Publications by authors named "Samuel Ensor"
Background: The role of computed tomography (CT) before lumbar puncture (LP) is unclear, with limited evidence for a causal link between LP and cerebral herniation or for the ability of CT to identify individuals at risk of herniation. The risks of LP delay or deferral are potentially greater in high-HIV prevalence, resource-limited settings; we analyzed data from such a setting to determine the impact of CT on time to LP and treatment, as well as mortality.
Methods: Adults with suspected central nervous system (CNS) infection were enrolled prospectively into the Botswana National Meningitis Survey between 2016 and 2019.
Article Synopsis
- Tuberculous meningitis (TBM) is a major health issue in Botswana, especially linked to high HIV rates, and prior to 2016, TB testing was limited to mycobacterial cultures, making diagnosis difficult.
- The introduction of the GeneXpert platform significantly improved TB-specific investigations in cerebrospinal fluid samples, increasing from 4.5% to 29% from 2016 to 2022, as access to testing became more widespread.
- Despite a decline in total CSF samples analyzed, the proportion of microbiologically confirmed TBM cases rose slightly, indicating that better testing methods are leading to more accurate diagnoses in remote healthcare settings.
Background: Cryptococcal meningitis (CM) causes substantial mortality in African countries with a high prevalence of human immunodeficiency virus (HIV), despite advances in disease management and increasing antiretroviral therapy (ART) coverage. Reliable diagnosis of CM is cheap and more accessible than other indicators of advanced HIV disease burden such as CD4 testing or investigation for disseminated tuberculosis; therefore, monitoring CM incidence has the potential to serve as a valuable metric of HIV programmatic success.
Methods: Botswana national meningitis surveillance data from 2015 to 2022 were obtained from electronic health records.
Introduction: Uninterrupted access to HIV and sexual and reproductive health (SRH) services is essential, particularly in high HIV prevalence settings, to prevent unintended pregnancy and vertical HIV transmission. Understanding the challenges that COVID-19 and associated social distancing measures (SDMs) posed on health service access is imperative for future planning.
Methods: This cross-sectional study was conducted in Botswana between January-February 2021.
Introduction: UNAIDS has recommended that in 14 countries across sub-Saharan Africa (SSA), 90% of men aged 10 to 29 years should be circumcised by 2021 to help reduce transmission of HIV. To achieve this target demand creation programmes have been widely implemented to increase demand for Voluntary Medical Male Circumcision (VMMC). This review explores the effectiveness of demand creation interventions and factors affecting programme implementation.
View Article and Find Full Text PDF