DEVELOPMENT AND REPRODUCIBILITY OF THE INSTRUMENTO DE AVALIAÇÃO DA PROMOÇÃO DA SAÚDE NA UNIVERSIDADE - IAPSU (ASSESSMENT TOOL FOR HEALTH PROMOTION AT THE UNIVERSITY)

Objective: To present the Instrumento de Avaliação da Promoção da Saúde na Universidade – IAPSU (Assessment Tool for Health Promotion at the University) and its reproducibility assessment process. Methods: Cross-sectional study conducted between May and July 2014 with 50 students from a university of Fortaleza, Ceará, which developed the IAPSU through the analysis of government documents and a systematic review of the literature on a potentially healthy university. The tool has 41 questions divided into five domains: physical activity, diet, environmental factors, psychosocial factors and alcohol and drug use, integrative and complementary practices. To assess the inter-examiner reproducibility, the students answered the IAPSU twice, applied by two different examiners; to assess the intraexaminer reproducibility, another application of the instrument was performed after seven days. Results: The study comprised 40 Nursing students and 10 Physical Therapy students, with a mean age of 25 ± 5.4 years; 88% were women and white individuals were predominant. In the reproducibility assessment, strong intraclass, intra- and inter-examiner correlation coefficients - above 0.8 - were observed in all the domains. Conclusion: The IAPSU is a reproducible and reliable instrument for assessing health promotion at the university.

The quality of rapid HIV testing in South Africa: an assessment of testers’ compliance.

Background: The aim of this study was to assess the quality of rapid HIV testing in South Africa. Method: A two-stage sampling procedure was used to select HCT sites in eight provinces of South Africa. The study employed both semi-structured interviews with HIV testers and observation of testing sessions as a means of data collection. In total, 63 HCT sites (one HIV tester per site) were included in the survey assessing qualification, training, testing practices and attitudes towards rapid tests. Quantitative data was analysed using descriptive statistics and qualitative data was content analysed. Results: Of the 63 HIV testers, 20.6% had a nursing qualification, 14.3% were professional counsellors, 58.7% were lay HIV counsellors and testers and 6.4% were from other professions. Most HIV testers (87.3%) had had a formal training in testing, which ranged between 10-14 days, while 6 (9.5%) had none. Findings revealed sub-standard practices in relation to testing. These were mainly related to non-adherence to testing algorithms, poor external quality control practices, poor handling and communication of discordant results. Conclusion: Quality of HIV rapid testing may be highly compromised through poor adherence to guidelines as observed in our study.

Assessment of a Planned Municipal Solid Waste Management System in Sri Lanka

Systematic Municipal Solid Waste Management (MSWM) authorities of Sri Lanka contributes to exchange some productive outputs with localities; however it is still not in a successful mode due to limitations and environmental failures in their operation. Most of these local administrations are directly dumping Municipal Solid Waste (MSW) to an open dumping site, this manner of inappropriate disposal of MSW is become a major threat to the environment and public health in developing countries like Sri Lanka. This study was conducted for the MSWM practices of Balangoda Urban Council. The research was performed based on analyzing information obtained from field observations; reports; literature; questionnaire distribution among community; and a series of formal interviews with major stakeholders. The ongoing MSWM practices of Balangoda Urban Council encompass six categories as waste minimization and handling; waste collection; on-site separation; waste transportation; further management including grading, composting, recycling, producing sludge fertilizer; and final disposal to an open dump site. Apart from those, training sessions on MSWM are also being conducted. The purpose of this paper is to assess current status of urban waste management scenario and highlight strengths and weaknesses to understand the sustainability of the system which would help any local authority to improve MSWM.

Assessment of laboratory test utilization for HIV/AIDS care in urban ART clinics of Lilongwe, Malawi

Background The 2011 Malawi HIV guidelines promote CD4 monitoring for pre-ART assessment and considering HIVRNA monitoring for ART response assessment, while some clinics used CD4 for both. We assessed clinical ordering practices as compared to guidelines, and determined whether the samples were successfully and promptly processed. Methods We conducted a retrospective review of all patients seen in from August 2010 through July 2011,, in two urban HIV-care clinics that utilized 6-monthly CD4 monitoring regardless of ART status. We calculated the percentage of patients on whom clinicians ordered CD4 or HIVRNA analysis. For all samples sent, we determined rates of successful labprocessing, and mean time to returned results. Results Of 20581 patients seen, 8029 (39%) had at least one blood draw for CD4 count. Among pre-ART patients, 2668/2844 (93.8%) had CD4 counts performed for eligibility. Of all CD4 samples sent, 8082/9207 (89%) samples were successfully processed. Of those, mean time to processing was 1.6 days (s.d 1.5) but mean time to results being available to clinician was 9.3 days (s.d. 3.7). Regarding HIVRNA, 172 patients of 17737 on ART had a blood draw and only 118/213 (55%) samples were successfully processed. Mean processing time was 39.5 days (s.d. 21.7); mean time to results being available to clinician was 43.1 days (s.d. 25.1). During the one-year evaluated, there were multiple lapses in processing HIVRNA samples for up to 2 months. Conclusions Clinicians underutilize CD4 and HIVRNA as monitoring tools in HIV care. Laboratory processing failures and turnaround times are unacceptably high for viral load analysis. Alternative strategies need to be considered in order to meet laboratory monitoring needs.

Assessment of the storage and disposal of medicines in some homes in Jos north local government area of Plateau State, Nigeria

Purpose: The purpose of this study was to assess the way medicines are stored and disposed in some households in Jos North Local Government Area (LGA) of Plateau State, Nigeria. Methods: A cross-sectional survey of 130 households in Jos was carried out using a questionnaire to ascertain practices associated with medicine storage and their disposal. Results: The results showed that 105 (80.8%) households had 635 medicines in their homes, 65.8% of which were unused medicines (3.2 unused medicines per household). Some households stored their medicines in bags/containers (76.2%) while others kept them in cup-boards/cabinets (21.96%), refrigerators (10.5%) or other places (3.3%). Methods for disposal of unused drugs varied among households with some disposing them in trash cans (70.5%) while other disposed them in toilets (19.0%) or burnt them (10.5%). Only 10.5% (n=11) of respondents knew how medicines were properly disposed. Conclusion: While most households store their medicines appropriately, majority of them adopt poor disposal methods for medicines they no longer need in their homes. Public health education on problem disposal of medicines is of the essence.