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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Recent Submissions

  • 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;
  • Field Research Survey

    MSF USA; LuxOR; MSF (2018-07-12)
  • 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
  • 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
  • A prospective, randomized, controlled trial of negative-pressure wound therapy use in conflict-related extremity wounds

    Alga, Andreas; Bashaireh, Khaldoon; Wong, Sidney; Lundgren, Kalle; von Schreeb, Johan; MSF-OCA (2018-07)
    Extremity wounds and fractures constitute the majority of conflict-related traumatic injuries, both for civilians (1) and combatants (2). Conflict-related injuries often result in soft and boney tissue being contaminated with foreign material, generally leading to secondary infection (3,4). Negative-pressure wound therapy (NPWT) is widely used in the treatment of wounds and is considered to promote wound healing and prevent infectious complications. The technique involves the application of a wound dressing through which a negative pressure is applied. Any wound and tissue fluid is drawn away from the area and collected into a canister. Due to a plastic film overlaying the wound the risk of wound contamination is reduced. NPWT is supported for use in a range of surgical applications, including after or in between debridements as a bridge to definite closure of soft tissue wounds (5). The technique has previously been used in the treatment of acute conflict-related wounds with satisfactory results (6–8). Cochrane reviews of NPWT for the treatment of chronic wounds (9) and surgical wounds (10) were inconclusive due to the lack of suitably powered, high-quality trials. A recent systematic review of randomized, controlled trials (RCTs) of NPWT for the treatment of acute and chronic wounds concluded there is a lack of evidence and that good RCTs are needed (11). For the use in limb trauma, NPWT is considered suitable for complex soft tissue injuries (12). NPWT appears to be an effective and safe adjunctive treatment of high-energy combat wounds but existing results are retrospective and lack follow-up (13). The support of RCTs is needed to establish best treatment strategies. Summary of potential risks and benefits Both treatment methods (NPWT and conventional dressings) are well established and used in Jordan for the treatment of acute and chronic wounds. As neither of the two treatment modalities are known to be better in terms of outcome neither patient group may be regarded as receiving preferential treatment. NPWT is generally considered a safe treatment method. Potential benefits are shortened healing time and fewer infectious complications. Potential risks are pain, mainly associated with dressing changes (14) and bleeding, predominantly minor bleeding from granulation tissue (15). Conventional wound dressing has the potential benefit of being a safe treatment method used for many years. Since this method permits air into the wound there is a potential risk of contamination and the development of wound infection. Objectives We aim to evaluate the efficacy and safety of NPWT in the treatment of traumatic extremity wounds in a context associated with a high level of contamination and infection.
  • Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Final Survey) 1613C

    Lenglet, Annick; Vernier, Larissa; Monge, Susana; White, Kate; Sang, Sibylle; MSF-OCA (2018-07)
    3 OBJECTIVES 3.1 PRIMARY OBJECTIVES To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district. 3.2 SECONDARY OBJECTIVES - To describe the population in terms of age breakdown, sex, household composition etc. - To estimate overall mortality rate and under 5 mortality rate - To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities; - To estimate the coverage of insecticide treated bednets in the community; - To estimate the coverage of soap and hygiene practices in the community - To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz.
  • Malnutrition, morbidity and vaccination coverage in Bokoro District, Chad, 2016 (Mid Term Survey).

    Lenglet, Annick; Monge, Susana; Ndumbi, Patricia; Nyarwangu, Justin; Hamdan, Musa; Cramond, Vanessa; Sang, Sibylle; MSF-OCA (2018-07)
    3 OBJECTIVES 3.1 PRIMARY OBJECTIVES To estimate the impact of an integrated program targeted at preventing malnutrition on children under 5 years of age in Bokoro district. 3.2 SECONDARY OBJECTIVES - To describe the population in terms of age breakdown, sex, household composition etc. - To estimate overall mortality rate and under 5 mortality rate - To estimate the prevalence of severe and global acute malnutrition (SAM and GAM) in the under 5 year age group and in children between 6 and 23 months that are the specific target of MSF prevention activities; - To estimate the coverage of insecticide treated bednets in the community; - To estimate the coverage of soap and hygiene practices in the community - To estimate coverage of plumpydoz (nutritional food) in children between 6 months and 2 years of age and to investigate practices around plumpydoz.
  • Prevalence of depression, anxiety and posttraumatic stress related symptoms in the Kashmir Valley – a cross sectional study, 2015.

    Housen, Tambri; Shah, Showkat; Janes, Simon; Pintaldi, Govanni; Lenglet, Annick; Ariti, Cono; MSF-OCA (2018-07)
    Objectives 1.5 Primary objective To estimate prevalence of mental health related problems, specifically depression/anxiety and posttraumatic stress symptoms in the Kashmir Valley and to determine the accessibility to mental health services. 1.6 Specific objectives • Using validated screening tools determine the percentage of people with depression, anxiety and PTSD symptoms in Kashmir; • To correlate scores obtained on validated mental health screening tools with individual psychiatric evaluations using the mini international neuropsychiatric interview (MINI); • To explore local knowledge and perceptions of mental illness in Kashmir; • To determine the level of access to mental heath services across Kashmir; • To identify mental health service needs perceived by the Kashmiri community. 1.7 Goal To provide an updated insight into current mental health needs in Kashmir, which will help MSF to increase relevance and impact of current activities in Kashmir and to advocate for supportive programming and policy review.
  • Health and developmental outcomes of low-birth-weight infants born at the Centre de Référence d’Urgences Obstétricales (CRUO), Port-au-Prince, Haiti.

    Hillaire, Marjorie; Lenglet, Annick; Ariti, Cono; Ledger, Elizabeth; Reilly, Liam; Berthet, Marine; Faniyan, Olu; MSF-OCA (2018-07)
    Summary Title A prospective cohort study investigating health and developmental outcomes of low birth weight infants born at the Centre de Reference d’Urgences Obstretricales (CRUO), Port-au-Prince, Haiti. Primary objective: To describe and compare health and developmental outcomes between low birthweight (LBW) and normal weight infants up to 24 months post-partum, corrected for gestational age. Secondary objective To identify risk factors associated with negative health and developmental outcomes in LBW infants.
  • Mental health literacy of internally displaced Syrian young people and their parents in Syria: paving the way for mental health education and promotion in vulnerable communities.

    Hitchman, Eleanor; Slewa-Younan, Shameran; Cramond, Vanessa; White, Kate; Carrion-Martin, Isidro; Jorm, Anthony F.; MSF-OCA (2018-07)
    4. Objectives 4.1 Primary objective To determine levels of MHL relating to trauma related mental health disorders, namely posttraumatic stress disorder (PTSD) and depression among the displaced Syrian young people in northern Syria (see study population) . 4.2 Specific objectives 1. To estimate MHL relating to PTSD (and Depression) in a group of displaced Syrian young people (13-17 years old) and the parents of children (age 8-12 years old) pertaining to: a. Problem recognition (including “self-recognition”) b. Beliefs about the severity of the problem described and its prevalence in the target population c. Beliefs about causes and risk factors d. Beliefs about how best to support someone with PTSD/depression e. Beliefs about the helpfulness of specific treatments and treatment providers f. Beliefs about likely outcome with and without treatment g. Beliefs about possible barriers to treatment h. Stigma and perceived discrimination towards someone with PTSD/depression i. 2. To determine associations between specific aspects of MHL as outlined above, and individuals’ demographic characteristics (age, gender, religion, ethnicity, lengthen of displacement etc.) and symptom levels. 3. To estimate the prevalence of mental health distress (major depression, anxiety disorders or suicidality ) using the Self Reporting Questionnaire (SRQ-20) in care takers of children 8-12 years old; 4. To estimate the prevalence of constructs of intrusion, avoidance and arousal in children 8-17 years of age in the study population; 5. To estimate the prevalence of self-reported depression in children 8-17 years old. The categories specified in objective 1 above were chosen because they were considered to be the aspects of MHL most likely to be of interest in informing the determinants of mental health and quality of life in the proposed population. Objective 2 which seeks to examine the associations between specific aspects of MHL and individuals’ demographic characteristics and symptoms levels is important because associations of this kind can indicate specific targets for health promotion programs.
  • Predicting Visceral Leishmaniasis in HIV Infected Patients (PreLeisH)

    Griensven, JV; Diro, Ermias; MSF-OCA (2018-07)
    Aim To study the asymptomatic period preceding the onset of active VL in HIV‐infected individuals from VL endemic regions in Ethiopia as an avenue to develop an evidence‐based screen and treat strategy to prevent progression to active VL.Primary: 1. To estimate the prevalence of asymptomatic Leishmania infection . 2. To estimate the incidence rate of asymptomatic Leishmania infection. 3. To describe the evolution of Leishmania infection markers over time. 4. To estimate the incidence rate of active VL. 5. To identify risk factors associated with the development of active VL. 6. To translate these risk factors into a clinical prognostic tool to identify individuals at high risk to develop active VL within 12 months . Secondary: 1. To identify patterns in host immune markers that are associated with asymptomatic Leishmania infection. 2. To describe the evolution of host immune markers over time. 3. To identify patterns in host immune markers that are associated with treatment failure. 4. To identify patterns in host immune markers that are associated with VL relapse.
  • Morbidity, healthcare needs and barriers to access medical care amongst local and displaced populations in west Dar’a and Quneitra, Southern Syria.

    Homan, Tobias; Shoaib, Muhammad; de Rosa, Allan; Alfadel, Imad Aldin; Stein, Susan; Khalaileh, Fadi; Al-Khalouf, Nahed; Bil, Karla; MSF-OCA (2018-07)
    Objectives 2.1 Primary objective To determine the health care needs for local population and IDP’s in west Dar’a and Quneitra by estimating the prevalence of underlying morbidities, vaccination coverage and identifying barriers to access to health care, in order to obtain a baseline that can guide MSF and actor response. 2.2 Secondary objectives The relevance of subjects for the (secondary) objective(s) has been informed by insights from reports of, and explorative meetings with MSF and medical NGOs active in southern Syria (section 3.2.3). Of the secondary objectives identified, similar objectives are reflected in MSF-ERB approved protocols for surveys conducted in the region. We formulated the objectives (and related indicators on page 15) as much as possible on basis of these approved secondary objectives . I. To describe the socio-demographic characteristics of the surveyed population including age, gender and household characteristics. II. To estimate the prevalence of self-reported morbidities in previous two weeks, an estimate of the prevalence of non-communicable diseases, and the main reasons for requiring medical care. III. To estimate the vaccination coverage for key vaccine preventable diseases in children aged 6-59 months. IV. To characterise health care utilisation, the degree of access to healthcare for common morbidities in the population (health seeking behviour) and determine the most common barriers to access to health care. V. To estimate the global acute malnutrition [GAM] rate of in children aged 6-59 months. VI. To estimate the prevalence of conflict-related trauma experienced during the recall period. VII. To what extent maternal and reproductive health services are utilized by assessed crisis-affected women of 15-49 years of age in this area. VIII. To estimate the retrospective mortality and cause of mortality, over the past 6 months (since Ramadan 2017). IX. To better understand the configuration of the health system following the crisis, the characteristics of care-seeking and the quality of the services.
  • Understanding the health status and humanitarian impact of the recent events in the internally displaced population (IDPs) in Tal Abyad and Manbij districts, northern Syria, 2017

    Malaeb, Rami; Lenglet, Annick; Langlois, Celine; White, Kate; Hussein, Shajib; de Boever, Rieneke; Onus, Robert; Desoulieres, Sophie; MSF-OCA (2018-07)
    Aims and objectives 2.1. Primary objective To estimate the prevalence of current illnesses (self-reported), vaccination coverage, and mental health distress related symptoms in the IDP population in order to obtain a baseline that can guide MSF response activities in Raqqa as well as in Tal Abyad and Manbij districts. 2.2. Secondary objectives 1) To estimate the vaccination coverage for key vaccine preventable diseases in children aged 6-59 months among the new IDP population; 2) To describe the demographic characteristics of the IDP population; 3) To describe the displacement routes and experiences of the IDP population; 4) To estimate the prevalence of self-reported morbidities in the previous two weeks; 5) To estimate the global acute malnutrition (GAM) rate of in children aged 6-59 months and pregnant women; 6) To estimate the prevalence of self-reported major chronic diseases; 7) To estimate the prevalence of symptoms commonly associated with mental health distress; 8) To estimate the prevalence of conflict-related violence/trauma experienced during the recall period (365 days); 9) To estimate the retrospective mortality since the beginning of Ar-Raqqa offensive in northern Syria (12 June 2016); 10) To gain more understanding related to the concerns, challenges and priority needs of the IDPs in the community.
  • Determining sero-prevalence of antibodies against Hepatitis E during an acute outbreak scenario.

    Lenglet, Annick; Kamau, Charity; Boris, Hogema; MSF-OCA (2018-07)
    OBJECTIVES 3.1 PRIMARY OBJECTIVES To estimate sero prevalence of anti-HEV antibodies (IgG and IgM) in different age groups in Am Timam, Chad 3.2 SECONDARY OBJECTIVES • To determine individual risk factors associated with different anti-HEV antibody status during an acute outbreak; • To determine household level risk factors associated with different anti-HEV antibody status during an acute outbreak; • To compare the sero prevalence of anti-HEV antibodies (IgG and IgM) in different age groups at two different time periods during an acute HEV outbreak to inform our understanding of viral transmission dynamics in a population in this context; • To determine sero prevalence in different age groups of other jaundice causing agents (malaria, hepatitis A, B and C, leptospirosis and arboviral diseases such as yellow fever, viral haemorrhagic fever, Dengue and Rift valley fever; • To compare dried blood spots (DBS) with blood samples for detection of HEV IgM and IgG and HEV RNA through PCR; • To compare oral swabs with blood samples for the detection of HEV IgM and IgG and HEV RNA through PCR.
  • Vaccination coverage survey for diphtheria, Streptococcus pneumoniae, polio and tetanus in Rohingya refugee settlements in Ukhiya and Teknaf Upazilas, Cox’s Bazar, Bangladesh

    Pereboom, Monique; White, Kate; Van Leeuwen, Crystal; Siddiqui, Ruby; Guzek, John; Sangma, Mitchell; MSF-OCA (2018-07)
    OBJECTIVES PRIMARY OBJECTIVES a) To describe the vaccine coverage (penta / dT) in children aged 6 months to 14 years for diphtheria in the Rohingya Settlement Camps; SECONDARY OBJECTIVES To describe the vaccine coverage of pentavalent, bOPV and PCV vaccines in children aged 6 weeks to 6 years of age in the Rohingya Settlement Camps; To describe the vaccine coverage for diphtheria and tetanus vaccination among 7 - 14 year olds to assess vaccination rates in this age-group in the Rohingya Settlement Camps
  • Evaluating the input of the nurse to quality of medical/or healthcare in humanitarian settings

    Gilday, Josie; Chatler, Tracey; Treacy-Wong, Vicky; Stringer, Beverley; MSF-OCA (2018-07)
    Key objective • Develop a basic framework to evaluate quality nursing care in humanitarian settings.
  • Assessing the feasibility of preventing injury risks and improving work safety amongst factory workers in an urban slum: a participatory before-and-after intervention study

    Caleo, Grazia; Dada, Martins; Gray, Nell; Sangma, Mitchell; Scoizzato, Luca; Bangs, Gary W.; Stringer, Beverley; Islam, Zahirul; Baset, Kamrun Ul; MSF-OCA (2018-07)
    Specific Objectives: 1. Explain dynamics of injury risk over time by: 1.1. Describing the circumstances of incidents leading to an injury (injury risks or dynamics of incident) 1.2. Describing the circumstances of near-miss incident where no injury or illness occurs (incident risks) 1.3. Measuring frequency and severity of injuries (burden) 1.4. Describe perceptions of risks amongst owner/manager/workers 2. Design acceptable interventions to reduce injury risks 3. Document intervention feasibility by: 3.1. Describing acceptability, capturing adherence to interventions and changes in risk perceptions 3.2. Describing practicality: 3.2.1. Documenting operational challenges and lessons learned 3.2.2. Capturing resources (human resources, time, materials and cost) of implementation 4. Describe any changes in worker safety behaviour and incident incidence rate

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