The use of mobile health technologies (mHealth) to ameliorate HIV care has considerably risen in low-and middle-income countries (LMICs) since 2010. Yet, the discrepancies in the results of accompanying studies warrant an updated and systematic consolidation of all available evidence. We report a systematic review of studies testing whether text/image messages, interactive voice response reminders, or calls promote adherence and retention to antiretroviral therapy (ART) in LMICs. We systematically compiled studies published in English until June 2018 from PubMed/Medline, Web of Science, WHO database, ProQuest Dissertations and Theses, and manual search. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and used frequency analysis to assess reported findings. In total, we compiled 35 published articles: 27 completed studies and 8 protocols. Among the main 27 studies, 17 examine adherence, 5 retention, and 5 both measures. Results indicate that 56% report positive and statistically significantly impacts of mHealth on primary outcomes, the remaining 44% report insignificant results. While 41% of studies found a positive and significant effect for adherence, only 12% improved retention. The evidence shows ambiguous results (with high variability) about the effectiveness of mobile phone-assisted mHealth interventions to boost adherence and retention to ART. The literature also points to short follow-up periods, small samples, and limited geographical coverage. Hence, future research should focus on evaluating longer interventions with more patients spread across wider areas to address whether mHealth can be effectively used in LMICs.
Cattle production is an essential livelihood strategy in southwestern Burkina Faso. Although having a distinct cultural role and known to be resistant against African animal trypanosomosis, the Lobi taurine cattle breed is endangered due to its low market value. As the first step in preservation efforts, our study aimed to develop a typology of production systems at the farm level. We used a structured questionnaire and focus group discussions for collecting data on household characteristics, socioeconomic activities, livestock, and access to services. The sample comprised 169 households in three communities. The analytical strategy included factor analysis of mixed data and hierarchical clustering. We identified four distinct types of cattle production systems: (1) sedentary Lobi farms, (2) sedentary crossbreed farms, (3) semi-transhumant Fulani zebu farms, and (4) transhumant Fulani zebu farms. Significant factors in developing this typology were the farmers' ethnic group, crop diversity, cattle herd size, cattle herd composition, number of small ruminants, and livestock management strategies. Across all production systems, men were considered being primary decision-makers in cattle production, with women, herders, and children being responsible for specific tasks. All identified production systems are increasingly confronting disease pressure and scarcity of water and land. Future efforts in preservation and breeding will need to respond to these trends in the agroecosystem, integrate risk management measures, and resonate with the specific needs of the different household members involved in cattle rearing.
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