Papers by Kathleen (Kathi) Fox
Over the past decade, the annual number of new HIV infections and HIV-related deaths has been dec... more Over the past decade, the annual number of new HIV infections and HIV-related deaths has been declining steadily in most regions of the world, primarily due to significant scale-up in prevention and treatment. Approximately 2.5 million people became newly infected in 2011—a 20% reduction from 2001 (1). Even in sub-Saharan Africa, the number of newly infected people has decreased in 23 of the 49 countries in the region (1). Despite this progress, sub-Saharan Africa still accounted for 71% of newly infected adults and children and 69% of people living with HIV in the world in 2011 (1). While there has also been decreasing incidence of HIV infection in adolescents in many countries—linked to clear trends toward safer behaviours and practices, including increased condom use and reduction in the number of sexual partners—adolescents remain particularly vulnerable to the infection, and HIV continues to be a prominent cause of death in this segment of the population (1). In many countries,...
BMC public health, Jan 11, 2018
The use of insecticide-treated bed nets (ITNs) is crucial to the prevention, control, and elimina... more The use of insecticide-treated bed nets (ITNs) is crucial to the prevention, control, and elimination of malaria. Using household surveys conducted in 2014-2015 by the Health Communication Capacity Collaborative project in Madagascar, Mali, and Nigeria, we compared a model of psychosocial influence, called Ideation, to examine how malaria-related variables influence individual and household bed net use in each of these countries. Evaluations of non-malaria programs have confirmed the value of the ideational approach, but it is infrequently used to guide malaria interventions. The study objective was to examine how well this model could identify potentially effective malaria prevention approaches in different contexts. Sampling and survey designs were similar across countries. A multi-stage random sampling process selected female caregivers with at least one child under 5 years of age for interviews. Additional data were collected from household heads about bed net use and other char...
Background: In 2010, malaria was responsible for an estimated 41% of deaths among children under ... more Background: In 2010, malaria was responsible for an estimated 41% of deaths among children under the age of five years in Liberia. The same year, the Rebuilding Basic Health Services Project launched " Healthy Baby, Happy Mother, " a social and behavior change communication campaign. The campaign encouraged caregivers to take children under the age of five years to a health facility as soon as children developed fever. This study investigated correlates of two case management outcomes: care-seeking for children under five with fever during the past two weeks and administration of an artemisinin-based combination therapy (ACT) the same or next day as fever onset. Methods: Data from a 2014 cross-sectional household survey from four counties was used to investigate correlates of two case management outcomes. Using multilevel analysis, the association between these outcomes and a car-egiver's recall of the campaign, her sociodemographic characteristics, and unmeasured characteristics of the community she lived in was investigated. Results: Caregivers living in Grand Kru County were less likely (OR = 0.21, 95% CI 0.073, 0.632) to take a child to a health facility than those in Bong County. Caregiver recall of the campaign was positively associated with the odds that a child received an ACT promptly (OR 3.62, 95% CI 1.398–9.372), but not with the odds of a caregiver taking a child in their care to a health facility. While unmeasured community-level factors accounted for 19.0% of the variation in the odds that a caregiver's child was brought to a health facility, they did not play a role in the odds of prompt ACT treatment. Conclusions: Recalling the " Healthy Mother, Happy Baby " campaign was positively associated with the odds that children received ACT promptly, even in the absence of other malaria prevention and treatment messaging. While caregiver exposure was not associated with care-seeking during the two weeks before interview, prompt care-seeking likely preceded prompt receipt of ACT since most ACT came from health facilities. Unmeasured community-level factors, such as distance from the health facility, may play a role in determining the odds that a caregiver takes a child to a health facility.
Retention in care and adherence to antiretroviral treatment (ART) are critical elements of HIV ca... more Retention in care and adherence to antiretroviral treatment (ART) are critical elements of HIV care interventions and are closely associated with optimal individual and public health outcomes and cost effectiveness. This literature review was conducted to analyse how the roles of clients in HIV care and treatment are discussed, from terminology used to measurement methods to consequences of a wide range of patient-related factors impacting client adherence to ART and retention in care. Unfortunately, data suggests that clients find it hard to follow recommended behaviour. For HIV, the greatest loss to follow-up occurs before starting treatment, though each step of the continuum of care is affected. Measurement approaches can be divided into 'direct' and 'indirect' methods; in practice, a combination is often considered the best strategy. Inadequate retention and adherence lead to decreased health outcomes (morbidity, mortality, drug resistances, risk of transmission) and cost effectiveness (increased costs and lower productivity).
Guidance & policy docs (as contributor or editor) by Kathleen (Kathi) Fox
Uploads
Papers by Kathleen (Kathi) Fox
Guidance & policy docs (as contributor or editor) by Kathleen (Kathi) Fox