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Causes and determinants of mortality in HIV-infected adults with tuberculosis: an analysis from the CAMELIA ANRS 1295-CIPRA KH001 randomized trial
Get PDFShortening the interval between antituberculosis treatment onset and initiation of antiretroviral therapy (ART) reduces mortality in severely immunocompromised human immunodeficiency virus (HIV)-infected patients with tuberculosis. A better understanding of causes and determinants of death may lead to new strategies to further enhance survival
Plasmodium prevalence and artemisinin-resistant falciparum malaria in Preah Vihear Province, Cambodia: a cross-sectional population-based study
Get PDFIntensified efforts are urgently needed to contain and eliminate artemisinin-resistant Plasmodium falciparum in the Greater Mekong subregion. Medecins Sans Frontieres plans to support the Ministry of Health in eliminating P. falciparum in an area with artemisinin resistance in the north-east of Cambodia. As a first step, the prevalence of Plasmodium spp. and the presence of mutations associated with artemisinin resistance were evaluated in two districts of Preah Vihear Province
Evaluation of the modified colorimetric resazurin microtiter plate-based antibacterial assay for rapid and reliable tuberculosis drug susceptibility testing
Get PDFBackgroundThe resazurin microtiter assay (classic REMA), a colorimetric liquid culture-based drug susceptibility assay for Mycobacterium tuberculosis (MTB), has been endorsed by the World Health Organization. The assay requires 8-16 days to obtain results, delaying management of drug resistant tuberculosis patients. A modified REMA which allows results in as little as 24 hours for bacterial strains, has been developed and validated using Staphylococcus aureus, but has not yet been evaluated for MTB. Therefore we assessed the performance of the modified REMA for rifampicin (RIF) and isoniazid (INH) susceptibility, using the classic REMA as the reference standard. We also compared simplicity (from the technicians¿ point of view), time taken to obtain results (rank-sum testing), specificity and Kappa statistics of the two methods.ResultsThe modified REMA, which is a one-step procedure, was found to be simpler to perform and results were obtained in a significantly shorter time (5 versus 9 days, p¿<¿0.0001) compared to the classic REMA due to addition of indicator and strain at the same time. The specificity of the modified REMA was low {46.8% (35.5% - 58.4%) for RIF and 13.9% (7.2% - 23.5%) for INH}. Kappa statistics were 16.0% for RIF and 2.0% for INH. Low specificity and kappa statistics are due to indicator reduction by the strains before complete drug activity.ConclusionAlthough modified REMA is faster and simpler compared to classic REMA, it is not reliable for MTB drug susceptibility testing
Literature review on health seeking behaviour, health understanding and access to health care of Muony-Jang/Jieng (Dinka) in the Abyei Administrative Area.
Get PDFConception of Kala Azar medicines: literature review for an anthropological study of patients’ perception of and experience with Kala Azar and its treatment in Bihar, India
Get PDFAkonolinga - Buruli Ulcer Project, Cameroon, 2002 - 2014
Get PDFThe primary objective of the evaluation was to identify the lessons learned throughout the period that the BU Project was in operation in Akonolinga, from its launch in 2002 until its conclusion in late June 2014. To accomplish this, the assessors relied on existing documentation, interviews with persons directly or indirectly involved with the project, and on any observations that they made during their time in the field.\ud
The findings presented in the evaluation deal essentially with the study of the project phases, its strategic evolution, its management, the partnerships entered into by MSF, decentralisation, awareness-raising campaigns and advocacy activities. One major chapter is devoted to an analysis and an appreciation of medical activities, with their therapeutic choices, performance, support elements and the research carried out in and around the project. The evaluation also looked at planning for the disengagement phase and on the legacy left by MSF after twelve years of engagement.\ud
A total of 1231 patients with ulcers, including 435 confirmed cases of BU, were diagnosed. They received institutional care, based on quality standards and methods which were unknown in Cameroon until now. Numerous research papers, training courses and a multi-disciplinary approach were also part of the care given over the years. A modest advocacy action was carried out. All these activities were developed against a background that highlighted a reduction in the incidence and number of new BU cases detected, not only on the national level, but also on the international level. Also, with time, there was a growing threat to the sustainability of activities after MSF had left
Capitalisation de la mise en œuvre de la chimio-prévention du paludisme saisonnier au Niger
Get PDFLa chimio-prévention du paludisme saisonnier (CPS) a été mise en œuvre au Niger en 2013, conformément aux recommandations de l'Organisation mondiale de la Santé (OMS) et à la politique nationale de lutte contre le paludisme (PNLP). Elle s'est déroulée sous la forme d'une campagne de masse qui a consisté en l'administration de doses curatives de sulphadoxine-pyriméthamine et d'amodiaquine durant trois jours, à un mois d'intervalle entre juillet et novembre, aux enfants de 3 à 59 mois.\ud
La population cible des enfants de 3 à 59 mois résidant dans 12 aires de santé (AS) de cinq districts sanitaires (DS) (Magaria, Madaoua, Bouza, Madaraounfa et Guidam-Roumdji) répartis dans trois régions du Niger (Zinder, Tahoua, Maradi) a été initialement estimée à 139 000. Cette estimation a été revue à la hausse de 50 % à l'issue de recensements exhaustifs effectués dans les différents DS, portant le nombre total d'enfants ciblés par la CPS à 206 000.\ud
Les médicaments de CPS, disponibles sous la forme de plaquettes alvéolées combinant le SP et l'AQ, ont été distribués par plus de 2 000 agents communautaires encadrés par 90 superviseurs, et ce, sur un ensemble de 179 sites fixes et de 75 sites fixes avancés et par 99 équipes faisant du porte-à-porte.\ud
Seules les équipes du COB dans le DS de Guidam Roumdji ont surveillé la prise des médicaments pendant les trois jours. Dans les autres DS, seule la première dose de médicaments a été administrée sous surveillance, les deux autres ont été administrées à domicile par les accompagnants
Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan
Get PDFThe Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services
