Advanced searches left 3/3

South Africa - ClinicalTrials.gov

Summarized by Plex Scholar
Last Updated: 28 July 2022

* If you want to update the article please login/register

Home Link: Post Hospital Care to Reduce HIV Mortality in South Africa

Inpatient mortality in Africa is consistently high, from 17. 2 to 29. 6%, including in South Africa. There are approximately 84,633 public sector acute care hospital beds in South Africa, of which 25% are adult medicine beds. The annual mortality among PWH with a hospital discharge in the last six months can be estimated by extrapolating the post-discharge mortality investigators found to all discharges within PWH in South Africa investigators. About the national proportion of all admissions that are for PWH, the average length of stay, and the annual readmission rate, an estimated 240,000 PWH are admitted to South African medicine wards every year. In South Africa, a modest decline in post-hospital deaths could greatly reduce overall HIV mortality. Determine post-hospital health care out-of-pocket expenses for participants Determine the study's final goals Determined re-admission Estimate 12 months mortality by the study arm SIGNIFICANCE This report aligns with the South African National Strategic Plan to increase effective HIV care. Tshepong Hospital in Matlosana is a tertiary care facility. Tshepong Hospital: Tshepong Hospital Tshepong Hospital: Tshepong Hospital is a tertiary care center. Tshepong Hospital is one of five hospitals in Kenneth Kaunda District and the sole tertiary care public hospital in Matlosana, which is serving the population of 400,000 people. Tshepong Hospital now provides discharge services that include discharge consulting and education provided by counselors and a medical record notebook with a discharge summary for the patient to carry to his or her clinic visits. Investigators selected Tshepong Hospital based on a long-standing working relationship between the PI, the Perinatal HIV Research Unit, and the Tshepong Hospital, which resulted in the settling of study areas. Population Analysis (Population): Adults, male or female, who spent at least two nights in a medical ward of Tshepong Hospital, spent at least two nights in the study population. Investigators will only include people with confirmed HIV status, whether HIV-positive or HIV-negative. Participants will receive standard discharge services as provided at Tshepong Hospital during the investigation, according to the study's Care-as-usual study arm. Arms of the Home Link project: A primary care nurse and counselor with experience in patient-centered care will deliver the Home Link intervention. During a household visit, a rotating hospital-based doctor will be available for pre-home visit clinical file review and post-visit discussion, on cell phone, for decision making and feedback on patient care during a household visit. Through a 26 and 52 week review of the Tshepong Hospital file and matching of participant national identification numbers to the vital statistics registry, which will be further determined by consultation with the Department of Home Affairs, mortality will be determined. Clinic visit records will be confirmed by self-report and verification by means of analysis of clinic paper or electronic records, and National Health Laboratory Service electronic records based in clinics.

Source link: https://clinicaltrials.gov/ct2/show/NCT04436289


Traditional Healer-initiated HIV Counseling and Testing in South Africa

Patients in SSA are increasingly susceptible to poor health care services, resulting in patients rejecting or delaying allopathic health care services and/or seeking alternative health services. People who first visit a traditional healer for HIV-related illnesses before doing an HIV test are 2. 4 times longer in seeking health care than those who do not. Patients who are enrolled in HIV care and therapy are 15 percent less likely to enroll in antiretroviral therapy services than those who are not. Traditional healers have been successfully employed in health care to raise care linkage among people living with diabetes, TB, HIV, malaria, and mental disorders, many of whom did not believe in their allopathic diagnosis until a healer told them that their illness was not caused by a curse, not curses. Many that are reluctant to test need a trusted and culturally conscient nexor, as well as the same hospital's creation of a bridge to the allopathic health center, providing a metaphorical "safe space" for the patient as they transition to HIV care. Traditional healers are strongly encouraged to serve in this role for two reasons: Patient wellbeing outcomes are highly correlated with perceived quality of traditional healer care. As allopathic medical evidence is disseminated, healer viewpoints on disease causation are expanding to include the germ theory of disease.

Source link: https://clinicaltrials.gov/ct2/show/NCT05079347


A Couples-focused Intervention for HIV Prevention and Care in South Africa

South Africa remains one of the countries most heavily affected by the HIV epidemic, with an average adult HIV prevalence of 18% to 30% among female antenatal clinic attendees. Besides the low prevalence of HIV testing in South Africa, recent studies by Haber in KZN reveals significant gaps along the continuum of care: only 45% of HIV-positive individuals are connected to healthcare, 35% initiate ART, and 33% report viral suppression. Couples HIV testing and counseling is a tried and tested method to minimize the risk of HIV transmission between partners. However, CHTC is solely focused on the first stage of the cascade of HIV care - testing - in fact, there are no steps that require couples to pass through the cascade of care together.

Source link: https://clinicaltrials.gov/ct2/show/NCT05231707


The PrEPARE Project: Prevention, Empowering, and Protecting Young Women in South Africa

In South Africa, the researchers recommend a cluster controlled trial with a factorial approach to determine the effectiveness of a multi-level intervention that investigates stigma in accessing healthcare, social care, and individual risk behaviors of adolescent girls and young women. The initiative aims to raise the number of SRH services and PrEP readiness, uptake, and adherence among AGYW aged 16 to 24, which participate in high-risk sex. In the Pretoria area during a pre-formative phase, the study's aim was to involve stakeholders, the Community Collaborative Board, and the Youth Advisory Board in modifying the Women's Health CoOp and stigma and discrimination reduction curriculum. At a 4- and 8-month follow-up, we'll analyze the effect of training on S&D among healthcare professionals on the use of HIV and reproductive health products among adolescent girls and young women, including pre-exposure prophylaxis, and healthcare workers' attitudes and behaviors toward AGYW.

Source link: https://clinicaltrials.gov/ct2/show/NCT04048551


Finding Barriers and Designing Solutions to Promote Women s Cancer Screening in South Africa

Cervical cancer is a common cause of cancer death among South African women. Phase 3 Design Thinking will co-create an intervention package for cervical cancer screening and enhanced linkage between screening, diagnosis, and treatment will be developed.

Source link: https://clinicaltrials.gov/ct2/show/NCT05414097


Hybrid Effectiveness-Implementation Trial for ART Adherence and Substance Use in HIV Care in South Africa

South Africa's HIV epidemic is one of the world's largest. SA has a large antiretroviral therapy service, but some individuals exhibit poor ART adherence, which increases the risk of developing drug resistance and failing the only available first and second line ART regimens in SA. At the same time, HIV-infected individuals in SA are also vulnerable to increased ART adherence, reduced rates of viral suppression, and HIV transmission risk factors. Despite the impacts of untreated opioid use on poor HIV treatment outcomes and continued HIV transmission, HIV transmission continues to thrive, yet there is no evidence of harmonization and HIV care in SA, which has created a fragmented and incomplete system of care. This report is a Type 1 hybrid effectiveness-implementation trial of a lay counselor-delivered behavioral intervention for adherence and opioid use integrated into SA's HIV primary care setting.

Source link: https://clinicaltrials.gov/ct2/show/NCT03529409


Preferences for Services in a Patient's First Six Months on Antiretroviral Therapy for HIV in South Africa

With the introduction of universal coverage for HIV and same-day and community-based antiretroviral therapy, as well as one-day and community-based antiretroviral therapy, increasing patient retention in care after a patient has started ART remains the biggest obstacle to achieving optimal outcomes in HIV treatment services. One of the reasons for the high mortality from care in this early retention period is that the care provided to the majority of newly-initiating and re-initiating patients has barely changed from its original outline. Patients in the first six months on ART are usually not eligible for lower-intensity, patient-centered "differentiated service delivery" models that make staying in care less accessible for current patients. We will do an observational, prospective cohort survey of newly-initiated or re-initiated adult ART patients at a select group of 18 healthcare facilities in South Africa.

Source link: https://clinicaltrials.gov/ct2/show/NCT05454839


Leveraging Community-based Platforms to Improve Access and Adherence to PrEP for Young Women in South Africa

The HIV incidence among young women aged 15-24 in South Africa is four times higher than that of their male counterparts. In 15-24 year old young women in South Africa, 5-6% per year has been reported. Given the high incidence of HIV, implementing effective HIV prevention programs, including PrEP, is vital to combating HIV globally. The current study utilizes existing community-based HIV counseling and testing platforms in South Africa and evaluates, utilizing a mixed methods approach, a community-based PrEP adherence service for young women, and optimizing the PrEP cascade. Several barriers have been identified that delay or prevent young women from accessing clinic-based health care, especially reproductive health and HIV testing and prevention services. Hence, to reach young women at large scale with HIV prevention services, it is necessary to have delivery platforms outside of clinic-based clinics. The best coverage and potential to achieve high rates of HIV serostatus and HIV care have been found in community-based counseling and testing services. 1 Assess young women's uptake of PrEP when it was provided by large-scale community-based HIV testing and testing platforms in urban and rural settings in South Africa; 2 Evaluate the cost per young woman started on PrEP and delivered community-based solutions to encourage prevention-effective adherence to PrEP among young women, with community-based solutions; and 3 Evaluate the incidence of HIV infection averted.

Source link: https://clinicaltrials.gov/ct2/show/NCT03977181


Survey of Procedures and Resources for Initiating Treatment of HIV in Africa: The SPRINT Study in South Africa

The World Health Organisation's 2017 update to the global guidelines for HIV prevention and treatment called for accelerated or same-day implementation of antiretroviral therapy for eligible patients testing positive for HIV. Studies in sub-Saharan Africa, where most HIV patients are located, continue to show significant reductions of treatment-eligible patients from healthcare before they receive their first dose of antiretroviral drugs. Treatment initiation protocols that necessitate multiple clinic visits and long waiting times before a patient who tests positive for HIV is denied an initial supply of medications, according to facility-level reasons for these losses. From start to finish, the report by a retrospective cohort of patients eligible for ART will determine the actual number of clinic visits, services offered, and duration of the steps for treatment transition from start to finish.

Source link: https://clinicaltrials.gov/ct2/show/NCT04170374

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions