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Fritz Allhoff, K Potts
Under customary international law, the First Geneva Convention and Additional Protocol I, medical personnel are protected against intentional attack. In § 1 of this paper, we survey these legal norms and situate them within the broader international humanitarian law framework. In § 2, we explore the historical and philosophical basis of medical immunity, both of which have been underexplored in the academic literature. In § 3, we analyse these norms as applied to an attack in Afghanistan (2015) by the United States; the United States was attempting to target a Taliban command-and-control centre but inadvertently destroyed a Médecins Sans Frontières hospital instead, killing 42 people...
October 16, 2018: Journal of the Royal Army Medical Corps
M Verdecchia, K Keus, S Blankley, D Vambe, C Ssonko, T Piening, E C Casas
INTRODUCTION: Since 2011 Médecins sans Frontières together with the eSwatini Ministry of Health have been managing patients with multi-drug resistant tuberculosis (MDR-TB) at Matsapha and Mankayane in Manzini region. This analysis describes the model of care and outcomes of patients receiving a 20 months MDR-TB treatment regimen between 2011 and 2013. METHOD: We conducted a retrospective observational cohort study of MDR-TB patients enrolled for treatment between May 2011 and December 2013...
2018: PloS One
Brian T Garibaldi, Chandrakant Ruparelia, Kathryn Shaw-Saliba, Lauren M Sauer, Lisa L Maragakis, Margaret Glancey, Marion Subah, Allyson R Nelson, Colby Wilkason, Laura Scavo, Lindsay Litwin, Patience Osei, Youseph Yazdi
BACKGROUND: During the 2014-2016 Ebola virus epidemic, more than 500 health care workers (HCWs) died in spite of the use of personal protective equipment (PPE). The Johns Hopkins University Center for Bioengineering Innovation and Design (CBID) and Jhpiego, an international nongovernmental organization affiliate of Johns Hopkins, collaborated to create new PPE to improve the ease of the doffing process. METHODS: HCWs in Liberia and a US biocontainment unit compared standard Médecins Sans Frontière PPE (PPE A) with the new PPE (PPE B)...
October 6, 2018: American Journal of Infection Control
Peter Hutten-Czapski
No abstract text is available yet for this article.
2018: Canadian Journal of Rural Medicine
Amanda Skoll, Amélie Boutin, Emmanuel Bujold, Jason Burrows, Joan Crane, Michael Geary, Venu Jain, Thierry Lacaze-Masmonteil, Jessica Liauw, William Mundle, Kellie Murphy, Suzanne Wong, K S Joseph
OBJECTIF: Évaluer les avantages et les risques de la corticothérapie prénatale chez les femmes qui présentent un risque d'accouchement prématuré ou qui subissent une césarienne à terme avant début de travail, et formuler des recommandations visant l'amélioration des issues néonatales et des issues à long terme. OPTIONS: Administrer ou ne pas administrer une corticothérapie prénatale aux femmes qui présentent un risque élevé d'accouchement prématuré ou qui subissent une césarienne avant travail à terme...
September 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Iza Ciglenecki, Andrew S Azman, Christine Jamet, Micaela Serafini, Francisco J Luquero, Jean-Clement Cabrol
The use of oral cholera vaccine (OCV) has increased since 2011, when Shanchol, the first OCV suitable for large-scale use, became available. Médecins Sans Frontières considers OCVs an essential cholera outbreak control tool and has contributed to generating new evidence on OCV use in outbreaks. We showed that large-scale mass campaigns are feasible during outbreaks, documented high short-term effectiveness and showed that vaccines are likely safe in pregnancy. We found that a single-dose regimen has high short-term effectiveness, making rapid delivery of vaccine during outbreaks easier, especially given the on-going global vaccine shortage...
October 15, 2018: Journal of Infectious Diseases
James A Elliott, Debashish Das, Philippe Cavailler, Fabien Schneider, Maya Shah, Annette Ravaud, Maria Lightowler, Philippa Boulle
Background: Patients with diabetes require knowledge and skills to self-manage their disease, a challenging aspect of treatment that is difficult to address in humanitarian settings. Due to the lack of literature and experience regarding diabetes self-management, education and support (DSMES) in refugee populations, Medecins Sans Frontieres (MSF) undertook a DSMES survey in a cohort of diabetes patients seen in their primary health care program in Lebanon. Methods: Structured interviews were conducted with diabetes patients in three primary care clinics between January and February 2015...
2018: Conflict and Health
Momoko Iwamoto, Aurelie Calzia, Amelie Dublineau, François Rouet, Janin Nouhin, Sokchea Yann, Sophorn Pin, Chhorvy Sun, Kimchamroeun Sann, Chhit Dimanche, Celine Lastrucci, Rebecca M Coulborn, David Maman, Jean-Philippe Dousset, Anne Loarec
GeneXpert® (Cepheid) is the only WHO prequalified platform for Hepatitis C Virus (HCV) Nucleic Acid Amplification Testing that is suitable for point-of-care use in resource-limited contexts. However, its application is constrained by the lack of evidence on genotype 6 (GT6) HCV. We evaluated its field performance among a patient population in Cambodia predominantly infected with GT6. Between August and September 2017, we tested plasma samples obtained from consenting patients at Médecins Sans Frontières' HCV clinic at Preah Kossamak Hospital for HCV viral load (VL) using GeneXpert® and compared its results to those obtained using COBAS® AmpliPrep/Cobas® TaqMan® HCV Quantitative Test, v2...
September 10, 2018: Journal of Viral Hepatitis
Sheila Isanaka, Kerstin E Hanson, Severine Frison, Christopher T Andersen, Sandra Cohuet, Rebecca F Grais
The use of mid upper arm circumference (MUAC) measurement to screen and determine eligibility for admission to therapeutic feeding programs has been established, but evidence and programmatic experience to inform guidance on the use of MUAC as a discharge criterion is limited. We present results from a large scale nutritional program using MUAC for admission and discharge and compare program outcomes and response to treatment when determining eligibility for discharge by proportional weight gain vs. discharge by MUAC...
September 8, 2018: Maternal & Child Nutrition
David A Shaye, Ryan Winters, Jens Rabbels, Adenyiyi Seminyu Adentunji, Aidan Magee, Daniel Vo
OBJECTIVE: Noma is a devastating and destructive disease of the face for which there is a dearth of information regarding surgical options. Herein, we describe the facial deformities and patient characteristics in a patient population affected by noma and the surgical approaches used in treatment. METHODS: Retrospective case series of a Doctors Without Borders (Médecins Sans Frontières) intervention at Sokoto Children's Noma Hospital in northern Nigeria, the highest-volume noma hospital in the world...
September 8, 2018: Laryngoscope
Amy S Kravitz Del Solar, Bharat Parekh, Meaghan O'Keefe Douglas, Dianna Edgil, Joel Kuritsky, John Nkengasong
As part of the global response to the HIV/AIDS epidemic, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is committed to the provision of high-quality services and ensuring testing accuracy. Two recently published papers focusing on HIV testing and misdiagnosis in sub-Saharan Africa by Kosack et al. report on evaluations of HIV rapid diagnostic tests (RDTs) and found lower than expected specificity and sensitivity on some tests when used in certain geographic locations. The magnitude of PEPFAR's global HIV response has been possible due to the extensive use of RDTs, which have made HIV diagnosis accessible all over the world...
August 2018: Journal of the International AIDS Society
Dominique Baron, Christian Flin, Jérôme Porterie, Jacques Despaux, Patrice Vincent
Introduction: La viscosupplémentation du liquide synovial par injection intra-articulaire d'acide hyaluronique est un traitement symptomatique de l'arthrose, largement utilisé dans la gonarthrose (arthrose du genou). À côté des produits conçus pour être administrés par injections multiples (typiquement 3 à 5 injections à intervalles de 1 semaine), un intérêt particulier se porte sur produits en injection unique (mono-injection) qui offrent des avantages spécifiques tels que la réduction du nombre de visites au médecin et du nombre d'interventions invasives avec leurs risques associés...
2018: Current Therapeutic Research, Clinical and Experimental
Qabale Golicha, Sharmila Shetty, Orkhan Nasiblov, Abubakar Hussein, Eliud Wainaina, Mark Obonyo, Daniel Macharia, Raymond N Musyoka, Hussein Abdille, Maurice Ope, Rachael Joseph, Willy Kabugi, John Kiogora, Munawwar Said, Waqo Boru, Tura Galgalo, Sara A Lowther, Bonventure Juma, Robert Mugoh, Newton Wamola, Clayton Onyango, Zeinab Gura, Marc-Alain Widdowson, Kevin M DeCock, John W Burton
Dadaab Refugee camp in Garissa County, Kenya, hosts nearly 340,000 refugees in five subcamps (Dagahaley, Hagadera, Ifo, Ifo2, and Kambioos) (1). On November 18 and 19, 2015, during an ongoing national cholera outbreak (2), two camp residents were evaluated for acute watery diarrhea (three or more stools in ≤24 hours); Vibrio cholerae serogroup O1 serotype Ogawa was isolated from stool specimens collected from both patients. Within 1 week of the report of index cases, an additional 45 cases of acute watery diarrhea were reported...
August 31, 2018: MMWR. Morbidity and Mortality Weekly Report
Joel Hellewell, Patrick Walker, Azra Ghani, Bhargavi Rao, Thomas S Churcher
BACKGROUND: The number of clinical cases of malaria is often recorded in resource constrained or conflict settings as a proxy for disease burden. Interpreting case count data in areas of humanitarian need is challenging due to uncertainties in population size caused by security concerns, resource constraints and population movement. Malaria prevalence in women visiting ante-natal care (ANC) clinics has the potential to be an easier and more accurate metric for malaria surveillance that is unbiased by population size if malaria testing is routinely conducted irrespective of symptoms...
August 29, 2018: Malaria Journal
Xavier Humbert, Basile Chrétien, Marion Sassier, Antoine Coquerel, Joachim Alexandre, Sophie Fedrizzi
BACKGROUND: Spontaneous reporting of adverse drug reactions remains the cornerstone of postmarketing drug safety surveillance (pharmacovigilance). However, the marked underreporting of adverse drug reactions constitutes a major limitation. The main objective of this study was to assess the use of this simplified reporting by general practitioners (GPs) in Western Normandy based on the number of ADRs reported and to assess its impact on the quality of these reports. METHOD: Simplified online pharmacovigilance reporting was proposed in June 2015 by the Caen Normandie regional pharmacovigilance center (CRPV) in conjunction with the Normandy Union régionale des médecins libéraux (URML Normandie) for GPs...
March 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Annick Lenglet, Barbara Lopes-Cardozo, Leslie Shanks, Curtis Blanton, Concetta Feo, Zalina Tsatsaeva, Kyuri Idrisov, Paul A Bolton, Giovanni Pintaldi
OBJECTIVES: To evaluate the effectiveness of individual counselling on functioning of clients participating in a mental health intervention in a humanitarian setting. DESIGN: Randomised controlled trial. SETTING: Mental health programme implemented by Médecins Sans Frontières in Grozny, Republic of Chechnya. PARTICIPANTS: 168 eligible clients were randomly assigned to the intervention and waitlisted (2 months) arms between November 2014 and February 2015...
August 23, 2018: BMJ Open
Katharine Hutchinson, Malcolm Bryant, Mary Bachman DeSilva, Deborah Price, Lora Sabin, Lindsay Bryson, Roger Jean Charles, Eugene Declercq
BACKGROUND: The primary objective of this comparative, cross-sectional study was to identify factors affecting delays in accessing emergency obstetric care and clinical consequences of delays among preeclamptic and non-preeclamptic women in Port-au-Prince, Haiti. METHODS: We administered 524 surveys to women admitted to the Médecins Sans Frontières Centre de Référence en Urgences Obstétricales (CRUO) obstetric emergency hospital. Survey questions addressed first (at home), second (transport) and third (health facility) delays; demographic, clinical, and behavioral risk factors for delay; and clinical outcomes for women and infants...
August 20, 2018: BMC Pregnancy and Childbirth
Martin Schneider, François Chappuis, Sophie Pautex
BACKGROUND: Given the worldwide increase of chronic diseases, expatriate health workers on assignment with humanitarian emergency organisations can face more clinical situations that require advanced pain control or palliative care. Multiple reasons can prevent the provision of this care. AIM: To better know how health workers react to and cope with this dilemma. DESIGN: A qualitative interview study using inductive thematic analysis was performed...
August 16, 2018: Palliative Medicine
Geneviève Rail, Luisa Molino, Caroline Fusco, Moss Edward Norman, LeAnne Petherick, Jessica Polzer, Fiona Moola, Mary Bryson
RéSUMé: OBJECTIF: L'objectif était d'étudier le déploiement des discours sur la vaccination contre les VPH (VVPH) et leur impact sur les filles, les parents, les infirmiers/infirmières et les médecins canadiens. MéTHODES: Des entrevues ont été réalisées avec des participant(e)s (n = 146) de quatre provinces canadiennes. Une analyse poststructuraliste du discours a permis d'examiner les campagnes de VVPH et les transcriptions d'entrevues pour documenter la façon dont les participant(e)s interprètent les VVPH et se positionnent comme sujets au sein des discours de l'industrie ou des agences de santé publique...
August 3, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Camille Chenevier-Gobeaux, Louis Deweerdt, Anne-Valérie Cantero, Bertrand Renaud, Bruno Desmaizières, Sandrine Charpentier, Aline Leroy, Emmanuelle Adelaïde, Delphine Collin-Chavagnac, Eric Bonnefoy-Cudraz, Laurence Estepa, Akli Chekroune, Sylvie Basco, Stéphane Andrieu, Stéphane Bourgeois, Marie-Agnès Costa, Christine Vallejo, Tiphaine Robert, Siham Ouahabi, Bruno Baudin, Benedicte Beneteau-Burnat, Anne-Marie Gorce-Dupuy, Patrick Ray, Claire Gast, Monique Dehoux, Guillaume Lefèvre
Objectives: We aimed to compare the use of nine different cardiac troponin (cTn) assays (2 cTnT and 7 cTnI) for the diagnosis of NSTEMI in a single multi-centre population. Design and methods: One hundred and fifty-eight patients were included (mean age 60 years, SD 17 years), including 23 patients (14%) with NSTEMI. Results: The analytical comparison highlighted a large heterogeneity of cTn assays, as reflected by percentages of patients with detectable cTn, correlation coefficients, Passing-Bablok comparisons and concordance coefficients...
July 2018: Practical Laboratory Medicine
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