• Does the type of treatment supporter influence tuberculosis treatment outcomes in Zimbabwe? [Short communication]

      Mlilo, N; Sandy, C; Harries, A D; Kumar, A M V; Masuka, N; Nyathi, B; Edginton, M; Isaakidis, P; Manzi, M; Siziba, N (Public Health Action, 2013-06-21)
      Zimbabwe is one of the world’s 22 high tuberculosis(TB) burden countries, and ⩾60% of its TB patients are infected with the human immunodeficiency virus (HIV).1 In 2010, the treatment success rate for new sputum smear-positive TB patients was 81%, lower than the 90% rate recommended by the new Global Plan to Stop TB.The World Health Organization’s (WHO’s) Stop TB strategy recommends supervised treatment and support,including direct observation of treatment (DOT), ensuring that every dose of medication is swallowed under observation. The Zimbabwean National TB Guidelines recommend that DOT should be provided, in order of priority, by a health facility-based worker, a trained community worker or a family member/relative as a last resort, with the belief that untrained family members/relatives might not be the best people to perform DOT. However, health facility-based DOT may be challenging due to distances travelled by patients,time spent away from home/work and transport costs.Studies in Thailand, Nepal, Malawi and Tanzania have shown that family- or community-based DOT is associated with good treatment outcomes.There is no published information on whether TB treatment outcomes are infl uenced by different types of DOT supporter in Zimbabwe. We therefore conducted this study in a district of Zimbabwe to describe 1) the number and proportions of registered TB patients receiving different types of DOT in relation to baseline characteristics and 2) the association of different types of DOT with TB treatment outcomes.
    • Good clinical outcomes from a seven years holistic program of fistula repair in Guinea

      Delamou, A; Diallo, M; Beavogui, A H; Delvaux, T; Millimono, S; Kourouma, M; Beattie, K; Barone, M; Barry, T H; Khogali, M; et al. (Wiley-Blackwell, 2015-02-23)
      Female genital fistula remains a public health concern in developing countries. From January 2007 to September 2013, the Fistula Care project, managed by EngenderHealth in partnership with the Ministry of Health, and supported by USAID, integrated fistula repair services in the maternity wards of general hospitals in Guinea. The objective of this article is to present and discuss the clinical outcomes of 7 years of work involving 2116 women repaired in three hospitals across the country.
    • Making Progress Towards Food Security: Evidence from an Intervention in Three Rural Districts of Rwanda

      Nsabuwera, V; Hedt-Gauthier, B; Khogali, M; Edginton, M; Hinderaker, S G; Nisingizwe, M P; Tihabyona, J d D; Sikubwabo, B; Sembagare, S; Habinshuti, A; et al. (Cambridge University Press, 2015-08-06)
      Determining interventions to address food insecurity and poverty, as well as setting targets to be achieved in a specific time period have been a persistent challenge for development practitioners and decision makers. The present study aimed to assess the changes in food access and consumption at the household level after one-year implementation of an integrated food security intervention in three rural districts of Rwanda.
    • Operational research training: the course and beyond

      Bissell, K; Harries, A D; Reid, A J; Edginton, M; Hinderaker, S G; Satyanarayana, S; Enarson, D A; Zachariah, R (The TB Union, 2012-09)
    • References for scientific papers: why not standardise to one global style? [Notes from the field]

      Harries, A D; Kumar, A M V; Satyanarayana, S; Bissell, K; Hinderaker, S G; Edginton, M; Reid, A J; Zachariah, R (2013-09)
    • The Structured Operational Research and Training Initiative for public health programmes

      Ramsay, A; Harries, A D; Zachariah, R; Bissel, K; Hinderaker, S G; Edginton, M; Enarson, D A; Satyanarayana, S; Kumar, A M V; Hoa, N B; et al. (The Union, 2014-06-21)
    • The Union and Médecins Sans Frontières approach to operational research.

      Harries, A D; Rusen, I D; Reid, T; Detjen, A K; Berger, S D; Bissell, K; Hinderaker, S G; Edginton, M; Fussell, M; Fujiwara, P I; et al. (2011-02)
      Operational research (OR) has become a hot topic at national meetings, international conferences and donor fora. The International Union Against Tuberculosis and Lung Disease (The Union) and Médecins Sans Frontières (MSF) Operational Centre Brussels strongly promote and implement OR with colleagues in low- and middle-income countries. Here we describe how the two organisations define OR, and explain the guiding principles and methodology that underpin the strategy for developing and expanding OR in those countries. We articulate The Union's and MSF's approach to supporting OR, highlighting the main synergies and differences. Then, using the Malawi National Tuberculosis Control Programme as an example, we show how OR can be embedded within tuberculosis control activities, leading to changes in policy and practice at the national level. We discuss the difficult, yet vitally important, issue of capacity building, and share our vision of a new paradigm of product-related training and performance-based OR fellowships as two ways of developing the necessary skills at country level to ensure research is actually performed. Finally, we highlight the need to consider and incorporate into practice the ethical components of OR. This is a key moment to be involved in OR. We are confident that in partnership with interested stakeholders, including the World Health Organization, we can stimulate the implementation of quality, relevant OR as an integral part of health service delivery that in turn will lead to better health for people, particularly for those living in the poorer parts of the world.
    • Why ethics is indispensable for good-quality operational research [Short communication]

      Edginton, M; Enarson, D; Zachariah, R; Reid, T; Satyanarayana, S; Bissell, K; Hinderaker, S G; Harries, A D (The TB Union, 2012-03)