• Characteristics and mortality of neonates in an emergency obstetric and neonatal care facility, rural Burundi

      Zuniga, I; Van den Bergh, R; Ndelema, B; Bulckaert, D; Manzi, M; Lambert, V; Zachariah, R; Reid, A J; Harries, A D (International Union Against TB and Lung Disease, 2013-12)
    • Cholera in Haiti: please do not forget zinc.

      Rossi, G; Zachariah, R; Draguez, B; Van Herp, M (2011-05-21)
    • Excellent outcomes among HIV+ children on ART, but unacceptably high pre-ART mortality and losses to follow-up: a cohort study from Cambodia.

      Raguenaud, M-E; Isaakidis, P; Zachariah, R; Te, V; Soeung, S; Akao, K; Kumar, V; Médecins Sans Frontières, 72, Street 592, Phnom Penh, Cambodia. eve_raguenaud@hotmail.com (2009-08-20)
      BACKGROUND: Although HIV program evaluations focusing on mortality on ART provide important evidence on treatment effectiveness, they do not asses overall HIV program performance because they exclude patients who are eligible but not started on ART for whatever reason. The objective of this study was to measure mortality that occurs both pre-ART and during ART among HIV-positive children enrolled in two HIV-programs in Cambodia. METHODS: Retrospective cohort study on 1168 HIV-positive children <15 years old registered in two HIV-programs over a four-year period. Mortality rates were calculated for both children on treatment and children not started on ART. RESULTS: Over half (53%) of children were 5 years or above and only 69(6%) were <18 months. Overall, 9% (105/1168) of children died since the set-up of the programs. By the end of the observation period, 66(14.5%) patients not on ART had died compared to 39(5.5%) of those under treatment, and 100(22%) who did not start ART were lost-to-follow-up compared to 13(2%) on ART. 66/105 (62.8%) of all in-program deaths occurred before starting ART, of which 56% (37/66) and 79% (52/66) occurred within 3 and 6 months of enrollment respectively. Mortality rate ratio between children not on ART and children on ART was 4.1 (95%CI: 2.7-6.2) (P < 0.001). The most common contributing cause of death in first 3 months of treatment and in first 3 months of program enrollment was tuberculosis. 41/52 (79%) children who died within 6 months of enrollment had met the ART eligibility criteria before death. CONCLUSION: HIV-positive children experienced a high mortality and loss-to-follow-up rates before starting ART. These program outcomes may be improved by a more timely ART initiation. Measuring overall in-program mortality as opposed to only mortality on ART is recommended in order to more accurately evaluate pediatric HIV-programs performance.
    • HAART can be provided safely in African HIV positive children: analysis of patients in 2 urban health centres in Kigali (Rwanda)

      De Naeyer, L; van Griensven, J; Ubarijoro, S; Mushi, T; Ntabashwa, G; Gazille, C; Zachariah, R (2006)
    • How Do Low Birth Weight Neonates Fare Two Years After Discharge from a Low-Technology Neonatal Care Unit in a Rural District Hospital in Burundi?

      van den Boogaard, W; Zuniga, I; Manzi, M; Van den Bergh, R; Lefevre, A; Nanan-N'zeth, K; Duchenne, B; Etienne, W; Juma, N; Ndelema, B; et al. (Wiley-Blackwell, 2017-01-31)
      As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birth-weight neonates (LBW, <2500 grams). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments, and nutritional status of LBW children.
    • Is mid-upper arm circumference alone sufficient for deciding admission to a nutritional programme for childhood severe acute malnutrition in Bangladesh?

      Ali, E; Zachariah, R; Shams, Z; Vernaeve, L; Alders, P; Salio, F; Manzi, M; Allaouna, M; Draguez, B; Delchevalerie, P; et al. (Oxford University Press, 2013-05)
      Mid-upper arm circumference (MUAC) and weight-for-height Z-score (WHZ) identify different populations of children with severe acute malnutrition (SAM) with only some degree of overlap. In an urban slum in Bangladesh, we conducted a prospective cohort study on children assessed as being severely malnourished by WHZ (<-3) but not by MUAC (>115 mm), to: 1. Assess their nutritional outcomes, and 2. Report on morbidity and mortality.
    • Non-adherence to standard treatment guidelines in a rural paediatric hospital in Sierra Leone

      De Bruycker, M; Van den Bergh, R; Dahmane, A; Khogali, M; Schiavetti, B; Nzomukunda, Y; Alders, P; Allaouna, M; Cloquet, C; Enarson, D A; et al. (2013-06)
    • Paediatric Care in Relation to the 2014-2015 Ebola Outbreak and General Reporting of Deaths in Sierra Leone

      Sesay, T; Denisiuk, O; Shringarpure, K; Wurie, B; George, P; Sesay, M; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2017-06-21)
      Setting: All peripheral health units countrywide in Sierra Leone and one hospital in Port Loko. Objectives: Sierra Leone was severely affected by the 2014-2015 Ebola outbreak, whose impact on paediatric care and mortality reports merits assessment. We sought to compare the periods before, during and after the Ebola outbreak, the countrywide trend in morbidities in children aged < 5 years and exit outcomes in one district hospital (Port Loko). During the Ebola outbreak period, gaps in district death reporting within the routine Health Management Information System (HMIS) were compared with the Safe and Dignified Burials (SDB) database in Port Loko. Design: This was a retrospective records analysis. Results: The average number of monthly consultations during the Ebola outbreak period declined by 27% for malaria and acute respiratory infections and 38% for watery diarrhoea, and did not recover to the pre-Ebola levels. For measles, there was an 80% increase during Ebola, which multiplied by 6.5-fold post-Ebola. The number of unfavourable hospital exit outcomes was 52/397 (13%) during Ebola, which was higher than pre-Ebola (47/496, 9%, P = 0.04). Of 6565 deaths reported in the Port Loko SDB database, only 2219 (34%) appeared in the HMIS, a reporting deficit of 66%. Conclusion: The Ebola disease outbreak was associated with reduced utilisation of health services, and appears to have triggered a measles epidemic. Almost 70% of deaths were missed by the HMIS during the Ebola outbreak period. These findings could guide health system responses in future outbreaks.
    • Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality? [Short communication]

      Ngoy, B B; Zachariah, R; Hinderaker, S G; Khogali, M; Manzi, M; van Griensven, J; Ayada, L; Jemmy, J P; Maalim, A; Amin, H (2013-06)
    • Practicing medicine without borders: tele-consultations and tele-mentoring for improving paediatric care in a conflict setting in Somalia?

      Zachariah, R; Bienvenue, B; Ayada, L; Manzi, M; Maalim, A; Engy, E; Jemmy, J P; Ibrahim Said, A; Hassan, A; Abdulrahaman, F; et al. (2012-09)
    • Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural Malawi

      Bwirire, L; Fitzgerald, M; Zachariah, R; Chikafa, V; Massaquoi, M; Moens, M; Kamoto, K; Schouten, E (Elsevier, 2008-05-16)