This section contains resources for MSF and other researchers working in the field. It includes information on MSF's Ethics Review Board and Research Tools.

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  • Exploring the perceptions of communities toward the impact novel Coronavirus-2 (SARS-CoV-2), COVID-19 outbreak and response can have on their lives and security

    Stringer, B; Alcayna, T; Caleo, G; Carrion-Martin, I; Froud, A; Gray, N; Keating, P; Kuehne, A; Lenglet, A; Stellmach, D; et al. (2020-06)
  • Seroprevalence of SARS-CoV-2 antibodies among people experiencing homelessness

    Roederer, T; Fourrey, E; Mollo, B; Vanhomwegen, J; Simons, E; Torre, C; Vincent, C; Llosa, A; Luquero, F (2020-05)
  • Research Protocol - Exploring Menstrual Hygiene Management (MHM) Systems, Practices and Perceptions in Selected MSF Health Structures: A Mixed Method Study

    Scott Moncrieff, Izzy; Fesselet, Jeff; Stringer, Beverley; Lenglet, Annick; MSF OCA (2019-05)
    To establish the degree to which sanitation and hygiene facilities at MSF heath structures meet the requirements of menstruating women.
  • Health Seeking Behaviour in Kamrangirchar

    Jeroen van der Heijden; OCA (2018-09-28)
  • Retrospective mortality survey in the MSF catchment area in Fizi health zone, South Kivu, Democratic Republic of Congo

    Lenglet, Annick; Bil, Karla; Mandelkow, Jantina; MSF-OCA (2018-07-31)
    . 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;
  • The Impact of a Tick-Sheet in Improving Interpretation Accuracy of Chest Radiographs by Non-Specialists in an HIV positive cohort

    Kosack, Cara; Mesic, Anita; Spijker, Saskia; Bonnet, Maryline; Joekes, Elizabeth; MSF-OCA (2018-07)
    Study objective 3.1 Primary objective To determine if the application of a tick-sheet after four hour training on its use and on CXR interpretation, improves the interpretation accuracy of CXRs for active TB, by nonspecialists, in an HIV-positive cohort. 3.2 Secondary objective To determine whether the application of a tick-sheet reduces the inter-reader variability of CXR interpretation in a group of non-specialists by comparing the inter-reader agreement before and after intervention.
  • Retrospective population-based mortality survey in an urban and rural area of Sierra Leone, 2015

    Caleo, Grazia; Kardamanidis, Katina; Broeder, Rob; Belava, Jaroslava; Kremer, Ronald; Lokuge, Kamalini; Greig, Jane; Turay; Saffa, Gbessay; MSF-OCA (2018-07)
    2. Objectives 2.1. Primary objectives The Primary objective of the survey is to:  Estimate mortality in a sample of the population in the urban and rural area of Bo District from the approximate start of the Ebola outbreak in Sierra Leone (mid May 2014) until the day of the survey. 2.2. Secondary objectives  Estimate overall and cause-specific mortality (EVD and non-EVD) in children under the age of 5 years, and the population aged 5 years and older within the study area, with particular attention to the period prior to the MSF Ebola Management Centre (EMC) opening in Bo district (19 September 2014) and the period during which it was receiving cases from the district (last confirmed case exited 26 January 2015);  Estimate overall and cause-specific mortality (EVD and non-EVD) in quarantined and non-quarantined households; and contact-traced and non-contact-traced households;  Describe health seeking behaviour in terms of whether health care was sought, where health care was sought and whether access to health care was possible.
  • Maternal and child health care seeking behaviour: a household survey and interview study in an urban and rural area of Sierra Leone, 2016

    Elston, James; Snag, Sibylle; Kazungu, Donald Sonne; Jimissa, A; Caleo, Grazia; Danis, Kostas; Lokuge, Kamalini; Black, Benjamin; Gray, Nell; MSF-OCA (2018-07)
    To describe health seeking behaviour during pregnancy, for childbirth and in children under the age of five years, and to identify barriers to accessing and receiving healthcare services at the time of the study and since the start of the Ebola outbreak in an urban and rural area of Tonkolili District. 2.2 PRIMARY OBJECTIVES 1. To estimate utilisation of health facilities by women for childbirth in Magburaka town and Yoni chiefdom since the start of the Ebola outbreak ; 2. To estimate utilisation of healthcare services by children aged <5 years in Magburaka town and Yoni chiefdom during their most recent febrile illness within the three month period preceding the day of the survey. 3. To identify and describe factors influencing utilisation of health services and delays in seeking and receiving adequate healthcare during pregnancy and for childbirth 4. To identify and describe factors influencing utilisation of health services and delays in seeking and receiving adequate healthcare for febrile illness in children aged <5 years
  • Health Service Access Survey among Non-camp Syrian Refugees in Irbid Governorate, Jordan

    Rehr, Manuela; Shoaib, Muhammad; Deprade, Anais; Lenglet, Annick; Ait-Bouziad, Idriss; Altarawneh, Mohammad; Alshafee, Abdel Razzaq; Gabashneh, Sadeq; MSF-OCA (2018-07)
    2. OBJECTIVES 2.1. PRIMARY OBJECTIVES • To determine the level of access to health care services for Syrian refugees living out-of-camp in Irbid governorate, Jordan. 2.2. SECONDARY OBJECTIVES • To describe the socio-demographic characteristics of the surveyed population including age, gender, disabilities, time living in Jordan, living conditions, and legal status • To describe the economic situation of the surveyed households with regards to income & income sources, dependency on humanitarian assistance, household expenditures and direct and indirect expenditures on health • To characterize health care utilization of non-camp Syrian refugees including frequency & type of services used as well as the main reasons for requiring medical care • To estimate coverage with the most crucial health services such as vaccination coverage of under 5-year-old children, coverage with services for non-communicable diseases and maternal health coverage. • To estimate the coverage of MSF services including specifically NCD care as well as ANC and child health care • To estimate health service needs by estimating the household- prevalence of NCDs as well as the birth rate. • To identify barriers to accessing general-, as well as specialized health care services with regards to economic constraints, barriers resulting from knowledge gaps as well as limitations in accessibility and/or acceptability of existing services. • To identify risk factors for not accessing general and specialized health services as needed. • To estimate retrospectively the crude mortality rate (CMR) and specific mortality rates for the total population and for children under five years of age (U5MR).
  • Improving utilisation of services for sexual and gender-based violence (SGBV): knowledge, attitudes, practices and perceptions (KAP) in Jahangipuri, Delhi India protocol

    Himanshu, M; Sharmin, Sabrina; Renjhen, Prachi; Saheb, Baba; Gupta, Vinita; MSF-OCA (2018-07)
    2 Research question and objectives 2.1 Research question To identify factors that could improve SGBV service utilisation and acceptance amongst MSF’s catchment population in Delhi, India 2.2 Primary objective To understand how to improve utilization of SGBV services for the population in MSF catchment area Delhi, India 2.3 Specific objectives 1. To understand community knowledge related to SGBV, including its consequences, treatment and clinical services 2. To understand attitudes towards health aspects of SGBV 3. To explore practices related to SGBV care seeking pathways, including barriers and enablers affecting service access and uptake 4. To understand which strategies/activities people consider would be effective in improving access and uptake of clinical services by survivors of SGBV
  • Longitudinal cohort to evaluate Hepatitis C treatment effectiveness in HIV co-infected patients: Manipur, India

    Himanshu, M; Singh, Karam Romeo; Shougrakpam, Jeetesh; MSF-OCA (2018-07)
    4. OBJECTIVES Primary objective The primary objective of this study is to assess the effectiveness of HCV curative treatments in patients with chronic hepatitis C (CHC), co-infected with HIV in Manipur, India. Secondary objectives a. To describe the demographic, clinical and biological characteristics of patients with chronic hepatitis C and HIV co-infection b. To assess the effectiveness of HCV curative strategies in patients with chronic HCV, co-infected with HIV stratified by regimen and by site c. To identify risk factors associated with differing virological responses d. To assess the safety of HCV treatment e. To monitor the safety of HCV treatment in HIV co-infected patients f. To document the clinical and biological tolerance of the HCV treatment g. To assess the feasibility of HCV treatment h. To assess comparative performance of elastography (Fibroscan®) and APRI (AST to Platelet Ration Index), to evaluate liver fibrosis among HIV/HCV co-infected individuals i. To describe causes of non-eligibility for treatment j. To describe the clinical and biological evolution of co-infected patients, not eligible for HCV treatment k. To assess treatment adherence
  • Field evaluation of the performance of HCV Serological Rapid Diagnostic Tests among HCV/HIV co-infected patients

    Gupta, Ekta; Carnimeo, Valentina; Samukcham, Inao; Loarec, Anne; Mahajan, Supriya; Choudhary, Manish; Bastard, Mathieu; Maman, David; Page, Anne Laure; MSF-OCA (2018-07)
    P R O T O C O L S U M M A R Y  Title: Field evaluation of the performance of HCV Serological Rapid Diagnostic Tests among HCV/HIV co-infected patients.  Aim: To evaluate the performance of serological HCV Rapid Diagnostic Tests (RDTs) to identify tests adapted to resource-limited settings, reliable for HIV-infected patients.  Study design: Prospective evaluation of the performance of serological RDTs for HCV screening.  Primary objective: o To evaluate the performance of serological HCV RDTs under field conditions using as reference standard a combination of enzyme immunoassay (EIA) and recombinant immunoblot assay (RIBA) for the detection of antibodies anti-HCV in HIV infected patients.  Secondary objectives: o To describe the accuracy (sensitivity, specificity) of the RDTs as screening tests o To describe the performance of the RDTs according to the HCV genotype and HCV VL o To describe the performance of the RDTs according to the CD4 counts and HIV VL o To describe the performance of the RDTs in presence of HBV co-infection (presence of antigen anti-HBs (HBsAg)) o To describe the operational characteristics of the tests including ease of use, technical complexity and inter-reader variability. o To evaluate predictive values of each HCV RDT based on the prevalence of the testing center.
  • Secondary prophylaxis of visceral leishmaniasis relapses in HIV co-infected patients using pentamidine as a prophylactic agent: a prospective cohort study

    Diro, Ermias; Griensven, Johan van; Woldegebreal, Teklu; Belew, Zewdu; Taye, Melese; Yifru, Sisay; Davidson, Robert N.; Balasegaram, Manica; Lynen, Lut; Boelaert, Marleen; et al. (2018-07)
    2.1 OBJECTIVES 2.1.1 General objective: To document the effectiveness, safety and feasibility of monthly PM secondary prophylaxis (PSP) in VL/HIV co-infected patients that have documented parasite clearance after VL treatment when used for prevention of VL relapse. 2.1.2 Specific objectives of the primary study period Primary objectives In VL/HIV co-infected patients that have documented parasite clearance after VL treatment: - to assess the effectiveness of PSP in terms of preventing relapse and death; - to assess the safety of PSP in terms of drug-related serious adverse events or permanent drug discontinuations due to adverse events; - to assess the feasibility of PSP in terms of number of patients compliant to therapy during the first year of monthly PM secondary prophylaxis. Secondary objectives; In VL/HIV co-infected patients that have documented parasite clearance after VL treatment: - to assess the safety of PSP in terms of: - drug-related non-serious adverse events - serious adverse events (drug-related or not) - to assess the feasibility of PSP in terms of: - number of treatment interruptions/discontinuations, - number of therapeutic interventions needed to treat adverse drug reactions
  • A randomized trial of AmBisome monotherapy and combination of AmBisome and miltefosine for the treatment of VL in HIV positive patients in Ethiopia followed by secondary VL prophylactic treatment with pentamidine

    Hailu, Asrat; Diro, Ermias; Kolja, Stille; Ritmeijer, Koert; Yifru, Sisay; Griensven, Johan van; Zijstra, Ed; Dorlo, Thomas; Strub-Wougaft, Nathalie; Bardonneau, Clelia; et al. (2018-07)
    General Objectives The overall objective of this trial is to identify a safe and effective treatment for VL in HIV coinfected patients. Primary Objective: To evaluate at day 29 assessment the efficacy of a combination regimen of AmBisome® + miltefosine and AmBisome® monotherapy in Ethiopian co-infected HIV + VL patients. Secondary Objectives: 1. To evaluate relapse-free survival at day 390 (after initial cure at day 29 or cure at day 58 after extended treatment). 2. To assess safety of the regimens. Other objectives: 1.To evaluate of viral load and CD4 count in all patients 2. To evaluate the pharmacokinetics of ARV, Ambisome and miltefosine and immune function markers in a subset of patients
  • Determination of the most accurate diagnostic approach for the diagnosis of human brucellosis in Lankien, South-Sudan

    Kosack, Cara; Page, Anne-Laure; Moriyon, Ignacio; Zuniga, Amaia; Conde, Raquel; Laku, Richard; MSF-OCA (2018-07)
    3. Objectives 3.1 Primary objective To estimate the diagnostic accuracy (sensitivity, specificity, positive and negative predicative values and likelihood ratios) of the modified RBT method and the rapid diagnostic test developed by the KIT tests performed (if commercially available) at Institute for Tropical Health (ITH), the University of Navarra, Pamplona, Spain for the diagnosis of brucellosis. Specimens collected in an endemic region (South Sudan) will be used and characterized at the ITH at the University of Navarra, Pamplona, Spain with undiluted RBT, SAT, Coombs test, Brucellacapt and when necessary an indirect ELISA used as the reference tests. 3.2 Secondary objectives • To assess the diagnostic accuracy (sensitivity, specificity, positive and negative predicative values and likelihood ratios) of the Rose Bengal test (Spinreact, Spain) at the study site. • To assess inter-user agreement of the RB test performed on site and at ITH. • To optimize the buffer used in the RBT using characterized sera available at ITH and evaluate the diagnostic performance of the modified method with serum dilution using specimens collected in this study. To date the buffer conditions are those used for diagnosis in cattle and they have not been optimized for diagnosis in humans. In fact, the conditions used in the Brucellacapt (i.e. a special buffer at pH 5.0) also render all antibodies agglutinating. Therefore, some simple modifications of the RBT conditions (i.e. pH and ionic strength) may improve the performance of RBT and produce a similarly simple but better test. • To estimate the diagnostic performance of an ‘in-house’ latex-agglutination test against Brucella-specific cytosoluble proteins. • To describe the clinical characteristics of brucellosis suspects and confirmed cases • To assess/identify risk factors for brucellosis in the study population
  • Multi-site evaluation of HIV testing algorithms

    Kosack, Cara; Page, Anne-Laure; Shanks, Leslie; Chaillet, Pascale; Beelaert, Greet; Fransen, Katrien; Benson, Tumwesigye T.; Savane, Aboubacar; Nganga, Anne; MSF-OCA (2018-07)
    Objectives 3.1 Primary objective  To evaluate the overall and site-specific performance of the diagnostic algorithm performed at 6 MSF African program sites (i.e. using RDT results from the program sites) comparing using the diagnostic algorithm with ELISA, LIA, EIA-Ag and DNA-PCR as gold standard. 3.2 Secondary objectives  To evaluate the accuracy (sensitivity, specificity and predictive values) of Orgenics ImmunoComb® II HIV 1&2 Combfirm as an HIV confirmatory test.  To model different HIV RDT testing algorithms in order to define acceptable testing algorithm in each study setting (i.e. using RDT results from reference laboratory).  To determine the inter-user reliability of RDT testing (i.e. program sites vs. reference laboratory)  To evaluate accuracy of each HIV RDT measured by the sensitivity (SN), specificity (SP) and predictive values based on the prevalence of each testing centre.  To evaluate the accuracy of HIV testing using DPS samples for quality control purpose in HIV testing.  To assess whether additional confirmatory testing (i.e. Orgenics ImmunoComb® II HIV 1&2 Combfirm) improves the accuracy of the diagnostic algorithm used at the different study sites.  To perform a descriptive analysis on the differentiation between HIV 1 and 2 of the discriminative RDTs.
  • The perceptions and experiences of health and health seeking behaviour for the community living in the slum areas of Kamrangirchar and Hazaribag, Dhaka, Bangladesh: a qualitative study

    van der Heijden, Jeroen; Stringer, Beverly; Gray, Nell; Kalon, Stobdan; Dada, Martins; Shaheen, Aminur; Akhter, Sadika; Hussian, Enayet; Bishwash, Animesh; MSF-OCA (2018-07)
    Objectives This study aims to provide a better understanding of community perceptions toward health and health services in order to inform programme strategies: • Describe community and local-level perspectives and opinions on health care provision; • Document gaps, barriers and influences that impact access and acceptance of health care; • Contribute to best practice and development of health policy for this population
  • Severe acute malnutrition and retrospective all-cause mortality in children under 5 years of age in target areas of Zamfara State, Nigeria: a SMART survey.

    Hadera, Amdom; Huisman, Geke; Kaur, Gurpreet; Oluyide, Bukola; Greig, Jane E.; Bil, Karla; Roggeveen, Harriet; van der Kam, Saskia; MSF-OCA (2018-07)
    2. OBJECTIVES 2.1. PRIMARY OBJECTIVES To estimate the all-cause mortality rate and proportion of SAM in children under 5 years of age in target areas in Zamfara State. 2.2. SECONDARY OBJECTIVES  To determine causes of death  To assess morbidity  To assess health seeking behaviour  To assess food security and nutritional practices  Estimate the prevalence of gingivitis in children <5 years of age
  • Evaluating the effectiveness and burden of diabetes care in a complex humanitarian emergency setting in Mweso, North Kivu, Democratic Republic of the Congo (DRC), 2015

    Caleo, Grazia; Ngadjo, Cyril; Roberts, Bayard; Kitembo, Augustin Wika; Jobanputra, Kiran; Perel, Pablo; de la Croix, Jean; Sadique, Zia; de Wit, Marit; MSF-OCA (2018-07)
    Executive summary Background: Since 2008 Médecins Sans Frontières-Operational Centre Amsterdam (MSF-OCA) has been working in Mweso health zone, North Kivu, Democratic Republic of the Congo (DRC). In collaboration with the local Ministry of Health (MoH), MSF-OCA supports the Hospital in Mweso and 4 out of 23 Primary Health Care clinics. Mweso Hospital routinely treats diabetic patients presenting with acute complications and in need of treatment (insulin and/or oral treatment). Since 2011, this has been extended to the out-patient clinic, but without clinical guidance or standard operating procedures (SOP), nor specifically trained staff. The Mweso project reports increasing numbers of patients with diabetes and diabetes-related complications, and requested from MSF-OCA to implement a formal diabetes service to improve quality of care for Diabetics. Rationale: A new model of diabetes care was implemented by MSF-OCA in Mweso in March 2015. The model (Integrated Diabetic Clinic within an Outpatient Department (IDC-OPD)) is based on simplified context-adapted clinical guidelines, clinical SOPs, adapted patient counselling & support materials, medications from World Health Organization(WHO) Essential Medicines list, and one-off staff training by a Diabetologist. This represents an opportunity to evaluate and refine this model of diabetes care to support its application in comparable settings. Furthermore there is an opportunity to benchmark diabetes burden in the MSF Catchment area and measure its diabetes care coverage in the area. Overall aim: To evaluate IDC-OPD in Mweso health zone, North Kivu, DRC. The specific objectives are to examine: • The reach (coverage) of the diabetes service to the intended target population. • The effectiveness of IDC-OPD in improving diabetes outcomes (fasting blood glucose and complications) • Adoption / acceptance of IDC-OPD by staff and patients • Implementation of IDC-OPD in terms of consistency/fidelity, adaptation and costs • Maintenance of IDC-OPD in patients and programme over time.

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