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Médecins sans frontières

Pete Buth, Benoit de Gryse, Sean Healy, Vincent Hoedt, Tara Newell, Giovanni Pintaldi, Hernan Del Valle, Julian C Sheather, Sidney Wong
Humanitarian organisations often work alongside those responsible for serious wrongdoing. In these circumstances, accusations of moral complicity are sometimes levelled at decision makers. These accusations can carry a strong if unfocused moral charge and are frequently the source of significant moral unease. In this paper, we explore the meaning and usefulness of complicity and its relation to moral accountability. We also examine the impact of concerns about complicity on the motivation of humanitarian staff and the risk that complicity may lead to a retreat into moral narcissism...
March 17, 2018: Journal of Medical Ethics
Mohammed Dalwai, Katie Tayler-Smith, Michèle Twomey, Masood Nasim, Abdul Qayum Popal, Waliul Haq Haqdost, Olivia Gayraud, Sophia Cheréstal, Lee Wallis, Pola Valles
OBJECTIVE: The South African Triage Scale (SATS) has demonstrated good validity in the EDs of Médecins Sans Frontières (MSF)-supported sites in Afghanistan and Haiti; however, corresponding reliability in these settings has not yet been reported on. This study set out to assess the inter-rater and intrarater reliability of the SATS in four MSF-supported EDs in Afghanistan and Haiti (two trauma-only EDs and two mixed (including both medical and trauma cases) EDs). METHODS: Under classroom conditions between December 2013 and February 2014, ED nurses at each site assigned triage ratings to a set of context-specific vignettes (written case reports of ED patients)...
March 16, 2018: Emergency Medicine Journal: EMJ
Alan de Lima Pereira, Rosamund Southgate, Hikmet Ahmed, Penelope O'Connor, Vanessa Cramond, Annick Lenglet
Introduction: In 2015, following an influx of population into Kobanê in northern Syria, Médecins Sans Frontières (MSF) in collaboration with the Kobanê Health Administration (KHA) initiated primary healthcare activities. A vaccination coverage survey and vaccine-preventable disease (VPD) risk analysis were undertaken to clarify the VPD risk and vaccination needs. This was followed by a measles Supplementary Immunization Activity (SIA). We describe the methods and results used for this prioritisation activity around vaccination in Kobanê in 2015...
February 2, 2018: PLoS Currents
Justin Lessler, Sean M Moore, Francisco J Luquero, Heather S McKay, Rebecca Grais, Myriam Henkens, Martin Mengel, Jessica Dunoyer, Maurice M'bangombe, Elizabeth C Lee, Mamoudou Harouna Djingarey, Bertrand Sudre, Didier Bompangue, Robert S M Fraser, Abdinasir Abubakar, William Perea, Dominique Legros, Andrew S Azman
BACKGROUND: Cholera remains a persistent health problem in sub-Saharan Africa and worldwide. Cholera can be controlled through appropriate water and sanitation, or by oral cholera vaccination, which provides transient (∼3 years) protection, although vaccine supplies remain scarce. We aimed to map cholera burden in sub-Saharan Africa and assess how geographical targeting could lead to more efficient interventions. METHODS: We combined information on cholera incidence in sub-Saharan Africa (excluding Djibouti and Eritrea) from 2010 to 2016 from datasets from WHO, Médecins Sans Frontières, ProMED, ReliefWeb, ministries of health, and the scientific literature...
March 1, 2018: Lancet
Gabriella Ferlazzo, Erika Mohr, Chinmay Laxmeshwar, Catherine Hewison, Jennifer Hughes, Sylvie Jonckheere, Naira Khachatryan, Virginia De Avezedo, Lusine Egazaryan, Amir Shroufi, Stobdan Kalon, Helen Cox, Jennifer Furin, Petros Isaakidis
BACKGROUND: Bedaquiline and delamanid have been approved for treatment of multidrug-resistant (MDR) tuberculosis in the past 5 years. Because of theoretical safety concerns, patients have been unable to access the two drugs in combination. Médecins Sans Frontières has supported the use of combination bedaquiline and delamanid for people with few treatment options since 2016. We describe early safety and efficacy of regimens containing the bedaquiline and delamanid combination in patients with drug-resistant tuberculosis in Yerevan, Armenia; Mumbai, India; and Khayelitsha, South Africa...
February 13, 2018: Lancet Infectious Diseases
Marc Poncin, Gideon Zulu, Caroline Voute, Eva Ferreras, Clara Mbwili Muleya, Kennedy Malama, Lorenzo Pezzoli, Jacob Mufunda, Hugues Robert, Florent Uzzeni, Francisco J Luquero, Elizabeth Chizema, Iza Ciglenecki
Objective: To describe the implementation and feasibility of an innovative mass vaccination strategy - based on single-dose oral cholera vaccine - to curb a cholera epidemic in a large urban setting. Method: In April 2016, in the early stages of a cholera outbreak in Lusaka, Zambia, the health ministry collaborated with Médecins Sans Frontières and the World Health Organization in organizing a mass vaccination campaign, based on single-dose oral cholera vaccine...
February 1, 2018: Bulletin of the World Health Organization
Daphne Lagrou, Rony Zachariah, Karen Bissell, Catherine Van Overloop, Masood Nasim, Hamsaya Nikyar Wagma, Shafiqa Kakar, Séverine Caluwaerts, Eva De Plecker, Renzo Fricke, Rafael Van den Bergh
Background: Provision of Emergency Obstetric and Neonatal Care (EmONC) reduces maternal mortality and should include three components: Basic Emergency Obstetric and Neonatal Care (BEmONC) offered at primary care level, Comprehensive EmONC (CEmONC) at secondary level and a good referral system in-between. In a conflict-affected province of Afghanistan (Khost), we assessed the performance of an Médecins Sans Frontières (MSF) run CEmONC hospital without a primary care and referral system...
2018: Conflict and Health
Vini Fardhdiani, Lucas Molfino, Ana Gabriela Zamudio, Rolanda Manuel, Gilda Luciano, Iza Ciglenecki, Barbara Rusch, Laurence Toutous Trellu, Matthew E Coldiron
Background: Kaposi's sarcoma (KS) is a common HIV-associated malignancy associated with disability, pain and poor outcomes. The cornerstone of its treatment is antiretroviral therapy, but advanced disease necessitates the addition of chemotherapy. In high-income settings, this often consists of liposomal anthracyclines, but in Mozambique, the first line includes conventional doxorubicin, bleomycin and vincristine, which is poorly-tolerated. Médecins Sans Frontières supports the Ministry of Health (MOH) in a specialized HIV and KS treatment center at the Centro de Referencia de Alto Maé in Maputo...
2018: Infectious Agents and Cancer
Thomas J Peto, Mark Debackere, William Etienne, Lieven Vernaeve, Rupam Tripura, Gregoire Falq, Chan Davoeung, Chea Nguon, Huy Rekol, Lorenz von Seidlein, Arjen M Dondorp, Nou Sanann, Phaik Yeong Cheah, Martin De Smet, Christopher Pell, Jean-Marie Kindermans
Two mass drug administrations (MDA) against falciparum malaria were conducted in 2015-16, one as operational research in northern Cambodia, and the other as a clinical trial in western Cambodia. During an April 2017 workshop in Phnom Penh the field teams from Médecins Sans Frontières and the Mahidol-Oxford Tropical Medicine Research Unit discussed lessons for future MDAs.
January 27, 2018: Malaria Journal
Richard Hurley
No abstract text is available yet for this article.
January 24, 2018: BMJ: British Medical Journal
Kerry A Thomson, Barbara Telfer, Patricia Opondo Awiti, Jane Munge, Mathew Ngunga, Anthony Reid
Within the first year of implementation, 43% of women who tested HIV positive at their first antenatal care visit were no longer retained and being followed in the free prevention of mother to child transmission (PMTCT) of HIV program offered by the Kenyan Ministry of Health and Médecins Sans Frontières in the informal settlement of Kibera, Nairobi. This study aimed to explore barriers to enrolling and remaining engaged in PMTCT services throughout the pregnancy and postpartum periods. Qualitative data from 31 focus group discussions and 35 in-depth interviews across six stakeholder groups that included women, men, and PMTCT service providers were analyzed...
2018: PloS One
Sara Albuquerque, Anneli Eriksson, Helle M Alvesson
BACKGROUND: Low retention of humanitarian workers poses constraints on humanitarian organisations' capacity to respond effectively to disasters. Research has focused on reasons for humanitarian workers leaving the sector, but little is known about the factors that can elucidate long-term commitment. OBJECTIVE: To understand what motivates and supports experienced humanitarian health workers to remain in the sector. METHODS: Semi-structured interviews were conducted with 10 experienced nurses who had been on at least three field missions with Médecins Sans Frontières Sweden...
2018: Global Health Action
Laura M Nic Lochlainn, Ivan Gayton, Georgios Theocharopoulos, Robin Edwards, Kostas Danis, Ronald Kremer, Karline Kleijer, Sumaila M Tejan, Mohamed Sankoh, Augustin Jimissa, Jane Greig, Grazia Caleo
BACKGROUND: During the 2014-16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned...
2018: PloS One
Séverine Caluwaerts
During the 2014-2016 Ebola epidemic, Médecins Sans Frontières (MSF) treated Ebola-positive pregnant women in its Ebola Treatment Centers (ETCs). For pregnant women with confirmed Ebola virus disease, inclusion in clinical vaccine/drug/therapeutic trials was complicated. Despite their extremely high Ebola-related mortality in previous epidemics (89-93%) and a neonatal mortality of 100%, theoretical concerns about safety of vaccines and therapeutics in pregnancy were invoked, limiting pregnant women's access to an experimental live attenuated vaccine and brincidofovir, an experimental antiviral...
December 14, 2017: Reproductive Health
Jane Feinmann
No abstract text is available yet for this article.
December 29, 2017: BMJ: British Medical Journal
Cavin Epie Bekolo, Abdourahimi Diallo, Mit Philips, Joseph-Desire Yuma, Letizia Di Stefano, Stéphanie Drèze, Jerome Mouton, Youssouf Koita, Ousseni W Tiomtore
BACKGROUND: The outbreak of the Ebola virus disease (EVD) in 2014 led to massive dropouts in HIV care in Guinea. Meanwhile, Médecins Sans Frontières (MSF) was implementing a six-monthly appointment spacing approach adapted locally as Rendez-vous de Six Mois (R6M) with an objective to improve retention in care. We sought to evaluate this innovative model of ART delivery in circumstances where access to healthcare is restricted. METHODS: A retrospective cohort study in 2014 of the outcome of a group of stable patients (viral load ≤1000 copies/μl) enrolled voluntarily in R6M compared with a group of stable patients continuing standard one to three monthly visits in Conakry...
December 13, 2017: BMC Infectious Diseases
Cavin E Bekolo, Mohamed M Soumah, Ousseni W Tiemtore, Abdourahimi Diallo, Joseph-Desire Yuma, Letizia Di Stefano, Carol Metcalf, Mohamed Cisse
BACKGROUND: Médecins Sans Frontières is supporting comprehensive HIV care and treatment for Kaposi Sarcoma (KS) in Guinea, where antiretroviral coverage is low and access to KS treatment is very limited. We aimed to evaluate treatment response and survival outcomes of epidemic KS in this setting. METHODS: Retrospective survival analysis of routinely collected clinical data of HIV-infected patients with clinically diagnosed KS, receiving ART and chemotherapy consisting of a combination of bleomycin and vincristine at the Donka National Hospital in Conakry between 2012 and 2015...
December 2, 2017: BMC Cancer
Jane Feinmann
No abstract text is available yet for this article.
November 30, 2017: BMJ: British Medical Journal
Charles Abongomera, Ermias Diro, Florian Vogt, Achilleas Tsoumanis, Zelalem Mekonnen, Henok Admassu, Robert Colebunders, Rezika Mohammed, Koert Ritmeijer, Johan van Griensven
Background: East Africa, where Leishmania donovani is prevalent, faces the highest burden world-wide of visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) coinfection. However, data on the risk and predictors of VL relapse are scarce. Such information is vital to target medical follow-up and interventions to those at highest risk. Methods: We conducted a retrospective cohort study at a Médecins Sans Frontières-supported health center in northwest Ethiopia...
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Suzette S Kämink, Simon M Collin, Tim Harrison, Francis Gatluak, Abdul Wasay Mullahzada, Koert Ritmeijer
BACKGROUND: South Sudan is one of the most endemic countries for visceral leishmaniasis (VL), and is frequently affected by large epidemics. In resource-limited settings, clinicians require a simple clinical tool to identify VL patients who are at increased risk of dying, and who need specialised treatment with liposomal amphotericin B and other supportive care. The aim of this study was to develop and validate a clinical severity scoring system based on risk factors for death in VL patients in South Sudan...
October 2017: PLoS Neglected Tropical Diseases
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