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Outbreak of Pneumococcal Meningitis, Paoua Subprefecture, Central African Republic, 2016-2017

Title: Outbreak of Pneumococcal Meningitis, Paoua Subprefecture, Central African Republic, 2016-2017 Authors: Coldiron, Me; Touré, O; Frank, T; Bouygues, N; Grais, RF Abstract: We report a pneumococcal meningitis outbreak in the Central African Republic (251 suspected cases; 60 confirmed by latex agglutination test) in 2016-2017. Case-fatality rates (10% for confirmed case-patients) were low. In areas where a recent pneumococcal conjugate vaccine campaign was conducted, a smaller proportion of cases was seen in youngest children.

Leishmaniasis

Title: Leishmaniasis Authors: Burza, S; Croft, SL; Boelaert, M Abstract: Leishmaniasis is a poverty-related disease with two main clinical forms: visceral leishmaniasis and cutaneous leishmaniasis. An estimated 0·7-1 million new cases of leishmaniasis per year are reported from nearly 100 endemic countries. The number of reported visceral leishmaniasis cases has decreased substantially in the past decade as a result of better access to diagnosis and treatment and more intense vector control within an elimination initiative in Asia, although natural cycles in transmission intensity might play a role. In east Africa however, the case numbers of this fatal disease continue to be sustained. Increased conflict in endemic areas of cutaneous leishmaniasis and forced displacement has resulted in a surge in these endemic areas as well as clinics across the world. WHO lists leishmaniasis as one of the neglected tropical diseases for which the development of new treatments is a priority. Major evidence gaps remain, and new tools are needed before leishmaniasis can be definitively controlled.

For Family-Centered Differentiated Service Delivery for HIV

Title: For Family-Centered Differentiated Service Delivery for HIV Authors: Grimsrud, A; Bygrave, H; Wilkinson, L Abstract: Differentiated care, or differentiated service delivery (DSD), is increasingly being promoted as one of the possible ways to address and improve access, quality, and efficiency of HIV prevention, care, and treatment. Family-centered care has long been promoted within the provision of HIV services, but the full benefits have not necessarily been realized. In this article, we bring together these two approaches and make the case for how family-centered DSD can offer benefits to both people affected by HIV and the health system. Family-centered DSD approaches are presented for HIV testing and antiretroviral therapy (ART) delivery, referencing policies, best practice examples, and evidence from the field. With differentiated family-centered ART delivery, the potential efficiencies gained by extending ART refills can both benefit clients by reducing the frequency and intensity of contact with the health service and lead to health system gains by not requiring multiple providers to care for one family. A family-centered DSD approach should also be leveraged along the HIV care cascade in the provision of prevention technologies and mobilizing family members to receive regular HIV testing. Furthermore, a family-centered lens should be applied wherever DSD is implemented to ensure that, for example, adolescents who are pregnant receive an adapted package of quality care.

Does the Structured Operational Research and Training Initiative (SORT IT) continue to influence health policy and/or practice?

Title: Does the Structured Operational Research and Training Initiative (SORT IT) continue to influence health policy and/or practice? Authors: Tripathy, JP; Kumar, AM; Guillerm, N; Berger, SD; Bissell, K; Reid, A; Zachariah, R; Ramsay, A; Harries, AD Abstract: The Structured Operational Research and Training Initiative (SORT IT) is a successful model of integrated operational research and capacity building with about 90% of participants completing the training and publishing in scientific journals.

Retrospective mortality survey in the MSF catchment area in Fizi health zone, South Kivu, Democratic Republic of Congo

Title: Retrospective mortality survey in the MSF catchment area in Fizi health zone, South Kivu, Democratic Republic of Congo Authors: Lenglet, Annick; Bil, Karla; Mandelkow, Jantina Abstract: . OBJECTIVES 2.1. PRIMARY OBJECTIVES To estimate the crude mortality rate for the total population (host and IDP) and for children under five years of age in the health zone of Fizi, South Kivu, DRC, in order to understand the current health status of the population in this catchment area. 2.2. SECONDARY OBJECTIVES  To determine the prevalence of self-reported morbidities in the two weeks preceding the survey in household members;  To determine the frequency and reasons for displacement;  To assess access to health care;  To determine the main causes of deaths during the recall period;  To measure the incidence and types of direct violence experienced by the civilian population;  To evaluate household ownership of basic non-food items; Description: Research Protocol

Prevalence and vaccination coverage of Hepatitis B among healthcare workers in Cameroon: A national seroprevalence survey

Title: Prevalence and vaccination coverage of Hepatitis B among healthcare workers in Cameroon: A national seroprevalence survey Authors: Bilounga Ndongo, C; Eteki, L; Siedner, M; Mbaye, R; Chen, J; Ntone, R; Donfack, O; Bongwong, B; Essaka, RE; Zeh, F; Njouom, R; Nguefack-Tsague, Georges; Etoundi, GAM; Biwole Sida, M; Boum, Y Abstract: Hepatitis B virus (HBV) infection is hyperendemic in Cameroon, and health care workers (HCWs) are at high-risk of infection. We aimed to assess prevalence, risk factors and vaccine coverage of HBV infection among HCWs in Cameroon. We conducted a cross-sectional study in 16 hospitals across all regions of Cameroon. HCWs were tested for HBV using rapid diagnostic tests (RDT). We collected data on socio-demographics and HBV vaccination status. We estimated prevalence of HBV and used Poisson regression models with robust standard errors to model the prevalence ratios of HBV positivity between covariates. We enrolled 1,824 of 1,836 eligible HCWs (97.5%). The mean age was 34 (SD: 10) years, 65.3% (n=1787) were women, and 11.4% (n=1747) had three or more doses of the HBV vaccine. Overall, we found a HBV prevalence of 8.7% (95% CI: 5.2 - 14.3%). Patient transporters had the highest crude prevalence (14.3%; 95%CI: 5.4-32.9%), whereas medical doctors had the lowest (3.2%; 95%CI: 0.8%-12.1%). The Far North Region had the highest prevalence of HBV (24.0%; 95%CI: 18.3%-30.8%). HBV prevalence decreased with increasing doses of the HBV vaccine (10.3% for no doses vs 3.5% for three or more doses; P<0.001). In conclusion, approximately 1 in 12 HCWs in Cameroon have evidence of HBV infection, yet fewer than 1 in 6 have been fully vaccinated. Our results illustrate the urgent need to scale up systematic HBV screening and targeted vaccination of HCWs in the region. This article is protected by copyright. All rights reserved.

Body and mind: retention in antiretroviral treatment care is improved by mental health training of care providers in Ethiopia

Title: Body and mind: retention in antiretroviral treatment care is improved by mental health training of care providers in Ethiopia Authors: Berheto, TM; Hinderaker, SG; Senkoro, M; Tweya, H; Deressa, T; Getaneh, Y; Gezahegn, G Abstract: Ethiopia has achieved a high coverage of antiretroviral treatment (ART), but maintaining lifelong care is still a great challenge. Mental illnesses often co-exist with HIV/AIDS and may compromise the retention on ART. In order to improve prolonged retention in ART care, basic training in mental health care was introduced for ART providers, but this hasn't been evaluated yet. The aim of this study was to examine if this training has improved patient retention in care.

MSF OCA NCD Guidelines version 4

Title: MSF OCA NCD Guidelines version 4 Authors: MSF Description: Non-communicable diseases (NCDs) make the largest contribution to mortality both globally and in the majority of low- and middle- income countries (LMICs). Worldwide, NCDs account for 60% (35 million) of global deaths. The major NCDs used to be diseases of affluence; however, the changing epidemiology of NCDs (increasingly affecting low- and middle-income countries) and the changing patterns of refugee crises (away from settings where infectious disease represents the main burden of disease) mean that they now represent an increasing proportion of the cases we see in many MSF projects.

Field Research Survey

Title: Field Research Survey Authors: MSF USA; LuxOR Description: To access the survey, click on Additional Links.

Estimating program coverage in the treatment of severe acute malnutrition: a comparative analysis of the validity and operational feasibility of two methods

Title: Estimating program coverage in the treatment of severe acute malnutrition: a comparative analysis of the validity and operational feasibility of two methods Authors: Isanaka, S; Hedt-Gauthier, BL; Grais, RF; Allen, BGS Abstract: Many health programs can assess coverage using standardized cluster survey methods, but estimating the coverage of nutrition programs presents a special challenge due to low disease prevalence. Used since 2012, the Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) employs both qualitative and quantitative methods to identify key barriers to access and estimate coverage of therapeutic feeding programs. While the tool has been increasingly used in programs, the validity of certain methodological elements has been the subject of debate.

Is 6 months of bedaquiline enough? Results from the compassionate use of bedaquiline in Armenia and Georgia

Title: Is 6 months of bedaquiline enough? Results from the compassionate use of bedaquiline in Armenia and Georgia Authors: Hewison, C; Bastard, M; Khachatryan, N; Kotrikadze, T; Hayrapetyan, A; Avaliani, Z; Kiria, N; Yegiazaryan, L; Chumburidze, N; Kirakosyan, O; Atshemyan, H; Qayyum, S; Lachenal, N; Varaine, F; Huerga, H Abstract: Bedaquiline (BDQ) was initially only available through compassionate use programmes.

Determinants of dietary practices during pregnancy: A longitudinal qualitative study in Niger

Title: Determinants of dietary practices during pregnancy: A longitudinal qualitative study in Niger Authors: Rosen, JG; Clermont, A; Kodish, SR; Seck, AM; Salifou, A; Grais, RF; Isanaka, S Abstract: Undernutrition is associated with maternal morbidity and poor pregnancy outcomes. This qualitative study seeks to understand the multilevel factors influencing maternal dietary practices in Niger, including the impact of pregnancy illnesses on diet. Criterion-based, purposive sampling was used to select pregnant women and household members from 24 villages in a rural district of the Maradi Region in south-central Niger. Semistructured interviews (n = 153) and focus group discussions (n = 38) explored 4 primary themes: (a) perceptions of ideal diet during pregnancy, (b) barriers to consuming the ideal diet, (c) coping strategies including dietary responses related to pregnancy illnesses, and (d) changes in perceptions from early to late pregnancy. Longitudinal data collection allowed for repeated interviews of pregnant women to document changes in dietary practices throughout pregnancy. Transcripts were coded using an inductive approach informed by grounded theory methodology. Participants categorized foods into 4 primary dietary taxonomies when discussing ideal maternal diets but cited constraints related to accessibility and availability impeding routine consumption of these foods. Perceptions of "modern," urban foods as healthy, coupled with key structural barriers such as food costs, were identified. Maternal morbidity influenced food consumption, as women reported reducing food intake early in pregnancy in response to illness episodes. Although awareness of optimal foods for supporting healthy pregnancies was moderately high, some misconceptions were observed and multilevel barriers to food security restricted opportunities for consuming these foods. Nutrition-specific and nutrition-sensitive interventions could improve access and availability of acceptable foods for supporting increased dietary intake during pregnancy.

Seroprevalence and risk factors of recent infection with hepatitis E virus during an acute outbreak in an urban setting in Chad, 2017

Title: Seroprevalence and risk factors of recent infection with hepatitis E virus during an acute outbreak in an urban setting in Chad, 2017 Authors: Vernier, L; Lenglet, A; Hogema, BM; Moussa, AM; Ariti, C; Vollmer, S; Irwin, A; Alfani, P; Sang, S; Kamau, C Abstract: From September 2016-April 2017, Am Timan, Chad, experienced a large HEV outbreak in an urban setting with a limited impact in terms of morbidity and mortality. To better understand HEV epidemiology in this context, we estimated the seroprevalence of anti-HEV antibodies (IgM and IgG) and assessed the risk factors for recent HEV infections (positive anti-HEV IgM) during this outbreak.

Single-dose oral ciprofloxacin prophylaxis as a response to a meningococcal meningitis epidemic in the African meningitis belt: A 3-arm, open-label, cluster-randomized trial

Title: Single-dose oral ciprofloxacin prophylaxis as a response to a meningococcal meningitis epidemic in the African meningitis belt: A 3-arm, open-label, cluster-randomized trial Authors: Coldiron, ME; Assao, B; Page, A; Hitchings, MDT; Alcoba, G; Ciglenecki, I; Langendorf, C; Mambula, C; Adehossi, E; Sidikou, F; Tassiou, EI; De Lastours, V; Grais, RF Abstract: Antibiotic prophylaxis for contacts of meningitis cases is not recommended during outbreaks in the African meningitis belt. We assessed the effectiveness of single-dose oral ciprofloxacin administered to household contacts and in village-wide distributions on the overall attack rate (AR) in an outbreak of meningococcal meningitis.

Survey report OCA Southern Syria

Title: Survey report OCA Southern Syria Authors: MSF Description: Conducted in Dar’aa and Quneitra,during a cease fire in 2017, this study attempted to provide a baseline of health care needs and barriers to accessing health care. By triangulating information sources, we have attempted to cover important health care subjects from different perspectives.

Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015

Title: Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015 Authors: Linn, NYY; Kathirvel, S; Das, M; Thapa, B; Rahman, Mm; Maung, TM; Kyaw, AMM; Thi, A; Lin, Z Abstract: Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar.

Standardized Nutrition Surveys

Title: Standardized Nutrition Surveys Authors: MSF Description: The guideline starts with the assumption that the need to carry out a nutrition survey, in an area where MSF is working, has been discussed with all decision makers at headquarters and field level. This is stipulated in criterion two of ”surveys based on the standardised intersectional survey protocols, approved by the MSF ERB”. Moreover, it was agreed to perform the nutrition survey to better evaluate the health status of the population living in the MSF catchment area.

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