Browsing by Author "Saidi, Trust"
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- ItemOpen AccessMobile phone applications to screen for hearing loss in low-and middle-income countries: a state-of-the-art review(2022) Abbey, Humphrey Kwaku; Douglas, Tania S; Saidi, TrustHearing impairment is a chronic condition for which limited screening and diagnostic services are available in low-and-middle income countries (LMICs). In addition to the conventional medical devices existing to screen for the condition, several smartphone- and tablet-based applications have been introduced as mobile health (mHealth) solutions. This study was aimed at reviewing the set of mobile health tools available for screening for hearing loss in both developed countries and LMICs. Furthermore, to consider the suitability of the screening tools identified in the first objective for use in developing countries. The research approach adopted for this study was that of a state-of-the-art review. Relevant literature on mobile technology solutions to assess hearing loss were identified in electronic databases and reviewed. The mHealth solutions were reviewed with a focus on: countries of origin and evaluation; devices, software platforms and hardware considerations; hearing loss characteristics of recruited populations; features of the tests conducted and of the testing environment; reference methods to which the mobile application was compared; application performance; feedback from users; and cost. Eighteen available smartphone- and tablet-based applications for hearing loss screening were reviewed. Studies on these applications included participants from a variety of ages and, with and without hearing loss. A variety of testing environments were used. Studies on the applications found 11 of them to have acceptable functionality for use in screening for hearing loss. These 11 applications are also potentially suitable for use in LMICs, although they have some limitations. While these applications are not able to replace the conventional audiometer, they have potential as a first point of access for referral to conventional audiometry, and to help increase access to hearing loss tests in resource-constrained health systems.
- ItemOpen AccessNanomedicine for drug delivery in South Africa: a protocol for systematic review(BioMed Central, 2018-10-06) Saidi, Trust; Fortuin, Jill; Douglas, Tania SBackground: The emergence of nanomedicine in the past decade has changed the landscape of disease diagnosis and treatment. Nanomedicine makes use of nanostructures for applications in different fields of medicine, including drug delivery, biosensors, neuro-electronic interfaces, in vivo imaging, and cell-specific molecular interactions. Despite its relative infancy, nanomedicine has generated a significant body of research as evidenced by peer reviewed literature and several patents. This proposed systematic review will focus specifically on drug delivery systems in which nanoparticles are used to enhance the pharmacological and therapeutic properties of drugs. The strength of nanoparticulate drug delivery systems is their ability to alter the pharmacokinetics and bio-distribution of drugs. Globally, the discourse on nanomedicine is dominated by research being done in the developed countries of Europe and in the United States of America. Less attention has been given to the applications of nanomedicine in developing countries, particularly Africa. There is dearth of information on the applications of nanomedicine in terms of drug delivery with particular reference to which diseases are being targeted generally in Africa. The review will describe the specific diseases that are being targeted and the progress being made in South Africa, with a view to determining whether the applications of nanomedicine are being appropriated to address the context-specific challenges in this country or if they mimic what is being done globally. Methods: Keywords related to nanomedicine and drug delivery will be combined to build a search strategy for each of the following databases: PubMed, Cochrane Library (including Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Cochrane Methodology Register), Google Scholar, NHS Health Technology Assessment Database and Web of Science. We will also check reference lists of included studies for other eligible reports and search unpublished data. To ensure that the search is comprehensive, grey literature will be searched extensively. Literature to be included will have nanomedicine in drug delivery as the primary application and report on the specific diseases that are targeted in South Africa. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion. When no consensus is reached, the third author will be consulted. Discussion: The systematic review will inform the government, policy-makers, investors, health professionals, scientists, and engineers about the applications of nanomedicine in drug delivery. In particular, it will identify the diseases targeted by the application of nanomedicine for drug delivery and the progress being made in South Africa as the disease burden of this country differs from that of developed countries where nanomedicine has been widely used for drug delivery. Systematic review registration PROSPERO CRD42017057388
- ItemOpen AccessTowards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa(BioMed Central, 2017-05-30) Saidi, Trust; Salie, Faatiema; Douglas, Tania SBackground: Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon’s theoretical framework of policy streams, we explore the temporal ordering of policy framework changes. We also consider the role of research in motivating policy changes. Methods: Policy documents addressing MDR-TB in South Africa over the period 1994 to 2014 were extracted. Literature on MDR-TB infection control in South Africa was extracted from PubMed using key search terms. The documents were analysed to identify the changes that occurred and the factors driving them. Results: During the period under study, five different policy frameworks were implemented. The policies were meant to address the overwhelming challenge of MDR-TB in South Africa, contextualised by high prevalence of HIV infection, that threatened to undermine public health programmes and the success of antiretroviral therapy rollouts. Policy changes in MDR-TB infection control were supported by research evidence and driven by the high incidence and complexity of the disease, increasing levels of dissatisfaction among patients, challenges of physical, human and financial resources in public hospitals, and the ideologies of the political leadership. Activists and people living with HIV played an important role in highlighting the importance of MDR-TB as well as exerting pressure on policymakers, while the mass media drew public attention to infection control as both a cause of and a solution to MDR-TB. Conclusion: The critical factors for policy change for infection control of MDR-TB in South Africa were rooted in the socioeconomic and political environment, were supported by extensive research, and can be framed using Kingdon’s policy streams approach as an interplay of the problem of the disease, political forces that prevailed and alternative proposals.