Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rwanda”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1994

Risk factors associated with prevalent HIV-1 infection among pregnant women in Rwanda. National University of Rwanda-Johns Hopkins University AIDS Research Team.

This study evaluated risk factors associated with prevalent HIV-1 infection among pregnant women in a semi-rural but densely populated area surrounding the town of Butare in Rwanda. Overall seroprevalence was 9.3% in 5690 pregnant women who sought antenatal care at one of five health centres. Factors associated with higher seroprevalence of HIV-1 included history of multiple sexual partners, history of at least one sexually transmitted disease (STD), relatively high socioeconomic status (SES), being unmarried, young age at first pregnancy, and low gravidity. Women who had used oral contraceptives, smoked more than one cigarette per day, whose partners were circumcised, and had had sex to support themselves were also at higher risk of being infected. A history of blood transfusion in the past 5 years was not associated with HIV-1 infection. History of multiple sexual partners, history of STD, high household income, partner circumcision, and past oral contraceptive use remained strongly associated with HIV-1 infection even when simultaneously controlling for other covariates. Among legally married women who lacked sexual behaviour risk factors, history of STD, high SES, young age at first pregnancy, and low gravidity were significantly associated with HIV-1 seroprevalence.

Adolescent↗
PubMed2006

Current trends in Rwanda's HIV/AIDS epidemic.

OBJECTIVE: To review the trajectory of Rwanda's HIV epidemic, including long term trends and more recent trends in HIV prevalence, markers of HIV incidence, and behavioural indicators. METHODS: This paper reviews the history of HIV serological and behavioural surveillance efforts in Rwanda, dating back to the early 1980s, synthesising findings from surveillance, research, and other relevant HIV programmatic data. The documentation reviewed includes published findings, conference abstracts, and unpublished analyses. Special emphasis is given to more recent sentinel surveillance results and data collected using known, documented methods. Recent trends in HIV prevalence were assessed among sites participating in the three most recent consecutive rounds of antenatal clinic sentinel surveillance. RESULTS: Early HIV surveillance in Rwanda documented high HIV prevalence in urban areas with HIV widely disseminated into rural areas by 1986. Between 1988 and 1996, HIV prevalence among pregnant women ranged from 21% to 33% in Kigali, from 8% to 22% in other urban settings, and from 2% to 12% in rural settings. More recent surveillance among pregnant women has demonstrated more moderate prevalence, with urban/rural differences narrowing slightly. Between 1998 and 2003, HIV prevalence may have declined in urban areas, whereas rural areas appear to have remained stable. Age at first sexual intercourse is relatively late in Rwanda (20 years for both males and females) and has remained stable since at least 1992. CONCLUSIONS: The present analysis suggests that Rwanda may have experienced declines over the long term in HIV prevalence in urban areas, especially in Kigali, and may have stable or slightly rising HIV prevalence in rural areas. The limited behavioural data available suggest that, on the national level, Rwanda may benefit from a unique combination of low numbers of partners and late sexual debut, which may have had a mitigating effect on HIV prevalence.

Adolescent↗
PubMed2004

Trauma and PTSD symptoms in Rwanda: implications for attitudes toward justice and reconciliation.

CONTEXT: The 1994 genocide in Rwanda led to the loss of at least 10% of the country's 7.7 million inhabitants, the destruction of much of the country's infrastructure, and the displacement of nearly 4 million people. In seeking to rebuild societies such as Rwanda, it is important to understand how traumatic experience may shape the ability of individuals and groups to respond to judicial and other reconciliation initiatives. OBJECTIVES: To assess the level of trauma exposure and the prevalence of posttraumatic stress disorder (PTSD) symptoms and their predictors among Rwandans and to determine how trauma exposure and PTSD symptoms are associated with Rwandans' attitudes toward justice and reconciliation. DESIGN, SETTING, AND PARTICIPANTS: Multistage, stratified cluster random survey of 2091 eligible adults in selected households in 4 communes in Rwanda in February 2002. MAIN OUTCOME MEASURES: Rates of exposure to trauma and symptom criteria for PTSD using the PTSD Checklist-Civilian Version; attitudes toward judicial responses (Rwandan national and gacaca local trials and International Criminal Tribunal for Rwanda [ICTR]) and reconciliation (belief in community, nonviolence, social justice, and interdependence with other ethnic groups). RESULTS: Of 2074 respondents with data on exposure to trauma, 1563 (75.4%) were forced to flee their homes, 1526 (73.0%) had a close member of their family killed, and 1472 (70.9%) had property destroyed or lost. Among the 2091 total participants, 518 (24.8%) met symptom criteria for PTSD. The adjusted odds ratio (OR) of meeting PTSD symptom criteria for each additional traumatic event was 1.43 (95% CI, 1.33-1.55). More respondents supported the local judicial responses (90.8% supported gacaca trials and 67.8% the Rwanda national trials) than the ICTR (42.1% in support). Respondents who met PTSD symptom criteria were less likely to have positive attitudes toward the Rwandan national trials (OR, 0.77; 95% CI, 0.61-0.98), belief in community (OR, 0.76; 95% CI, 0.60-0.97), and interdependence with other ethnic groups (OR, 0.71; 95% CI, 0.56-0.90). Respondents with exposure to multiple trauma events were more likely to have positive attitudes toward the ICTR (OR, 1.10; 95% CI, 1.04-1.17) and less likely to support the Rwandan national trials (OR, 0.90; 95% CI, 0.84-0.96), the local gacaca trials (OR, 0.80; 95% CI, 0.72-0.89), and 3 factors of openness to reconciliation: belief in nonviolence (OR, 0.92; 95% CI, 0.87-0.97), belief in community (OR, 0.92; 95% CI, 0.87-0.98), and interdependence with other ethnic groups (OR, 0.86; 95% CI, 0.81-0.92). Other variables that were associated with attitudes toward judicial processes and openness to reconciliation were educational level, ethnicity, perception of change in poverty level and access to security compared with 1994, and ethnic distance. CONCLUSIONS: This study demonstrates that traumatic exposure, PTSD symptoms, and other factors are associated with attitudes toward justice and reconciliation. Societal interventions following mass violence should consider the effects of trauma if reconciliation is to be realized.

Adult↗
PubMed2026

Spatial clustering and transmission networks of multidrug-resistant tuberculosis in Rwanda: a national retrospective genomic and spatial epidemiological study.

BACKGROUND: Approximately 96% of rifampicin resistance/multidrug-resistant tuberculosis (RR/MDR-TB) cases in Rwanda result from direct transmission rather than acquired resistance. However, the nationwide spatial distribution and transmission dynamics of RR/MDR-TB remain poorly characterised. This study aims to analyse spatial patterns of RR/MDR-TB in Rwanda and explore relationships between spatial proximity and RR/MDR-TB strains' genetic relatedness. METHODS: We conducted a retrospective analysis of 249 confirmed RR-TB cases across Rwanda from 2017 to 2024, using the known geolocations of patients' residences. Spatial and space-time clustering was assessed using Kulldorff's scan statistics. Demographic and socioeconomic determinants were evaluated using multivariable regression. For 201 cases with whole-genome sequencing data, we performed transmission analysis using a 5-SNP threshold to define recent transmission clusters and investigated spatial relationships within genetically related strains. RESULTS: Significant spatial clustering of RR/MDR-TB was identified in 21 sectors, mainly in Nyarugenge, southern Gasabo and western Kicukiro (relative risk: 10.06; p<0.001). Our multivariable analysis showed that population density is positively associated with case notification rates. Molecular analysis revealed 88.5% of cases belonged to genotype clusters defined using a 12-SNP threshold, with 73.6% forming clusters at a strict 5-SNP threshold. Spatial K-function analysis of the six major clusters revealed heterogeneous transmission patterns, characterised by both tightly clustered outbreaks and regional transmission networks that spanned administrative boundaries. Most clusters (5/6) extended beyond Kigali, indicating that transmission networks operate across administrative divides. CONCLUSION: RR/MDR-TB in Rwanda shows significant spatial clustering with transmission occurring through both localised and regional networks. Integrating genomic and spatial data reveals transmission patterns that extend beyond household contacts and administrative boundaries. These findings underscore the need to implement geographically targeted interventions that address community-level transmission to control RR/MDR-TB in Rwanda effectively.

Rwanda↗
PubMed2005

Restoring diabetes care in Rwanda: the need for effective partnerships.

In 1994, more than one million people died in Rwanda in one of the worst genocides in modern times. Rwandan society, at all levels including healthcare, continues to count the human and financial costs of the tragedy--a burden which is compounded by the debilitating scarcity of resources in the nation as a whole. Most of Rwanda's 8,200,000 inhabitants are united by poverty: according to figures published by the World Bank, the yearly per capita income in Rwanda is US dollar 220. The author reports on the status of diabetes care and makes a call for cost effective collaborative solutions to the dire problems faced by people with diabetes in Rwanda.

Cooperative Behavior↗
PubMed1996

Cancer in Rwanda.

Data are presented on the frequency of malignant tumours registered at the population-based cancer registry in the southern prefecture of Butare, Rwanda, from May 1991 until 2 months before the outbreak of civil war in April 1994. Beginning in 1992, subjects were also interviewed about socio-demographic and life-style factors that have been associated with cancer risk in the West. The distribution of cancer in Rwanda is similar to that in other countries in sub-Saharan Africa. The most frequent cancers are those with possible infectious aetiologies: liver cancer (12%), cervical cancer (12%) and stomach cancer (9%). In addition, cancers known to be associated with HIV infection are relatively frequent (Kaposi's sarcoma [6%] and non-Hodgkin's lymphoma [3%]). Chronic infection, including infection with HIV, high parity and multiple sexual partners are important determinants of cancer incidence in this population. Tobacco consumption is low in Rwanda and there are few tobacco-related tumours, such as lung and laryngeal cancer. Other tumours believed to be associated with aspects of Western life-style, such as colorectal and breast cancer, are also relatively infrequent.

Adolescent↗
PubMed1991

Exposure of Ankole and crossbred cattle to theileriosis in Rwanda.

Susceptible Ankole (Sanga: Bos indicus/Bos taurus) and crossbred Ankole x Jersey (B. taurus) and Ankole x Sahiwal (B. indicus) cattle derived from a farm in Rwanda with no recent history of theileriosis, were infected with Theileria parva stocks from Rwanda either by feeding infected Rhipicephalus appendiculatus ticks on the ears, inoculation of tick derived stabilate or natural exposure to tick challenge. The Ankole cattle originated from local stock born and bred in East Coast fever (ECF) endemic areas of Rwanda. Disease, followed by spontaneous recovery, was observed in 49 of the 72 Ankole cattle after infection with T. parva (68%); the other 23 animals (32%) died of ECF. In contrast 21 of the 33 infected crossbred cattle (64%) died of ECF. It is concluded that the partial Theileria tolerance of the Ankole is, to a great extent, genetic. The basis of this partial tolerance seems to be their ability to limit the explosive multiplication of macroschizonts during the acute phase of the disease.

Animals↗
PubMed1994

A survey of occupational blood contact and HIV infection among traditional birth attendants in Rwanda.

OBJECTIVE: To investigate the risk of occupationally acquired HIV infection among traditional birth attendants (TBA) in Rwanda, Africa. DESIGN AND METHODS: A serosurvey was conducted among 219 TBA practicing in a rural but densely populated area in southern Rwanda. Each TBA was interviewed about sociodemographic information, work-related habits and practices, and presence of nonoccupational risk factors for HIV infection. The frequency of skin exposure to HIV-infected blood was estimated for each TBA from HIV seroprevalence data collected previously from pregnant women stratified by the geographic zones in which the TBA practiced. RESULTS: Four TBA (1.8%) tested HIV-1-antibody-positive; all four had reported nonoccupational risk factors for HIV infection. We estimated that the 215 HIV-negative TBA had 2234 potentially infectious blood-skin contacts out of a total of approximately 35,000 deliveries assisted in the past 5 years. However, we found no evidence of HIV infection caused by occupational blood contact (none out of 2234; upper limit of the 95% confidence interval because of one potentially infectious blood-skin contact = 0.2%). CONCLUSION: Although these findings may not be universal to all TBA in Africa, the risk of occupationally acquired HIV infection among TBA appears small. The high frequency of blood-skin contact among TBA in Rwanda highlights the need to include infection control precautions in the training of TBA.

Adult↗
PubMed1994

Seroincidence of HIV-1 infection in African women of reproductive age: a prospective cohort study in Kigali, Rwanda, 1988-1992.

OBJECTIVE: To estimate the seroincidence of HIV-1 infection among women of reproductive age in Kigali, Rwanda. DESIGN: Fixed prospective cohort followed for 36 months between November 1988 and June 1992, as part of an ongoing study of mother-to-child transmission of HIV-1. SETTING: Centre Hospitalier, Kigali, Rwanda. SUBJECTS: A total of 216 HIV-seronegative women were enrolled at delivery between November 1988 and June 1989. METHODS: A blood sample was obtained at delivery to test for HIV antibodies (by enzyme-linked immunosorbent assay and Western blot). Serum was tested every 3 months during follow-up. Incidence density rates of HIV seroconversion were estimated. RESULTS: The follow-up rate after 3 years was 89%, assessed by the maximum person-years method. The seroincidence density rate was 3.5 per 100 women-years (95% confidence interval, 1.9-5.0). It decreased linearly from 7.6 during the first 6-months postpartum to 2.5 per 100 women-years during the last 6 months of the third year of follow-up. Maternal age did not affect HIV incidence rates. We examined the role of the cohort, counselling, and the first 6-month postpartum effects on this estimate. CONCLUSION: This fixed cohort provided an overall estimation of the HIV infection incidence rate and its dynamics. These figures could be used for programming future HIV preventive vaccine efficacy trials in Rwanda.

Adolescent↗
PubMed2006

Antiviral efficacy and resistance in patients on antiretroviral therapy in Kigali, Rwanda: the real-life situation in 2002.

Our study aimed to complete the published data on ARV therapy in Africa by describing the baseline situation in Rwanda before the launch of a large ARV programme (ESTHER). Prescription habits, frequency and reasons for treatment interruptions but also antiviral efficay, resistance to ARVs and genotypic variability of the viruses present in Rwanda were analysed. Among the 233 patients included in the study, it appeared that a vast majority (91%) were under triple therapy and that half of them had experienced at least one treatment interruption caused mainly by drug shortage or financial difficulties. Among 60 blood samples analysed, 26 were in virological failure with a viral load above 1000 RNA copies/ml and 11 presented major drug resistance mutations. Finally, virological failure could mainly be explained by the high frequency of treatment interruptions but also by the emergence of drug resistance mutations. Consequently the major objective for the ESTHER programme to improve the situation in Rwanda will be to reduce the drug shortage and facilitate the financial accessibility of the treatments.

Anti-HIV Agents↗
PubMed2006

Reference values for serum protein and electrolyte study from Rwanda.

OBJECTIVE: To estimate reference values of serum proteins and electrolytes in a student population in Butare, Rwanda (altitude: 1768 m; barometric pressure: 629 mm Hg). DESIGN: A laboratory based cross-sectional study. SETTING: The units of physiology and clinical chemistry, department of medical biology, Butare University Hospital and Faculty of Medicine, National University of Rwanda, from February 2002 to May 2003. SUBJECTS: Young healthy adults were selected randomly from the students of the National University of Rwanda, using Epi-Info 6.04 software. RESULTS: The results mean and reference range (2.5th-97.5th percentile) in brackets - are as follows: total proteins: male: 7.3 (6.3-8.4) g/dL, female: 7.3 (6.5-8.5) g/dL; albumin: male: 4.3 (3.1-5.2) g/dL, female: 4.1 (3.2-5.0) g/dL; globulins: male: 3.1 (2.0-4.2) g/dL. female: 3.2 (2.1-4.2) g/dL; sodium: male: 138.5 (130-147) mmol/L, female: 139.8 (132-153) mmol/L; potassium: 4.0 (3.1-5.0) mmol/L both in male and in female; chloride: males: 104.4 (96-112) mmol/L, females: 106.1 (98-114) mmol/L; phosphates: male: 1.13 (0.65-1.59) mmol/L, female: 1.17 (0.71-1.52) mmol/L. CONCLUSION: The values of serum proteins and electrolytes are comparable to classical sea level values; however there is a slight increase in serum chloride.

Adult↗
PubMed1982

Subtyping of phosphoglucomutase locus 1 (PGM1) polymorphism in some populations of Rwanda: description of variant phenotypes, "haplotype" frequencies, and linkage disequilibrium data.

Some populations of Rwanda (South Twa Pygmies, Hutu, and Tutsi) have been analyzed by acid starch gel electrophoresis for the subtyping of PGM1 polymorphism. The new polymorphic third PGM11 allele, the PGM1(1Twa), which we recently detected in Twa Pygmies from North Rwanda, has not been found in this survey, whereas the rare PGM1(6) allele attains subpolymorphic frequencies in all groups. Comparison between the various populations of Rwanda shows that they differ significantly from each other with the exception of South Twa Pygmies and Tutsi. A relatively low frequency (9.6%) of the PGM1(2S) allele appears to be typical of North Twa Pygmies; a low frequency of PGM1(2F) (1.2%-3.6%) has been found in all these groups but not in the Hutu (6.4%); and a particularly high incidence of the PGM1(1F) allele (the highest so far reported) has been observed in the South Twa Pygmies (20%) and in the Tutsi (18%). The PGM1(1Twa) and PGM1(6) enzymes, which in acid starch gel are not distinguishable, can be clearly differentiated by isoelectric focusing. In addition, the same technique has shown that the rare PGM1(7) allele observed in one Hutu is different from that found at polymorphic frequency in the Japanese and from a rare PGM1(7) allele found in Germany. On the very likely hypothesis that the PGM1(1S), PGM1(1F), PGM1(2S), and PGM1(2F) result from variations at two different polymorphic sites, 1/2 and F/S, within the PGM1 structural gene, all the available population data have been analyzed to investigate whether preferential combinations (haplotypes) were identifiable. Whereas Caucasians show a prevalence of 2F and 1S combination with an 8.02% mean value of linkage disequilibrium expressed as % Dmax, from the very few and scattered African data, it is impossible to draw any inference at present.

Alleles↗
PubMed1997

Primary infections with HIV-1 of women and their offspring in Rwanda: findings of heterogeneity at seroconversion, coinfection, and recombinants of HIV-1 subtypes A and C.

Variation in HIV-1 genomic RNA was studied in seroconversion samples from mother-child pairs from a Rwandan cohort. The mothers (n = 8) were heterosexually infected and their children (n = 6) were vertically infected by breast milk. Five of the children seroconverted within the same 3-month period as did their mothers. Highly homogeneous subtype A V3 and p17gag sequence populations were observed in three mother-child pairs, one of the two nontransmitting mothers, and one child (mean nucleotide distances 0 to 0.9%). Heterogeneous populations of subtype A V3 and p17gag sequences were found in one mother and a mother-child pair (1.4 to 2.8% for V3, 1.0 to 1.9% for p17). The second nontransmitting mother was infected with a heterogeneous AV1-V3/Cp17-p24 recombinant virus population (3. 8% for V3, 2.4% for p17). Finally, in one woman subtype C V3 sequences were observed, in addition to highly homogeneous subtype A V3 and p17gag sequence populations, also found in the child. Coexistence of subtype AV1-V3 and CV1-V3 env sequences in the mother was confirmed in a follow-up sample. The gag gene of both the maternal and the child's virus population represented an A/C recombinant sequence (Ap17/Cp24). An infection with subtype CV1-V3/p17-p24 was found upon testing of three additional participants of the mother-child cohort, indicating that subtype C is present in Rwanda. In conclusion, heterogeneity, coinfection, and intersubtype recombinants are not uncommon in primary HIV-1 infections in Rwanda.

Amino Acid Sequence↗
PubMed1993

Antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae from Rwanda, 1984-1990.

A total of 383 clinical isolates of Streptococcus pneumoniae, obtained from an equal number of patients in Kigali, Rwanda, was tested for resistance to penicillin G with a 1 microgram oxacillin disc. Of these isolates, 99 (25.8%) showed reduced zones of inhibition. By means of an agar dilution method, 21% all isolates were confirmed as relatively resistant (MIC > or = 0.12- < or = 1.0 mg/l) strains of Streptococcus pneumoniae (RRSP). A high degree of resistance to penicillin G (MIC > or = 2 mg/l) was not observed. Resistance to chloramphenicol (MIC > or = 8 mg/l) was found in 31% RRSP and in 6% penicillin susceptible strains (PSSP). Doxycycline resistance was common in both RRSP and PSSP strains. All isolates remained fully susceptible to erythromycin. Children more often harboured a strain giving a reduced inhibition zone than did adults (74/230 versus 25/153; P = 0.0005). A total of 32 serotypes or serogroups were identified, seven of them relating to 64.8% all isolates typed. Of all the isolates 84% belonged to a serotype represented in the 23-valent vaccine or to a cross-reacting serotype. Serotype 25, not included in the vaccine, accounted for 10.7% typed isolates from adults but only for 2.0% typed isolates from children. Results of susceptibility testing and clinical experience suggest that penicillin G, ampicillin and chloramphenicol should not be used alone as empirical treatment for pneumococcal meningitis in patients in Rwanda.

Adult↗
PubMed1987

Public awareness of AIDS in Rwanda.

AIDS is a rapidly growing epidemic in Kigali, Rwanda. To understand the level of public awareness of AIDS in that city, 33 informants (15 men and 18 women) were interviewed during September, 1985. Most (66.7%) said that they first heard of the disease only within the previous eight months. About half (46.9%) could not mention one or more AIDS symptoms. Younger informants and women reported less knowledge of AIDS symptoms. While nearly everyone recognized AIDS as a stigmatized disease, most informants apparently did not know why it is stigmatized. Only about one-third of the informants (34.4%) could correctly state the mode of AIDS transmission. People who are at greatest risk for the disease, unmarried men and women, were least likely to know how it is transmitted. Half (50.0%) of those informants who responded to the question of the origins of AIDS said that it began in 'America.' While many informants are frightened by the disease, no one has yet changed their sexual behavior as a response to the epidemic. All informants agreed that more information about AIDS should be made available in Rwanda. Preventive measures against the spread of AIDS are urgently needed in central Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Condoms and cosmology: the 'fractal' person and sexual risk in Rwanda.

While condoms are readily available in the urban centers of Rwanda, where the AIDS epidemic has ranged most intensely, researchers report that women are reluctant to have their partners use them. When asked to explain their reluctance, these women express the fear (along with other misgivings) that the condom might remain lodged in the vagina after intercourse. This behavior flies in the face of the biomedical assessment of risk. Rwandans, however, perceive risk in a manner which is consistent with their views concerning the social construction of the moral person. Of prime importance in this process is the body's perceived aptitude to engage in meaningful exchange and fertile sexuality. Moreover, these notions take root within a coherent cosmological matrix which emphasizes the socially ordered flow of fertility fluids. Only when these issues are considered in light of the concept of the 'fractal person' does the meaning of risk--as it relates to sexual behavior and AIDS in Rwanda--become clear.

Acquired Immunodeficiency Syndrome↗