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Pediatric Access and Continuity of HIV Care Before the Start of Antiretroviral Therapy in Sub-Saharan Africa
No full textThe number of HIV-infected children starting antiretroviral treatment (ART) has increased in resource-limited settings during the past decades. However, there are still few published data on the characteristics of pediatric patients at program enrolment and on the dynamics of dropping out before the start of ART
A Randomised Phase II Trial to Evaluate the Toxicity of High-Dose Rifampicin to Treat Pulmonary Tuberculosis
No full textRandomised Phase IIB clinical trial
Identification of Patients Who Could Benefit from Bedaquiline or Delamanid: a Multisite MDR-TB Cohort Study
No full textThe World Health Organization recommends adding bedaquiline or delamanid to multidrug-resistant tuberculosis (MDR-TB) regimens for which four effective drugs are not available, and delamanid for patients at high risk of poor outcome
Effect of Short-Term Supplementation with Ready-to-Use Therapeutic Food or Micronutrients for Children after Illness for Prevention of Malnutrition: A Randomised Controlled Trial in Nigeria
No full textGlobally, Médecins Sans Frontières (MSF) treats more than 300,000 severely malnourished children annually. Malnutrition is not only caused by lack of food and poor infant and child feeding practices but also by illnesses. Breaking the vicious cycle of illness and malnutrition by providing ill children with nutritional supplementation is a potentially powerful strategy for preventing malnutrition that has not been adequately investigated. Therefore, MSF investigated whether incidence of malnutrition among ill children <5 y old could be reduced by providing a fortified food product or micronutrients during their 2-wk convalescence period. Two trials, one in Nigeria and one in Uganda, were conducted; here we report on the trial that took place in Goronyo, a rural region of northwest Nigeria with high morbidity and malnutrition rates
Ebola Virus Disease Complications as Experienced by Survivors in Sierra Leone.
No full text Thousands of people have survived Ebola virus disease (EVD) during the ongoing outbreak. However, data about the frequency and risk factors of long-term post-EVD complications remain scarce. We describe the clinical characteristics of EVD survivors followed in a survivor clinic in Freetown, Sierra Leone
The Journey to Dreamland Never Ends: A Refugee’s Journey from Somalia to Sweden
No full textLarge numbers of people continue to flee conflict and instability, moving along human smuggling routes, hiding in transit cities, and getting locked up in detention centres in the process of seeking safety and asylum. This is widely known, but the human cost and intricacies of individual journeys is often hidden behind statistics and political discourse. In this article, Ali Hassan from Mogadishu, Somalia shares the story of his two-year flight from Yemen to Sweden, illustrating the harsh conditions and dangers faced by forced migrants: the lack of food and water, the overcrowding inside vehicles or boats, the exploitation and abuse by smuggling networks, and the hostile reception from security and governmental officials. This detailed life story illustrates both the human impact of restrictive migration policies, and the problems this generates for aid workers, especially since information about the needs of forced migrants at different stages, and how and where they access assistance, is largely inadequate. By exploring how forced migrants negotiate invisibility and vulnerability, this detailed life story is an illustration of the challenges humanitarians face when responding to an unfolding crisis
Managing and Monitoring Chronic Non-Communicable Diseases in a Primary Health Care Clinic, Lilongwe, Malawi
Get PDFSetting: Patients with chronic non-communicable diseases attending a primary health care centre, Lilongwe, Malawi.\ud
Objective: Using an electronic medical record monitoring system, to describe the quarterly and cumulative disease burden, management and outcomes of patients registered between March 2014 and June 2015.\ud
Design: A cross-sectional study.\ud
Results: Of 1135 patients, with new registrations increasing each quarter, 66% were female, 21% were aged 65 years, 20% were obese, 53% had hypertension alone, 18% had diabetes alone, 12% had asthma, 10% had epilepsy and 7% had both hypertension and diabetes. In every quarter, about 30% of patients did not attend the clinic and 19% were registered as lost to follow-up (not seen for 1 year) in the last quarter. Of those attending, over 90% were prescribed medication, and 80–90% with hypertension and/or diabetes had blood pressure/blood glucose measured. Over 85% of those with epilepsy had no seizures and 60–75% with asthma\ud
had no severe attacks. Control of blood pressure (41–51%) and diabetes (15–38%) was poor.\ud
Conclusion: It is feasible to manage patients with non-communicable diseases in a primary health care setting in Malawi, although more attention is needed to improve clinic attendance and the control of hypertension and diabetes
Safety, Feasibility, and Acceptability of the PrePex Device for Adult Male Circumcision in Malawi
No full textNonsurgical adult male circumcision devices present an alternative to surgery where health resources are limited. This study aimed to assess the safety, feasibility, and acceptability of the PrePex device for adult male circumcision in Malawi
Inpatient Signs and Symptoms and Factors Associated with Death in Children Aged 5 Years and Younger Admitted to Two Ebola Management Centres in Sierra Leone, 2014: a Retrospective Cohort Study
No full textMédecins Sans Frontières (MSF) opened Ebola management centres (EMCs) in Sierra Leone in Kailahun in June, 2014, and Bo in September, 2014. Case fatality in the west African Ebola virus disease epidemic has been highest in children younger than 5 years. Clinical data on outcomes can provide important evidence to guide future management. However, such data on children are scarce and disaggregated clinical data across all ages in this epidemic have focussed on symptoms reported on arrival at treatment facilities, rather than symptoms and signs observed during admission. We aimed to describe the clinical characteristics of children aged 5 years and younger admitted to the MSF EMCs in Bo and Kailahun, and any associations between these characteristics and mortality
Upholding Tuberculosis Services during the 2014 Ebola Storm: An Encouraging Experience from Conakry, Guinea
No full textTen targeted health facilities supported by Damien Foundation (a Belgian Non Governmental Organization) and the National Tuberculosis (TB) Program in Conakry, Guinea