2564 research outputs found
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Successes and challenges in optimizing the viral load cascade to improve antiretroviral therapy adherence and rationalize second-line switches in Swaziland
No full textAs antiretroviral therapy (ART) is scaled up, more patients become eligible for routine viral load (VL) monitoring, the most important tool for monitoring ART efficacy. For HIV programmes to become effective, leakages along the VL cascade need to be minimized and treatment switching needs to be optimized. However, many HIV programmes in resource-constrained settings report significant shortfalls
Seasonal upsurge of pneumococcal meningitis in the Central African Republic
No full textA high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by\ud
Streptococcus pneumoniae\ud
(249/328; 75.9%), which occurred disproportionately during the dry season (November-April) with a high case-fatality ratio of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt are typically caused by\ud
Neisseria meningitidis\ud
(meningococcal meningitis), and our observations suggest that the risk of contracting\ud
S. pneumoniae\ud
(pneumococcal) meningitis is increased by the same environmental factors. Cases of meningococcal meningitis (67/328; 20.4%) observed over the same period were predominantly type W and had a lower case fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing medical facilities, it is likely that the reported cases represented only a small proportion of the overall burden and that there is high underlying prevalence of\ud
S. pneumoniae\ud
carriage in the community. Nationwide vaccination campaigns in the CAR against meningitis have been limited to the use of MenAfriVac, which targets only meningococcal meningitis type A. We therefore highlight the need for expanded vaccine coverage to prevent additional causes of seasonal outbreaks
High treatment success rate for multidrug-resistant and extensively drug-resistant tuberculosis using a bedaquiline-containing treatment regimen
No full textWe regret that this article is behind a paywall.Background: South African patients with rifampicin-resistant tuberculosis and resistance to fluoroquinolones and/or injectables (pre/XDR-TB) were granted access to bedaquiline through a Clinical Access Programme with strict inclusion and exclusion criteria.Methods: Pre/XDR-TB and XDR-TB patients were treated with 24 weeks bedaquiline within an optimised, individualised background regimen that could include levofloxacin, linezolid and clofazimine as needed.Results: 200 patients were enrolled: 87 (43.9%) with XDR-TB, 99 (49.3%) were female, median age 34 years (IQR 27, 42). 134 (67.0%) were living with HIV; median CD4+ 281 (IQR 130; 467) and all on antiretroviral therapy.16/200 patients (8.0%) did not complete 6 months of bedaquiline of which 8 were lost to follow up, 6 died, 1 stopped for side effects and 1 patient was diagnosed with drug-sensitive TB.146/200 (73.0%) patients had favourable outcomes: 139/200 were cured (69.5%) and 7 completed treatment (3.5%). 25 died (12.5%), were lost from treatment (10.0%), 9 had treatment failure (4.5%).22 adverse events were attributed to bedaquiline: including QTcF >500 ms (n=5), QTcF increase >50 ms from baseline (n=11), paroxysmal atrial flutter (n=1).Conclusion: Bedaquiline added to an optimised background regimen was associated with a high rate of successful treatment outcomes for this MDR-TB and XDR-TB cohort
Single low-dose primaquine for blocking transmission of Plasmodium falciparum malaria - a proposed model-derived age-based regimen for sub-Saharan Africa
No full textIn 2012, the World Health Organization recommended blocking the transmission of Plasmodium falciparum with single low-dose primaquine (SLDPQ, target dose 0.25 mg base/kg body weight), without testing for glucose-6-phosphate dehydrogenase deficiency (G6PDd), when treating patients with uncomplicated falciparum malaria. We sought to develop an age-based SLDPQ regimen that would be suitable for sub-Saharan Africa
What's coming for health science and policy in 2018? Global experts look ahead in their field
No full textIn PLOS Medicine's first editorial of 2018, editorial board members and other leading researchers share their hopes, pleas, concerns, and expectations for this year in health research and policy
Impact of pyrazinamide resistance on multidrug-resistant tuberculosis in Karakalpakstan, Uzbekistan
No full textThe World Health Organization (WHO) recommends the inclusion of pyrazinamide (PZA) in treatment regimens for multidrug-resistant tuberculosis (MDR-TB) unless resistance has been confirmed
Mapping the burden of cholera in sub-Saharan Africa and implications for control: an analysis of data across geographical scales
No full textCholera remains a persistent health problem in sub-Saharan Africa and worldwide. Cholera can be controlled through appropriate water and sanitation, or by oral cholera vaccination, which provides transient (∼3 years) protection, although vaccine supplies remain scarce. We aimed to map cholera burden in sub-Saharan Africa and assess how geographical targeting could lead to more efficient interventions
Vaccination coverage survey for diphtheria, Streptococcus pneumoniae, polio and tetanus in Rohingya refugee settlements in Ukhiya and Teknaf Upazilas, Cox’s Bazar, Bangladesh
No full textResearch ProtocolOBJECTIVES\ud
\ud
PRIMARY OBJECTIVES\ud
a) To describe the vaccine coverage (penta / dT) in children aged 6 months to 14 years for diphtheria in the Rohingya Settlement Camps;\ud
\ud
SECONDARY OBJECTIVES\ud
\ud
To describe the vaccine coverage of pentavalent, bOPV and PCV vaccines in children aged 6 weeks to 6 years of age in the Rohingya Settlement Camps; \ud
To describe the vaccine coverage for diphtheria and tetanus vaccination among 7 - 14 year olds to assess vaccination rates in this age-group in the Rohingya Settlement Camp
Assessing the feasibility of preventing injury risks and improving work safety amongst factory workers in an urban slum: a participatory before-and-after intervention study
No full textResearch ProtocolSpecific Objectives: 1. Explain dynamics of injury risk over time by:\ud
1.1. Describing the circumstances of incidents leading to an injury (injury risks or dynamics of incident)\ud
1.2. Describing the circumstances of near-miss incident where no injury or illness occurs (incident risks)\ud
1.3. Measuring frequency and severity of injuries (burden)\ud
1.4. Describe perceptions of risks amongst owner/manager/workers\ud
\ud
2. Design acceptable interventions to reduce injury risks \ud
\ud
3. Document intervention feasibility by:\ud
3.1. Describing acceptability, capturing adherence to interventions and changes in risk perceptions\ud
3.2. Describing practicality: \ud
3.2.1. Documenting operational challenges and lessons learned\ud
3.2.2. Capturing resources (human resources, time, materials and cost) of implementation\ud
\ud
4. Describe any changes in worker safety behaviour and incident incidence rat