discussions were conducted. This was conducted in four urban health facilities in Conakry, the capital of Guinea. Three group of participants were included in this study namely patients with HIV; health providers including facilities and services managers; and psychosocial counsellors. Psychosocial counsellors provide emotional and psychosocial support to HIV patients. Their role in the organization care in Guinea is new and they contribute to strengthening adherence of patients with HIV to ARV treatment. Results Patients with HIV, health providers, and psychosocial counsellors have a positive perception of the patient-provider relationship. This relationship was characterized essentially by maintaining confidentiality of HIV status disclosure, caring attitudes towards patients (being available, adjusting locations for accessing ART, based on patients' preferences), and participating in HIV patient's social life. However, scolding and miscommunication about the interpretation of viral load tests were reported. The shortage of human resources, low salaries of health staff, poor infrastructure, and the financial burden borne by patients with HIV impede the implementation of optimal patient-centred care. Conclusion Integrating psychosocial counsellors in HIV care organization, improving access to ARV, infrastructure, increasing human resources, and removing the financial burden for HIV patients are needed to optimal patient-centred care in Guinea.
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Affiliation(s)
- Delphin Kolié
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | | | - Hawa Manet
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Bienvenu Salim Camara
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | | | | | - Alexandre Delamou
- Ministry of Health and Public Hygiene, Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
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Camara BS, Belaid L, Manet H, Kolie D, Guillard E, Bigirimana T, Delamou A. What do we know about patient-provider interactions in sub-Saharan Africa? a scoping review. Pan Afr Med J 2020; 37:88. [PMID: 33244351 PMCID: PMC7680249 DOI: 10.11604/pamj.2020.37.88.24009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/17/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction patient-centred care has become a rallying call for improving quality and access to care in countries where health system responsiveness and satisfaction with health services remain low. Understanding patient-provider interactions is important to guide implementation of an effective patient-centred care approach in sub-Saharan Africa. This review aims to overcome this knowledge gap by synthesizing the evidence on patient-provider interactions in sub-Saharan Africa. Methods we conducted a scoping review using Arksey and O´Malley´s framework. We searched in eight databases and the grey literature. We conducted a thematic analysis using an inductive approach to assess the studies. Results of the 80 references identified through database searching, nine met the inclusion criteria. Poor communication and several types of mistreatment (service denial, oppressive language, harsh words and rough examination) characterize patient-provider interactions in sub-Saharan Africa. Nevertheless, some health providers offer support to patients who cannot afford their medical expenses, cost of transportation, food or other necessities. Maintaining confidentiality depends on the context of care. Some patients blamed health providers for consulting with the door open or carrying out concomitant activities in the consultation room. However, in the context of HIV care provision, nurses emphasized the importance of keeping their patients´ HIV status confidential. Conclusion this review advocates for more implementation studies on patient-provider interactions in sub-Saharan Africa so as to inform policies and practices for patient-centred health systems. Decision-makers should prioritize training, mentorship and regular supportive supervision of health providers to provide patient-centred care. Patients should be empowered in care processes.
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Affiliation(s)
- Bienvenu Salim Camara
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Loubna Belaid
- Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Hawa Manet
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | - Delphin Kolie
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea
| | | | | | - Alexandre Delamou
- Centre National de Formation et de Recherche en Santé Rurale de Maferinyah, Forécariah, Guinea.,Department of Public Health, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
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Turenne CP, Gautier L, Degroote S, Guillard E, Chabrol F, Ridde V. Conceptual analysis of health systems resilience: A scoping review. Soc Sci Med 2019; 232:168-180. [PMID: 31100697 DOI: 10.1016/j.socscimed.2019.04.020] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/02/2019] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
Abstract
System resilience has long been an area of study, and the term has become increasingly used across different sectors. Studies on resilience in health systems are more recent, multiplying particularly since the 2014 Ebola epidemic in West Africa. The World Health Organization (WHO) is calling for national governments to increase the resilience of their health systems. Concepts help define research objects and guide the analysis. Yet, to be useful, concepts need to be clear and precise. We aimed to improve the conceptual understanding of health systems resilience by conducting a scoping review to describe the state of knowledge in this area. We searched for literature in 10 databases, and analyzed data using a list of themes. We evaluated the clarity and the precision of the concept of health systems resilience using Daigneault & Jacob's three dimensions of a concept: term, sense, and referent. Of the 1091 documents initially identified, 45 met the inclusion criteria. Term: multiple terms are used, switching from one to the other to speak about the same subject. Sense: there is no consensus yet on a unique definition. Referent: the magnitude and nature of events that resilient health systems face differ with context, covering a broad range of situations from sudden crisis to everyday challenges. The lack of clarity in this conceptualization hinders the expansion of knowledge, the creation of reliable analytical tools, and the effectiveness of communication. The current conceptualization of health systems resilience is too scattered to enable the enhancement of this concept with great potential, opening a large avenue for future research.
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Affiliation(s)
- Charlotte Pailliard Turenne
- Institute for Research on Sustainable Development, CEPED (IRD-Université de Paris), Université de Paris, ERL INSERM SAGESUD, 45 Rue des Saints-Pères, 75006, Paris, France.
| | - Lara Gautier
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada; Public Health Research Institute, University of Montreal, 2900, Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada; CESSMA (IRD-Paris-Diderot University), Université Sorbonne Paris Cité, Bâtiment Olympe de Gouges (8ème étage - secrétariat bureau 817) rue Albert Einstein, 75013, PARIS, France.
| | - Stéphanie Degroote
- Institute for Research on Sustainable Development, CEPED (IRD-Université de Paris), Université de Paris, ERL INSERM SAGESUD, 45 Rue des Saints-Pères, 75006, Paris, France.
| | | | - Fanny Chabrol
- Institute for Research on Sustainable Development, CEPED (IRD-Université de Paris), Université de Paris, ERL INSERM SAGESUD, 45 Rue des Saints-Pères, 75006, Paris, France.
| | - Valéry Ridde
- Institute for Research on Sustainable Development, CEPED (IRD-Université de Paris), Université de Paris, ERL INSERM SAGESUD, 45 Rue des Saints-Pères, 75006, Paris, France; Fellow de l'Institut Français des Migrations, Paris, France.
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Ameyan W, Kamara H, Sesay J, Sheriff M, Dumbuya K, Timbo M, Conteh S, Guillard E. A Participatory Approach to Improving Retention in HIV Treatment and Care for Newly Diagnosed Patients in a Secondary Health Facility in Sierra Leone. ACTA ACUST UNITED AC 2017. [DOI: 10.4172/2155-6113.1000686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Camara S, Zucman D, Vasse M, Goudjo A, Guillard E, Peytavin G. [Lack of bioavailability of generic lopinavir/ritonavir not prequalified by WHO marketed in Africa (Congo Brazzaville)]. ACTA ACUST UNITED AC 2014; 108:46-8. [PMID: 25256250 DOI: 10.1007/s13149-014-0389-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 07/11/2014] [Indexed: 11/27/2022]
Abstract
Although second-line generic antiretroviral drugs are of great value in developing countries there are concerns regarding their quality and safety. This study is a case report and pharmacological study in healthy volunteers. A French subject of sub-saharan origin who visited Republic of Congo received a post-exposure treatment with AZT+3TC and LPV/r (200/50 mg, Arga-L®, India) following unprotected sexual intercourse. Two days later, in France, tests showed that plasma concentrations of lopinavir and ritonavir were undetectable. The WHO prequalification list showed Arga-L® was not prequalified. A pharmacological study in healthy volunteers evaluated oral bioavailability: plasma concentrations of generic LPV/r Arga-L® and LPV/r Kaletra® (400/100 mg) were measured after one single dose at 7 days apart in four healthy volunteers. Concentrations of Arga-L® at 12 h after intake were considerably lower than those of Kaletra®, revealing very low oral bioavailability of generic lopinavir and ritonavir (<10%) compared to the brand-name drug. We found that Arga-L®, despite having adequate qualitative and quantitative drug contents, had very poor bio availability compared to Kaletra®. In order to avoid the selection and the spread of drug-resistant HIV strains, rigorous pharmacological monitoring of generic antiretroviral drugs that are not pre-qualified by WHO, but are marketed in Africa, must be a priority for health authorities.
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Affiliation(s)
- S Camara
- Hôpital Foch, 40 rue Worth, 92151, Suresnes cedex, France.
| | - D Zucman
- Hôpital Foch, 40 rue Worth, 92151, Suresnes cedex, France
| | - M Vasse
- Hôpital Foch, 40 rue Worth, 92151, Suresnes cedex, France
| | - A Goudjo
- France Expertise Internationale, 1, quai de Grenelle, 75015, Paris, France
| | - E Guillard
- Solthis, 58A, rue du Dessous des Berges, 75013, Paris, France
| | - G Peytavin
- Hôpital Bichat-Claude Bernard laboratoire pharmaco-toxicologie, 46 rue Henri Huchard, 75877, Paris cedex 18, France
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Jaisson S, Leroy N, Desroches C, Tonye-Libyh M, Guillard E, Gillery P. Interference of the most frequent haemoglobin variants on quantification of HbA1c: Comparison between the LC–MS (IFCC reference method) and three routinely used methods. Diabetes & Metabolism 2013; 39:363-9. [DOI: 10.1016/j.diabet.2013.01.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/18/2013] [Accepted: 01/21/2013] [Indexed: 11/28/2022]
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Gueret G, Guillouet M, Vermeersch V, Guillard E, Talarmin H, Nguyen BV, Rannou F, Giroux-Metges MA, Pennec JP, Ozier Y. [ICU acquired neuromyopathy]. ACTA ACUST UNITED AC 2013; 32:580-91. [PMID: 23958176 DOI: 10.1016/j.annfar.2013.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 05/08/2013] [Indexed: 12/19/2022]
Abstract
ICU acquired neuromyopathy (IANM) is the most frequent neurological pathology observed in ICU. Nerve and muscle defects are merged with neuromuscular junction abnormalities. Its physiopathology is complex. The aim is probably the redistribution of nutriments and metabolism towards defense against sepsis. The main risk factors are sepsis, its severity and its duration of evolution. IANM is usually diagnosed in view of difficulties in weaning from mechanical ventilation, but electrophysiology may allow an earlier diagnosis. There is no curative therapy, but early treatment of sepsis, glycemic control as well as early physiotherapy may decrease its incidence. The outcomes of IANM are an increase in morbi-mortality and possibly long-lasting neuromuscular abnormalities as far as tetraplegia.
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Affiliation(s)
- G Gueret
- Pôle anesthésie réanimations soins intensifs blocs opératoires urgences (ARSIBOU), CHRU de Brest, boulevard Tanguy-Prigent, 29200 Brest, France; Laboratoire de physiologie, faculté de médecine et des sciences de la santé, EA 1274 (mouvement, sport santé), université de Bretagne-Occidentale, 22, avenue Camille-Desmoulins, 29200 Brest, France; Université européenne de Bretagne, 5, boulevard Laennec, 35000 Rennes, France.
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Guillard E, Hélaine L, Subileau A, Cotterel M, Arvieux CC. [Myelopathy cervicarthrosis decompensation: regional anaesthesia is not involved!]. ACTA ACUST UNITED AC 2009; 28:603-4. [PMID: 19473805 DOI: 10.1016/j.annfar.2009.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Le Brun C, Guillard E, Citerne J. Communication Systems Interactive Software (COMSIS): Modeling of Components and its Application to the Simulation of Optical Communication Systems. Appl Opt 1998; 37:6059-6065. [PMID: 18286103 DOI: 10.1364/ao.37.006059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
comsis, which stands for communication systems interactive software, is a computer-aided-design tool based on a time approach. It allows the design, analysis, and performance optimization of optical transmission systems by use of various optical devices. comsis allows scalar or vectorial simulations, depending on whether the polarization is taken into account. An overview concerning the optical component models is given. A new model of an erbium-doped fiber amplifier allows the user to describe the amplifier through either physical or system parameters by using silicate or fluoride glass fibers or any other material, provided the user can give a file that contains the amplifier's characteristics. The new model of a single-mode fiber allows the user to describe chromatic dispersion through a constant, a function, or a file (given by the user) and to take optionally into account the Kerr and the Raman effects and the polarization-mode dispersion. The simulation tools that are used to characterize the quality of an optical transmission system are also presented. To show the system's full range of capabilities in the optical domain, we describe examples of wavelength-division-multiplexing and soliton-transmission systems.
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