2564 research outputs found
Sort by
Predicting Visceral Leishmaniasis in HIV Infected Patients (PreLeisH)
No full textResearch ProtocolAim To study the asymptomatic period preceding the onset of active VL in HIV‐infected individuals from VL endemic regions in Ethiopia as an avenue to develop an evidence‐based screen and treat strategy to prevent progression to active VL.Primary:\ud
1. To estimate the prevalence of asymptomatic Leishmania infection .\ud
2. To estimate the incidence rate of asymptomatic Leishmania infection.\ud
3. To describe the evolution of Leishmania infection markers over time.\ud
4. To estimate the incidence rate of active VL.\ud
5. To identify risk factors associated with the development of active VL.\ud
6. To translate these risk factors into a clinical prognostic tool to identify individuals at high risk to develop active VL within 12 months .\ud
Secondary:\ud
1. To identify patterns in host immune markers that are associated with asymptomatic Leishmania infection.\ud
2. To describe the evolution of host immune markers over time.\ud
3. To identify patterns in host immune markers that are associated with treatment failure.\ud
4. To identify patterns in host immune markers that are associated with VL relapse
Evaluating the effectiveness and burden of diabetes care in a complex humanitarian emergency setting in Mweso, North Kivu, Democratic Republic of the Congo (DRC), 2015
No full textResearch ProtocolExecutive summary\ud
Background: Since 2008 Médecins Sans Frontières-Operational Centre Amsterdam (MSF-OCA) has been working in Mweso health zone, North Kivu, Democratic Republic of the Congo (DRC). In collaboration with the local Ministry of Health (MoH), MSF-OCA supports the Hospital in Mweso and 4 out of 23 Primary Health Care clinics. Mweso Hospital routinely treats diabetic patients presenting with acute complications and in need of treatment (insulin and/or oral treatment). Since 2011, this has been extended to the out-patient clinic, but without clinical guidance or standard operating procedures (SOP), nor specifically trained staff. The Mweso project reports increasing numbers of patients with diabetes and diabetes-related complications, and requested from MSF-OCA to implement a formal diabetes service to improve quality of care for Diabetics.\ud
Rationale: A new model of diabetes care was implemented by MSF-OCA in Mweso in March 2015. The model (Integrated Diabetic Clinic within an Outpatient Department (IDC-OPD)) is based on simplified context-adapted clinical guidelines, clinical SOPs, adapted patient counselling & support materials, medications from World Health Organization(WHO) Essential Medicines list, and one-off staff training by a Diabetologist. This represents an opportunity to evaluate and refine this model of diabetes care to support its application in comparable settings. Furthermore there is an opportunity to benchmark diabetes burden in the MSF Catchment area and measure its diabetes care coverage in the area.\ud
Overall aim: To evaluate IDC-OPD in Mweso health zone, North Kivu, DRC. \ud
The specific objectives are to examine:\ud
• The reach (coverage) of the diabetes service to the intended target population.\ud
• The effectiveness of IDC-OPD in improving diabetes outcomes (fasting blood glucose and complications)\ud
• Adoption / acceptance of IDC-OPD by staff and patients\ud
• Implementation of IDC-OPD in terms of consistency/fidelity, adaptation and costs \ud
• Maintenance of IDC-OPD in patients and programme over time
Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Mid Term Survey).
No full textResearch Protocol3 OBJECTIVES\ud
\ud
3.1 PRIMARY OBJECTIVES\ud
To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district.\ud
\ud
3.2 SECONDARY OBJECTIVES\ud
- To describe the population in terms of age breakdown, sex, household composition etc.\ud
- To estimate overall mortality rate and under 5 mortality rate \ud
- To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities;\ud
- To estimate the coverage of insecticide treated bednets in the community;\ud
- To estimate the coverage of soap and hygiene practices in the community\ud
- To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz
Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Final Survey) 1613C
No full textResearch Protocol3 OBJECTIVES\ud
\ud
3.1 PRIMARY OBJECTIVES\ud
To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district.\ud
\ud
3.2 SECONDARY OBJECTIVES\ud
- To describe the population in terms of age breakdown, sex, household composition etc.\ud
- To estimate overall mortality rate and under 5 mortality rate \ud
- To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities;\ud
- To estimate the coverage of insecticide treated bednets in the community;\ud
- To estimate the coverage of soap and hygiene practices in the community\ud
- To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz
A randomized trial of AmBisome monotherapy and combination of AmBisome and miltefosine for the treatment of VL in HIV positive patients in Ethiopia followed by secondary VL prophylactic treatment with pentamidine
No full textResearch ProtocolGeneral Objectives\ud
The overall objective of this trial is to identify a safe and effective treatment for VL in HIV coinfected\ud
patients.\ud
Primary Objective:\ud
To evaluate at day 29 assessment the efficacy of a combination regimen of AmBisome®\ud
+\ud
miltefosine and AmBisome®\ud
monotherapy in Ethiopian co-infected HIV + VL patients.\ud
Secondary Objectives:\ud
1. To evaluate relapse-free survival at day 390 (after initial cure at day 29 or cure at day 58 after\ud
extended treatment).\ud
2. To assess safety of the regimens.\ud
Other objectives:\ud
1.To evaluate of viral load and CD4 count in all patients\ud
2. To evaluate the pharmacokinetics of ARV, Ambisome and miltefosine and immune function\ud
markers in a subset of patient
Low uptake of preventive interventions among malaria cases in Swaziland: towards malaria elimination
No full textSettings: Swaziland is striving to achieve sustainable malaria elimination. Three preventive interventions are vital for reaching this goal: 1) effective household utilisation of long-lasting insecticide nets (LLINs), 2) indoor residual spraying (IRS), and 3) provision of chemoprophylaxis for those travelling to malaria-endemic areas. Objectives: To assess the uptake of preventive intervention among confirmed malaria cases. Design: A longitudinal study using nation-wide programme data from 2010 to 2015. Data on malaria cases from health facilities were sourced from the Malaria Surveillance Database System. Results: Of a total 2568 confirmed malaria cases in Swaziland, 2034 (79%) had complete data on case investigations and were included in the analysis. Of 341 (17%) individuals who owned LLINs, 169 (8%) used them; 338 (17%) had IRS and 314 (15%) slept in sprayed structures. Of 1403 travellers to areas at high malaria risk, 59 (4%) used any form of malaria prevention, including chemoprophylaxis. Conclusion: The uptake of all three key malaria prevention interventions is low, and could threaten the progress made thus far toward malaria elimination. Efforts to improve this situation, including qualitative research to understand the reasons for low uptake, are urgently needed
New insights into leishmaniasis in the immunosuppressed
No full textImmunosuppression contributes significantly to the caseload of visceral leishmaniasis (VL). HIV coinfection, solid organ transplantation, malnutrition, and helminth infections are the most important immunosuppression-related factors. This review briefly describes the challenges of these associations. East Africa and the Indian subcontinent are the places where HIV imposes the highest burden in VL. In the highlands of Northern Ethiopia, migrant rural workers are at a greater risk of coinfection and malnutrition, while in India, HIV reduces the sustainability of a successful elimination programme. As shown from a longitudinal cohort in Madrid, VL is an additional threat to solid organ transplantation. The association with malnutrition is more complex since it can be both a cause and a consequence of VL. Different regimes for therapy and secondary prevention are discussed as well as the role of nutrients on the prophylaxis of VL in poverty-stricken endemic areas
Hepatitis C Virus Diagnosis and the Holy Grail
No full textThe world has embraced the call for global elimination of hepatitis C virus by 2030. The unprecedented speed of therapeutic development and increased access to direct-acting antivirals has made elimination a possibility. We must screen hundreds of millions of people to diagnose and treat those currently infected. Global access to hepatitis C virus diagnostics will be a keystone to success. Key challenges must be overcome and systems optimized to ensure widespread access to existing diagnostics. Although promising technologies may soon transform the landscape, innovative strategies are needed to stimulate investment and accelerate the development of point-of-care hepatitis C virus diagnostics
Sub-national variation in measles vaccine coverage and outbreak risk: a case study from a 2010 outbreak in Malawi
No full textDespite progress towards increasing global vaccination coverage, measles continues to be one of the leading, preventable causes of death among children worldwide. Whether and how to target sub-national areas for vaccination campaigns continues to remain a question. We analyzed three metrics for prioritizing target areas: vaccination coverage, susceptible birth cohort, and the effective reproductive ratio (RE) in the context of the 2010 measles epidemic in Malawi
Prevalence of non-communicable diseases and access to care among non-camp Syrian refugees in northern Jordan
No full textTackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of key interventions for NCD care into humanitarian programs as well as sustainable financing. To provide evidence for effective NCD intervention planning, we conducted a cross-sectional survey among non-camp Syrian refugees in northern Jordan to investigate the burden and determinants for high NCDs prevalence and NCD multi-morbidities and assess the access to NCD care