Table 3 Description of text content of ‘how research was used’, from products of masters’ students’ dissertations
Student and thesis year | Research use | Description of text citing research product | Title of citing document |
|---|---|---|---|
Aceng, 2003 | Instrumental (treatment option) | When these children were analysed, “… eleven other trials found no significant difference in mortality between artemisinin derivatives and quinine …the frequency of serious AEs was small in most studies and no statistical inferences can be drawn…” | The WHO Pocketbook of Hospital Care for Children: [Evidence behind the WHO Guidelines: Hospital Care for Children: Efficacy and Safety of Artemisinin Derivatives in Children with Malaria] [58] |
Achan, 2004 | Instrumental (treatment option) | In a meta-analysis of comparison of the effect of intrarectal or intravenous administered quinine showed reduced mortality in African children, RR 0.77, 95% CI 0.22–2.72; this study contributed 42.7% of the data to the meta-analysis results, RR 0.55, 95% CI 0.24–1.24 | Treatment of African children with severe malaria-towards evidence-informed clinical practice using GRADE [59] |
Alia, 2002 | Symbolic (tactical) (justify a decision) | A wealth of scientific evidence, “…including numerous randomized and comparative clinical trials…supports our view that misoprostol should be included in the EML for this indication…for treatment of incomplete abortion and miscarriage…high success rates, in the range of 90 to 100%…” | Support of Gynuity Health Projects’ application for misoprostol to be added to WHO’s Essential Medicines List (EML) for the indication of treatment of incomplete abortion and miscarriage [60] |
Bongomin, 2003 | Instrumental (frame a problem) | “…Our study confirms the high prevalence of hepatitis B infection among health personnel in Uganda…consistent…with previous studies in…medical students at Mulago National Referral Hospital…11%, respectively, to be chronic carriers. Age and duration of service have similarly been associated with an increase in hepatitis B sero-positivity in other surveys in health personnel…infection continues in adulthood through sexual transmission…” | Hepatitis B infection among health workers in Uganda: evidence of the need for health worker protection [61] |
Iriso, 2002 | Instrumental (diagnostic option) | “…Diagnosis: A standardized protocol that includes...the potential utility of induced sputum…obtaining diagnostic specimens from children in the outpatient setting…” | Guidelines for the prevention and treatment of opportunistic infections among HIV-exposed and HIV infected children: recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the American Academy of Pediatrics [62] |
Kambugu, 2002 | Instrumental (treatment option) | “…Finally, several clinical trials, many undertaken in Southern Africa, have improved our understanding of issues such as…how to safely administer amphotericin B deoxycholate, which has been used by many more South African clinicians as first-line induction-phase treatment for CM in the last 5 years…” | Guideline for the prevention, diagnosis and management of cryptococcal meningitis among HIV-infected persons: 2013 update [63] |
Symbolic (tactical) (justify a decision) | “…We and others have previously demonstrated manageable and reversible renal impairment in cohorts of HIV-infected patients managed with AmBd at 0.7–1 mg/kg/day with careful pre-hydration and electrolyte monitoring and supplementation, without a requirement for renal replacement therapy…” | British HIV Association opportunistic infection guidelines: in defense of amphotericin B deoxycholate [64] | |
Kitaka, 2002 | Instrumental (frame a problem) | “… Respiratory samples from pneumonia patients in clinical studies (%)… isolated from NPA and IS...Pneumocystis jiroveci [found in] 18 of 43 HIV positive children aged 2–60 months (41.9%) and 2 of 78 HIV negative (2.6%)…” | The WHO Pocketbook of Hospital Care for Children: [Evidence behind the WHO Guidelines: hospital care for children: what is the etiology of pneumonia in HIV-infected children in developing countries?] [34] |
Instrumental (diagnostic option) | “…study of Ugandan children with severe pneumonia reported that those with PCP had a smaller head circumference compared to those without PCP (41.4 cm compared with 44.4 cm, p < 0.0001)…” “…Similarly, Bakeera–Kitaka, et al. found mean levels of 816 units/L in PCP compared with 568 units/L in others (p = 0.004). Those died from PCP, in this study, had significantly higher levels than survivors. This is supported by evidence from developed countries…” | The WHO Pocketbook of Hospital Care for Children: [Evidence behind the WHO Guidelines: hospital care for children: what is the etiology of pneumonia in HIV-infected children in developing countries?] [34] | |
Mpimbaza, 2007 | Instrumental (treatment option) | “… Outcome 1: Seizure cessation within 10 minutes…allocation concealment only mentioned in Mpimbaza 2008…recommended doses is usually about 0.3–0.5 mg/kg in children…and the rest of the adverse events studies did not report any serious adverse effect with use of buccal midazolam…” | Application for inclusion of buccal midazolam in the WHO List of Essential Medicines: (submitted to) Expert Committee on the Selection and Use of Essential Medicines [42] |
Instrumental (treatment option) | “…the superior effectiveness and safety of buccal midazolam compared to rectal diazepam came from…three RCTs…although the evidence for effectiveness came from studies in both high-income and resource-poor countries, the majority of the evidence for efficacy and safety had been generated from its use in accident and emergency departments and not at community level…buccal midazolam is not available in many…” | The selection and use of essential medicines: Report of the WHO Expert Committee, 2009 (including the 16th WHO Model List of Essential Medicines and the 2nd WHO Model List of Essential Medicines for Children), WHO Technical Report Series [65] | |
Instrumental (treatment option) | “…a greater amount of time is required to place the IV than to deliver [midazolam] by non-IV routes…therefore, the total amount of time from the decision to treat with a benzodiazepine to seizure cessation is equivalent or less when alternative routes are used…has been shown for midazolam when delivered by…buccal routes…” “…we recommend buccal midazolam over rectal diazepam for pre-hospital seizure cessation and control... low evidence quality and strong recommendation…randomized trials have suggested…buccal midazolam leads to more frequent seizure cessation than rectal diazepam…no difference in respiratory arrest or depression…” | An evidence-based guideline for pediatric pre-hospital seizure management using grade methodology [66] | |
Instrumental (treatment option) | “...the largest study of 330 children in Uganda found a lower rate of treatment failure for buccal midazolam compared with rectal diazepam (30.3% vs 43%; p = 0.016)…studies reported respiratory depression with use of buccal midazolam in children…” | American Epilepsy Society Guideline: Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society [67] | |
Musiime, 2004 | Instrumental (frame a problem) | “…In Uganda, E. coli, Salmonella and Shigella species caused most acute diarrhoea in children with high resistance to cotrimoxazole…” | Integrated Management of Childhood Illness (IMCI): WHO recommendations on the management of diarrhea and pneumonia in HIV-infected infants and children [43] |
Nabukeera, 2005 | Instrumental (treatment option) | “…data from five studies of children ages 2–18 years, conducted in Italy, Togo, Uganda and the United States, indicate a nearly 20% greater rate of adherence to ARV medication regimens among children whose HIV-positive status had been disclosed to them compared with children who were in treatment but had not been told their status…not significant, low quality, RR = 1.18, 95% CI .88–1.57)…” | Guideline on HIV disclosure counseling for children up to 12 years of age [41] |
Nakanjako, 2005 | Instrumental (frame a problem and diagnostic option) | “…A study in Uganda showed that, among adults who were offered HIV testing at a hospital (about half of whom were subsequently found to be HIV-positive), 83% were unaware of their HIV status, even though 88% had been to a health unit in the previous six months…” | HIV/AIDS Programme: strengthening health services to fight HIV/AIDS: guidance on provider-initiated HIV testing and counseling in health facilities [68] |
Njama, 2003 | Instrumental (frame a problem) | “…Prevalence among people from other malaria endemic areas is much lower… the risk of development of symptomatic malaria after screening is 20% to 40%...” | Evidence-based clinical guidelines for immigrants and refugees [69] |
Ojulong, 2007 | Instrumental (frame a problem) | “… Staphylococcus aureus resistance to methicillin [in the] African Region; Uganda 0% ... 54 tested isolates…” | Anti-microbial resistance: global report on surveillance [70] |
Orikiiriza, 2008 | Instrumental (frame a problem) | “…it is important to consider that some children with HIV infection who are started on antiretroviral therapy may experience a radiological deterioration despite clinical improvement due to immune reconstitution inflammatory syndrome (IRIS)…” | Consensus statement on research definitions for drug resistant tuberculosis in children [71] |
Instrumental (diagnostic option) | “…IRIS should be suspected in children with advanced immunosuppression who initiate cART and develop new symptoms shortly thereafter (within 3–6 months), despite evidence of good HIV control…in patients who have occult TB before cART initiation, TB may be unmasked by subsequent immune recovery…” | Recommendations/guidelines for the prevention and treatment of opportunistic infections in HIV-exposed and HIV-infected children [62] | |
Wobudeya, 2008 | Instrumental (frame a problem) | “…Studies that suggest that breastfeeding can interfere with immune reaction to rotavirus vaccines. However, the results of these studies were not always statistically significant…” | Recommendations for increasing the efficacy & coverage of the rotavirus vaccination program in Ghana [72] |
Worodria, 2000 | Instrumental (diagnostic option) | “…a Ugandan study where patients suspected of PTB were found to have Pneumocystis jiroveci (38.6%), MTB (24%), pulmonary Kaposi’s sarcoma (11%), pyogenic bacteria (8%)…thus misdiagnosis of PTB can be reduced if appropriate investigations are conducted, particularly in countries with high HIV burdens…without a standardized clinical work up, rates of misdiagnosis have been estimated to be as high as 35% to 52%...” | National guidelines not always followed when diagnosing smear-negative pulmonary tuberculosis in patients with HIV in Botswana [47] |