2564 research outputs found
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Retrospective mortality and baseline health survey in Kutupalong and Balukhali settlement camps, Bangladesh
No full textResearch Protocol2.1. PRIMARY OBJECTIVES\ud
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age\ud
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2.2. SECONDARY OBJECTIVES\ud
To describe the population in terms of age, sex and household composition;\ud
To determine the coverage of measles, polio, MenACWY, DPT-Hib-HepB (Pentavalent), cholera (OCV) and pneumococcal virus (PCV) vaccination in 6-59 month olds;\ud
To determine the rate of severe and global acute malnutrition in 6-59 month olds;\ud
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;\ud
To describe the health seeking behaviour in terms of access to primary and secondary care;\ud
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan; \ud
To identify major causes of death, by age group and sex; \ud
To gain knowledge of violence-related events\ud
2.1. PRIMARY OBJECTIVES\ud
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age\ud
\ud
2.2. SECONDARY OBJECTIVES\ud
To describe the population in terms of age, sex and household composition;\ud
To determine the coverage of measles, polio, MenACWY, DPT-Hib-HepB (Pentavalent), cholera (OCV) and pneumococcal virus (PCV) vaccination in 6-59 month olds;\ud
To determine the rate of severe and global acute malnutrition in 6-59 month olds;\ud
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;\ud
To describe the health seeking behaviour in terms of access to primary and secondary care;\ud
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan; \ud
To identify major causes of death, by age group and sex; \ud
To gain knowledge of violence-related event
Retrospective mortality and baseline health survey in Ofua village, Rhino settlement camp, Uganda
No full textResearch ProtocolOBJECTIVES\ud
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2.1. PRIMARY OBJECTIVES\ud
To estimate the scale of the emergency through measurement of crude mortality rate for the total population and for children under five years of age\ud
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2.2. SECONDARY OBJECTIVES\ud
To estimate the size of the population in Rhino (Ofua) settlement camp\ud
To describe the population in terms of age, sex and household composition;\ud
To determine the coverage of measles, polio, MenAfriVac, DPT-Hib-HepB (Pentavalent) and pneumococcal virus (PCV) vaccination in 6-59 month olds;\ud
To determine the rate of severe and global acute malnutrition in 6-59 month olds;\ud
To identify the most prevalent morbidities in the population in the two weeks preceding the survey;\ud
To describe the health seeking behaviour in terms of access to primary and secondary care;\ud
To estimate crude mortality rate for the total population and for children under five years of age before and after the SPLA advance into Equatoria, South Sudan; \ud
To identify major causes of death, by age group and sex; \ud
To gain knowledge of violence-related events\ud
To determine the coverage of Long-Lasting Insecticide Treated bedNets (LLITNs
Health Service Access Survey among Non-camp Syrian Refugees in Irbid Governorate, Jordan
No full textResearch Protocol2. OBJECTIVES\ud
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2.1. PRIMARY OBJECTIVES\ud
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• To determine the level of access to health care services for Syrian refugees living out-of-camp in Irbid governorate, Jordan.\ud
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2.2. SECONDARY OBJECTIVES\ud
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• To describe the socio-demographic characteristics of the surveyed population including age, gender, disabilities, time living in Jordan, living conditions, and legal status\ud
• To describe the economic situation of the surveyed households with regards to income & income sources, dependency on humanitarian assistance, household expenditures and direct and indirect expenditures on health\ud
• To characterize health care utilization of non-camp Syrian refugees including frequency & type of services used as well as the main reasons for requiring medical care\ud
• To estimate coverage with the most crucial health services such as vaccination coverage of under 5-year-old children, coverage with services for non-communicable diseases and maternal health coverage.\ud
• To estimate the coverage of MSF services including specifically NCD care as well as ANC and child health care\ud
• To estimate health service needs by estimating the household- prevalence of NCDs as well as the birth rate.\ud
• To identify barriers to accessing general-, as well as specialized health care services with regards to economic constraints, barriers resulting from knowledge gaps as well as limitations in accessibility and/or acceptability of existing services.\ud
• To identify risk factors for not accessing general and specialized health services as needed.\ud
• To estimate retrospectively the crude mortality rate (CMR) and specific mortality rates for the total population and for children under five years of age (U5MR)
A prospective, randomized, controlled trial of negative-pressure wound therapy use in conflict-related extremity wounds
No full textResearch ProtocolExtremity wounds and fractures constitute the majority of conflict-related traumatic injuries, both for civilians (1) and combatants (2). Conflict-related injuries often result in soft and boney tissue being contaminated with foreign material, generally leading to secondary infection (3,4). Negative-pressure wound therapy (NPWT) is widely used in the treatment of wounds and is considered to promote wound healing and prevent infectious complications. The technique involves the application of a wound dressing through which a negative pressure is applied. Any wound and tissue fluid is drawn away from the area and collected into a canister. Due to a plastic film overlaying the wound the risk of wound contamination is reduced. NPWT is supported for use in a range of surgical applications, including after or in between debridements as a bridge to definite closure of soft tissue wounds (5). The technique has previously been used in the treatment of acute conflict-related wounds with satisfactory results (6–8).\ud
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Cochrane reviews of NPWT for the treatment of chronic wounds (9) and surgical wounds (10) were inconclusive due to the lack of suitably powered, high-quality trials. A recent systematic review of randomized, controlled trials (RCTs) of NPWT for the treatment of acute and chronic wounds concluded there is a lack of evidence and that good RCTs are needed (11). For the use in limb trauma, NPWT is considered suitable for complex soft tissue injuries (12). NPWT appears to be an effective and safe adjunctive treatment of high-energy combat wounds but existing results are retrospective and lack follow-up (13). The support of RCTs is needed to establish best treatment strategies.\ud
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Summary of potential risks and benefits\ud
Both treatment methods (NPWT and conventional dressings) are well established and used in Jordan for the treatment of acute and chronic wounds. As neither of the two treatment modalities are known to be better in terms of outcome neither patient group may be regarded as receiving preferential treatment. NPWT is generally considered a safe treatment method. Potential benefits are shortened healing time and fewer infectious complications. Potential risks are pain, mainly associated with dressing changes (14) and bleeding, predominantly minor bleeding from granulation tissue (15). Conventional wound dressing has the potential benefit of being a safe treatment method used for many years. Since this method permits air into the wound there is a potential risk of contamination and the development of wound infection.\ud
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Objectives\ud
We aim to evaluate the efficacy and safety of NPWT in the treatment of traumatic extremity wounds in a context associated with a high level of contamination and infection
Global programmatic use of bedaquiline and delamanid for the treatment of multidrug-resistant tuberculosis
No full textThe World Health Organization recommended two new drugs, bedaquiline (BDQ) and delamanid (DLM), for the treatment of multidrug-resistant tuberculosis (MDR-TB) in 2013 and 2014, respectively. An estimated one third of patients with MDR-TB would benefit from the inclusion of these drugs in their treatment regimens
From diagnosis to case investigation for malaria elimination in Swaziland: is reporting and response timely?
No full textBackground: Swaziland is one of the southern African countries that aim to eliminate malaria by 2020. In 2010, the country introduced an Immediate Disease Notification System (IDNS) for immediate reporting of notifiable diseases, including malaria. Health facilities are to report malaria cases within 24 h through a toll-free telephone number (977), triggering an alert for case investigation at the patient's household within 48 h. We assessed the completeness of reporting in the IDNS, the subsequent case investigation, and whether it was done within the stipulated timelines. Methods: A cross-sectional study using routine country-wide data. Results: Of 1991 malaria cases notified between July 2011 and June 2015, 76% were reported in the IDNS, of which 68% were investigated-a shortfall of 24% in reporting and 32% in case investigations. Of the 76% of cases reported through the IDNS, 62% were reported within 24 h and 20% were investigated within 48 h. These shortcomings were most pronounced in hospitals and private facilities. Investigated cases (n = 1346) were classified as follows: 60% imported, 35% local and 5% undetermined. Conclusion: The utilisation of the IDNS for case reporting to trigger investigation is crucial for active surveillance. There is a need to address the reporting and investigation gaps identified to ensure that malaria cases receive appropriate interventions
Changing distribution and abundance of the malaria vector Anopheles merus in Mpumalanga Province, South Africa
No full textBackground: The malaria vector Anopheles merus occurs in the Mpumalanga Province of South Africa. As its contribution to malaria transmission in South Africa has yet to be ascertained, an intensification of surveillance is necessary to provide baseline information on this species. The aim of this study was therefore to map An. merus breeding sites in the Ehlanzeni District of Mpumalanga Province and to assess qualitative trends in the distribution and relative abundance of this species over a 9-year period. Methods: The study was carried out during the period 2005-2014 in the four high-risk municipalities of Ehlanzeni District. Fifty-two breeding sites were chosen from all water bodies that produced anopheline mosquitoes. The study data were extracted from historical entomological records that are captured monthly. Results: Of the 15 058 Anopheles mosquitoes collected, 64% were An. merus. The abundance and distribution of An. merus increased throughout the four municipalities in Ehlanzeni District during the study period. Conclusion: The expanded distribution and increased abundance of An. merus in the Ehlanzeni District may contribute significantly to locally acquired malaria in Mpumalanga Province, likely necessitating the incorporation of additional vector control methods specifically directed against populations of this species
Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008-2014
No full textBackground: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008-2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices
Moving towards malaria elimination: trends and attributes of cases in Kavango region, Namibia, 2010-2014
No full textSetting: Kavango, a 'moderate' transmission risk region located in north-eastern Namibia, borders Angola, a country with higher malaria transmission levels. Objective: To determine 1) the trends in malaria incidence between 2010 and 2014 in Kavango, 2) the socio-demographic and clinical characteristics of confirmed cases in 2014, and 3) associated risk factors of cases classified as imported. Design: This was a retrospective study of malaria case investigation forms conducted in all 52 public health facilities in 2014. Incidence was derived from aggregate routine surveillance data from the Health Information System (HIS). Results: During the 5-year study, incidence fell from 53.6 to 3.6 cases per 1000 population, then increased again to 47.3/1000. Fifty-five per cent of cases were males, and 49% were aged between 5 and 17 years. Of the 2014 cases, 23% were imported, and were associated with higher odds of severe malaria (adjusted odds ratio [aOR] 1.8; 95%CI 1.01-3.29), not having long-lasting insecticide treated nets (aOR 2.1, 95%CI, 1.3-3.4) and not receiving insecticide residual spraying (aOR 3.2, 95%CI, 2.1-5.1). Conclusion: Sporadic outbreaks in the 5-year period posed a threat to malaria elimination. Better targeting of vector control interventions, strong cross-border collaboration and robust health promotion will be key to achieving malaria elimination
Evaluation of the SD Bioline Cholera Rapid Diagnostic Test During the 2016 Cholera Outbreak in Lusaka, Zambia
No full textTo assess the performance of the SD Bioline Cholera Ag O1/O139 rapid diagnostic test (RDT) compared to a reference standard combining culture and PCR for the diagnosis of cholera cases during an outbreak