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Young children and children living with HIV are at high risk of progressing to tuberculosis (TB) disease following Mycobacterium tuberculosis (Mtb) exposure and infection, and also of developing severe forms of disease and TB-related mortality. Identifying children who have very early (sub-clinical) TB disease, prior to progression to clinically apparent TB, would mean that TB preventive treatment (TPT) could be more efficiently targeted to this group. Identifying biomarker changes on drug therapy in children with Mtb infection or very early disease could pave the way for the development of tests that can identify which children have viable bacilli and are therefore at increased risk of disease progression.
The INTREPID study will use already collected samples taken from well-phenotyped paediatric cohorts in three clinical studies conducted in South Africa in children Mtb exposure to disease and from children treated for Mtb infection and early TB disease, as well as targeted Mtb antibody analysis. Data on viral co-infections and relevant clinical and epidemiological parameters will be integrated and evaluated to identify the optimal biosignatures that can predict future progression to clinically overt disease in children below 5 years of age, including those living with HIV.
The study protocol received ethical approval from the Stellenbosch University Health Research Ethics Committee (N23/03/025). The study findings will be disseminated through peer-reviewed publications, scientific conferences and formal presentations to healthcare professionals and to local communities, in collaboration with the Desmond Tutu TB Centre Community Advisory Board.
Venous leg ulcers (VLU) account for the majority of chronic wounds, with an estimated rise in prevalence due to demographic change. Care often does not comply with evidence, and patients remain passive and uninformed. To support general practice VLU care, the ‘UlcusCrurisCare’ (UCC) project developed a multimodal intervention comprising provider training, software-supported case management and standardised patient education. Experts from the medical community (physicians, nurses, association of medical assistants), health insurance and patient representatives provided their assessment of barriers in VLU care, requirements for intervention components and their expected effects. Semi-structured interviews and questionnaires were used at two measuring points. Qualitative data analysis was based on the Theoretical Domains Framework. Quantitative data were analysed descriptively. Ten experts named a lack of knowledge and application regarding compression therapy, reluctance to assume role as primary care provider, and inadequate remuneration as barriers for evidence-based VLU care. To effectively address these barriers, interventions are required to foster the use of compression therapy and patient education. A multimodal approach such as pursued in UCC is expected to effectively address deficits in VLU care at general practitioner level by promoting provider knowledge about evidence-based treatment and supporting patient adherence.
The specific preferences that shape the daily lives of people with dementia serve as the basis for the concept of person-centred care. However, information on the complex experiences of culturally and linguistically diverse people with dementia (CALDPwD), which determine their multifaceted preferences, is lacking. Therefore, the objective of this scoping review is to identify the range, extent and nature of evidence available in peer-reviewed and grey literature examining how the multilayered experiences of CALDPwD influence everyday living preferences.
We aim to conduct a scoping review to explore the multilayered experiences of CALDPwD and the intersectional determinants of their everyday living preferences. Using PubMed, MEDLINE (via Ovid for precision and controlled searching), CINAHL (via EBSCO), Scopus and the Cochrane Library, as well as grey literature, we will systematically search for literature in English, German and Turkish without any publication date restrictions. The titles/abstracts and full texts of the identified records will be independently screened by two reviewers. Data extraction will be performed by one researcher and verified by another. All the authors will discuss the conflicts. We will analyse the identified intersectional determinants of preferences using inductive content analysis.
There are no ethical concerns related to conducting this study. We will share our findings with nursing care practitioners. The results will be presented at conferences and disseminated through peer-reviewed articles and practical publications.
The findings of the study will address the important gaps in knowledge on the complex intersecting factors that influence the preferences of CALDPwD. A key strength of this study is its comprehensive search strategy, which includes multiple databases and citation tracking to capture diverse, intersectional perspectives of CALDPwD. However, excluding the studies focused on caregiver’s burden may limit insights into how care systems shape the needs and expectations of this population.
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