We aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and patient preferences for cardiovascular care and education.
A prospective observational study.
This study was conducted at the Majengo HIV Care and Treatment Clinic, an outpatient government-funded clinic in Moshi, Tanzania
Adult patients presenting to an HIV clinic for routine care in northern Tanzania were enrolled from 1 September 2020 to 1 March 2021.
At enrolment, participants completed a survey and a resting 12-lead ECG was obtained. At 6 month follow-up, a repeat survey regarding interim health events and repeat ECG was obtained.
Interim major adverse cardiovascular events (MACE) were defined by: self-reported interim stroke, self-reported hospitalisation for heart failure, self-reported interim myocardial infarction, interim myocardial infarction by ECG criteria (new pathologic Q waves in two contiguous leads) or death due to cardiovascular disease (CVD).
Of 500 enrolled participants, 477 (95.4%) completed 6 month follow-up and 3 (0.6%) died. Over the 6 month follow-up period, 11 MACE occurred (3 strokes, 6 myocardial infarctions, 1 heart failure hospitalisation and 1 cardiovascular death), resulting in an incidence rate of 4.58 MACE per 100 person-years. Of participants completing 6 month follow-up, 31 (6.5%) reported a new non-communicable disease diagnosis, including 23 (4.8%) with a new hypertension diagnosis.
The incidence of MACE among PLWH in Tanzania is high. These findings are an important preliminary step in understanding the landscape of CVD among PLWH in Tanzania and highlight the need for interventions to reduce cardiovascular risk in this population.
Ecuador es un país pluricultural y multiétnico, caracterizado por la búsqueda de promover la propiedad comunal, la toma de decisiones colectiva y prácticas de vida sostenibles en sus comunidades autónomas. A través de este enfoque principal que enfatiza la solidaridad y la cooperación, estas comunas han podido crear soluciones alternativas a los problemas que enfrentan sus comunidades. A pesar de estos éxitos, las comunidades de los diversos grupos indígenas, aún enfrentan desafíos, como acceso limitado a recursos básicos, apoyo gubernamental, estigmatización y conflictos con comunidades vecinas. Sin embargo, continúan abogando por su derecho a la autodeterminación y trabajan para crear una sociedad más equitativa. Explorando los temas y experiencias de estas comunas, podemos comprender mejor el potencial de los movimientos de base para abordar las injusticias sociales y allanar el camino hacia comunidades más sostenibles e inclusivas. Cabe destacar que esta es solo una pequeña comuna indígena, y que hay muchos más grupos en todo el país, como los Shuar, Tsáchilas, Huaorani, Chachi, entre otros.
Ecuador es un país pluricultural y multiétnico, caracterizado por la búsqueda de promover la propiedad comunal, la toma de decisiones colectiva y prácticas de vida sostenibles en sus comunidades autónomas. A través de este enfoque principal que enfatiza la solidaridad y la cooperación, estas comunas han podido crear soluciones alternativas a los problemas que enfrentan sus comunidades. A pesar de estos éxitos, las comunidades de los diversos grupos indígenas, aún enfrentan desafíos, como acceso limitado a recursos básicos, apoyo gubernamental, estigmatización y conflictos con comunidades vecinas. Sin embargo, continúan abogando por su derecho a la autodeterminación y trabajan para crear una sociedad más equitativa. Explorando los temas y experiencias de estas comunas, podemos comprender mejor el potencial de los movimientos de base para abordar las injusticias sociales y allanar el camino hacia comunidades más sostenibles e inclusivas. Cabe destacar que esta es solo una pequeña comuna indígena, y que hay muchos más grupos en todo el país, como los Shuar, Tsáchilas, Huaorani, Chachi, entre otros.
The purpose of this study was to identify coping strategies, resources, and strengths that predict well-being in a community-based sample of youth with varying levels of adversity.
Grounded in the resilience portfolio model, we used a mixed methods approach with data from a cross-sectional sample of 231 youth ages 8–17.
Data were collected using a survey, participant-generated timeline activity, and brief interview. Measures included assessments of coping and appraisal, resilience resources and assets, and subjective well-being and depression.
Active and passive coping strategies predicted subjective well-being and depression. Controlling for demographics and coping, meaning making strengths and supportive relationships were significant predictors of subjective well-being and lower depression, and decreased the impact of adversity on these outcomes.
The results of this study provide support for the resilience portfolio model in a community-based sample of youth, with relationships as predicted for subjective well-being and symptoms of depression. For both outcomes, family relationships held the strongest associations with positive well-being and lower symptoms of depression. Supportive relationships with peers, meaning making strengths, interpersonal strengths, less passive coping, and fewer adverse life events were also associated with better outcomes.
These findings underscore the need to assess youth resources and strengths and to design interventions that target these protective factors for all youth, regardless of exposure to adversity.
A theory-informed understanding of resources and strengths that predict youth well-being is essential to inform strengths-based interventions for pediatric research and practice. The resilience portfolio model is a useful framework for understanding predictors of youth well-being.