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https://www.readbyqxmd.com/read/28810670/journey-towards-universal-viral-load-monitoring-in-maputo-mozambique-many-gaps-but-encouraging-signs
#1
Sarah Swannet, Tom Decroo, Sheila M T L de Castro, Caroline Rose, Ruggero Giuliani, Lucas Molfino, Ana W Torrens, Walter S E D Macueia, Sharon Perry, Tony Reid
Introduction: Viral load (VL) monitoring for people on antiretroviral therapy (ART) is extremely challenging in resource-limited settings. We assessed the VL testing scale-up in six Médecins Sans Frontières supported health centres in Maputo, Mozambique, during 2014-15. Methods: In a retrospective cohort study, routine programme data were used to describe VL testing uptake and results, and multi-variate logistical regression to estimate predictors of VL testing uptake and suppression...
July 1, 2017: International Health
https://www.readbyqxmd.com/read/28770590/delivering-hiv-care-in-challenging-operating-environments-the-msf-experience-towards-differentiated-models-of-care-for-settings-with-multiple-basic-health-care-needs
#2
REVIEW
Charles Ssonko, Lucia Gonzalez, Anita Mesic, Marcio Silveira da Fonseca, Jay Achar, Nadia Safar, Beatriz Martin, Sidney Wong, Esther C Casas
INTRODUCTION: Countries in the West and Central African regions struggle to offer quality HIV care at scale, despite HIV prevalence being relatively low. In these challenging operating environments, basic health care needs are multiple, systems are highly fragile and conflict disrupts health care. Médecins Sans Frontières (MSF) has been working to integrate HIV care in basic health services in such settings since 2000. We review the implementation of differentiated HIV care and treatment approaches in MSF-supported programmes in South Sudan (RoSS), Central African Republic (CAR) and Democratic Republic of Congo (DRC)...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28770589/implications-of-differentiated-care-for-successful-art-scale-up-in-a-concentrated-hiv-epidemic-in-yangon-myanmar
#3
REVIEW
Anita Mesic, Julie Fontaine, Theingy Aye, Jane Greig, Thin Thin Thwe, Laura Moretó-Planas, Jarmila Kliesckova, Khin Khin, Nana Zarkua, Lucia Gonzalez, Erwin Lloyd Guillergan, Daniel P O'Brien
INTRODUCTION: National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around the hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28750691/the-use-of-interpreters-in-medical-triage-during-a-refugee-mass-gathering-incident-in-europe
#4
Lykourgos Christos Alexakis, Anastasia Papachristou, Chiara Baruzzi, Angeliki Konstantinou
Introduction During a refugees' mass-gathering incident in Kos Island, Greece, Médecins Sans Frontières (MSF; Brussels, Belgium) teams provided emergency medical care. A case report of the event focusing on difficulties encountered by the interpreters during triage and emergency response was prepared. METHODS: Data collected during the event were reviewed from the patient's register and qualitative interviews were obtained from the MSF interpreters involved in the response. In addition, a description of the event and a literature review were included...
July 28, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28725259/cardiovascular-disease-risk-and-prevention-amongst-syrian-refugees-mixed-methods-study-of-m%C3%A3-decins-sans-fronti%C3%A3-res-programme-in-jordan
#5
Dylan R J Collins, Kiran Jobanputra, Thomas Frost, Shoaib Muhammed, Alison Ward, Abed Alrazzaq Shafei, Taissir Fardous, Sadeq Gabashneh, Carl Heneghan
BACKGROUND: The growing burden of non-communicable diseases (NCDs) presented new challenges for medical humanitarian aid and little was known about primary health care approaches for these diseases in humanitarian response. We aimed to evaluate Médecins Sans Frontières (MSF's) use of total CVD risk based prevention strategies amongst Syrian refugees in northern Jordan to identify opportunities to improve total CVD risk based guidance for humanitarian settings. METHODS: We evaluated CVD risk assessment and management in two outpatient NCD clinics in the Irbid governorate of Jordan using a mixed methods design with qualitative and quantitative strands of equal priority, integrated during data collection and interpretation...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28716879/international-issues-teleneurology-in-humanitarian-crises-lessons-from-the-m%C3%A3-decins-sans-fronti%C3%A3-res-experience
#6
Altaf Saadi, Farrah J Mateen
Humanitarian emergencies defined by armed conflict, political strife, famine, or natural disaster can devastate populations rapidly. Neurologic disorders accompany these complex humanitarian emergencies but often go unheeded, exacerbated by a scarcity of neurologists. Teleneurology offers the promise of neurologic care remotely in the face of this inadequate local clinician supply. We describe our experiences as voluntary neurology teleconsultants with Médecins Sans Frontières in order to highlight both the promises and challenges of teleneurology in humanitarian contexts...
July 18, 2017: Neurology
https://www.readbyqxmd.com/read/28700045/chagas-disease-review-of-needs-neglect-and-obstacles-to-treatment-access-in-latin-america
#7
REVIEW
Eloan Pinheiro, Lucia Brum-Soares, Renata Reis, Juan-Carlos Cubides
After more than one century since its discovery, Chagas disease is still extremely prevalent in 21 Latin American countries. Chagas disease is one of the most concerning public health problems in Latin America; the overall cost of CD treatment is approximately 7 billion United States dollars per year and it has a strong social impact on populations. Little progress has been made regarding the access to diagnosis and treatment at the primary health care level, calling into question the current policies to ensure the right to health and access to essential medications...
May 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/28649273/high-burden-of-malaria-and-anemia-among-tribal-pregnant-women-in-a-chronic-conflict-corridor-in-india
#8
Gustavo Corrêa, Mrinalini Das, Rama Kovelamudi, Nagendra Jaladi, Charlotte Pignon, Kalyan Vysyaraju, Usha Yedla, Vijya Laxmi, Pavani Vemula, Vijaya Gowthami, Hemant Sharma, Daniel Remartinez, Stobdan Kalon, Kirrily de Polnay, Martin De Smet, Petros Isaakidis
BACKGROUND: With more than 200 million cases a year, malaria is an important global health concern, especially among pregnant women. The forested tribal areas of Andhra Pradesh, Telangana and Chhattisgarh in India are affected by malaria and by an on-going chronic conflict which seriously limits access to health care. The burden of malaria and anemia among pregnant women in these areas is unknown; moreover there are no specific recommendations for pregnant women in the Indian national malaria policy...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28645279/diabetes-care-in-a-complex-humanitarian-emergency-setting-a-qualitative-evaluation
#9
Adrianna Murphy, Michel Biringanine, Bayard Roberts, Beverley Stringer, Pablo Perel, Kiran Jobanputra
BACKGROUND: Evidence is urgently needed from complex emergency settings to support efforts to respond to the increasing burden of diabetes mellitus (DM). We conducted a qualitative study of a new model of DM health care (Integrated Diabetic Clinic within an Outpatient Department [IDC-OPD]) implemented by Médecins Sans Frontières (MSF) in Mweso Hospital in eastern Democratic Republic of Congo (DRC). We aimed to explore patient and provider perspectives on the model in order to identify factors that may support or impede it...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28645201/benznidazole-treatment-safety-the-m%C3%A3-decins-sans-fronti%C3%A3-res-experience-in-a-large-cohort-of-bolivian-patients-with-chagas-disease
#10
Gilberto Marcelo Sperandio da Silva, Mauro Felippe Felix Mediano, Alejandro Marcel Hasslocher-Moreno, Marcelo Teixeira de Holanda, Andrea Silvestre de Sousa, Luiz Henrique Conde Sangenis, Pedro Emmanuel Alvarenga Americano do Brasil, Roger Arteaga Mejía, Carina Perotti Fux, Juan-Carlos Cubides, Roberto Magalhães Saraiva, Lucia Maria Brum-Soares
Background: Up to half of patients with Chagas' disease under benznidazole treatment present adverse drug reactions (ADRs) and up to one-third do not complete standard treatment. Objectives: To verify the incidence and possible factors associated with the suspension of benznidazole treatment in a large cohort of patients. Methods: We included 2075 patients treated with benznidazole during the projects managed by the medical humanitarian organization Doctors Without Borders (Médecins Sans Frontières) in Bolivia from 2009 to 2013...
June 22, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28628463/operational-research-during-the-ebola-emergency
#11
Gabriel Fitzpatrick, Tom Decroo, Bertrand Draguez, Rosa Crestani, Axelle Ronsse, Rafael Van den Bergh, Michel Van Herp
Operational research aims to identify interventions, strategies, or tools that can enhance the quality, effectiveness, or coverage of programs where the research is taking place. Médecins Sans Frontières admitted ≈5,200 patients with confirmed Ebola virus disease during the Ebola outbreak in West Africa and from the beginning nested operational research within its emergency response. This research covered critical areas, such as understanding how the virus spreads, clinical trials, community perceptions, challenges within Ebola treatment centers, and negative effects on non-Ebola healthcare...
July 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28567113/research-ethics-governance-in-times-of-ebola
#12
Doris Schopper, Raffaella Ravinetto, Lisa Schwartz, Eunice Kamaara, Sunita Sheel, Michael J Segelid, Aasim Ahmad, Angus Dawson, Jerome Singh, Amar Jesani, Ross Upshur
The Médecins Sans Frontières (MSF) ethics review board (ERB) has been solicited in an unprecedented way to provide advice and review research protocols in an 'emergency' mode during the recent Ebola epidemic. Twenty-seven Ebola-related study protocols were reviewed between March 2014 and August 2015, ranging from epidemiological research, to behavioural research, infectivity studies and clinical trials with investigational products at (very) early development stages. This article examines the MSF ERB's experience addressing issues related to both the process of review and substantive ethical issues in this context...
April 2017: Public Health Ethics
https://www.readbyqxmd.com/read/28489890/unmasking-inequalities-sub-national-maternal-and-child-mortality-data-from-two-urban-slums-in-lagos-nigeria-tells-the-story
#13
Erin Anastasi, Ekanem Ekanem, Olivia Hill, Agnes Adebayo Oluwakemi, Oluwatosin Abayomi, Andrea Bernasconi
INTRODUCTION: Nigeria has one of the highest maternal mortality ratios in the world as well as high perinatal mortality. Unfortunately, the country does not have the resources to assess this critical indicator with the conventional health information system and measuring its progress toward the goal of ending preventable maternal deaths is almost impossible. Médecins Sans Frontières (MSF) conducted a cross-sectional study to assess maternal and perinatal mortality in Makoko Riverine and Badia East, two of the most vulnerable slums of Lagos...
2017: PloS One
https://www.readbyqxmd.com/read/28459838/ebola-management-centre-proximity-associated-with-reduced-delays-of-healthcare-of-ebola-virus-disease-evd-patients-tonkolili-sierra-leone-2014-15
#14
Georgios Theocharopoulos, Kostas Danis, Jane Greig, Alexandra Hoffmann, Henriette De Valk, Augustine Jimissa, Sumaila Tejan, Mohammed Sankoh, Karline Kleijer, Will Turner, Jay Achar, Jennifer Duncombe, Kamalini Lokuge, Ivan Gayton, Rob Broeder, Ronald Kremer, Grazia Caleo
Between August-December 2014, Ebola Virus Disease (EVD) patients from Tonkolili District were referred for care to two Médecins Sans Frontières (MSF) Ebola Management Centres (EMCs) outside the district (distant EMCs). In December 2014, MSF opened an EMC in Tonkolili District (district EMC). We examined the effect of opening a district-based EMC on time to admission and number of suspect cases dead on arrival (DOA), and identified factors associated with fatality in EVD patients, residents in Tonkolili District...
2017: PloS One
https://www.readbyqxmd.com/read/28458866/a-live-term-intra-abdominal-pregnancy-in-a-field-hospital-a-case-report
#15
Shadi Abdelrahman, Matthew Deeter, Anitha Muthusami, Trine G Peterson, Leen Wackenier
Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be challenging, especially in a resource-limited setting. We report a case of abdominal pregnancy that presented to Médecins Sans Frontières field hospital in Agok, South Sudan, with abdominal pain. Examination revealed a term pregnancy and a live fetus in transverse lie. The diagnosis of abdominal pregnancy was made intraoperatively, with successful management and delivery of a healthy baby...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28416965/a-crisis-of-protection-and-safe-passage-violence-experienced-by-migrants-refugees-travelling-along-the-western-balkan-corridor-to-northern-europe
#16
Jovana Arsenijević, Erin Schillberg, Aurelie Ponthieu, Lucio Malvisi, Waeil A Elrahman Ahmed, Stefano Argenziano, Federica Zamatto, Simon Burroughs, Natalie Severy, Christophe Hebting, Brice de Vingne, Anthony D Harries, Rony Zachariah
BACKGROUND: Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28400124/sex-disparities-among-persons-receiving-operative-care-during-armed-conflicts
#17
Joseph D Forrester, Jared A Forrester, Jean-Paul Basimouneye, Mohammad-Zahir Tahir, Miguel Trelles, Adam L Kushner, Sherry M Wren
BACKGROUND: Armed conflict increasingly involves civilian populations, and health care needs may be immense. We hypothesized that sex disparities may exist among persons receiving operative care in conflict zones and sought to describe predictors of disparity. METHODS: We performed a retrospective analysis of operative interventions performed between 2008 and 2014 at Médecins Sans Frontières Operation Center Brussels conflict projects. A Médecins Sans Frontières Operation Center Brussels conflict project was defined as a program established in response to human conflict, war, or social unrest...
April 8, 2017: Surgery
https://www.readbyqxmd.com/read/28328346/efficacy-of-a-low-cost-heat-stable-oral-rotavirus-vaccine-in-niger
#18
RANDOMIZED CONTROLLED TRIAL
Sheila Isanaka, Ousmane Guindo, Celine Langendorf, Amadou Matar Seck, Brian D Plikaytis, Nathan Sayinzoga-Makombe, Monica M McNeal, Nicole Meyer, Eric Adehossi, Ali Djibo, Bruno Jochum, Rebecca F Grais
BACKGROUND: Each year, rotavirus gastroenteritis is responsible for about 37% of deaths from diarrhea among children younger than 5 years of age worldwide, with a disproportionate effect in sub-Saharan Africa. METHODS: We conducted a randomized, placebo-controlled trial in Niger to evaluate the efficacy of a live, oral bovine rotavirus pentavalent vaccine (BRV-PV, Serum Institute of India) to prevent severe rotavirus gastroenteritis. Healthy infants received three doses of the vaccine or placebo at 6, 10, and 14 weeks of age...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28320759/basic-occupational-health-services-bohs-in-community-primary-care-the-msf-dhaka-model
#19
Venkiteswaran Muralidhar, Md Faizul Ahasan, Ahad Mahmud Khan, Mohammad Shariful Alam
The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols...
March 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28282377/before-the-bombing-high-burden-of-traumatic-injuries-in-kunduz-trauma-center-kunduz-afghanistan
#20
Hamayoun Hemat, Safieh Shah, Petros Isaakidis, Mrinalini Das, Nang Thu Thu Kyaw, Sattar Zaheer, Abdul Qayeum Qasemy, Mutallib Zakir, Gbane Mahama, Catherine Van Overloop, Lynette Dominguez
BACKGROUND: Médecins Sans Frontières (MSF) has been providing healthcare in Afghanistan since 1981 including specialized health services for trauma patients in Kunduz Trauma Center (KTC) from 2011. On October 3rd, 2015, a US airstrike hit the KTC, killing 42 people including 14 MSF staff. This study aims to demonstrate the impact on healthcare provision, after hospital destruction, by assessing the extent of care provided for trauma and injuries by the MSF KTC and to report on treatment outcomes from January 2014 to June 2015, three months prior to the bombing...
2017: PloS One
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