Effect of tenofovir containing ART on renal function in patients with moderate/severe reduced creatinine clearance at baseline: A retrospective study at two referral hospitals in Namibia.

Prescription of tenofovir disoproxil fumarate (TDF) for patients with baseline creatinine clearances (CrCl) <60 mL/min is said to increase risk of further decline in CrCl. Study objectives were to assess incidence of improvement and predictors thereof; to assess incidence of decline and transition to lower stages of CrCl; and comparison of declines between patients with a baseline CrCl < 60mL/min (group-I) and ≥ 60 mL/min (group-II). The study was retrospective, included patients 16 yrs or older who received TDF-containing ART.

Comparison of kidney transplant outcomes in HLA compatible and incompatible transplantation: A national cohort study.

Background: Reports of HLA incompatible (HLAi) kidney transplant outcomes are inconclusive, especially in the context of lower level Donor Specific Antibodies (DSA).

Methods: Multi-centre national cohort study of HLAi kidney transplant recipients matched in 1:2 ratio with HLA compatible (HLAc) kidney transplant recipients. HLAi defined as DSA identified by Luminex.

Highly sensitised patients awaiting deceased donor renal transplants are disadvantaged by the presence of denatured HLA antibody detected in routine HLA antibody testing.

Luminex single antigen bead (SAB) assays used to detect HLA antibodies may artificially increase sensitisation in highly sensitised patients (HSP). The presence of denatured HLA (dHLA) within the assay enables antibodies specific to cryptic HLA epitopes to bind, such antibodies are not clinically relevant. We sought to exclude dHLA reactivity in a cohort of very HSP, calculated reaction frequency (cRF) 95%-100% and determine the effect upon sensitisation.

Corn? When did I eat corn? Gastrointestinal transit time in health science students.

The objective of this study was to determine gastrointestinal transit time in first-year health science students with a laboratory practical exercise conducted in two cohorts (classes of 2018 and 2019) of first-year health sciences students at the Health Science Campus in Windhoek, Namibia. All first-year health science students undertaking the Physiology course were invited to take part in the laboratory exercise. The primary outcome was the measurement of gastrointestinal transit time from the amount of time taken for ingested whole-kernel sweetcorn to be eliminated, which was calculated as the time period between ingestion of corn and the time of corn first seen in the stool and the time corn was last seen in the stool.

Regional climate influences manure temperature and methane emissions - A pan-Canadian modelling assessment.

This study explores the variation of liquid manure temperature (T) and CH emissions associated with contrasting regional climates, inter-annual weather variation, and manure storage emptying. As a case-study, six regions across Canada were used, spanning 11°32' latitude and 58°30' longitude. Annual average air temperatures ranged from 3.

Does pharmaceutical information systems data inform decision-making in public healthcare? Utility of a national system in a limited resource setting.

Background: Globally, weak pharmaceutical information systems (PIS) negatively affect universal health coverage and outcomes. Few studies in sub-Saharan Africa qualitatively and quantitatively assess drivers and utility of data from PIS in public healthcare.

Methods: A nationwide cross-sectional descriptive study interviewed PIS focal persons in all 14 regions of Namibia.

Creating clinical pharmacy capacity in Namibia: a collaboration to establish a post-graduate pharmacy degree programme.

Namibia has previously relied on external training of pharmacists but began in-country training in 2011. In response to an identified need for postgraduate clinical pharmacy development and training in the country, a Master's degree was set up at the University of Namibia in 2016. The country has a considerable health burden of HIV and TB as well as a shortage of healthcare professionals.

Tenofovir disoproxil fumarate associated nephrotoxicity: a retrospective cohort study at two referral hospitals in Namibia.

Introduction: The incidence and risk factors of tenofovir disoproxil fumarate (TDF)-related renal impairment (RI) in Namibia are unknown where TDF-containing ART regimens are used as the first line for HIV.

Methodology: A retrospective cohort study among HIV-infected patients at two intermediate hospitals. A decline in estimated glomerular filtration rate (eGFR) was significant if it was ≥25% and included a change to a lower eGFR stage.

Patient experiences in managing non-communicable diseases in Namibia.

Introduction: The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it, the need for pharmacists to empower patients. This research aims to 1) identify patient-reported barriers and facilitators to managing chronic NCDs for Namibians, and 2) characterize common patient-reported medication and health-related needs of Namibians with chronic NCDs.

Methods: This qualitative study used semi-structured interviews to elicit participant perspectives regarding NCDs.

Protein Identification of Venoms of the African Spitting Cobras, and .

Cobra snakes, including and are one of the major groups of snakes responsible for snakebites in southern Africa, producing significant cytotoxicity and tissue damage. The venom of has been briefly characterised, but that of is not reported. The current study identifies the venom proteins of and .

A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings.

Background: Limited utility of quality health data undermines efforts to strengthen healthcare delivery, particularly in resource-limited settings. Few studies model the effective utility of quality pharmaceutical information system (PIS) data in sub-Saharan Africa, typified with weak health systems.

Aim: To develop a model and guidelines for strengthening utility of quality PIS data in public healthcare in Namibia, a resource-limited setting.

The impact of age on patient tolerance of mycophenolate following kidney transplantation.

Background: In Scotland, standard maintenance immunosuppression following kidney transplantation consists of mycophenolate (MPA), tacrolimus and prednisolone irrespective of recipient age. We analyzed the tolerability of this immunosuppression regimen and the association with transplant outcomes.

Methods: A national, multicentre retrospective analysis of patients transplanted in 2015 and 2016, comparing graft function, acute rejection, significant infection rates and immunosuppression dosing between patients aged 18 and 59 years (Group 1) and ≥60 years (Group 2).

Predictors of loss to follow-up of tuberculosis cases under the DOTS programme in Namibia.

Background: In Namibia, one out of every 25 cases of tuberculosis (TB) is "lost to follow-up" (LTFU). This has impacted negatively on national efforts to end the disease by 2035. The aim of this study was to determine the trends and predictors of LTFU under the directly observed treatment short-course (DOTS) programme in Namibia.

A pragmatic approach to introducing mixed methods research training for pharmacy students in Namibia.

Background And Purpose: Pharmacy and medical training were introduced for the first time in Namibia in 2011 and 2010 respectively. All students must complete a research project as part of their training, which is supported by various courses in the respective curricula including research methods. Following a revision of the medical curriculum, there was an opportunity to review the way research methods was taught for both degrees, piloting in pharmacy then expanding to other disciplines.

Effect of TDF-containing regimens on creatinine clearance in HIV patients in Namibia with a baseline CrCl <60ml/min; findings and implications.

: The advent of antiretroviral therapy (ART) and early diagnosis of the human immunodeficiency virus (HIV) has resulted in an appreciable reduction in morbidity and mortality among people infected with HIV. However, tenofovir disoproxil fumarate (TDF)-containing ART regimens are associated with a reduction in creatinine clearance (CrCl). No evaluation has been conducted in Namibia to date on the relationship between TDF-containing ART and CrCl among patients with moderate to severe reductions in CrCl to guide future practice.

Effective integration of pharmacovigilance systems at public health facilities in resource-limited settings: A qualitative study.

Background: Pharmacovigilance systems increase access to safe medicines and healthcare, but their integration in public healthcare remains a challenge in many countries. The main barriers to pharmacovigilance integration are attributed to high patient load and limited capacities.

Objective: To explore the challenges associated with the effective integration of pharmacovigilance systems in public healthcare in a developing country such as Namibia.

Competency (and Beyond): Think Patient. Collaborate. Develop. Evaluate. Improve. Repeat.

The global workforce needs to be competent, flexible, adaptable, sustainable, and patient-focused. A competency approach towards education, development, and professional practice strengthens services and increases better health outcomes. This paper will provide a global perspective on competency approaches from different health care professions.

Optimizing data quality of pharmaceutical information systems in public health care in resource limited settings.

Background: Robust pharmaceutical management information systems (PMIS) strengthen healthcare planning and delivery. Few nationwide studies in resource limited settings in Africa validate the data quality of PMIS in public healthcare.

Objective: To determine predictors and quality of data in a nationwide PMIS database in Namibia.

Optimizing spontaneous adverse drug reaction reporting in public healthcare setting in Namibia.

Despite the universal scale-up of pharmacovigilance systems globally, adverse drug reaction (ADR) reporting remains suboptimal among resource-limited countries. Few studies in sub-Saharan Africa evaluate the effectiveness of adverse drug reaction (ADR) reporting programmes. A cross-sectional survey using a self-administered questionnaire to assess ADR reporting knowledge, attitude and practices among healthcare workers in Namibia's public sector was conducted between September and December 2018.

Introduction of an Alcohol-Related Electronic Screening and Brief Intervention (eSBI) Program to Reduce Hazardous Alcohol Consumption in Namibia's Antiretroviral Treatment (ART) Program.

Alcohol is the most widely abused substance in Namibia and is associated with poor adherence and retention in care among people on antiretroviral therapy (ART). Electronic screening and brief interventions (eSBI) are effective in reducing alcohol consumption in various contexts. We used a mixed methods approach to develop, implement, and evaluate the introduction of an eSBI in two ART clinics in Namibia.

Evidence-Responsive Health Training to HIV/TB Risks in Namibia.

Training health-care students in settings with high-prevalence HIV and tuberculosis (TB) presents a challenge to reduce the risk of infection during their clinical training while maintaining quality education. We sought to gauge the risk of exposure to HIV and TB and identify associated variables through two cross-sectional surveys of health students at the University of Namibia. In the HIV exposure survey, overall almost one-quarter of students ( = 367) reported exposure to HIV-most often needle-stick injury-with a much higher rate reported in senior years (73% in year 6).

Health students' knowledge and infectious disease exposure: findings from a cross-sectional study in Namibia.

Background: Namibia has recently introduced a number of health training programmes that expose students to infectious disease risks such as human immunodeficiency virus (HIV) and tuberculosis (TB). We explored the knowledge of students in relation to HIV and TB and whether or not there was evidence of exposure.

Methods: We conducted two cross-sectional surveys of Namibian health students (medicine and pharmacy) in 2018.