• Active Case-Finding for Tuberculosis by Mobile Teams in Myanmar: Yield and Treatment Outcomes

      Myint, O; Saw, S; Isaakidis, P; Khogali, M; Reid, A; Hoa, N; Kyaw, T; Zaw, K; Khaing, T; Aung, S (BioMed Central, 2017-06-02)
      Since 2005, the Myanmar National Tuberculosis Programme (NTP) has been implementing active case finding (ACF) activities involving mobile teams in hard-to-reach areas. This study revealed the contribution of mobile team activities to total tuberculosis (TB) case detection, characteristics of TB patients detected by mobile teams and their treatment outcomes.
    • Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008-2014

      Moakofhi, K; Edwards, JK; Motlaleng, M; Namboze, J; Butt, W; Obopile, M; Mosweunyane, T; Manzi, M; Takarinda, KC; Owiti, P (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008-2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices.
    • Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable?

      Ncube, RT; Takarinda, KC; Zishiri, C; van den Boogaard, W; Mlilo, N; Chiteve, C; Siziba, N; Trinchán, F; Sandy, C (International Union Against Tuberculosis and Lung Disease, 2017-09-21)
      Setting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly. The highest proportion of smear-negative pulmonary TB cases was among the elderly (40%). Unfavourable outcomes, mainly deaths, increased proportionately with age, and were highest among the elderly (adjusted relative risk 3.8, 95%CI 1.3-10.7). Having previous TB, being human immunodeficiency virus positive and not on antiretroviral treatment or cotrimoxazole preventive therapy were associated with an increased risk of unfavourable outcomes. Conclusion: The elderly had the worst outcomes among all the age groups. This may be related to immunosuppressant comorbidities or other age-related diseases mis-classified as TB, as a significant proportion were smear-negative. Older persons need better adapted TB management and more sensitive diagnostic tools, such as Xpert® MTB/RIF.
    • Alarming prevalence and clustering of Modifiable Noncommunicable Disease risk factors among adults in Bhutan: a nationwide cross-sectional community survey

      Pelzom, D; Isaakidis, P; Oo, MM; Gurung, MS; Yangchen, P (BioMed Central, 2017-12-21)
      Bhutan is currently facing a double burden of non-communicable (NCDs) and communicable diseases, with rising trends of NCDs. The 2014 STEPS survey identified high prevalence of several NCD risk factors; however, associations with socio-demographic characteristics as well as clustering of risk factors were not assessed. This study aimed to determine the distribution and clustering of modifiable NCD risk factors among adults in Bhutan and their demographic and social determinants.
    • "Alert-Audit-Act": assessment of surveillance and response strategy for malaria elimination in three low-endemic settings of Myanmar in 2016

      Kyaw, AMM; Kathirvel, S; Das, M; Thapa, B; Linn, NYY; Maung, TM; Lin, Z; Thi, A (BioMed Central, 2018-04-13)
      Myanmar, a malaria endemic country of Southeast Asia, adopted surveillance and response strategy similar to "1-3-7" Chinese strategy to achieve sub-national elimination in six low-endemic region/states of the country. Among these, Yangon, Bago-East, and Mon region/states have implemented this malaria surveillance and response strategy with modification in 2016. The current study was conducted to assess the case notification, investigation, classification, and response strategy (NICR) in these three states.
    • Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007–2013

      Kihara, A-B; Harries, A D; Bissell, K; Kizito, W; Van Den Berg, R; Mueke, S; Mwangi, A; Sitene, J C; Gathara, D; Kosgei, R J; Kiarie, J; Gichangi, P (International Union Against Tuberculosis and Lung Disease, 2015-03-21)
    • Antibiotic Prescribing for Upper Respiratory Infections Among Children in Rural China: a Cross-Sectional Study of Outpatient Prescriptions

      Zhang, Z; Hu, Y; Zou, G; Lin, M; Zeng, J; Deng, S; Zachariah, R; Walley, J; Tucker, JD; Wei, X (Taylor & Francis, 2017-05-02)
      Overuse of antibiotics contributes to the development of antimicrobial resistance.
    • Antibiotic use in a district hospital in Kabul, Afghanistan: are we overprescribing?

      Bajis, S; Van den Bergh, R; De Bruycker, M; Mahama, G; Van Overloop, C; Satyanarayana, S; Bernardo, R S; Esmati, S; Reid, A J (International Union Against Tuberculosis and Lung Disease, 2014-12-21)
    • Are village health volunteers as good as basic health staffs in providing malaria care? A country wide analysis from Myanmar, 2015

      Linn, NYY; Kathirvel, S; Das, M; Thapa, B; Rahman, Mm; Maung, TM; Kyaw, AMM; Thi, A; Lin, Z (BioMed Central, 2018-06-20)
      Malaria is one of the major public health problems in Myanmar. Village health volunteers (VHV) are the key malaria diagnosis and treatment service provider at community level in addition to basic health staffs (BHS). This countrywide analysis aimed to assess and compare the accessibility to- and quality of malaria care (treatment initiation, treatment within 24 h and complete treatment delivery) between VHV and BHS in Myanmar.
    • Assessment of Community Led Total Sanitation Uptake in Rural Kenya

      Ogendo, KN; Kihara, AB; Kosgey, RJ; Tweya, H; Kizito, W; Murkomen, B; Ogutu, O (African Journals Online, 2017-05-29)
    • Assessment of household ownership of bed nets in areas with and without artemisinin resistance containment measures in Myanmar

      Maung, TM; Oo, T; Wai, KT; Hlaing, T; Owiti, P; Kumar, B; Shewade, HD; Zachariah, R; Thi, A (BioMed Central, 2018-03-23)
      Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum malaria. As the artemisinin compound is the pillar of effective antimalarial therapies, containing the spread of artemisinin resistance is a national and global priority. The use of insecticide-treated bed nets/long-lasting insecticidal nets (ITNs/LLINs) is the key intervention for ensuring the reduction of malaria transmission and the spread of resistant strains, and for eventually eliminating malaria. This study aimed at assessing household ownership of, access to, and utilization of bed nets in areas of Myanmar with and without artemisinin resistance containment measures.
    • An Assessment of Water, Sanitation, and Hygiene (WASH) Practices and Quality of Routinely Collected Data in Machakos County Kenya

      Kavoo, DM; Ali, SH; Kihara, AB; Kosgei, RJ; Tweya, H; Kizito, W; Omondi, O; Tauta, CN (African Journals Online, 2016-10)
    • Body and mind: retention in antiretroviral treatment care is improved by mental health training of care providers in Ethiopia

      Berheto, TM; Hinderaker, SG; Senkoro, M; Tweya, H; Deressa, T; Getaneh, Y; Gezahegn, G (BioMed Central, 2018-07-20)
      Ethiopia has achieved a high coverage of antiretroviral treatment (ART), but maintaining lifelong care is still a great challenge. Mental illnesses often co-exist with HIV/AIDS and may compromise the retention on ART. In order to improve prolonged retention in ART care, basic training in mental health care was introduced for ART providers, but this hasn't been evaluated yet. The aim of this study was to examine if this training has improved patient retention in care.
    • 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 Global Capacity for Conducting Operational Research Using the SORT IT Model: Where and Who?

      Zachariah, R; Rust, S; Berger, SD; Guillerm, N; Bissell, K; Delaunois, P; Reid, AJ; Kumar, AM; Olliaro, PL; Reeder, JC; Harries, AD; Ramsay, A (Public Library of Science, 2016)
      Research capacity is weakest in low and middle-income countries (LMICs) where operational research is highly relevant and needed. Structured Operational Research and Training Initiative (SORT IT) courses have been developed to train participants to conduct and publish operational research and influence policy and practice. Twenty courses were completed in Asia, Africa, Europe and the South Pacific between 2009 and 2014.
    • Building Global Capacity for Conducting Operational Research Using the SORT IT Model: Where and Who?

      Zachariah, R; Rust, S; Berger, SD; Guillerm, N; Bissell, K; Delaunois, P; Reid, AJ; Kumar, AMV; Olliaro, PL; Reeder, JC; Harries, AD; Ramsay, A (Public Library of Science, 2016-08-09)
      Research capacity is weakest in low and middle-income countries (LMICs) where operational research is highly relevant and needed. Structured Operational Research and Training Initiative (SORT IT) courses have been developed to train participants to conduct and publish operational research and influence policy and practice. Twenty courses were completed in Asia, Africa, Europe and the South Pacific between 2009 and 2014.
    • 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; Marks, G; Linh, N N; Ram, S; Reid, S; Roseveare, C; Tayler-Smith, K; Van den Bergh, R; Harries, A D (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.
    • Building the capacity of public health programmes to become data rich, information rich and action rich

      Harries, AD; Khogali, M; Kumar, AMV; Satyanarayana, S; Takarinda, KC; Karpati, A; Olliaro, P; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2018-06-21)
      Good quality, timely data are the cornerstone of health systems, but in many countries these data are not used for evidence-informed decision making and/or for improving public health. The SORT IT (Structured Operational Research and Training Initiative) model has, over 8 years, trained health workers in low- and middle-income countries to use data to answer important public health questions by taking research projects through to completion and publication in national or international journals. The D2P (data to policy) training initiative is relatively new, and it teaches health workers how to apply 'decision analysis' and develop policy briefs for policy makers: this includes description of a problem and the available evidence, quantitative comparisons of policy options that take into account predicted health and economic impacts, and political and feasibility assessments. Policies adopted from evidence-based information generated through the SORT IT and D2P approaches can be evaluated to assess their impact, and the cycle repeated to identify and resolve new public health problems. Ministries of Health could benefit from this twin-training approach to make themselves 'data rich, information rich and action rich', and thereby use routinely collected data in a synergistic manner to improve public health policy making and health care delivery.
    • 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.
    • Burden of Soil Transmitted Helminthiases in Primary School Children in Migori County, Kenya

      Ng'ang'a, A; Matendechero, S; Kariuki, L; Omondi, W; Makworo, N; Owiti, P; Kizito, W; Tweya, H; Edwards, JK; Takarinda, KC; Ogutu, O (African Journals Online, 2016-10)