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Effect of Male Involvement on the Nutritional Status of Children Less Than 5 Years: A Cross Sectional Study in a Rural Southwestern District of Uganda
No full textUndernutrition among children less than 5 years is still a public health concern in most developing countries. Fathers play a critical role in providing support in improving maternal and child health. There is little studied on male involvement and its measurement in child nutrition; therefore, this paper explores the level of male involvement in child feeding and its association with the nutritional status of the children less than 5 years of age
"I Wasted 3 Years, Thinking It's Not a Problem": Patient and Health System Delays in Diagnosis of Leprosy in India: A Mixed-Methods Study
No full textWorldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers' perspectives into reasons for late presentation
Knockdown and recovery of malaria diagnosis and treatment in Liberia during and after the 2014 Ebola outbreak
No full textSetting: The malaria-endemic country of Liberia, before, during and after the 2014 Ebola outbreak. Objective: To describe the consequences of the Ebola outbreak on Liberia's National Malaria Programme and its post-Ebola recovery. Design: A retrospective cross-sectional study using routine countrywide programme data. Results: Malaria caseloads decreased by 47% during the Ebola outbreak and by 11% after, compared to the pre-Ebola period. In those counties most affected by Ebola, a caseload reduction of >20% was sustained for 12 consecutive months, while this lasted for only 4 consecutive months in the counties least affected by Ebola. Linear regression of monthly proportions of confirmed malaria cases-as a proxy indicator of programme performance-over the pre- and post-Ebola periods indicated that the malaria programme could require 26 months after the end of the acute phase of the Ebola outbreak to recover to pre-Ebola levels. Conclusions: The differential persistence of reduced caseloads in the least- and most-affected counties, all of which experienced similar emergency measures, suggest that factors other than Ebola-related security measures played a key role in the programme's reduced performance. Clear guidance on when to abandon the emergency measures after an outbreak may be needed to ensure faster recovery of malaria programme performance
Identification of main malaria vector species and their sensitivity to insecticides used for malaria control and Long Lasting Insecticide-treated Nets (LLINs) efficacy in the Democratic Republic of Congo (DRC) MSF-OCA, Baraka, South Kivu, DRC October 2017
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Overcoming Challenges in the Diagnosis, Prevention, and Treatment of Pediatric Drug-Resistant Tuberculosis
No full textDrug-resistant tuberculosis (DR-TB) is a growing global health threat and children are especially vulnerable to becoming infected and sick with DR-TB. There is a growing body of evidence on the optimal diagnosis, treatment and prevention of DR-TB in this vulnerable population. Areas covered: A comprehensive review of the literature on DR-TB in children was done using PubMed and Ovid databases up to 31 December 2016. Topic areas covered included diagnosis of DR-TB, treatment of DR-TB - including novel medications and regimens, prevention of DR-TB, community-based care, and stigma/discrimination. After presenting a case that highlights some of these challenges in each of these areas, for which we will propose mechanisms for overcoming them. Expert commentary: Overcoming the challenges facing children with DR-TB, requires a paradigm shift at multiple levels. The 'trickle down' approach to pediatric DR-TB has been woefully inadequate and it is essential that pediatric DR-TB - preventing it, diagnosing it, and treating it - be made a priority
Diagnostic Preparedness for Infectious Disease Outbreaks
No full textDiagnostics are crucial in mitigating the effect of disease outbreaks. Because diagnostic development and validation are time consuming, they should be carried out in anticipation of epidemics rather than in response to them. The diagnostic response to the 2014-15 Ebola epidemic, although ultimately effective, was slow and expensive. If a focused mechanism had existed with the technical and financial resources to drive its development ahead of the outbreak, point-of-care Ebola tests supporting a less costly and more mobile response could have been available early on in the diagnosis process. A new partnering model could drive rapid development of tests and surveillance strategies for novel pathogens that emerge in future outbreaks. We look at lessons learned from the Ebola outbreak and propose specific solutions to improve the speed of new assay development and ensure their effective deployment
Educating Nurses in Resource-Poor Areas
No full textJai Defranciscis is an Australian nurse with a passion for paediatrics and education in resource-poor settings. Last year she joined the international medical aid organisation M decins Sans Fronti res (MSF) - also known as Doctors Without Borders - heading to South Sudan for a year, working with refugees fleeing fighting between armed groups. This is her account
A Guide to Aid the Selection of Diagnostic Tests
No full textIn recent years, a wide range of diagnostic tests has become available for use in\ud
resource-constrained settings. Accordingly, a huge number of guidelines, performance\ud
evaluations and implementation reports have been produced. However, this wealth of\ud
information is unstructured and of uneven quality, which has made it difficult for endusers,\ud
such as clinics, laboratories and health ministries, to determine which test would\ud
be best for improving clinical care and patient outcomes in a specific context. This paper\ud
outlines a six-step guide to the selection and implementation of in vitro diagnostic tests\ud
based on Médecins Sans Frontières’ practical experience: (i) define the test’s purpose;\ud
(ii) review the market; (iii) ascertain regulatory approval; (iv) determine the test’s\ud
diagnostic accuracy under ideal conditions; (v) determine the test’s diagnostic accuracy\ud
in clinical practice; and (vi) monitor the test’s performance in routine use. Gaps in the\ud
information needed to complete these six steps and in regulatory systems are\ud
highlighted. Finally, ways of improving the quality of diagnostic tests are suggested,\ud
such as establishing a model list of essential diagnostics, establishing a repository of\ud
information on the design of diagnostic studies and improving quality control and\ud
postmarketing surveillance
Management of Chronic Hepatitis C at a Primary Health Clinic in the High-Burden Context of Karachi, Pakistan
No full textThe burden of hepatitis C (HCV) infection in Pakistan is among the highest in the world, with a reported national HCV prevalence of 6.7% in 2014. In specific populations, such as in urban communities in Karachi, the prevalence is suspected to be higher. Interferon-free treatment for chronic HCV infection (CHC) could allow scale up, simplification and decentralization of treatment to such communities. We present an interim analysis over the course of February-December 2015 of an interferon-free, decentralised CHC programme in the community clinic in Machar Colony, Karachi, Pakistan