Browsing by Author "Zarowsky, C"

Now showing 1 - 4 of 4
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    Commentary: Lessons from the COVID-19 global health response to inform TB case finding
    (Elsevier, 2021) Zarowsky, C; Oga-Omenka, C; Tseja-Akinrin, A
    The coronavirus disease 2019 (COVID-19) has emerged as a serious threat to global public health, demanding urgent action and causing unprecedented worldwide change in a short space of time. This disease has devastated economies, infringed on individual freedoms, and taken an unprecedented toll on healthcare systems worldwide. As of 1 April 2020, over a million cases of COVID-19 have been reported in 204 countries and territories, resulting in more than 51,000 deaths. Yet, against the backdrop of the COVID-19 pandemic, lies an older, insidious disease with a much greater mortality. Tuberculosis (TB) is the leading cause of death by a single infectious agent and remains a potent threat to millions of people around the world. We discuss the differences between the two pandemics at present, consider the potential impact of COVID-19 on TB case management, and explore the opportunities that the COVID-19 response presents for advancing TB prevention and control now and in future.
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    Integrating gestational diabetes and type 2 diabetes care into primary health care: Lessons from prevention of mother-to-child transmission of HIV in South Africa - A mixed methods study
    (Public Library of Science, 2021) Mutabazi, J C; Bonong, P R E; Trottier, H; Zarowsky, C
    Background Implementation of the programmes for the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) into antenatal care over the last three decades could inform implementation of interventions for other health challenges such as gestational diabetes mellitus (GDM). This study assessed PMTCT outcomes, and how GDM screening, care, and type 2 diabetes (T2DM) prevention were integrated into PMTCT in Western Cape (WC), South Africa. Methods A convergent mixed methods and triangulation design were used. Content and thematic analysis of PMTCT-related policy documents and of 30 semi-structured interviews with HIV/PMTCT experts, health care workers and women under PMTC diagnosed with GDM complement quantitative longitudinal analysis of PMTCT implementation indicators across the WC for 2012–2017. Results Provincial PMTCT and Post Natal Care (PNC) documents emphasized the importance of PMTCT, but GDM screening and T2DM prevention were not covered. Data on women with both HIV and GDM were not available and GDM screening was not integrated into PMTCT. Women who attended HIV counselling and testing annually increased at 17.8% (95% CI: 12.9% - 22.0%), while women who delivered under PMTCT increased at 3.1% (95% CI: 0.6% - 5.9%) annually in the WC. All 30 respondents favour integrating GDM screening and T2DM prevention initiatives into PMTCT. Conclusion PMTCT programmes have not yet integrated GDM care. However, Western Cape PMTCT integration experience suggests that antenatal GDM screening and post-partum initiatives for preventing or delaying T2DM can be successfully integrated into PMTCT and primary care
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    A qualitative meta-synthesis of facilitators and barriers to tuberculosis diagnosis and treatment in Nigeria
    (Springer Nature, 2021) Zarowsky, C; Oga-Omenka, C; Wakdet, L
    : Despite progress in tuberculosis (TB) control globally, TB continues to be a leading cause of death from infectious diseases, claiming 1.2 million lives in 2018; 214,000 of these deaths were due to drug resistant strains. Of the estimated 10 million cases globally in 2018, 24% were in Africa, with Nigeria and South Africa making up most of these numbers. Nigeria ranks 6th in the world for TB burden, with an estimated 4.3% multi-drug resistance in new cases. However, the country had one of the lowest case detection rates, estimated at 24% of incident cases in 2018 - well below the WHO STOP TB target of 84%. This rate highlights the need to understand contextual issues influencing tuberculosis management in Nigeria. Our synthesis was aimed at synthesizing qualitative evidence on factors influencing TB care in Nigeria.
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    Training community care workers to provide comprehensive TB⁄HIV⁄PMTCT integrated care in KwaZulu-Natal: Lessons learnt
    (Wiley, 2012) Uwimana, Jeannine; Zarowsky, C; Hausler, H
    To describe a participatory approach to implement and evaluate ways to integrate and traincommunity care workers (CCWs) to enhance collaborative TB⁄HIV⁄PMTCT activities, and home-basedHIV counseling and testing (HCT) at community level. The intervention study was conducted in Sisonke, a rural district of KwaZulu Natal, SouthAfrica. A baseline household (HH) survey was conducted in 11 villages. Six villages were randomlyselected into intervention and control clusters. Training was provided first to CCWs from the inter-vention cluster (IC) followed by the control cluster (CC). Routine monthly data from CCWs werecollected from March–December 2010. The data was subjected to bivariate tests.