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HIV prevalence is disproportionately high among sex workers and long distance truck drivers compared to the general population, both globally and in the Southern African region.

While measurement and attribution of maternal mortality is challenging, available evidence indicates that HIV-infected pregnant and postpartum women have an increased risk of death compared to their uninfected peers.

In 2014, the budget for high cost drugs in the Dominican Republic was USD 107 million, accounting for 51% of the Ministry of Health (MoH) budget for medicines. Resources allocated for the 2015 budget were USD 49 million, leaving a shortfall of USD 62 million. The MoH requested technical assistance from the USAID-funded SIAPS project to conduct an evidence based analysis of the 98 products included in the list.

The aim of this study was to assess the prevalence of MDR-TB and associated risk factors in West Armachiho and Metema districts of North Gondar. A cross-sectional study was conducted between February 1 and June 25, 2014. A total of 124 consecutive smear-positive pulmonary TB patients were included in the study. Socio-demographic and possible risk factor data were collected using a semi-structured questionnaire. Drug susceptibility testing was first performed for rifampicin using GeneXpert MTB/RIF. For those rifampicin resistant strains, drug susceptibility testing was performed for both isoniazid and rifampicin to identify MDR-TB. Of 124 smear-positive pulmonary TB patients, 117 (94.4 %) were susceptible to rifampicin, while 7 (5.7 %) were confirmed to be resistant to rifampicin and isoniazid. History of previous treatment was significantly associated with MDR-TB. Maximizing early case detection and treatment, strengthening TB infection control activities and proper implementation of DOTS are recommended to reduce the burden of MDR-TB.

This hospital-based study aimed to examine patient and primary healthcare factors and stage at diagnosis in women with cervical cancer in Northern Uganda in order to identify factors associated with advanced stages, to inform policies to improve survival from cervical cancer in low income and middle income countries. Of 166 patients attending care, 149 were enrolled and analysed. Most women were diagnosed at stages III (45%) or IV (21%). Understanding individual patient factors, patients' behavioural characteristics and healthcare factors associated with advanced stage at diagnosis is essential for targeted effective public health interventions to promote prompt health seeking, diagnosis at early stage and improved survival from cervical cancer.

The Government of Cameroon and its partners have made major investments in the last decade in prevention, treatment, and care of HIV-infected patients. However, unmet need for antiretroviral therapy (ART) among HIV-positive pregnant women remains high at 66%. Critical to satisfying this need is ensuring adequate availability of prevention of mother-to-child transmission (PMTCT) commodities for rollout of new Option B+ guidelines. This study examines options for improving the supply and availability of these commodities. Supply chain operational data was collected in July 2014 from central (CENAME) and 4 regional warehouses (CAPRs); 10 district stores; and 30 service delivery points (SDPs), including ART and PMTCT sites. The study also included seven central private-sector logistics firms. In addition, SC cost data was obtained from CENAME and CAPRs financial statements. Data collected served for analysis of three options to improve effectiveness of delivering PMTCT commodities. Asset utilization within the cost recovery system ranged between 73% and 89% while inventory turnover was at 1.5. Therefore, a reliable supply of medicines to SDPs is ensured. However, for PMTCT and ART commodities, distribution to the SDPs was unreliable (in 2013, 40% of prescriptions remained unfilled). Meanwhile, results of the options analysis indicated that the model of CAPRs delivering PMTCT commodities to SDPs was the most desirable. Although the distance traveled was higher, the need for network storage space was minimal. Moreover, its total cost and human resource requirements were more favorable. As a result of disseminating the findings, the Ministry of Health adopted Option 2.

The neglected tropical diseases (NTDs) are the most common infections of humans in sub-Saharan Africa. Virtually all of the population living below the World Bank poverty figure is affected by one or more NTDs. New evidence indicates a high degree of geographic overlap between the highest-prevalence NTDs (soil-transmitted helminths, schistosomiasis, onchocerciasis, lymphatic filariasis, and trachoma) and malaria and HIV, exhibiting a high degree of co-infection. Recent research suggests that NTDs can affect HIV and AIDS, tuberculosis (TB), and malaria disease progression. A combination of immunological, epidemiological, and clinical factors can contribute to these interactions and add to a worsening prognosis for people affected by HIV/AIDS, TB, and malaria. Together these results point to the impacts of the highest-prevalence NTDs on the health outcomes of malaria, HIV/AIDS, and TB and present new opportunities to design innovative public health interventions and strategies for these "big three" diseases. This analysis describes the current findings of research and what research is still needed to strengthen the knowledge base of the impacts of NTDs on the big three.

Early detection and treatment of multidrug-resistant tuberculosis (MDR-TB) is an urgent global priority. Identifying and tracing close contacts of patients with MDR-TB could be a feasible strategy to achieve this goal. However, there is limited experience with contact tracing among patients with drug-resistant tuberculosis both globally and in Ethiopia. Here we present findings on the extent of screening symptomatic contacts and its yield in a tetrtiary hospital in a major urban setting in Ethiopia. Symptomatic household contacts were identified in 29 (5.7%) of 508 index cases treated at the hospital. There were a total of 155 family members in the households traced of whom 16 (10%) had confirmed MDR-TB. At least 1 confirmed MDR-TB case was identified in 15 (51.7%) of the 29 traced households. Tracing symptomatic contacts of MDR-TB cases could be a high yield strategy for early detection and treatment of MDR-TB cases in the community. The approach should be promoted for wider adoption and dissemination.

In 2010, the Ministry of Health (MoH) asked USAID for technical assistance to implement interventions to improve the HIV/AIDS supply chain system. Assessments revealed that fragmentation of the pharmaceutical system contributed to stock-outs and expiration of antiretroviral (ARVs) and other medicines and supplies used by disease control programs. The implementation of an integrated system was proposed as the most efficient and sustainable alternative to confront the HIV/AIDS pharmaceutical supply problems.

Since 2004 public provision of ARVs in the Dominican Republic has been funded, by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). Until 2009 there was a gross correspondence between the increase in the number of treated cases and the funding. From 2009 to 2012, however, the number of cases grew at an average rate of 33.4% (2,958 cases) per year, whereas funding experienced an average decrease of 21.7% (965,382 USD) per year. In 2012, the Ministry of Health (MoH) carried out the first national quantification exercise for the 2013 procurement of medicines, under a standard forecasting methodology.

In 2013, an estimated 2.8 million newborns died and 2.7 million were stillborn. A much greater number suffer from long term impairment associated with preterm birth, intrauterine growth restriction, congenital anomalies, and perinatal or infectious causes. With the approaching deadline for the achievement of the Millennium Development Goals (MDGs) in 2015, there was a need to set the new research priorities on newborns and stillbirth with a focus not only on survival but also on health, growth and development. We therefore carried out a systematic exercise to set newborn health research priorities for 2013-2025. We used adapted Child Health and Nutrition Research Initiative methods for this prioritization exercise. We identified and approached the 200 most productive researchers and 400 program experts, and 132 of them submitted research questions. These were collated into a set of 205 research questions, sent for scoring to the 600 identified experts, and assessed and scored by 91 experts. Nine out of top ten identified priorities were in the domain of research on improving delivery of known interventions, with simplified neonatal resuscitation program and clinical algorithms and improved skills of community health workers leading the list. The top 10 priorities in the domain of development were led by ideas on improved Kangaroo Mother Care at community level, how toimprove the accuracy of diagnosis by community health workers, and perinatal audits. The 10 leading priorities for discovery research focused on stable surfactant with novel modes of administration for preterm babies, ability to diagnose fetal distress and novel tocolytic agents to delay or stop preterm labour. These findings will assist both donors and researchers in supporting and conducting research to close the knowledge gaps for reducing neonatal mortality, morbidity and long term impairment.

Forecasting Consumption of Select Reproductive, Maternal, Newborn and Child Health Commodities This guide will assist program managers, service providers, and technical experts when conducting a quantification of commodity needs for the 13 reproductive, maternal, newborn, and child health commodities prioritized by the UN Commission on Life-Saving Commodities for Women and Children.

To improve tuberculosis (TB) diagnosis, many national TB programmes have committed to deploying Xpert® MTB/RIF. Implementation of this relatively new technology has suffered from a lack of comprehensive technical assistance, however, including the formulation of policies and plans to address operational issues. While providing technical assistance, we observed numerous operational challenges in the implementation and scale-up of Xpert in five sub-Saharan African countries: low coverage, poor laboratory infrastructure, limited access, poor linkages to treatment, inadequate data on outcomes, problems with specimen transport, diagnostic algorithms that are not aligned with updated World Health Organization recommendations on target patient groups and financing challenges. We recommend better country preparedness and training, laboratory information and quality systems, supply management and referral mechanisms.

This technical brief presents analysis of the impact of differential fertility decline among wealth quintiles on population age structure in four African countries, the trajectory of these trends through 2050, and the impact on access to economic opportunity.

Sleeping sickness (human African trypanosomiasis [HAT]) is a neglected tropical disease with limited treatment options that currently require parenteral administration. In previous studies, orally administered pafuramidine was well tolerated in healthy patients (for up to 21 days) and stage 1 HAT patients (for up to 10 days), and demonstrated efficacy comparable to pentamidine. This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospitals in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. The overall cure rate at 12 months was 89% in the pafuramidine group and 95% in the pentamidine group; pafuramidine was non-inferior to pentamidine as the upper bound of the 95% confidence interval did not exceed 15%. The safety profile of pafuramidine was superior to pentamidine; however, 3 patients in the pafuramidine group had glomerulonephritis or nephropathy approximately 8 weeks post-treatment. Two of these events were judged as possibly related to pafuramidine. Despite good tolerability observed in preceding studies, the development program for pafuramidine was discontinued due to delayed post-treatment toxicity.

MSH worked with school, community, and government partners to lead a pilot intervention with 30 adolescent girls (ages 13 to 19) at Government Day Secondary School, Tal in Billiri, Gombe State in northeast Nigeria for six months from 2014 to 2015.

"Improving Medicines Access and Use for Child Health—A Guide to Developing Interventions" represents an up-to-date and practical resource for those developing interventions to improve access to and use of medicines for child illness. It targets groups working in community organizations, health facilities, and district health offices, or within larger health systems.

Increasingly a part of corporations' business strategies, corporate social responsibility (CSR) is an expression of the business desire to create value for both the corporation and the community in which it operates.

In November 2015, the African Union Commission released this status report on maternal and child health. Developed with support from the African Strategies for Health (ASH) project, the status report is part of the African Union's contribution to enhancing MNCH on the continent. This is the third in a series of status reports prepared since 2012.

This report documents the outcomes of the Africa Regional Meeting on Digital Health for Overcoming Barriers to Ending Preventable Child and Maternal Deaths and Achieving Universal Health Coverage. From May 12-15 2015, over 150 government, private sector, and donor participants came together in Lilongwe, Malawi to exchange ideas and information on how to adopt and expand digital health technol

This report documents key topics presented and discussed at the first ever ministerial-level stakeholders meeting, "Investing in Technology and Innovations for Human Development in Africa," held on October 14, 2014 in Rabat, Morocco.

This report documents the proceedings of the International Conference of the African Evaluation Association in Yaounde, Cameroon, held March 3-7, 2014.

Integrated community case management (iCCM), the delivery of timely and low-cost interventions at the community level by community health workers, is an effective strategy for expanding access for the treatment of diarrhea, pneumonia, and malaria, which are the leading causes of child mortality and result in nearly 44 percent of deaths worldwide in children under five years old.

Integrated community case management (iCCM) is considered to be an effective strategy for expanding the treatment of diarrhea, pneumonia, and malaria, which are the leading causes of child mortality and result in nearly 44 percent of deaths worldwide in children under five years old.

MSH used USAID's iCCM Costing and Financing Tool to estimate the costs and impact of iCCM implementation and scale-up in two states of Nigeria: Kebbi and Benue. This study aims to forecast the costs and impact of introducing the iCCM program in Benue and Kebbi states.


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