School-age growth and development following infant feeding and/or water, sanitation, and hygiene interventions in rural Zimbabwe: long-term follow-up of a cluster-randomised trial.

Background: Few trials have explored long-term effects of interventions designed to reduce child stunting. We evaluated school-age outcomes in rural Zimbabwean children who received cluster-randomised water, sanitation and hygiene (WASH) and/or infant and young child feeding (IYCF) interventions from pregnancy up to 18 months of age.

Methods: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial enrolled pregnant women from two rural Zimbabwean districts (Chirumanzu and Shurugwi) between 2012 and 2015, and cluster-randomised them using a 2 × 2 factorial design to standard-of-care, WASH, IYCF, or combined WASH & IYCF, with a co-primary outcome of height-for-age Z-score and haemoglobin at 18 months (clinicaltrials.

Child play and caregiver support to promote convalescence following severe acute malnutrition in Zimbabwe: The Tamba-SAM pilot study.

Children hospitalised for severe acute malnutrition (SAM) have a high risk of mortality, relapse and rehospitalisation following hospital discharge. Current approaches fail to promote convalescence, or to address the underlying social determinants of SAM, meaning that restoration of long-term health, growth and neurodevelopment is not achieved. Although guidelines recommend play and stimulation to promote recovery, most caregivers are not supported to do this at home.

Piloting the adaptation of the Kaufman Assessment Battery for Children-2 edition (KABC-II) to assess school-age neurodevelopment in rural Zimbabwe.

Background: Neurodevelopment assessment tools for low-resource settings are urgently needed. However, most available tools were developed in high-income settings and may lack cross-cultural validity.

Methods: We piloted and adapted two subtests within the planning domain of the Kaufman Assessment Battery for Children-2nd edition (KABC-II) for use in rural Zimbabwean children aged 7years.

The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) Trial: Protocol for school-age follow-up.

: There is a need for follow-up of early-life stunting intervention trials into childhood to determine their long-term impact. A holistic school-age assessment of health, growth, physical and cognitive function will help to comprehensively characterise the sustained effects of early-life interventions. The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe assessed the effects of improved infant and young child feeding (IYCF) and/or improved water, sanitation and hygiene (WASH) on stunting and anaemia at 18 months.

Characterising school-age health and function in rural Zimbabwe using the SAHARAN toolbox.

Introduction: We developed the School-Age Health, Activity, Resilience, Anthropometry and Neurocognitive (SAHARAN) toolbox to address the shortage of school-age assessment tools that combine growth, physical and cognitive function. Here we present i) development, acceptability and feasibility of the SAHARAN toolbox; ii) characteristics of a pilot cohort; and iii) associations between the domains measured in the cohort.

Methods: Growth was measured with anthropometry, knee-heel length and skinfold thicknesses.

"We need more big trees as well as the grass roots": going beyond research capacity building to develop sustainable careers in mental health research in African countries.

Background: There are substantial gaps in our knowledge regarding the aetiology of mental, neurological and substance use disorders in sub-Saharan Africa, and the cost-effectiveness and scalability of interventions to reduce the burden of these conditions on the continent. To address these gaps, international investment has focussed on building research capacity, including funding doctoral students in African countries, to support development of high quality, contextually relevant interventions. Absent, however, is an understanding of how capacity building feeds into research careers.

Development and piloting of a novel, peer-led bereavement intervention for young people living with HIV in Zimbabwe.

: Research emphasizes lasting psychological implications when young people are not adequately supported following close family deaths. In sub-Saharan Africa, adolescents living with HIV (ALHIV) experience multiple personal deaths along with other serious losses. ALHIV highlight that not processing their grief negatively impacts their daily lives including their ART adherence.

Poverty, food insufficiency and HIV infection and sexual behaviour among young rural Zimbabwean women.

Background: Despite a recent decline, Zimbabwe still has the fifth highest adult HIV prevalence in the world at 14.7%; 56% of the population are currently living in extreme poverty.

Design: Cross-sectional population-based survey of 18-22 year olds, conducted in 30 communities in south-eastern Zimbabwe in 2007.

'How poor are you?' -- a comparison of four questionnaire delivery modes for assessing socio-economic position in rural zimbabwe.

Background: Assessing socio-economic position can be difficult, particularly in developing countries. Collection of socio-economic data usually relies on interviewer-administered questionnaires, but there is little research exploring how questionnaire delivery mode (QDM) influences reporting of these indicators. This paper reports on results of a trial of four QDMs, and the effect of mode on poverty reporting.

Burden of HIV among primary school children and feasibility of primary school-linked HIV testing in Harare, Zimbabwe: a mixed methods study.

Population-based surveys in Southern Africa suggest a substantial burden of undiagnosed HIV-infected long-term survivors of mother-to-child transmission. We conducted an HIV prevalence survey of primary school pupils in Harare, Zimbabwe, and evaluated school-linked HIV counselling and testing (HCT) for pupils, their families and schoolteachers. Population-weighted cluster sampling was used to select six primary schools.

Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

Background: Early infant male circumcision (EIMC) is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44) indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised.

Prevalence and factors associated with knowledge of and willingness for male circumcision in rural Zimbabwe.

Objective: To explore male circumcision (MC) prevalence, knowledge, attitudes and intentions among rural Zimbabweans.

Methods: Representative survey of 18-44 year olds in two provinces, as part of an evaluation of the Zimbabwe National Behaviour Change Programme. We conducted univariate, bivariate and multivariate analyses.

How you ask really matters: randomised comparison of four sexual behaviour questionnaire delivery modes in Zimbabwean youth.

Objective: A sexual health survey among rural Zimbabwean youth was used to compare the validity and reliability of sexual behaviour measures between four questionnaire delivery modes.

Methods: Using a random permuted block design, 1495 youth were randomised to one of four questionnaire delivery modes: self-administered questionnaire (SAQ=373); SAQ accompanied by an audio soundtrack (Audio-SAQ=376); face-to-face interview with sensitive questions placed in a confidential voting box (Informal confidential voting interview; ICVI=365); and audio computer-assisted survey instrument (ACASI=381). Key questions were selected a priori to compare item non-response and rates of reporting of sensitive behaviours between questionnaire delivery modes.

High prevalence of affective disorders among adolescents living in Rural Zimbabwe.

Poor mental health accounts for considerable disease burden among young people globally. We investigated the prevalence and determinants of affective disorders among rural Zimbabwean youth in 2006. We undertook a cross-sectional survey among 1495 Zimbabwean youth aged 15-23 (median 18) from 12 rural communities in three provinces in south-eastern Zimbabwe.

How to improve the validity of sexual behaviour reporting: systematic review of questionnaire delivery modes in developing countries.

Objectives: To systematically review comparative research from developing countries on the effects of questionnaire delivery mode.

Methods: We searched Medline, EMbase and PsychINFO and ISSTDR conference proceedings. Randomized control trials and quasi-experimental studies were included if they compared two or more questionnaire delivery modes, were conducted in a developing country, reported on sexual behaviours and occurred after 1980.

Field evaluation of diagnostic accuracy of an oral fluid rapid test for HIV, tested at point-of-service sites in rural Zimbabwe.

The objective of this study was to validate the use of OraQuick ADVANCE Rapid HIV-1/2 Antibody test (OraSure Technologies Inc., Bethlehem, PA) on oral fluid for a population-based HIV prevalence survey of rural youth in southeast Zimbabwe. The evaluation was conducted in patients presenting for voluntary counseling and testing at rural clinics.

The Regai Dzive Shiri Project: a cluster randomised controlled trial to determine the effectiveness of a multi-component community-based HIV prevention intervention for rural youth in Zimbabwe--study design and baseline results.

Objective: To assess the effectiveness of a community-based HIV prevention intervention for adolescents in terms of its impact on (1) HIV and Herpes simplex virus type 2 (HSV-2) incidence and on rates of unintended pregnancy and (2) reported sexual behaviour, knowledge and attitudes.

Methods: Cluster randomised trial of a multi-component HIV prevention intervention for adolescents based in rural Zimbabwe. Thirty communities were selected and randomised in 2003 to early or deferred intervention implementation.

Association of genital shedding of herpes simplex virus type 2 and HIV-1 among sex workers in rural Zimbabwe.

Introduction: Herpes simplex virus type 2 (HSV-2) facilitates sexual acquisition of HIV-1 but data on transmission are less clear. In this study the interaction between genital shedding of HIV-1 and HSV-2 was explored among Zimbabwean sex workers.

Methods: Women (n = 214) were interviewed about genital symptoms.

Is sexual contact with sex workers important in driving the HIV epidemic among men in rural Zimbabwe?

Objective: To establish the importance of commercial sex in driving the HIV epidemic in the general population by determining risk factors for HIV infection among male mine and farm workers and estimating the fraction of prevalent HIV infections attributable to sexual contact with sex workers (SWs).

Setting: Five commercial farms and 2 mines in Mashonaland West, Zimbabwe.

Methods: A cross-sectional interviewer-administered questionnaire and urine survey of 1405 male workers.

The appropriateness of core group interventions using presumptive periodic treatment among rural Zimbabwean women who exchange sex for gifts or money.

To map the characteristics of rural based sex workers in Zimbabwe with regard to demographics, mobility, behavior, HIV and sexually transmitted infection (STI) prevalence, to explore the appropriateness and feasibility of presumptive periodic treatment (PPT) for bacterial STIs as an HIV prevention intervention among these women, and to compare tolerability of 2 PPT regimens (1 g of azithromycin and 2 g of metronidazole+/-500 mg of ciprofloxacin). Five commercial farms and 2 mines in Mashonaland West, Zimbabwe. Three hundred sixty-three sex workers were recruited and completed a structured interviewer-administered questionnaire.

School based HIV prevention in Zimbabwe: feasibility and acceptability of evaluation trials using biological outcomes.

Objective: To determine the feasibility and acceptability of conducting a community randomized trial (CRT) of an adolescent reproductive health intervention (ARHI) using biological measures of effectiveness.

Setting: Four secondary schools and surrounding communities in rural Zimbabwe.

Methods: Discussions were held with pupils, parents, teachers and community leaders to determine acceptability.