• Knockdown and recovery of malaria diagnosis and treatment in Liberia during and after the 2014 Ebola outbreak

      Dunbar, NK; Richards, EE; Woldeyohannes, D; Van den Bergh, R; Wilkinson, E; Tamang, D; Owiti, P (International Union Against Tuberculosis and Lung Disease, 2017-06-21)
      Setting: The malaria-endemic country of Liberia, before, during and after the 2014 Ebola outbreak. Objective: To describe the consequences of the Ebola outbreak on Liberia's National Malaria Programme and its post-Ebola recovery. Design: A retrospective cross-sectional study using routine countrywide programme data. Results: Malaria caseloads decreased by 47% during the Ebola outbreak and by 11% after, compared to the pre-Ebola period. In those counties most affected by Ebola, a caseload reduction of >20% was sustained for 12 consecutive months, while this lasted for only 4 consecutive months in the counties least affected by Ebola. Linear regression of monthly proportions of confirmed malaria cases-as a proxy indicator of programme performance-over the pre- and post-Ebola periods indicated that the malaria programme could require 26 months after the end of the acute phase of the Ebola outbreak to recover to pre-Ebola levels. Conclusions: The differential persistence of reduced caseloads in the least- and most-affected counties, all of which experienced similar emergency measures, suggest that factors other than Ebola-related security measures played a key role in the programme's reduced performance. Clear guidance on when to abandon the emergency measures after an outbreak may be needed to ensure faster recovery of malaria programme performance.
    • Knowledge, Access and Utilization of Bed-Nets Among Stable and Seasonal Migrants in an Artemisinin Resistance Containment Area of Myanmar

      Phyo Than, W; Oo, T; Wai, K; Thi, A; Owiti, P; Kumar, B; Deepak Shewade, H; Zachariah, R (BioMed Central, 2017-09-14)
      Myanmar lies in the Greater Mekong sub-region of South-East Asia faced with the challenge of emerging resistance to artemisinin combination therapies (ACT). Migrant populations are more likely than others to spread ACT resistance. A vital intervention to reduce malaria transmission, resistance spread and eliminate malaria is the use of bed nets. Among seasonal and stable migrants in an artemisinin resistance containment region of Myanmar, we compared a) their household characteristics, b) contact with health workers and information material, and c) household knowledge, access and utilization of bed nets.
    • Leprosy Trends at a Tertiary Care Hospital in Mumbai, India, From 2008 to 2015

      Muthuvel, T; Isaakidis, Pe; Shewade, HD; Kattuppara, L; Singh, R; Govindarajulu, S (Co-Action Publishing, 2016-11-23)
      Leprosy remains an important cause of preventable disabilities. After the advent of multidrug therapy, new leprosy cases have come down dramatically. Despite this achievement, India, which contributes 60% of the global leprosy burden, faces some challenges to eliminate the disease, including active transmission in the community and delayed diagnosis of leprosy patients.
    • Linkage Between Diagnosis and Treatment of Smear-Positive Pulmonary Tuberculosis in Urban and Rural Areas in Kyrgyzstan

      Kulzhabaeva, A; Nabirova, D; Usenbaev, N; Denisiuk, O; Zachariah, R (The World Health Organization, 2016-03)
    • Low Mother-to-Child HIV Transmission Rate But High Loss-to-Follow-Up Among Mothers and Babies in Mandalay, Myanmar; A Cohort Study

      Kyaw, K; Oo, M; Kyaw, N; Phyo, K; Aung, T; Mya, T; Aung, N; Oo, H; Isaakidis, P (Public Library of Science, 2017-09-08)
      Loss-to-follow-up (LTFU) throughout the Prevention of Mother-To-Child Transmission (PMTCT) cascade remains one of the major threats to the success of PMTCT programs. In this study, we aimed to determine the mother-to-child transmission rate in a programmatic setting and to determine factors associated with LTFU among enrolled mothers and unfavorable outcomes among HIV-exposed babies which includes being HIV positive, death and LTFU.
    • Low uptake of preventive interventions among malaria cases in Swaziland: towards malaria elimination

      Makadzange, K; Dlamini, N; Zulu, Z; Dlamini, S; Kunene, S; Sikhondze, W; Owiti, P; Geoffroy, E; Zachariah, R; Mengestu, TK (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Settings: Swaziland is striving to achieve sustainable malaria elimination. Three preventive interventions are vital for reaching this goal: 1) effective household utilisation of long-lasting insecticide nets (LLINs), 2) indoor residual spraying (IRS), and 3) provision of chemoprophylaxis for those travelling to malaria-endemic areas. Objectives: To assess the uptake of preventive intervention among confirmed malaria cases. Design: A longitudinal study using nation-wide programme data from 2010 to 2015. Data on malaria cases from health facilities were sourced from the Malaria Surveillance Database System. Results: Of a total 2568 confirmed malaria cases in Swaziland, 2034 (79%) had complete data on case investigations and were included in the analysis. Of 341 (17%) individuals who owned LLINs, 169 (8%) used them; 338 (17%) had IRS and 314 (15%) slept in sprayed structures. Of 1403 travellers to areas at high malaria risk, 59 (4%) used any form of malaria prevention, including chemoprophylaxis. Conclusion: The uptake of all three key malaria prevention interventions is low, and could threaten the progress made thus far toward malaria elimination. Efforts to improve this situation, including qualitative research to understand the reasons for low uptake, are urgently needed.
    • Malaria profiles and challenges in artemisinin resistance containment in Myanmar

      Nwe, TW; Oo, T; Wai, KT; Zhou, S; van Griensven, J; Chinnakali, P; Shah, S; Thi, A (BioMed Central, 2017-04-25)
      This study examined evolving malaria profiles from January, 2010 to December, 2014 to evaluate achievements and challenges of implementing measures to prevent and control spread of artemisinin resistance in Myanmar.
    • 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.
    • Management of malaria in children with fever in rural Sierra Leone in relation to the 2014-2015 Ebola outbreak

      Moses, FL; Tamang, D; Denisiuk, O; Dumbuya, U; Hann, K; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2017-06-21)
      Setting: Sixty-eight primary health facilities, Koinadugu District, rural Sierra Leone. Objectives: Sierra Leone, a country with one of the highest burdens of malaria, was severely affected by the 2014-2015 Ebola virus disease outbreak. In under-five children, we compared trends in the completeness of malaria reports sent to the district office during the pre-Ebola, Ebola and post-Ebola periods, including the number of children with reported fever, malaria diagnostic testing performed and treatment for malaria initiated with artemisinin-based combination therapy (ACT). Design: A cross-sectional study. Results: Of 1904 expected malaria reports, 1289 (68%) were received. Completeness of reporting was 61% pre-Ebola, increased to 88% during the outbreak and dropped to 44% post-Ebola (P = 0.003). Total malaria testing (n = 105 558) exceeded the number of fever cases (n = 105 320). Pre-Ebola, 75% (n = 43 245) of all reported fever cases received malaria treatment, dropping to 34% (n = 50 453) during the Ebola outbreak. Of 36 804 confirmed malaria cases during Ebola, 17 438 (47%) were treated, significantly fewer than in the pre-Ebola period (96%, P < 0.001). Of the fever cases, 95% in both the pre- and post-Ebola periods received ACT, a rate that increased to 99% during the Ebola outbreak. Conclusion: Pre-existing gaps in malaria reporting worsened after the Ebola outbreak. Reassuringly, malaria testing matched fever cases, although only half of all confirmed cases received treatment during the outbreak, possibly explained by outbreak-related operational difficulties. These findings could be useful to guide health systems strengthening and recovery.
    • Management of multi- and extensively drug-resistant tuberculosis in Ukraine: how well are we doing?

      Lytvynenko, N; Cherenko, S; Feschenko, Y; Pogrebna, M; Senko, Y; Barbova, A; Manzi, M; Denisiuk, O; Ramsay, A; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2014-10-21)
    • Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?

      Abeygunawardena, S C; Sharath, B N; Van den Bergh, R; Naik, B; Pallewatte, N; Masaima, M N N (The Union, 2014-06-21)
    • 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; Chikosi, L; Harries, A D; Gadabu, O J (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; Chikosi, L; Harries, A D; Gadabu, O J (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.
    • Mass Treatment to Eliminate Tuberculosis from an Island Population

      Hill, P C; Dye, C; Viney, K; Tabutoa, K; Kienene, T; Bissell, K; Williams, B G; Zachariah, R; Marais, B J; Harries, A D (International Union Against Tuberculosis and Lung Disease, 2014-08-01)
      The global target of tuberculosis (TB) elimination by 2050 requires new approaches. Active case finding plus mass prophylactic treatment has been disappointing. We consider mass full anti-tuberculosis treatment as an approach to TB elimination in Kiribati, a Pacific Island nation, with a persistent epidemic of high TB incidence.
    • Moving towards malaria elimination: trends and attributes of cases in Kavango region, Namibia, 2010-2014

      Nghipumbwa, H; Ade, S; Kizito, W; Takarinda, KC; Uusiku, P; Mumbegegwi, DR (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Setting: Kavango, a 'moderate' transmission risk region located in north-eastern Namibia, borders Angola, a country with higher malaria transmission levels. Objective: To determine 1) the trends in malaria incidence between 2010 and 2014 in Kavango, 2) the socio-demographic and clinical characteristics of confirmed cases in 2014, and 3) associated risk factors of cases classified as imported. Design: This was a retrospective study of malaria case investigation forms conducted in all 52 public health facilities in 2014. Incidence was derived from aggregate routine surveillance data from the Health Information System (HIS). Results: During the 5-year study, incidence fell from 53.6 to 3.6 cases per 1000 population, then increased again to 47.3/1000. Fifty-five per cent of cases were males, and 49% were aged between 5 and 17 years. Of the 2014 cases, 23% were imported, and were associated with higher odds of severe malaria (adjusted odds ratio [aOR] 1.8; 95%CI 1.01-3.29), not having long-lasting insecticide treated nets (aOR 2.1, 95%CI, 1.3-3.4) and not receiving insecticide residual spraying (aOR 3.2, 95%CI, 2.1-5.1). Conclusion: Sporadic outbreaks in the 5-year period posed a threat to malaria elimination. Better targeting of vector control interventions, strong cross-border collaboration and robust health promotion will be key to achieving malaria elimination.
    • Multi- and extensively drug-resistant tuberculosis in Latvia: trends, characteristics and treatment outcomes

      Kuksa, L; Riekstina, V; Leimane, V; Ozere, I; Skenders, G; Van den Bergh, R; Kremer, K; Acosta, C D; Harries, A D (International Union Against Tuberculosis and Lung Disease, 2014-10-21)
    • Non-monetary incentives for pregnant women and antenatal attendance among Ethiopian pastoralists

      Zachariah, R; De Smet, M; Etienne, W; Khogali, M; van Den Bergh, R; Veerman, R; Harries, A D (International Union Against Tuberculosis and Lung Disease, 2014-06-21)
    • Notified tuberculosis among Singapore residents by ethnicity, 2002–2011

      Lim, L K-Y; Enarson, D A; Reid, A J; Satyanarayana, S; Cutter, J; Kyi Win, K M; Chee, C B-E; Wang, Y T (2013-12-21)
    • A 'one-stop shop' approach in antenatal care: does this improve antiretroviral treatment uptake in Zimbabwe?

      Gunguwo, H; Zachariah, R; Bissell, K; Ndebele, W; Moyo, J; Mutasa-Apollo, T (International Union Against Tuberculosis and Lung Disease, 2014-03-25)
    • Open access for operational research publications from low- and middle-income countries: who pays?

      Zachariah, R; Kumar, A M V; Reid, A J; Van den Bergh, R; Isaakidis, P; Draguez, B; Delaunois, P; Nagaraja, S B; Ramsay, A; Reeder, J C; Denisiuk, O; Ali, E; Khogali, M; Hinderaker, S G; Kosgei, R J; van Griensven, J; Quaglio, G L; Maher, D; Billo, N E; Terry, R F; Harries, A D (International Union Against Tuberculosis and Lung Disease, 2014-09-21)