• Bringing care to the community: expanding access to health care in rural Malawi through mobile health clinics

      Geoffroy, E; Harries, A D; Bissell, K; Schell, E; Bvumbwe, A; Tayler-Smith, K; Kizito, W (International Union Against Tuberculosis and Lung Disease, 2014-12-21)
    • Building operational research capacity in the Pacific

      Bissel, K; Viney, K; Brostrom, R; Gounder, S; Khogali, M; Kishore, K; Kool, B; Kumar, A M V; Manzi, M; Marais, B; et al. (The Union, 2014-06-21)
      Operational research (OR) in public health aims to investigate strategies, interventions, tools or knowledge that can enhance the quality, coverage, effectiveness or performance of health systems. Attention has recently been drawn to the lack of OR capacity in public health programmes throughout the Pacific Islands, despite considerable investment in implementation. This lack of ongoing and critical reflection may prevent health programme staff from understanding why programme objectives are not being fully achieved, and hinder long-term gains in public health. The International Union Against Tuberculosis and Lung Disease (The Union) has been collaborating with Pacific agencies to conduct OR courses based on the training model developed by The Union and Médecins Sans Frontières Brussels-Luxembourg in 2009. The first of these commenced in 2011 in collaboration with the Fiji National University, the Fiji Ministry of Health, the World Health Organization and other partners. The Union and the Secretariat of the Pacific Community organised a second course for participants from other Pacific Island countries and territories in 2012, and an additional course for Fijian participants commenced in 2013. Twelve participants enrolled in each of the three courses. Of the two courses completed by end 2013, 18 of 24 participants completed their OR and submitted papers by the course deadline, and 17 papers have been published to date. This article describes the context, process and outputs of the Pacific courses, as well as innovations, adaptations and challenges.
    • The Burden of Road Traffic Injuries in an Emergency Department in Addis Ababa, Ethiopia

      Getachew, S; Ali, E; Tayler-Smith, K; Hedt-Gauthier, B; Silkondez, W; Abebe, D; Deressa, W; Enquessilase, F; Edwards, J K (International Union Against Tuberculosis and Lung Disease, 2016-06-21)
      The emergency department (ED) of Zewditu Memorial Hospital, Addis Ababa, Ethiopia.
    • Characteristics, utilisation and influence of viewpoint articles from the Structured Operational Research and Training Initiative (SORT IT) – 2009-2020

      Khogali, M; Tayler-Smith, K; Harries, AD; Zachariah, R; Kumar, A; Davtyan, H; Satyanarayana, S; Denisiuk, O; van Griensven, J; Reid, A; et al. (F1000Research, 2021-03-21)
      Background: The Structured Operational Research and Training Initiative (SORT IT) teaches the practical skills of conducting and publishing operational research (OR) to influence health policy and/or practice. In addition to original research articles, viewpoint articles are also produced and published as secondary outputs of SORT IT courses. We assessed the characteristics, use and influence of viewpoint articles derived from all SORT IT courses. Methods: This was a cross-sectional study involving all published viewpoint articles derived from the SORT IT courses held from August 2009 - March 2020. Characteristics of these papers were sourced from the papers themselves and from SORT-IT members involved in writing the papers. Data on use were sourced from the metrics provided on the online publishing platforms and from Google Scholar. Influence on policy and practice was self-assessed by the authors of the papers and was performed only for papers deemed to be ‘calls for action’. Results: A total of 41 viewpoint papers were published. Of these, 15 (37%) were ‘calls for action’. In total, 31 (76%) were published in open-access journals and the remaining 10 in delayed access journals. In 12 (29%) of the papers, first authors were from low and middle-income countries (LMICs). Female authors (54%) were included in 22, but only four (10%) and two (5%) of first and last authors respectively, were female. Only seven (17%) papers had available data regarding online views and downloads. The median citation score for the papers was four (IQR 1-9). Of the 15 ‘call for action’ papers, six influenced OR capacity building, two influenced policy and practice, and three influenced both OR capacity building within SORT IT and policy and practice. Conclusion: Viewpoint articles generated during SORT IT courses appear to complement original OR studies and are valued contributors to the dissemination of OR practices in LMICs.
    • Does Research Through Structured Operational Research and Training (SORT IT) Courses Impact Policy and Practice?

      Kumar, AMV; Shewade, HD; Tripathy, JP; Guillerm, N; Tayler-Smith, K; Dar Berger, S; Bissell, K; Reid, AJ; Zachariah, R; Harries, AD (Cambridge University Press, 2016-03-21)
    • Factors Associated with Unfavorable Treatment Outcomes in New and Previously Treated TB Patients in Uzbekistan: A Five Year Countrywide Study

      Gadoev, J; Asadov, D; Tillashaykhov, M; Tayler-Smith, K; Isaakidis, P; Dadu, A; Colombani, P d; Gudmund Hinderaker, S; Parpieva, N; Ulmasova, D; et al. (Public Library of Science, 2015-06-15)
      TB is one of the main health priorities in Uzbekistan and relatively high rates of unfavorable treatment outcomes have recently been reported. This requires closer analysis to explain the reasons and recommend interventions to improve the situation. Thus, by using countrywide data this study sought to determine trends in unfavorable outcomes (lost-to-follow-ups, deaths and treatment failures) and describe their associations with socio-demographic and clinical factors.
    • High time to use rapid tests to detect multidrug resistance in sputum smear-negative tuberculosis in Belarus

      Rusovich, V; Kumar, A M V; Skrahina, A; Hurevich, H; Astrauko, A; de Colombani, P; Tayler-Smith, K; Dara, M; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2014-12-21)
    • Management and Treatment Outcomes of Patients Enrolled in MDR-TB Treatment in Viet Nam

      Phuong, NTM; Nhung, NV; Hoa, NB; Thuy, HT; Takarinda, KC; Tayler-Smith, K; Harries, AD (International Union Against Tuberculosis and Lung Disease, 2016-03-21)
      The programmatic management of drug-resistant tuberculosis (TB) in Viet Nam has been rapidly scaled up since 2009.
    • Managing and Monitoring Chronic Non-Communicable Diseases in a Primary Health Care Clinic, Lilongwe, Malawi

      Manjomo, RC; Mwagomba, B; Ade, S; Ali, E; Ben-Smith, A; Khomani, P; Bondwe, P; Nkhoma, D; Douglas, GP; Tayler-Smith, K; et al. (International Union Against Tuberculosis and Lung Disease, 2016-06-21)
      Patients with chronic non-communicable diseases attending a primary health care centre, Lilongwe, Malawi.
    • Managing and Monitoring Chronic Non-Communicable Diseases in a Primary Health Care Clinic, Lilongwe, Malawi

      Manjomo, R C; Mwagomba, B; Ade, S; Ali, E; Ben-Smith, A; Khomani, P; Bondwe, P; Nkhoma, D; Douglas, G P; Tayler-Smith, K; et al. (International Union Against TB and Lung Disease, 2016-06-21)
      Setting: Patients with chronic non-communicable diseases attending a primary health care centre, Lilongwe, Malawi. Objective: Using an electronic medical record monitoring system, to describe the quarterly and cumulative disease burden, management and outcomes of patients registered between March 2014 and June 2015. Design: A cross-sectional study. Results: Of 1135 patients, with new registrations increasing each quarter, 66% were female, 21% were aged 65 years, 20% were obese, 53% had hypertension alone, 18% had diabetes alone, 12% had asthma, 10% had epilepsy and 7% had both hypertension and diabetes. In every quarter, about 30% of patients did not attend the clinic and 19% were registered as lost to follow-up (not seen for 1 year) in the last quarter. Of those attending, over 90% were prescribed medication, and 80–90% with hypertension and/or diabetes had blood pressure/blood glucose measured. Over 85% of those with epilepsy had no seizures and 60–75% with asthma had no severe attacks. Control of blood pressure (41–51%) and diabetes (15–38%) was poor. Conclusion: It is feasible to manage patients with non-communicable diseases in a primary health care setting in Malawi, although more attention is needed to improve clinic attendance and the control of hypertension and diabetes.
    • Picking up the bill - improving health-care utilisation in the Democratic Republic of Congo through user fee subsidisation: a before and after study

      Maini, R; Van den Bergh, R; van Griensven, J; Tayler-Smith, K; Ousley, J; Carter, D; Mhatre, S; Ho, L; Zachariah, R (BioMed Central, 2014-11-05)
      BackgroundUser fees have been shown to constitute a major barrier to the utilisation of health-care, particularly in low-income countries such as the Democratic Republic of Congo (DRC). Importantly, such barriers can lead to the exclusion of vulnerable individuals from health-care. In 2008, a donor-funded primary health-care programme began implementing user fee subsidisation in 20 health zones of the DRC. In this study, we quantified the short and long-term effects of this policy on health-care utilisation.MethodsSixteen health zones were included for analysis. Using routinely collected health-care utilisation data before and after policy implementation, interrupted time series regression was applied to quantify the temporal impact of the user fee policy in the studied health zones. Payment of salary supplements to health-care workers and provision of free drugs - the other components of the programme - were controlled for where possible.ResultsFourteen (88%) health zones showed an immediate positive effect in health-care utilisation rates (overall median increase of 19%, interquartile range 11 to 43) one month after the policy was introduced, and the effect was significant in seven zones (P <0.05). This initial effect was sustained or increased at 24 months in five health zones but was only significant in one health zone at P <0.05. Utilisation reduced over time in the remaining health zones (overall median increase of 4%, interquartile range ¿10 to 33). The modelled mean health-care utilisation rate initially increased significantly from 43 consultations/1000 population to 51 consultations/1000 population during the first month following implementation (P <0.01). However, the on-going effect was not significant (P =0.69).ConclusionsOur research brings mixed findings on the effectiveness of user fee subsidisation as a strategy to increase the utilisation of services. Future work should focus on feasibility issues associated with the removal or reduction of user fees and how to sustain its effects on utilisation in the longer term.
    • Prevalence and incidence of cervical intra-epithelial neoplasia among female sex workers in Korogocho, Kenya

      Njagi, S K; Mugo, N R; Reid, A J; Satyanarayana, S; Tayler-Smith, K; Kizito, W; Kwatampora, J; Waweru, W; Kimani, J; Smith, J S (2013-12-21)
    • Public Health Action for public health action

      Harries, A D; Bianchi, L; Jensen, P M; Pantages, M; Bissell, K; Kumar, A M V; Hinderaker, S G; Tayler-Smith, K; Van den Bergh, R; van den Boogaard, W; et al. (International Union Against Tuberculosis and Lung Disease, 2014-09-21)
    • Recurrent Tuberculosis and Associated Factors: A Five - Year Countrywide Study in Uzbekistan

      Gadoev, J; Asadov, D; Harries, AD; Parpieva, N; Tayler-Smith, K; Isaakidis, P; Ali, E; Hinderaker, SG; Ogtay, G; Ramsay, A; et al. (Public Library of Science, 2017-05-04)
      In Uzbekistan, despite stable and relatively high tuberculosis treatment success rates, relatively high rates of recurrent tuberculosis have recently been reported. Recurrent tuberculosis is when a patient who was treated for pulmonary tuberculosis and cured, later develops the disease again. This requires closer analysis to identify possible causes and recommend interventions to improve the situation. Using countrywide data, this study aimed to analyse trends in recurrent tuberculosis cases and describe their associations with socio-demographic and clinical factors.
    • Scale-Up of ART in Malawi Has Reduced Case Notification Rates in HIV-Positive and HIV-Negative Tuberculosis

      Kanyerere, H; Girma, B; Mpunga, J; Tayler-Smith, K; Harries, A D; Jahn, A; Chimbwandira, FM (International Union Against Tuberculosis and Lung Disease, 2016-12-21)
      Setting: For 30 years, Malawi has experienced a dual epidemic of human immunodeficiency virus (HIV) infection and tuberculosis (TB) that has recently begun to be attenuated by the scale-up of antiretroviral therapy (ART). Objective: To report on the correlation between ART scale-up and annual national TB case notification rates (CNR) in Malawi, stratified by HIV-positive and HIV-negative status, from 2005 to 2015. Design: A retrospective descriptive ecological study using aggregate data from national reports. Results: From 2005 to 2015, ART was scaled up in Malawi from 28 470 to 618 488 total patients, with population coverage increasing from 2.4% to 52.2%. During this time, annual TB notifications declined by 35%, from 26 344 to 17 104, and the TB CNR per 100 000 population declined by 49%, from 206 to 105. HIV testing uptake increased from 51% to 92%. In known HIV-positive TB patients, the CNR decreased from a high of 1247/100 000 to 710/100 000, a 43% decrease. In known HIV-negative TB patients, the CNR also decreased, from a high of 66/100 000 to 49/100 000, a 26% decrease. Conclusion: TB case notifications have continued to decline in association with ART scale-up, with the decline seen more in HIV-positive than HIV-negative TB. These findings have programmatic implications for national TB control efforts.
    • 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)
    • What happens after participants complete a Union-MSF structured operational research training course?

      Guillerm, N; Tayler-Smith, K; Berger, S D; Bissell, K; Kumar, A M V; Ramsay, A; Reid, A J; Zachariah, R; Harries, A D (International Union Against Tuberculosis and Lung Disease, 2014-06-12)
    • What happens after participants complete a Union-MSF structured operational research training course?

      Guillerm, N; Tayler-Smith, K; Berger, S D; Bissell, K; Kumar, A M V; Ramsay, A; Reid, A J; Zachariah, R; Harries, A D (The Union, 2014-06-21)