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Gomez HM, Haw TJ, Ilic D, Robinson P, Donovan C, Croft AJ, Vanka KS, Small E, Carroll OR, Kim RY, Mayall JR, Beyene T, Palanisami T, Ngo DTM, Zosky GR, Holliday EG, Jensen ME, McDonald VM, Murphy VE, Gibson PG, Horvat JC. Landscape fire smoke airway exposure impairs respiratory and cardiac function and worsens experimental asthma. J Allergy Clin Immunol 2024:S0091-6749(24)00272-0. [PMID: 38513838 DOI: 10.1016/j.jaci.2024.02.022] [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: 05/09/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Millions of people are exposed to landscape fire smoke (LFS) globally, and inhalation of LFS particulate matter (PM) is associated with poor respiratory and cardiovascular outcomes. However, how LFS affects respiratory and cardiovascular function is less well understood. OBJECTIVE We aimed to characterize the pathophysiologic effects of representative LFS airway exposure on respiratory and cardiac function and on asthma outcomes. METHODS LFS was generated using a customized combustion chamber. In 8-week-old female BALB/c mice, low (25 μg/m3, 24-hour equivalent) or moderate (100 μg/m3, 24-hour equivalent) concentrations of LFS PM (10 μm and below [PM10]) were administered daily for 3 (short-term) and 14 (long-term) days in the presence and absence of experimental asthma. Lung inflammation, gene expression, structural changes, and lung function were assessed. In 8-week-old male C57BL/6 mice, low concentrations of LFS PM10 were administered for 3 days. Cardiac function and gene expression were assessed. RESULTS Short- and long-term LFS PM10 airway exposure increased airway hyperresponsiveness and induced steroid insensitivity in experimental asthma, independent of significant changes in airway inflammation. Long-term LFS PM10 airway exposure also decreased gas diffusion. Short-term LFS PM10 airway exposure decreased cardiac function and expression of gene changes relating to oxidative stress and cardiovascular pathologies. CONCLUSIONS We characterized significant detrimental effects of physiologically relevant concentrations and durations of LFS PM10 airway exposure on lung and heart function. Our study provides a platform for assessment of mechanisms that underpin LFS PM10 airway exposure on respiratory and cardiovascular disease outcomes.
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Affiliation(s)
- Henry M Gomez
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Tatt J Haw
- Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; College of Health, Medicine, and Wellbeing, Centre of Excellence Newcastle Cardio-Oncology Research Group, University of Newcastle, Callaghan, Newcastle, Australia
| | - Dusan Ilic
- Newcastle Institute for Energy and Resources, University of Newcastle, Callaghan, Australia
| | - Peter Robinson
- Newcastle Institute for Energy and Resources, University of Newcastle, Callaghan, Australia
| | - Chantal Donovan
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia; School of Life Sciences, University of Technology Sydney, Faculty of Science, Sydney, Australia
| | - Amanda J Croft
- Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; College of Health, Medicine, and Wellbeing, Centre of Excellence Newcastle Cardio-Oncology Research Group, University of Newcastle, Callaghan, Newcastle, Australia
| | - Kanth S Vanka
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia; Newcastle Institute for Energy and Resources, University of Newcastle, Callaghan, Australia
| | - Ellen Small
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Olivia R Carroll
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Richard Y Kim
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia; School of Life Sciences, University of Technology Sydney, Faculty of Science, Sydney, Australia
| | - Jemma R Mayall
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Tesfalidet Beyene
- School of Medicine and Public Health, University of Newcastle and Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Thava Palanisami
- Global Innovative Centre for Advanced Nanomaterials, University of Newcastle, Callaghan, Australia
| | - Doan T M Ngo
- Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; College of Health, Medicine, and Wellbeing, Centre of Excellence Newcastle Cardio-Oncology Research Group, University of Newcastle, Callaghan, Newcastle, Australia
| | - Graeme R Zosky
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, Australia; College of Health and Medicine, Tasmanian School of Medicine, University of Tasmania, Hobart, Australia
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Megan E Jensen
- School of Medicine and Public Health, University of Newcastle and Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Vanessa M McDonald
- School of Medicine and Public Health, University of Newcastle and Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Vanessa E Murphy
- School of Medicine and Public Health, University of Newcastle and Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Peter G Gibson
- School of Medicine and Public Health, University of Newcastle and Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, Australia
| | - Jay C Horvat
- School of Biomedical Sciences and Pharmacy, University of Newcastle and Immune Health Program, Hunter Medical Research Institute, Newcastle, Australia.
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2
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Beyene T, Gibson PG, Murphy VE, Jensen ME, McDonald VM. Personal strategies to reduce the effects of landscape fire smoke on asthma-related outcomes: a protocol for systematic review and meta-analysis. BMJ Open 2024; 14:e069516. [PMID: 38331860 PMCID: PMC10860097 DOI: 10.1136/bmjopen-2022-069516] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/18/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Landscape fire smoke (LFS) contains several hazardous air pollutants that are known to be detrimental to human health. People with asthma are more vulnerable to the health impact of LFS than general populations. The aim of this review is to investigate the effectiveness of personal strategies to reduce the effect of LFS on asthma-related outcomes. METHODS AND ANALYSIS We will electronically search databases such as Medline, Embase, CINAHL and Cochrane Clinical Trials Register to identify eligible articles for the review. Screening of search results and data extraction from included studies will be completed by two independent reviewers. The risk of bias (RoB 2) will be assessed using the Risk of Bias Assessment Tool for Non-Randomised Studies for observational studies, the Cochrane Collaboration tool for assessing the RoB 2 for randomised controlled trials (RCTs) and the Risk Of Bias In Nonrandomized Studies of Interventions tool for non-RCTs. A random-effect meta-analysis will be performed to determine the pooled summary of findings of the included studies. If meta-analysis is not possible, we will conduct a narrative synthesis. Findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. ETHICS AND DISSEMINATION This study will synthesise the available evidence obtained from published studies and as such, no ethical approval is required. The review will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42022341120.
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Affiliation(s)
- Tesfalidet Beyene
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Peter G Gibson
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - V E Murphy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Megan E Jensen
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Vanessa M McDonald
- Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia
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McDonald VM, Archbold G, Beyene T, Brew BK, Franklin P, Gibson PG, Harrington J, Hansbro PM, Johnston FH, Robinson PD, Sutherland M, Yates D, Zosky GR, Abramson MJ. Asthma and landscape fire smoke: A Thoracic Society of Australia and New Zealand position statement. Respirology 2023; 28:1023-1035. [PMID: 37712340 PMCID: PMC10946536 DOI: 10.1111/resp.14593] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 07/14/2023] [Indexed: 09/16/2023]
Abstract
Landscape fires are increasing in frequency and severity globally. In Australia, extreme bushfires cause a large and increasing health and socioeconomic burden for communities and governments. People with asthma are particularly vulnerable to the effects of landscape fire smoke (LFS) exposure. Here, we present a position statement from the Thoracic Society of Australia and New Zealand. Within this statement we provide a review of the impact of LFS on adults and children with asthma, highlighting the greater impact of LFS on vulnerable groups, particularly older people, pregnant women and Aboriginal and Torres Strait Islander peoples. We also highlight the development of asthma on the background of risk factors (smoking, occupation and atopy). Within this document we present advice for asthma management, smoke mitigation strategies and access to air quality information, that should be implemented during periods of LFS. We promote clinician awareness, and the implementation of public health messaging and preparation, especially for people with asthma.
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Affiliation(s)
- Vanessa M. McDonald
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - Gregory Archbold
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
| | - Tesfalidet Beyene
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
| | - Bronwyn K. Brew
- National Perinatal Epidemiology and Biostatistics Unit, Centre for Big Data Research in Health, Discipline of Women's Health, Faculty of MedicineUNSWSydneyNew South WalesAustralia
| | - Peter Franklin
- School of Population and Global HealthThe University of Western AustraliaPerthWestern AustraliaAustralia
| | - Peter G. Gibson
- College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - John Harrington
- Asthma and Breathing Research ProgramThe Hunter Medical Research Institute (HMRI)New LambtonNew South WalesAustralia
- Department of Sleep and Respiratory MedicineHunter New England Local Health DistrictNewcastleNew South WalesAustralia
| | - Philip M. Hansbro
- Centre for InflammationCentenary Institute and University of Technology Sydney, School of Life Sciences, Faculty of ScienceSydneyNew South WalesAustralia
- Immune HealthHunter Medical Research Institute and The University of NewcastleCallaghanNew South WalesAustralia
| | - Fay H. Johnston
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
| | - Paul D. Robinson
- Department of Respiratory and Sleep MedicineQueensland Children's HospitalBrisbaneQueenslandAustralia
- Children's Health and Environment Program, Child Health Research CentreUniversity of QueenslandBrisbaneQueenslandAustralia
| | | | - Deborah Yates
- Department of Thoracic MedicineSt Vincent's HospitalDarlinghurstNew South WalesAustralia
- School of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Graeme R. Zosky
- Menzies Institute for Medical ResearchUniversity of TasmaniaHobartTasmaniaAustralia
- Tasmanian School of MedicineUniversity of TasmaniaHobartTasmaniaAustralia
| | - Michael J. Abramson
- School of Public Health & Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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Vertigan AE, Harvey ES, Beyene T, Van Buskirk J, Holliday EG, Bone SL, McDonald VM, Horvat JC, Murphy VE, Jensen ME, Morgan GG, Zosky GR, Peters M, Farah CS, Jenkins CR, Katelaris CH, Harrington J, Langton D, Bardin P, Katsoulotos GP, Upham JW, Chien J, Bowden JJ, Rimmer J, Bell R, Gibson PG. Impact of Landscape Fire Smoke Exposure on Patients With Asthma With or Without Laryngeal Hypersensitivity. J Allergy Clin Immunol Pract 2023; 11:3107-3115.e2. [PMID: 37329954 DOI: 10.1016/j.jaip.2023.06.015] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Individuals with asthma experienced severe and prolonged symptoms after the Australian 2019 to 2020 landscape fire. Many of these symptoms, such as throat irritation, occur in the upper airway. This suggests that laryngeal hypersensitivity contributes to persistent symptoms after smoke exposure. OBJECTIVE This study examined the relationship between laryngeal hypersensitivity and symptoms, asthma control, and health impacts on individuals exposed to landscape fire smoke. METHOD The study was a cross-sectional survey of 240 participants in asthma registries who were exposed to smoke during the 2019 to 2020 Australian fire. The survey, completed between March and May 2020, included questions about symptoms, asthma control, and health care use, as well as the Laryngeal Hypersensitivity Questionnaire. Daily concentration levels of particulate matter less than or equal to 2.5 μm in diameter were measured over the 152-day study period. RESULTS The 49 participants with laryngeal hypersensitivity (20%) had significantly more asthma symptoms (96% vs 79%; P = .003), cough (78% vs 22%; P < .001), and throat irritation (71% vs 38%; P < .001) during the fire period compared with those without laryngeal hypersensitivity. Participants with laryngeal hypersensitivity had greater health care use (P ≤ .02), more time off work (P = .004), and a reduced capacity to participate in usual activities (P < .001) during the fire period, as well as poorer asthma control during the follow-up (P = .001). CONCLUSIONS Laryngeal hypersensitivity is associated with persistent symptoms, reports of lower asthma control, and increased health care use in adults with asthma who were exposed to landscape fire smoke. Management of laryngeal hypersensitivity before, during, or immediately after landscape fire smoke exposure might reduce the symptom burden and health impact.
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Affiliation(s)
- Anne E Vertigan
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Speech Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia.
| | - Erin S Harvey
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Tesfalidet Beyene
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Joseph Van Buskirk
- Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Sarah L Bone
- Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Speech Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Vanessa M McDonald
- Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia; School of Nursing and Midwifery, University of Newcastle, Newcastle, New South Wales, Australia
| | - Jay C Horvat
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
| | - Vanessa E Murphy
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Megan E Jensen
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Geoffrey G Morgan
- Sydney School of Public Health and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Graeme R Zosky
- Tasmanian School of Medicine, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Matthew Peters
- Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia
| | - Claude S Farah
- Concord Clinical School, University of Sydney, Concord, New South Wales, Australia
| | - Christine R Jenkins
- Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia; Concord Clinical School, University of Sydney, Concord, New South Wales, Australia
| | - Constance H Katelaris
- School of Medicine, Western Sydney University, and Campbelltown Hospital, Campbelltown, New South Wales, Australia
| | - John Harrington
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - David Langton
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria, Australia; Department of Thoracic Medicine, Frankston Hospital, Frankston, Melbourne, Victoria, Australia
| | - Philip Bardin
- Lung and Sleep Medicine, Monash University and Medical Centre, Clayton, Melbourne, Victoria, Australia
| | - Gregory P Katsoulotos
- St George Specialist Centre, Kogarah, Southern Sydney, New South Wales, Australia; St George and Sutherland Clinical School, University of New South Wales, Kogarah, Southern Sydney, New South Wales, Australia; Woolcock Institute of Medical Research, Glebe, Sydney, New South Wales, Australia
| | - John W Upham
- Department of Respiratory Medicine, Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; University of Queensland Frazer Institute, Woolloongabba, Brisbane, Queensland, Australia
| | - Jimmy Chien
- Department of Respiratory and Sleep Medicine, Westmead Hospital, Westmead, Sydney, New South Wales, Australia; School of Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Jeffrey J Bowden
- Respiratory and Sleep Services, Flinders Medical Centre and Flinders University, Bedford Park, Adelaide, South Australia
| | - Janet Rimmer
- Woolcock Institute of Medical Research, Glebe, Sydney, New South Wales, Australia; St Vincent's Clinic, Darlinghurst, Sydney, New South Wales, Australia
| | - Rose Bell
- Asthma Australia, Melbourne, New South Wales, Australia
| | - Peter G Gibson
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia; Asthma and Breathing Research Centre, Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
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5
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Beyene T, Zosky GR, Gibson PG, McDonald VM, Holliday EG, Horvat JC, Vertigan AE, Van Buskirk J, Morgan GG, Jegasothy E, Hanigan I, Murphy VE, Jensen ME. The impact of the 2019/2020 Australian landscape fires on infant feeding and contaminants in breast milk in women with asthma. Int Breastfeed J 2023; 18:13. [PMID: 36823615 PMCID: PMC9947434 DOI: 10.1186/s13006-023-00550-8] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The 2019/2020 Australian landscape fires (bushfires) resulted in prolonged extreme air pollution; little is known about the effects on breastfeeding women and their infants. This study aimed to examine the impact of prolonged landscape fires on infant feeding methods and assess the concentration of polycyclic aromatic hydrocarbons (PAHs) and elements in breast milk samples. METHODS From May - December 2020, women with asthma, who were feeding their infants during the fires, were recruited from an existing cohort. Data on infant feeding and maternal concern during the fires were retrospectively collected. Breast milk samples were collected from a sample of women during the fire period and compared with samples collected outside of the fire period for levels of 16 PAHs (gas chromatography coupled with mass spectrometry), and 20 elements (inductively coupled plasma-mass spectrometry). RESULTS One-hundred-and-two women who were feeding infants completed the survey, and 77 provided 92 breast milk samples. Two women reported concern about the impact of fire events on their infant feeding method, while four reported the events influenced their decision. PAHs were detected in 34% of samples collected during, versus no samples collected outside, the fire period (cross-sectional analysis); specifically, fluoranthene (median concentration 0.015 mg/kg) and pyrene (median concentration 0.008 mg/kg) were detected. Women whose samples contained fluoranthene and pyrene were exposed to higher levels of fire-related fine particulate matter and more fire days, versus women whose samples had no detectable fluoranthene and pyrene. Calcium, potassium, magnesium, sodium, sulphur, and copper were detected in all samples. No samples contained chromium, lead, nickel, barium, or aluminium. No statistically significant difference was observed in the concentration of elements between samples collected during the fire period versus outside the fire period. CONCLUSIONS Few women had concerns about the impact of fire events on infant feeding. Detection of fluoranthene and pyrene in breast milk samples was more likely during the 2019/2020 Australian fire period; however, levels detected were much lower than levels expected to be related to adverse health outcomes.
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Affiliation(s)
- Tesfalidet Beyene
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia. .,Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
| | - Graeme R. Zosky
- grid.1009.80000 0004 1936 826XMenzies Institute for Medical Research, University of Tasmania, Hobart, TAS Australia ,grid.1009.80000 0004 1936 826XTasmanian School of Medicine, University of Tasmania, Hobart, TAS Australia
| | - Peter G. Gibson
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia ,grid.413648.cAsthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW Australia ,grid.414724.00000 0004 0577 6676Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW Australia
| | - Vanessa M. McDonald
- grid.413648.cAsthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW Australia ,grid.414724.00000 0004 0577 6676Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW Australia ,grid.266842.c0000 0000 8831 109XSchool of Nursing and Midwifery, University of Newcastle, Newcastle, NSW Australia
| | - Elizabeth G. Holliday
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Jay C. Horvat
- grid.266842.c0000 0000 8831 109XSchool of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW Australia
| | - Anne E. Vertigan
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia ,grid.413648.cAsthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW Australia ,grid.414724.00000 0004 0577 6676Department of Speech Pathology, John Hunter Hospital, Newcastle, NSW Australia
| | - Joe Van Buskirk
- grid.1013.30000 0004 1936 834XSydney School of Public Health, and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Geoffrey G. Morgan
- grid.1013.30000 0004 1936 834XSydney School of Public Health, and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Edward Jegasothy
- grid.1013.30000 0004 1936 834XSydney School of Public Health, and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Ivan Hanigan
- grid.1013.30000 0004 1936 834XSydney School of Public Health, and University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - Vanessa E. Murphy
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia ,grid.413648.cAsthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW Australia
| | - Megan E. Jensen
- grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia ,grid.413648.cAsthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, NSW Australia
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6
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Geleto A, Taylor J, Beyene T. Interruptions in contraception and unintended pregnancy during the COVID-19 pandemic: A protocol for systematic review and meta-analysis. Womens Health (Lond) 2023; 19:17455057221147382. [PMID: 36633116 PMCID: PMC9845071 DOI: 10.1177/17455057221147382] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted access to and use of maternal, newborn, and child health services. Due to lockdowns and travel restrictions implemented during the first wave of the pandemic, the provision of essential maternal health services such as family planning was critically affected. Unlike most healthcare, contraception-related services are impractical for virtual care provision as women need to attend the clinic in person. Therefore, most women across the world might have been left with an unmet need for contraception during the lockdown period. Interruptions in contraception services have led to an increased number of unintended pregnancies. With the emergence of several pocket studies, it is essential to pool the available evidence reporting the effects of COVID-19 on contraception to inform maternal health policy and practice. OBJECTIVE The aims of this review are (1) to determine the effects of the COVID-19 pandemic on access to contraceptives among sexually active women and (2) to identify the magnitude of unintended pregnancy linked to interruptions of contraceptives due to the COVID-19 pandemic. METHODS The protocol for this systematic review was registered in PROSPERO (CRD42021267077). Electronic databases such as MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, and Google Scholar will be searched for articles using appropriate key terms. The identified articles will be assessed against the eligibility criteria. Two reviewers (A.B. and T.B.) will independently screen titles and abstracts of all retrieved articles followed by a full-text review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. The quality of the papers will be assessed by using the Risk of Bias Assessment tool for Non-Randomized Studies. Quantitative findings will be pooled using a random-effects model meta-analysis, while qualitative findings will be presented using a narrative synthesis. ETHICS AND DISSEMINATION Ethical approval is not required. The findings will be disseminated through conference presentations and peer-reviewed publications. DISCUSSION This systematic review will present current data needed to design evidence-based programmes for improving access to contraception and preventing unintended pregnancy during the COVID-19 pandemic and future emergencies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021267077.
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Affiliation(s)
- Ayele Geleto
- School of Public Health, College of
Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Ayele Geleto, School of Public Health,
College of Health and Medical Sciences, Haramaya University, 4/91 Russell Road,
New Lambton, 2305, NSW, Australia.
| | - Jo Taylor
- College of Health, Medicine and
Well-Being, The University of Newcastle, Newcastle, NSW, Australia
| | - Tesfalidet Beyene
- College of Health, Medicine and
Well-Being, The University of Newcastle, Newcastle, NSW, Australia
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7
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Da Silva Sena CR, Lines O, Latheef MS, Amarasinghe GG, Quah WH, Beyene T, Van Buskirk J, Hanigan I, Morgan G, Oldmeadow C, Gibson PG, Murphy VE, de Waal K, Karmaus W, Platt L, Pearce K, Collison AM, Mattes J. Reduction in forced vital capacity in asthmatic children on days with bushfire smoke exposure in the Australian 2019/2020 bushfire. Pediatr Allergy Immunol 2022; 33:e13872. [PMID: 36433857 PMCID: PMC9827841 DOI: 10.1111/pai.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Carla Rebeca Da Silva Sena
- Priority Research Centre GrowUpWell, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Olivia Lines
- University of NewcastleNewcastleNew South WalesAustralia
| | | | | | - Wei Han Quah
- University of NewcastleNewcastleNew South WalesAustralia
| | - Tesfalidet Beyene
- Priority Research Centre Healthy Lungs, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Joseph Van Buskirk
- Sydney School of Public Health, and University Centre for Rural HealthThe University of SydneySydneyNew South WalesAustralia
| | - Ivan Hanigan
- Sydney School of Public Health, and University Centre for Rural HealthThe University of SydneySydneyNew South WalesAustralia
| | - Geoffrey Morgan
- Sydney School of Public Health, and University Centre for Rural HealthThe University of SydneySydneyNew South WalesAustralia
| | | | - Peter G. Gibson
- Priority Research Centre Healthy Lungs, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
- John Hunter Hospital and John Hunter Children's HospitalNewcastleNew South WalesAustralia
| | - Vanessa E. Murphy
- Priority Research Centre GrowUpWell, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
- Priority Research Centre Healthy Lungs, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Koert de Waal
- University of NewcastleNewcastleNew South WalesAustralia
- John Hunter Hospital and John Hunter Children's HospitalNewcastleNew South WalesAustralia
| | | | - Lauren Platt
- John Hunter Hospital and John Hunter Children's HospitalNewcastleNew South WalesAustralia
| | - Kasey Pearce
- John Hunter Hospital and John Hunter Children's HospitalNewcastleNew South WalesAustralia
| | - Adam M. Collison
- Priority Research Centre GrowUpWell, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Joerg Mattes
- Priority Research Centre GrowUpWell, Hunter Medical Research InstituteUniversity of NewcastleNewcastleNew South WalesAustralia
- John Hunter Hospital and John Hunter Children's HospitalNewcastleNew South WalesAustralia
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Beyene T, Melka AS, Yadecha B. Determinants of postnatal care service utilization among married women in rural areas in western Ethiopia. J Health Popul Nutr 2022; 41:38. [PMID: 35986357 PMCID: PMC9392263 DOI: 10.1186/s41043-022-00320-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background Worldwide studies have shown that three-fourths of the total deaths during the neonatal period occur in the first week of the postnatal period. However, most of these deaths can be prevented with care during pregnancy, childbirth, and postnatal care. According to the 2016 Ethiopia Demographic and Health Survey report, 17% of women in Ethiopia had received postnatal care after childbirth. This study aimed to identify determinants of postnatal care service utilization among married women in rural areas in Western Ethiopia. Methods A community-based cross-sectional study was conducted among 798 women who had given birth in the past 2 years prior to the survey between 2 and 31 January 2015. A pre-tested structured questionnaire was used to collect the data. Multivariable logistic regression was employed to determine factors affecting utilization of postnatal care. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were used to assess the strength of the associations. Results The study showed that 188 (23.6%) women utilized postnatal care services during their last pregnancy. Women’s educational level (AOR = 3.29, 95%CI = 1.89–5.73), utilization of antenatal care (AOR = 2.07, 95%CI = 1.28–3.36), awareness on the advantage of postnatal care (AOR = 2.10, 95%CI = 1.41–3.13), and knowledge of at least one danger sign during the postnatal period (AOR = 3.04, 95%CI = 2.07–4.46) showed a significant positive association with the utilization of postnatal care. Conclusion Educating women and creating awareness of maternal health care services during pregnancy increase the utilization of postnatal care services. Health care professionals should provide information on the importance of postnatal care for pregnant women during antenatal care visits.
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9
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Beyene T, Chojenta C, Smith R, Loxton D. Severe Maternal Outcomes and Quality of Maternal Health Care in South Ethiopia. Int J Womens Health 2022; 14:119-130. [PMID: 35140528 PMCID: PMC8820457 DOI: 10.2147/ijwh.s341912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/29/2021] [Accepted: 01/19/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To assess the incidence of severe maternal outcomes (SMO) and quality of maternal health care in south Ethiopia. Methods A facility-based prospective study was conducted in three hospitals among all women who presented while pregnant, during and after childbirth between 12 July and 26 November 2018. Participants were followed from the time of admission to discharge. The World Health Organization (WHO) maternal near-miss (MNM) approach was used to assess SMO indicators and quality of maternal health care. Results Of 2880 live births, 315 had potentially life-threatening conditions and 108 had SMOs (90 MNM and 18 maternal deaths). The SMO incidence ratio was 37.5 per 1000 live births (95% CI 30.6–44.4) and MNM incidence ratio was 31.3 per 1000 live births (95% CI 24.9–37.7). The ratio of near-miss to maternal deaths was 5:1. The hospitals’ maternal mortality ratio (MMR) was 625 per 100,000 live births. Most (82.1%) SMO cases were referred from other health facilities. The most common cause of SMO was eclampsia (37%) followed by postpartum haemorrhage (33.3%). The highest mortality index (MI) was among women with sepsis (27.3%). The intensive care unit (ICU) admission rate was 13% for women with SMO and 83.3% of maternal deaths occurred without ICU admission. Conclusion The SMO ratio was comparable to other studies in the country. Most women with SMO were referred from other health facilities, which demonstrate the presence of the first delay (seeking care) and/or the second delay (reaching care) in the study area. The study suggests that effectively using the ICU, reducing delays, and improving the referral system may reduce SMO and improve the quality of care in the hospitals. Furthermore, continuous reviewing of SMO is needed to learn what treatment was given to women who experienced complications in the hospitals.
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Affiliation(s)
- Tesfalidet Beyene
- Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia.,College of Medicine and Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia
| | - Catherine Chojenta
- Centre for Women's Health Research, University of Newcastle, Newcastle, NSW, Australia
| | - Roger Smith
- The Mothers and Babies Research Centre at the Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, University of Newcastle, Newcastle, NSW, Australia
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10
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Beyene T, Chojenta C, Smith R, Loxton D. The utility of delivery ward register data for determining the causes of perinatal mortality in one specialized and one general hospital in south Ethiopia. BMC Pediatr 2022; 22:6. [PMID: 34980034 PMCID: PMC8721979 DOI: 10.1186/s12887-021-03058-4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, the burden of perinatal mortality is high. Reliable measures of perinatal mortality are necessary for planning and assessing prenatal, obstetric, and newborn care services. However, accurate record-keeping is often a major challenge in low resource settings. In this study we aimed to assess the utility of delivery ward register data, captured at birth by healthcare providers, to determine causes of perinatal mortality in one specialized and one general hospital in south Ethiopia. Methods Three years (2014–2016) of delivery register for 13,236 births were reviewed from July 12 to September 29, 2018, in two selected hospitals in south Ethiopia. Data were collected using a structured pretested data extraction form. Descriptive statistics assessed early neonatal mortality rate, stillbirth rate, perinatal mortality rate and causes of neonatal deaths. Factors associated with early neonatal deaths and stillbirths were examined using logistic regression. The adjusted odds ratios with a 95% confidence interval were reported to show the strength of the association. Result The perinatal mortality ratio declined from 96.6 to 75.5 per 1000 births during the three-year study period. Early neonatal mortality and stillbirth rates were 29.3 per 1000 live births and 55.2 per 1000 total births, respectively. The leading causes of neonatal death were prematurity 47.5%, and asphyxia 20.7%. The cause of death for 15.6% of newborns was not recorded in the delivery registers. Similarly, the cause of neonatal morbidity was not recorded in 1.5% of the delivery registers. Treatment given for 94.5% of neonates were blank in the delivery registers, so it is unknown if the neonates received treatment or not. Factors associated with increased early neonatal deaths were maternal deaths and complications, vaginal births, APGAR scores less than 7 at five minutes and low birth weight (2500 g). Maternal deaths and complications and vaginal births were associated with increased stillbirths. Conclusion Our findings show that an opportunity exists to identify perinatal death and newborn outcomes from the delivery ward registers, but some important neonatal outcomes were not recorded/missing. Efforts towards improving the medical record systems are needed. Furthermore, there is a need to improve maternal health during pregnancy and birth, especially neonatal care for those neonates who experienced low APGAR scores and birth weight to reduce the prevalence of perinatal deaths. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-03058-4.
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Affiliation(s)
- Tesfalidet Beyene
- Priority Research Center for Healthy Lungs, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia. .,Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW, 2305, Australia.
| | - Catherine Chojenta
- Centre for Women's Health Research, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Roger Smith
- The Mothers and Babies Research Centre at the Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, Australia
| | - Deborah Loxton
- Centre for Women's Health Research, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
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11
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Beyene T, Akibu M, Bekele H, Seyoum W. Risk factors for precancerous cervical lesion among women screened for cervical cancer in south Ethiopia: Unmatched case-control study. PLoS One 2021; 16:e0254663. [PMID: 34265004 PMCID: PMC8282005 DOI: 10.1371/journal.pone.0254663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
Background Nearly 90% of deaths from cervical cancer occur in a low resource setting. In Ethiopia, the magnitude of precancerous cervical lesions ranges from 7% to 28%. Precancerous cervical lesions may progress to cervical cancer. Early screening and treatment of precancerous cervical lesions is a cost-effective way to avert the growth of cervical cancer. However, there has been limited research on risk factors for precancerous cervical lesions in Ethiopia. Therefore, this study aimed to identify risk factors for precancerous cervical lesions among women screened for cervical cancer in south Ethiopia. Method A facility-based unmatched case-control study was carried out in five health facilities in south Ethiopia between 8 May to 28 September 2018. Interviewer administered questionnaires were used to collect data from 98 cases and 197 controls. Multivariate logistic regression was employed to identify determinants of precancerous cervical lesions. Results Women aged 30–39 years (AOR = 2.51, 95% CI: 1.03–6.08), monthly income ≤66 (AOR = 3.51, 95% CI: 1.77–6.97), initiation of first sexual intercourse at age less than or equal to 20 (AOR = 2.39, 95% CI: 1.14–5.47), having more than one lifetime sexual partner (AOR = 4.70, 95% CI: 2.02–10.95), having a partner/ husband with more than one lifetime sexual partner (AOR = 2.98, 95% CI: 1.35–6.65) had higher odds of precancerous cervical lesions. Conclusion and recommendation Strategies to prevent precancerous cervical lesions should focus on modification of lifestyle and sexual behaviour. The findings of this study highlight several implications for policymakers: targeting older women for cervical cancer screening, addressing inequalities and education relating to risky sexual behaviour may reduce precancerous cervical lesions. Furthermore, future longitudinal studies are needed to assess the awareness of women about cervical cancer screening.
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Affiliation(s)
- Tesfalidet Beyene
- College of Medical and Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia
- Postdoctoral Research Fellow, University of Newcastle, Callaghan, Australia
- * E-mail: ,
| | - Mohammed Akibu
- Department of Midwifery, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Birhan, Ethiopia
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12
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Simon KR, Hartig M, Abrams EJ, Wetzel E, Ahmed S, Chester E, Chembezi C, Chavula B, Zinkanda S, Kavuta E, Chikoti C, Beyene T, Nkhono Z, Kabwinja A, Nyirenda R, Kazembe PN, Kim MH. The Tingathe Surge: a multi-strategy approach to accelerate HIV case finding in Malawi. Public Health Action 2019; 9:128-134. [PMID: 31803585 DOI: 10.5588/pha.18.0099] [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: 12/07/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
Setting Nineteen health facilities in rural, southeastern Malawi. Objective To describe the implementation and results of a 6-week intervention to accelerate human immunodeficiency virus (HIV) case finding. Design Six HIV testing strategies were simultaneously implemented. Routinely collected data from Ministry of Health registers were used to determine the number of HIV tests performed and of new cases identified. The weekly averages of the total number of tests and new cases before and during the intervention were compared. Testing by age group and sex was described. The percentage yield of new cases was compared by testing strategy. Results Of 29 703 HIV tests conducted, 1106 (3.7%) were positive. Of the total number of persons tested, 69.5% were women and 75.5% were aged >15 years. The yield of positive test results was 3.5% among women, 4.3% among men, 4.4% among those aged >15 years and 1.5% among those aged ⩽15 years. The average weekly number of tests increased 106.7% from 3337 to 6896 (P = 0.002). The average weekly number of positive cases identified increased 51.9% from 158 to 240 (P = 0.017). The testing strategy with the highest yield resulted in a 6.0% yield; the lowest was 1.3%. The yield for all strategies, except one, was highest in adult men. Conclusion A multi-strategy approach to HIV testing and counseling can be an effective means of accelerating HIV case finding.
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Affiliation(s)
- K R Simon
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - M Hartig
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - E J Abrams
- ICAP at Columbia University, Mailman School of Public Health, and Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - E Wetzel
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - S Ahmed
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - E Chester
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - C Chembezi
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - B Chavula
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - S Zinkanda
- Malawi Ministry of Health, Lilongwe, Malawi
| | - E Kavuta
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - C Chikoti
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - T Beyene
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - Z Nkhono
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - A Kabwinja
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi
| | - R Nyirenda
- Malawi Ministry of Health, Lilongwe, Malawi
| | - P N Kazembe
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
| | - M H Kim
- Baylor College of Medicine Children's Foundation Malawi, Lilongwe, Malawi.,Baylor College of Medicine International Pediatric AIDS Initiative, Houston, TX, USA
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Getachew T, Addis F, Beyene T, Mehretie S, Admassie S. Amino-substituted naphthalene sulfonic acid/graphene composite as metal -free catalysts for oxygen reduction reactions. B CHEM SOC ETHIOPIA 2019. [DOI: 10.4314/bcse.v33i2.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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14
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Mwinjiwa E, Isaakidis P, Van den Bergh R, Harries AD, Bezanson KD, Beyene T, Thompson C, Joshua M, Akello H, van Lettow M. Burden, characteristics, management and outcomes of HIV-infected patients with Kaposi's sarcoma in Zomba, Malawi. Public Health Action 2015; 3:180-5. [PMID: 26393024 DOI: 10.5588/pha.13.0003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 01/07/2013] [Accepted: 04/14/2013] [Indexed: 01/22/2023] Open
Abstract
SETTING Antiretroviral treatment (ART) clinic at Zomba Central Hospital, Malawi. DESIGN Retrospective analysis of records (2004-2011) of human immunodeficiency virus (HIV) infected patients with Kaposi's sarcoma (KS). OBJECTIVES To determine the number and characteristics of HIV-infected adult patients with KS on ART and vincristine (VCR) therapy and their treatment outcomes. RESULTS A total of 545 HIV-infected patients with KS (58% male, median age 33 years) were included in the study. The baseline median CD4 count was 180 cells/µl (interquartile range 111-287). Cumulative outcomes were as follows: 168 (31%) were still alive, 133 (24%) had died, 172 (32%) were lost to follow-up and 71 (13%) had transferred out; 229 had received at least one course of VCR, 171 had received less than one full course and 145 had not received VCR. The survival probability for 229 patients who received at least one course of VCR was 65% at 1 year, 42% at 2 years and 13% by 6 years. Patients who started VCR therapy before or concurrently with ART had a higher risk of death and generally a higher risk of death and loss to follow-up than those who started VCR after ART. CONCLUSION Poor outcomes were noted in HIV-infected patients with KS in a programme setting in Malawi. Other treatment interventions, including combination and/or second-line chemotherapy and earlier ART initiation, are needed to reduce morbidity and mortality.
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Affiliation(s)
| | - P Isaakidis
- Operational Centre Brussels, Operational Research Unit, Médecins Sans Frontières-Brussels, Brussels, Belgium
| | - R Van den Bergh
- Operational Centre Brussels, Operational Research Unit, Médecins Sans Frontières-Brussels, Brussels, Belgium
| | - A D Harries
- Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK ; International Union Against Tuberculosis and Lung Disease, Paris, France
| | - K D Bezanson
- Dignitas International, Zomba, Malawi ; Temmy Latner Centre for Palliative Care, Mount Sinai Hospital, Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - T Beyene
- Dignitas International, Zomba, Malawi
| | - C Thompson
- School of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - M Joshua
- Ministry of Health, Zomba Central Hospital, Zomba, Malawi
| | - H Akello
- Dignitas International, Zomba, Malawi
| | - M van Lettow
- Dignitas International, Zomba, Malawi ; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Tesgaye F, Defar A, Beyene T, Shafi O, Klinkenberg E, Howe R. Documentation and treatment outcomes of smear-negative and extra-pulmonary tuberculosis in Ethiopia. Public Health Action 2014; 4:S25-30. [PMID: 26478510 PMCID: PMC4542071 DOI: 10.5588/pha.14.0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 05/24/2014] [Accepted: 07/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smear-negative and extra-pulmonary tuberculosis (TB) comprise two thirds of TB cases reported in Ethiopia. Neither treatment outcomes nor underlying associated factors are routinely reported for these cases. OBJECTIVE To assess treatment outcomes and associated risk factors of smear-negative and extra-pulmonary TB in comparison with smear-positive cases. DESIGN Record review of all TB cases registered in 14 randomly selected public and private health facilities in Addis Ababa, Ethiopia, over a 1-year period. RESULTS Percentages of smear-negative and extra-pulmonary TB were independent of human immunodeficiency virus (HIV) status, and were not evenly distributed among health facilities. Extra-pulmonary TB was overrepresented in the private sector, and smear-negative TB was more frequent in health clinics than in hospitals. Outcomes reported by clinics were more favourable than those of the hospitals; no differences were observed when comparing public and private health facilities. Only 54% of the TB registers were complete; missing information correlated with unfavourable outcomes. Younger age, but not sex or HIV status, was associated with favourable outcomes. CONCLUSION The uneven distribution of smear-negative and extra-pulmonary TB among different health facilities requires further study and may provide important insight into diagnosis and care of these patients. Incomplete TB register information may be an underappreciated factor contributing to unfavourable outcomes.
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Affiliation(s)
- F. Tesgaye
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - A. Defar
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - T. Beyene
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - O. Shafi
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - E. Klinkenberg
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
- Department of Global Health, Academic Medical Centre, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - R. Howe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
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