• Cabergoline for suppression of puerperal lactation in a prevention of mother-to-child HIV-transmission programme in rural Malawi.

      Buhendwa, L; Zachariah, R; Teck, R; Massaquoi, M; Kazima, J; Firmenich, P; Harries, A D; Medecins sans Frontieres, Thyolo District, Malawi. (Royal Society of Medicine, 2008-01)
      This study shows that cabergoline (single oral-dose) is an acceptable, safe and effective drug for suppressing puerperal lactation. It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings.
    • Caesarean Sections in Rural Burundi: How Well Are Mothers Doing Two Years On?

      van den Boogaard, W; Manzi, M; De Plecker, E; Caluwaerts, S; Nanan-N'zeth, K; Duchenne, B; Etienne, W; Juma, N; Ndelema, B; Zachariah, R (International Union Against TB and Lung Disease, 2016-06-21)
      A caesarean section (C-section) is a life-saving emergency intervention. Avoiding pregnancies for at least 24 months after a C-section is important to prevent uterine rupture and maternal death.
    • Call for Preventive Care for Rheumatic Heart Disease in Refugee Children

      Rossi, G; Lee, VS (BMJ Publishing Group - We regret that this article is behind a paywall., 2016-04-26)
    • Calling tuberculosis a social disease--an excuse for complacency?

      Isaakidis, P; Smith, S; Majumdar, S; Furin, J; Reid, T (Elsevier, 2014-09-20)
    • Can aid switch gears to respond to sudden forced displacement? The case of Haut-Uele, DRC

      Derderian K; Schockaert L; Medecins Sans Frontieres Brussels (2012-06)
    • Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India

      Kundu, D; M V Kumar, A; Satyanarayana, S; Dewan, P K; Achuthan Nair, S; Khaparde, K; Nayak, P; Van den Bergh, R; Manzi, M; Enarson, D A; et al. (Public Library of Science, 2012-12-05)
      Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely.
    • Can height-adjusted cut-offs improve MUAC's utility as an assessment tool?

      Van Herp, M; Werwulgen, A; Leurquin, B; Delchevalerie, P (Emergency Nutrition Network, 2007-04)
    • Can non-monetary incentives increase health facility deliveries? The experience in Thyolo District, Malawi

      van den Akker, T; Radge, G; Mateyu, A; Mwagomba, B; Bemelmans, M; Reid, T (2011-09)
    • Can timely vector control interventions triggered by atypical environmental conditions prevent malaria epidemics? A case-study from wajir county, kenya.

      Maes, Peter; Harries, Anthony D; Van den Bergh, Rafael; Noor, Abdisalan; Snow, Robert W; Tayler-Smith, Katherine; Hinderaker, Sven Gudmund; Zachariah, Rony; Allan, Richard (Public Library of Science, 2014-04-03)
      Atypical environmental conditions with drought followed by heavy rainfall and flooding in arid areas in sub-Saharan Africa can lead to explosive epidemics of malaria, which might be prevented through timely vector-control interventions.
    • Can We Get More HIV-Positive Tuberculosis Patients on Antiretroviral Treatment in a Rural District of Malawi?

      Zachariah, R; Teck, R; Ascurra, O; Gomani, P; Manzi, M; Humblet, P; Nunn, P; Salaniponi, F M L; Harries, A D; Medical Department (HIV-TB Operational Research), Brussels Operational Centre, Médecins sans Frontières, Brussels, Belgium. zachariah@internet.lu (International Union Against TB and Lung Disease, 2005-03)
      The World Health Organization (WHO) has set a target of treating 3 million people with antiretroviral treatment (ART) by 2005. In sub-Saharan Africa, HIV-positive tuberculosis (TB) patients could significantly contribute to this target. ART (stavudine/lamivudine/nevirapine) was initiated in Thyolo district, Malawi, in April 2003, and all HIV-positive TB patients were considered eligible and offered ART. Despite this, only 44 (13%) of 352 TB patients were eventually started on ART by the end of November 2003. Most TB patients leave hospital after 2 weeks to complete the initial phase of anti-tuberculosis treatment (rifampicin-based) in the community, and ART is offered to HIV-positive TB patients after they have started the continuation phase of treatment (isoniazid/ ethambutol). ART is only offered at hospital, while the majority of TB patients take their continuation phase of anti-tuberculosis treatment from health centres. HIV-positive TB patients therefore find it difficult to access ART. In this paper, we discuss a series of options to increase the uptake of ART among HIV-positive TB patients. The main options are: 1) to hospitalise HIV-positive TB patients with a view to starting ART in the continuation phase in hospital; 2) to decentralise ART delivery so ART can be delivered at health centres; 3) to replace nevirapine with efavirenz so ART can be started earlier in the initial phase of anti-tuberculosis treatment. Decentralisation of ART from hospitals to health centres would greatly improve ART access.
    • Card Agglutination Test for Trypanosomiasis (CATT) End-Dilution Titer and Cerebrospinal Fluid Cell Count as Predictors of Human African Trypanosomiasis (Trypanosoma brucei gambiense) Among Serologically Suspected Individuals in Southern Sudan.

      Chappuis, F; Stivanello, E; Adams, K; Kidane, S; Pittet, A; Bovier, P A; Médecins Sans Frontières, Swiss Section, Geneva, Switzerland. francois.chappuis@hcuge.ch (Published by: American Society of Tropical Medicine and Hygiene, 2004-09)
      The diagnosis of human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense relies on an initial serologic screening with the card agglutination test for trypanosomiasis (CATT) for T. b. gambiense, followed by parasitologic confirmation in most endemic areas. Unfortunately, field parasitologic methods lack sensitivity and the management of serologically suspected individuals (i.e., individuals with a positive CATT result but negative parasitology) remains controversial. In Kajo-Keji County in southern Sudan, we prospectively collected sociodemographic and laboratory data of a cohort of 2,274 serologically suspected individuals. Thirty-three percent (n = 749) attended at least one follow-up visit and HAT was confirmed in 64 (9%) cases. Individuals with lower initial CATT-plasma (CATT-P) end-dilution titers had lowest risks (10.4 and 13.8/100 person-years for 1:4 and 1:8 titers, respectively) that significantly increased for higher dilutions: relative risks = 5.1 (95% confidence interval [CI] = 2.6-9.5) and 4.6 (95% CI = 2.8-9.8) for 1:16 and 1:32 titers, respectively. The cumulative yearly risk was also high (76%) in individuals found with 11-20 cells in the cerebrospinal fluid, but this involved only eight patients. Adjustment for potential confounders did not affect the results. In conclusion, treatment with pentamidine should be considered for all serologically suspected individuals with a CATT-P end-dilution titer >/= 1:16 in areas of a moderate to high prevalence of HAT.
    • Cardiovascular Disease among Syrian refugees: a descriptive study of patients in two Médecins Sans Frontières clinics in northern Lebanon.

      Boulle, P; Sibourd-Baudry, A; Ansbro, E; Merino, DP; Saleh, N; Zeidan, RK; Perel, P (BioMed Central, 2019-08-09)
      We included 514 patients with ASCVD in the cross-sectional study, performed in 2017. Most (61.9%) were male and mean age was 60.4 years (95% CI, 59.6-61.3). Over half (58.8%) underwent revascularization and 26.1% had known cerebrovascular disease. ASCVD risk factors included 51.8% with diabetes and 72.2% with hypertension. While prescription (75.7 to 98.2%) and self-reported adherence rates (78.4 to 93.9%) for individual ASCVD secondary prevention drugs (ACE-inhibitor, statin and antiplatelet) were high, the use of all three was low at 41.3% (CI95%: 37.0-45.6). The 5-year retrospective cohort study (ending April 2017) identified 1286 patients with ASCVD and 16,618 related consultations (comprising 24% of all NCD consultations). Over one third (39.7%) of patients were lost to follow-up, with lower risk among men.
    • Cardiovascular Disease Risk and Prevention Amongst Syrian Refugees: Mixed Methods Study of Médecins Sans Frontières Programme in Jordan

      Collins, D; Jobanputra, K; Frost, T; Muhammed, S; Ward, A; Shafei, A; Fardous, T; Gabashneh, S; Heneghan, C (BioMed Central, 2017-07-17)
      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.
    • Care for victims of sexual violence, an organization pushed to its limits: The case of Médecins Sans Frontières

      Duroch, F; Schulte-Hillen, C (International Committee of the Red Cross/Cambridge University Press, 2015-09-09)
      Over the past ten years, Médecins Sans Frontières (MSF) has provided medical care to almost 118,000 victims of sexual violence. Integrating related care into MSF general assistance to populations affected by crisis and conflicts has presented a considerable institutional struggle and continues to be a challenge. Tensions regarding the role of MSF in providing care to victims of sexual violence and when facing the multiple challenges inherent in dealing with this crime persist. An overview of MSF’s experience and related reflection aims to share with the reader, on the one hand,the complexity of the issue, and on the other, the need to continue fighting for the provision of adequate medical care for victims of sexual violence,which despite the limitations is feasible.
    • Care in crises: Nursing and humanitarian aid

      Freeman, A (Lippincott Williams & Wilkins, 2018-07)
    • Care in crisis

      Nicholl, J; Midwife, recently completed her sixth assignment working for Médecins Sans Frontières/Doctors Without Borders (MSF) (Mark Allen Healthcare, 2018-10-03)
    • Care of Non-Communicable Diseases in Emergencies

      Slama, S; Kim, HJ; Roglic, G; Boulle, P; Hering, H; Varghese, C; Rasheed, S; Tonelli, M (Elsevier, 2016-09-13)
    • Care Requirements for Clients Who Present After Rape and Clients Who Presented After Consensual Sex as a Minor at a Clinic in Harare, Zimbabwe, From 2011 to 2014

      Harrison, R; Pearson, L; Vere, M; Chonzi, P; Hove, B; Mabaya, S; Chigwamba, M; Nhamburo, J; Gura, J; Vandeborne, A; et al. (Public Library of Science, 2017-09-21)
      To describe the differences between clients presenting after rape and clients who have consented to sex as a minor to an SGBV clinic in Harare, Zimbabwe, and how these differences affect their care requirements.
    • Caring for patients with surgically resectable cancers: experience from a specialised centre in rural Rwanda

      Mubiligi, J M; Hedt-Gauthier, B; Mpunga, T; Tapela, N; Okao, P; Harries, A D; Edginton, M E; Driscoll, C; Mugabo, L; Riviello, R; et al. (The Union, 2014-06-21)
    • Carriage Prevalence and Serotype Distribution of Streptococcus Pneumoniae Prior to 10-Valent Pneumococcal Vaccine Introduction: A Population-Based Cross-Sectional Study in South Western Uganda, 2014

      Nackers, F; Cohuet, S; le Polain de Waroux, O; Langendorf, C; Nyehangane, D; Ndazima, D; Nanjebe, D; Karani, A; Tumwesigye, E; Mwanga-Amumpaire, J; et al. (Elsevier, 2017-08-04)
      Information on Streptococcus pneumoniae nasopharyngeal (NP) carriage before the pneumococcal conjugate vaccine (PCV) introduction is essential to monitor impact. The 10-valent PCV (PCV10) was officially introduced throughout Ugandan national childhood immunization programs in 2013 and rolled-out countrywide during 2014. We aimed to measure the age-specific Streptococcus pneumoniae carriage and serotype distribution across all population age groups in the pre-PCV10 era in South Western Uganda.