A5059489482- Tuberculosis Research and Epidemiology
- HIV/AIDS Research and Interventions
- Pneumocystis jirovecii pneumonia detection and treatment
- Pneumonia and Respiratory Infections
- HIV, Drug Use, Sexual Risk
- HIV Research and Treatment
- HIV/AIDS drug development and treatment
- HIV-related health complications and treatments
- Mycobacterium research and diagnosis
- HIV, TB, and STIs Epidemiology
- HIV/AIDS Impact and Responses
- Infective Endocarditis Diagnosis and Management
- COVID-19 epidemiological studies
- Global Maternal and Child Health
- Biosimilars and Bioanalytical Methods
- Diagnosis and treatment of tuberculosis
- Drug-Induced Hepatotoxicity and Protection
- Antibiotic Resistance in Bacteria
- Chronic Disease Management Strategies
- Congenital Diaphragmatic Hernia Studies
- COVID-19 diagnosis using AI
- Infectious Diseases and Mycology
- Esophageal and GI Pathology
- Viral Infections and Outbreaks Research
- Global Health and Epidemiology
Médecins Sans Frontières
2016-2024
Instituut voor Tropische Geneeskunde
2022-2024
University of Antwerp
2022-2024
Research Foundation - Flanders
2024
University of Exeter
2024
Myanmar Oxford Clinical Research Unit
2024
Abstract Introduction : National AIDS Programme in Myanmar has made significant progress scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around hospital reliant on physicians, country's HIV response is undergoing a process successful decentralization increasingly being integrated into other health as part systematic effort to expand access treatment. This study describes implementation...
Abstract Background Progress toward the global target for 95% virological suppression among those on antiretroviral treatment (ART) is still suboptimal. We describe viral load (VL) cascade, incidence of failure and associated risk factors people living with HIV receiving first-line ART in an cohort Myanmar treated by Médecins Sans Frontières collaboration Ministry Health Sports Myanmar. Methods conducted a retrospective study, including adult patients at least one test result having received...
Multidrug-resistant tuberculosis (MDR-TB) is a major threat to global TB control. MDR-TB treatment regimens typically have high pill burden, last 20 months or more and often lead unsatisfactory outcomes. A 9–11 month regimen with seven antibiotics has shown success rates among selected patients in different settings conditionally recommended by the World Health Organization. We construct transmission-dynamic model of estimate likely impact shorter when applied low HIV prevalence region...
HIV continues to be one of the leading causes infectious death worldwide and presentation with advanced disease is associated increased morbidity mortality. Recommendations for management include prompt screening treatment opportunistic infections, rapid initiation ART intensified adherence support. We present outcomes a cohort patients presenting in semi-urban Zimbabwean polyclinic.Retrospective analysis adult enrolled care at Epworth polyclinic, Zimbabwe between 2007 end June 2016....
Recent World Health Organization guidance on drug-resistant tuberculosis treatment de-prioritised injectable agents, in use for decades, and endorsed all-oral longer regimens. However, questions remain about the role of agent, particularly context regimens using new repurposed drugs. We compared effectiveness an injectable-containing regimen to that among patients with who received bedaquiline and/or delamanid as part their multidrug regimen.Patients a positive baseline culture were...
To assess the impact of introducing a chest radiograph reading and recording system (CRRS) with short training session, on accuracy inter-reader variability tuberculosis (TB) interpretation radiographs (CXRs) by group non-expert readers in human immunodeficiency virus (HIV)-positive cohort.A set 139 CXRs was reviewed eight physicians pre- post-intervention at two clinics Shan State, Myanmar, providing HIV/TB diagnosis treatment services. The results were compared against consensus expert...
An increasing proportion of adult patients initiating antiretroviral therapy (ART) in resource-limited settings are aged > 50 years. Older populations on ART appear to have heightened risk death, but little is known about factors influencing mortality this population.We performed a retrospective observational multisite cohort study including all (≥ 15 years) between 2003 and 2013 programmes supported by Médecins Sans Frontières across 12 countries Asia, Africa Europe. Patients were...
Introduction Afghanistan is affected by one of the world's longest protracted armed conflicts, frequent natural disasters, disease outbreaks and large population movements it suffers from a high burden tuberculosis (TB), including rifampicin-resistant TB (RR-TB). The study shows Médecins Sans Frontières' experiences with care for patients RR-TB in Kandahar Province. We describe uptake treatment, how World Health Organisation criteria choice between short an individualized regimen were...
Abstract Objectives To describe the effect of adaptations to a person‐centred care with short oral regimens on retention in for rifampicin‐resistant TB (RR‐TB) Kandahar province, Afghanistan. Methods The study included people RR‐TB registered programme between 01 October 2016 and 18 April 2021. From 19 November 2019, implemented trial investigating safety effectiveness regimens. During trial, was adapted. We data from living treated period before after model adapted applied Kaplan‐Meier...
Introduction Despite HIV viral load (VL) monitoring being serial, most studies use a cross-sectional design to evaluate the virological status of cohort. The objective our study was simplified approach calculate viraemic-time: proportion follow-up time with unsuppressed VL above limit detection. We estimated risk factors for higher viraemic-time and whether predicted mortality in second-line antiretroviral treatment (ART) cohort Myanmar. Methods conducted retrospective analysis people living...
In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with objective of reducing barriers to access new and repurposed drugs. Here we describe major implementation challenges encountered in 17 endTB countries. We provide insights on how national programmes other stakeholders can scale-up programmatic use drugs, while building scientific evidence about their safety efficacy. For any drug or diagnostic, multiple market slow pace scale-up. During 2015–2019, was successful...
Antiretroviral therapy (ART) treatment interruptions lead to poor clinical outcomes with unplanned or unstructured TIs (uTIs) likely be underreported. This study describes; uTIs, their risk factors and association survival. Analysis of ART programmatic data from 11 countries across Asia Africa between 2003 2013 where an uTI was defined as a ≥90-day patient initiated break calculated the last day previous prescription would have run out until date next prescription. Factors predicting were...
We performed a systematic review to generate evidence on the association between cumulative human immunodeficiency virus (HIV) viraemia and health outcomes.
Abstract Background The burden of advanced HIV disease (AHD) and predictors outcomes among people living with (PLHIV) re-engaging in care are not well known. Methods We conducted a retrospective cohort study PLHIV who re-engaged after being lost to follow-up (LFU), from 2003 2019, Myanmar. calculated the incidence rates attrition re-engagement performed Cox regression identify risk factors for attrition. Results Of 44 131 started antiretroviral treatment, 12 338 (28.0%) were LFU at least...
In recent years, MSF has been able to improve patients9 experiences of care for drug resistant tuberculosis, but the changing political situation threatens derail this progress, writes Anita Mesic
Phenotypic drug-susceptibility testing (pDST), which relies on growth inhibition in the drug-containing media, remains a challenge for fastidious Mycobacterium tuberculosis complex (MTBc) isolates due to insufficient controls (GC). Middlebrook 7H11 (M7H11) medium contains casein hydrolysate, may favor of such strains.In this study, we tested whether M7H11 reduces invalid results GCs and turnaround time (TAT) pDST MTBc compared 7H10 (M7H10) without affecting accuracy how it differs between...