The purpose of this study is to prospectively evaluate the process of implementing HFNO in several MSF projects, varying according to geographical and programmatic contexts, population, health structures, human resources, and management. It will generate evidence on the operational feasibility (in terms of human resources, equipment, logistics and costs) of integrating HFNO into PICU standard of care, as well as on the users' and caregivers' perspectives on HFNO and on the children clinical outcomes observed where HFNO is implemented. This relevant information will guide MSF in the decision making of scaling up HFNO therapy in its projects.

Start Date01 Jan 2025

Sponsor / Collaborator

Epicentre Technologies Corp.

[+2]

100 Clinical Results associated with MSF Medecins Sans Frontieres

0 Patents (Medical) associated with MSF Medecins Sans Frontieres

147

Literatures (Medical) associated with MSF Medecins Sans Frontieres

01 Sep 2024·IJTLD OPEN

Second-line drug-resistant TB and associated risk factors in Karakalpakstan, Uzbekistan

Article

Author: Parpieva, N. ; Mamitova, K. ; Kalmuratov, B. ; Sinha, A. ; Allamuratova, S. ; Bidwell, G. ; Safaev, K. ; Oluya, M. ; Moe, S. ; Gomez, D. ; Gomez-Restrepo, C. ; Azamat, I. ; Sitali, N. ; Rekart, M.L. ; Khristusev, A. ; Tigay, Z. ; Mikhail, A.

<sec><title>BACKGROUND</title>Drug-resistant TB (DR-TB) remains a major public health threat. In 2022, Uzbekistan reported 2,117 cases of DR-TB, with 69% tested for fluoroquinolone resistance. Limited information is available on the prevalence of resistance to bedaquiline, linezolid, and fluoroquinolone, which are key components of the all-oral treatment regimen for rifampicin-resistant TB in Uzbekistan.</sec><sec><title>METHODS</title>A retrospective study was conducted using extensive programmatic data from 2019 to 2023 in Uzbekistan. We assessed second-line drug-resistant TB (SLDR-TB) rates using phenotypic drug susceptibility testing (pDST). Demographic and clinical characteristics associated with SLDR-TB were analysed using multivariable logistic regression models based on the Allen-Cady approach.</sec><sec><title>RESULTS</title>In total, 2,405 patients with TB who had undergone pDST were included (median age 40 years, 47% female). The overall SLDR-TB resistance rate was 24% (95% CI 22–26). Prevalence of resistance to bedaquiline, linezolid, moxifloxacin, levofloxacin, and amikacin were respectively 3.1%, 0.8%, 15%, 13%, and 12%. Risk factors for SLDR-TB were resistance to rifampicin and/or isoniazid, exposure to clofazimine, retreatment status, contact with drug-susceptible TB case or DR-TB case, and diabetes.</sec><sec><title>CONCLUSIONS</title>The high prevalence of SLDR-TB is of major concern, emphasising the need for baseline pDST in RR-TB treatment. Identified risk factors can aid early detection of at-risk individuals and inform clinical practice.</sec>

01 Mar 2024·eBioMedicine

Affordable blood culture systems from China: in vitro evaluation for use in resource-limited settings

Article

Author: Jacobs, Jan ; Genbrugge, Els ; Ferreyra, Cecilia ; Natale, Alessandra ; Dailey, Peter ; Vermoesen, Tine ; Franquesa, Céline ; Hardy, Liselotte ; Gleeson, Birgitta

BACKGROUNDBloodstream infections (BSI) pose a significant threat due to high mortality rates and the challenges posed by antimicrobial resistance (AMR). In 2019, an estimated 4.95 million deaths were linked to bacterial AMR. The highest impact was seen in resource-limited settings (RLS). For diagnosis of BSI, performant continuously-monitoring blood culture systems (CMBCS) have been optimized. However, in RLS, the implementation of CMBCS is hindered by budget constraints and unsuitable environmental conditions. Manufacturers from growing economies are currently producing affordable in vitro diagnostics, which could fill the gap in capacity, but so far these are not established outside their domestic markets.METHODSThis study evaluated the performance, usability, and interchangeability of Chinese CMBCS in a laboratory setting using simulated blood cultures with a panel of 20 BSI-associated strains. Four systems were selected for the assessment: Autobio BC60, Mindray TDR60, Scenker Labstar50, and DL-biotech DL-60.FINDINGSOverall, all evaluated CMBCS demonstrated good performance with high yield (96.7-100%) and specificity (97.5-100%), comparable to the reference system (bioMérieux 3D). In addition, when used as "manual" blood cultures in a conventional incubator with visual growth detection, performance was also satisfactory: yield was between 90 and 100% and specificity was 100% for all BCBs. Both the CMBCS and the BCBs were easy to use and lot-to-lot variability in BCBs was minimal. The interchangeability testing indicated that the BCBs from different brands (all except Scenker) were compatible with the various automates, further highlighting the potential for a harmonized "universal BCB."INTERPRETATIONBased on this in vitro study, we recommend the use of these systems in settings with challenging environments and limited resources. The Autobio system performed best for automatic detection and DL-Biotech BCBs for manual cultures respectively (combination of performance, price, usability). The appropriateness for use in RLS should still be confirmed in a field study.FUNDINGThe study was funded by FIND.

01 Dec 2023·The International Journal of Tuberculosis and Lung Disease

Standards for clinical trials for treating TB

Article

Author: Greig, J. ; Nyang’wa, B-T. ; Berry, C. ; Furin, J. ; Marais, B. J. ; Menzies, D. ; Tiberi, S. ; Turkova, A. ; McKenna, L. ; Dooley, K. E. ; Huang, G. K. L. ; Cox, V. ; Phillips, P. P. J. ; Skrahina, A. ; Thi, S. S. ; Dheda, K. ; Marks, G. B. ; Velásquez, G. E. ; Nguyen, H. T. ; Horsburgh, C. R. ; Spigelman, M. ; Denholm, J. T. ; Khan, U. ; Brigden, G. ; Tsogt, B. ; Lange, C. ; Upton, C. M. ; Quelapio, M. ; Guglielmetti, L. ; Ong, C. W. M. ; Cousins, C. ; Singh, K. P. ; Motta, I. ; Chew, K. L. ; Seddon, J. A. ; Alffenaar, J.-W. C. ; Cross, G. B. ; du Cros, P. ; Gler, M. T. ; Maug, A. K. J.

BACKGROUND: The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice.METHODS: A global panel of experts participated in a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached.RESULTS: Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.CONCLUSION: These standards should improve the efficiency and effectiveness of evidence generation, as well as the translation of research into policy and practice.

100 Deals associated with MSF Medecins Sans Frontieres

100 Translational Medicine associated with MSF Medecins Sans Frontieres

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