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1. Strengthening Community Networks for Vital Event Reporting: Community-Based Reporting of Vital Events in Rural Mali.

Author

Melinda K Munos, Alain K Koffi, Hamadoun Sangho, Mariam Guindo Traoré, Masseli Diakité, Romesh Silva, and Mali RMM Working Group

Subjects
Medicine, Science
Abstract

Like many developing countries, Mali has few sources of mortality data. High quality mortality estimates are available from household surveys, such as the demographic and health surveys (DHS), approximately every five years, making it difficult to track progress in reducing mortality. The Rapid Mortality Monitoring (RMM) project in Mali aimed to address this issue by testing a community-based approach to measuring under-five mortality on a yearly basis.Seventy-eight community-based workers (relais) were identified in 20 villages comprising approximately 5,300 households. The relais reported pregnancies, births, and under-five deaths from July, 2012 to November, 2013. Data were double-entered, reconciled, cleaned, and analyzed monthly. In November-December 2013, we administered a full pregnancy history (FPH) to women of reproductive age in a census of the households in the project villages. We assessed the completeness of the counts of births and deaths, and the validity of under-five, infant, and neonatal mortality rates from the community-based method against the retrospective FPH for two rolling twelve-month periods. Monthly reporting by relais was high, with reports on pregnancies, births, and deaths consistently provided from all 78 relais catchment areas. Relais reported 1,660 live births and 276 under-five deaths from July, 2012 to November, 2013. The under-five mortality rate calculated from the relais data was similar to that estimated using the validation survey, where the overall ratios of the community-based to FPH-based mortality rates for the reporting periods were 100.4 (95% CI: 80.4, 120.5) and 100.8 (95% CI: 79.5, 122.0).On a small scale, the community-based method in Mali produced estimates of annualized under-five mortality rates that were consistent with those obtained from a FPH. The community-based method should be considered for scale-up in Mali, with appropriate measures to ensure community engagement, data quality, and cross-validation with comparable FPHs.

Published
2015
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2. A multi-institutional approach to data-driven decision-making: National Evaluation Platform in Mali

Author

Rebecca Heidkamp, Melinda K. Munos, Mamadou Souncalo Traoré, Assa Sidibé Keita, Ibrahim Téréra, Mariam Guindo Traoré, Talata Sawadogo-Lewis, Youssouf Keita, Haoua Dembélé Keïta, Bakary Diarra, Mama Coumaré, Niakalé Diawara, Emilia Vignola, Harouna Koné, Ousmane Ly, and Hamadoun Sangho

Subjects
Program evaluation, Evidence-based practice, Knowledge management, Capacity Building, business.industry, Health Policy, Decision Making, Public Health, Environmental and Occupational Health, MEDLINE, Mali, Data-driven, Viewpoints, Institutional approach, Interinstitutional Relations, Political science, Evidence-Based Practice, Humans, business, Program Evaluation
Published
2019

3. Recherche formative sur l’enregistrement d’évènements vitaux en milieu communautaire au Mali

Author

Melinda K. Munos, Haoua Dembélé Keïta, Assa Sidibé Keïta, Hamadoun Sangho, Olga Joos, and Mariam Guindo Traoré

Subjects
Community based, Political science, Public Health, Environmental and Occupational Health, Humanities, Formative research
Abstract

Objectif : Au Mali, la mortalite infanto-juvenile est elevee. La plupart de ces deces se produisent dans la communaute sans un systeme d’enregistrement fiable. L’objectif de l’etude etait de recueillir des informations sur l’enregistrement des evenements vitaux en milieu communautaire dans les districts sanitaires de Niono et de Baroueli dans la region de Segou, dans la perspective d’etablir un systeme ameliore d’enregistrement des evenements vitaux a base communautaire. Methodologie : L’etude etait transversale, descriptive et qualitative. La collecte des donnees s’est deroulee en mai 2010. Les cibles etaient des agents sociosanitaires, l’administration, des membres de la communaute, des associations de femmes et des organisations non-gouvernementales. Les techniques d’entretiens individuel et de groupe ont ete utilisees. Les donnees ont ete saisies et codifiees avec le logiciel Modalisa version 5.1. Resultats : L’enregistrement des grossesses se realisait seulement dans les structures sanitaires par les agents de sante et les matrones, et ne se faisait pas avant 3 mois par crainte de perdre la grossesse (par envoutement et sorcellerie). L’enregistrement des naissances se faisait par les agents de declaration dans les structures administratives et sanitaires ainsi que dans la communaute, mais il accusait un retard d’environ 7 jours. Les deces d’enfants etaient rarement enregistres car les populations ignoraient l’importance de cet enregistrement et certaines structures etaient difficilement accessibles. Les opinions etaient favorables pour mettre en place un systeme ameliore d’enregistrement en impliquant les relais communautaires. Conclusion : L’amelioration de l’enregistrement des evenements vitaux devrait impliquer les relais et passer par la sensibilisation et l’implication des populations.

Published
2015

4. [Formative research on community-based vital events registration in Mali]

Author

Hamadoun, Sangho, Mariam, Guindo Traoré, Olga, Joos, Haoua Dembélé, Keita, Assa Sidibé, Keita, and Melinda K, Munos

Subjects
Vital Statistics, Cross-Sectional Studies, Pregnancy, Birth Certificates, Humans, Female, Registries, Focus Groups, Mali, Death Certificates
Abstract

The under-five mortality rate in Mali is high, with most deaths occurring in the community where there is no reliable vital events registration. The objective of this study was to collect data on community-based vital events registration in the Niono and Baroueli districts of the Segou region, in order to improve the community-based vital events registration system.Data collection for this cross-sectional, descriptive, and qualitative study was conducted in May 2010. Participants included health and administrative workers, community members, women's associations, and non-governmental organizations. Data collection methods included individual interviews and focus groups, as well as document review. Data were entered and codified with Modalisa version 5.1.Pregnancy registration was performed exclusively by health workers in health facilities and was not performed before the third month of pregnancy due to concerns about losing the pregnancy (due to sorcery or spells). Birth registration was performed in administrative and health structures and at the community level, but after an interval of about 7 days. Childhood deaths were rarely registered because the community did not understand the importance of this registration, and because of problems accessing the structures in which deaths are registered. Community opinions were favourable to the implementation of an improved system involving relays (community-based volunteers).Improvements to vital events registration in this setting should make use of relays by increasing the awareness and involvement of the population.

Published
2016

5. Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries

Author

I. Izabelle, F. Ello, H. Ssemuwemba, S. Phiri, J. Olasode, Marie-Sylvie N’Gbeche, S. Kouadio, Jesper Eugen-Olsen, M. Mpoudi-Etame, Cristin Q. Fritz, S. Dapiap, J. Zoungrana, Antoine Jaquet, Aristophane Tanon, Rasmata Ouédraogo, N. T. Loan, E. J. Carter, Obaseki, F. F. Diakité, H. X. Zhao, Kulkanya Chokephaibulkit, Z. J. da Silva, Peter Aaby, Dewi Kumara Wati, David da Silva, L. Ayangma, K. Jjingo, P. Kim, Romanee Chaiwarith, James Ndirangu, Valériane Leroy, L. P. P. Atmikasari, N. Zobo, H. Chenal, Rita Lyamuya, Catherine C. McGowan, Keswadee Lapphra, Wanatpreeya Phongsamart, B. B. Mwebesa, Théodore Niyongabo, D. Katile, B. Ba, Matthias Egger, L. Mofenson, A. Mounkaila-Harouna, Boris Tchounga, M. Moh, Elom Takassi, Haby Signaté Sy, G. Sagbo, F. Kaeser, Eduardo Gotuzzo, Guillaume Bado, C. C. McGowan, S. Karcher, Constantin T. Yiannoutsos, V. H. Bui, Christopher J. Hoffmann, Didier K. Ekouevi, J. Akakpo, I. Azinyue, S. Kiertiburanakul, S. O. Koule, W. Bishai, Mariam Guindo Traoré, C. Williams, Elise Arrivé, A. Tapsoba, S. Bessekon, Patrick A. Coffie, F. Yuliana, A. Gougounon-Houéto, Somnuek Sungkanuparph, Y. Abo, Q. Vo, Praphan Phanuphak, M. B. Kokora, Kouadio Kouakou, Fla Kouéta, M. E. Dainguy, O. Benson, I. Soré, W. Prasitsuebsai, Harry Moultrie, C. Guehi, Beatriz Grinsztejn, T. Q. Du, L. Diecket Ahoussou, Z. Diallo, N. Traoré, Firas Wehbe, C. V. Do, J. Tatwangire, A. Kotosso, F. Soppi, Amabelia Rodrigues, Juan Sierra Madero, P. S. Sow, Rodolphe Thiébaut, I. Y. Malino, Moussa Seydi, Helena Rabie, A. Dienderé, Geoffrey Somi, Emmanuel Bissagnene, Elizabeth A. Bukusi, H. C. Traoré, David A. Cooper, N. M. Manga, P. Osakede, S. Ajayi, J. Paulo, Marguerite Timite-Konan, Andrew Edmonds, B. Diop, A. M. Traoré, W. Hiembo, A. Koïta, M. Faye, A. Azon-Kouanou, Christian Wejse, Claudia P. Cortes, T. Pety, N. Durier, Thira Sirisanthana, Camille Ndondoki, Karl-Günter Technau, J. S. Elvis Diby, G. Alim, M. D'Almeida, A. Komi, J. Bashi, J. M. Tine, D. Hawerlander, R. Ditangco, Akouda Patassi, A. Kalle, F. J. Zhang, Lorna Renner, N. H. Chau, Janet Giddy, G. Clouet, Samwel O. Ayaya, A. Sohn, Lars Østergaard, Sylvie Ouédraogo, Clement Adebamowo, Azar Kariminia, John Ssali, Joseph Drabo, M. Dembelé, Nicola Maxwell, Albert Minga, M. D.N. Amego, Wilai Kotarathititum, Christian Erikstrup, H. A. Traore, Kapella Zacharia Ngonyani, E. Geng, Lukas Fenner, A. Diagne, Marcelo Wolff, A. I. Assi, A. Sackey, A. R. Yao, M. F. Sami, Edmond Addi Aka, H. Adjide, Pagakrong Lumbiganon, Karen Malateste, L. Diero, M. Gansonré, P. N. An, A. H. Sohn, D. Meless, D. Avit-Edi, D. Walker, L. Hardwicke, A. S. Kaya, Véronique Mea-Assande, G. S. Gottlieb, Denis Padgett, Eric Balestre, Candida Medina, D. Amani, C. Kouakou, C. Shiboski, E Messou, B. G. Kariyare, M. Ballif, W. Wester, J. M. Gonsan, G. Gbadamassi, A. Ba, M. Fomba, Denis Malvy, R. Bantique, S. N. Owiafe, Andrew Kambugu, Festus Igbinoba, M. Y. Maiga, C. Ahomadegbé, A. Berthé, R. D. Gueye, C. C. Bassabi, Djimon Marcel Zannou, Olivia Keiser, Kara Wools-Kaloustian, K. E. Mensah-Zukong, A. Doring, C. Chimbetete, J. Rivenc, V. Andavi, F. Alihonou, S. Datté, S. Pestilli, T. Mengthaisong, Kathryn Anastos, A. D. Mbaye, D. Lameck, Claire Graber, J. Lewis-Kulzer, G. Reubenson, B. Siloué, Marcel Yotebieng, K. T.K. Dung, C. Ahouada, Severin Lenaud, J. Welbeck, D. Dickinsonn, L. Zoungrana, A. Avihingsanon, T. T. Cao, V. K. Nguyen, Morten Sodemann, J. C. Dusingize, B. Okwara, C. Lewden, H. Traoré, Patrick MacPhail, David C Boettiger, G. Oka-Berete, H. K. Truong, F. Houngbé, Robin Wood, Venerandah Nhandu, J. C. Azani, G. Wandeler, K. L. Issouf, K. C. Anzan, Andrea L. Ciaranello, Awachana Jiamsakul, M. T. Ha, K. Brou, M. Maskew, L. Tossa-Bagnan, B. Zerbo, P. Pakpame, Xavier Anglaret, Jean W. Pape, J. B. Essanin, A. Petit, A. Kouakou, E. Rabourdin, Orasri Wittawatmongkol, Daniela Garone, S. El-Hadj Djibril, S. Duda, C. Twizere, K. C. Chan, Annie J. Sasco, N. Sanmeema, N. V. Lam, J. Conrad, Q. T. Du, P. Tharnprisan, Z. Yao, A. Djeha, Siriatou A. Koumakpai, Joachim Gnokoro, I. Hodonou, Sabine Hermans, Timothy R. Sterling, C. Nchot, D. Minta, E. Yunihastuti, T. F. Eboua, T. Cissé, Revathy Nallusamy, Jeffrey S. A. Stringer, Dabis F, F. Bohossou, Brian Eley, E. Traore, R. McKaig, Matthew Law, Manhattan Charurat, G. M. Kouakou, Madeleine Amorissani Folquet, A. Mandalakas, Sophie Desmonde, S. Eholié, J. K. Assouan, Andrew Boulle, Tuti Parwati Merati, A. Koko Lawson-Evi, Eugene Mutimura, C. A. Bosse, M Dosso, Fred Nalugoda, T. T. Pham, T. Udomphanit, H. L. Ha, N. Kancheya, N. Han, J. Sehonou, S. N. Kangah, R. Huebner, A. Gasser, C. Gilbert, Appolinaire Horo, J. C. Kouakou, D. Yé, P. Acquah, A. Héma, Pope Kosalaraksa, Hans Prozesky, J. James, Fatoumata Dicko, P. Cahn, Moussa Doumbia, I. Oliviera-Souto, Morna Cornell, Elenore Judy B. Uy, G. Hounhoui, J. E. Carter, V. A. Yao, Adrien Sawadogo, B. Petersen, S. E. Reid, B. Goka, G. Carriquiry, M. A. Davies, P. Nipathakosol, J. Le Carrou, M. L. Lindegren, H. Dior, P. Cegielski, E. Baramperanye, Mariam Sylla, Anders Fomsgaard, P. Braitstein, S. T. Coulibaly, D. D. Cuong, C. N'Diaye, M. Kone, Dewa Nyoman Wirawan, A. Gitembagara, Niaboula Koné, K. Ruxrungtham, R. Bognounou, Aissatou Touré, A. Ephoévi-gah, Alex Lund Laursen, and Y. Atakouma

Subjects
Male, Questionnaires, West African, Pediatrics, Asia Pacific, Antitubercular Agents, HIV Infections, Drug resistance, rifampicin, South Africa, drug resistant tuberculosis, Surveys and Questionnaires, Tuberculosis, Multidrug-Resistant, Central Africa, antiretrovirus agent, Human immunodeficiency virus infected patient, clinical practice, microbial sensitivity test, Infectious Diseases, priority journal, urban population, Female, anti human immunodeficiency virus agent, supply and distribution, medicine.drug, Pulmonary and Respiratory Medicine, Adult, isoniazid, medicine.medical_specialty, Tuberculosis, Asia, phenotype, Anti-HIV Agents, Developing country, MDR-TB, Microbial Sensitivity Tests, purl.org/pe-repo/ocde/ford#3.03.08 [https], preventive medicine, Article, South and Central America, socioeconomics, medicine, Humans, controlled study, human, rural population, drug sensitivity, Developing Countries, Directly Observed Therapy, Preventive healthcare, ART programs, Caribbean, business.industry, questionnaire, Drug resistant tuberculosis, developing country, CD4 lymphocyte count, Central africa, Central America, South America, medicine.disease, major clinical study, Latin America, purl.org/pe-repo/ocde/ford#3.02.07 [https], Africa, world health organization, tuberculostatic agent, business, Rifampicin
Abstract

SETTING: Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons.OBJECTIVE: To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries.DESIGN: We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs.RESULTS: Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages.CONCLUSIONS: Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Published
2014

6. HIV status disclosure and retention in care in HIV-infected adolescents on antiretroviral therapy (ART) in West Africa

Author

François Dabis, Tanoh Eboua, Elise Arrivé, Hélène Dior, Haby Signaté Sy, Addi Edmond Aka, Hind Amghar, Patricia Ogbo, Didier K. Ekouevi, Fatoumata Dicko, Kouadio Kouakou, Mariam Guindo Traoré, Ahmadou Alioum, Hortense Aka Dago-Akribi, Belinda Bouah, and Valériane Leroy

Subjects
Male, Pediatrics, Viral Diseases, Non-Clinical Medicine, Epidemiology, lcsh:Medicine, HIV Infections, 030312 virology, Global Health, 0302 clinical medicine, 030212 general & internal medicine, Young adult, lcsh:Science, 10. No inequality, Child, 0303 health sciences, education.field_of_study, Multidisciplinary, Hazard ratio, Awareness, 3. Good health, Africa, Western, Infectious Diseases, Self-disclosure, Medicine, Female, Public Health, Cohort study, Research Article, Adult, medicine.medical_specialty, Self Disclosure, Adolescent, Anti-HIV Agents, Population, 03 medical and health sciences, Young Adult, medicine, Humans, education, Probability, Proportional Hazards Models, Retrospective Studies, Health Care Policy, Proportional hazards model, business.industry, lcsh:R, HIV, Retrospective cohort study, Confidence interval, lcsh:Q, business
Abstract

Objective We assessed the effect of HIV status disclosure on retention in care from initiation of antiretroviral therapy (ART) among HIV-infected children aged 10 years or more in Cote d'Ivoire, Mali and Senegal. Methods Multi-centre cohort study within five paediatric clinics participating in the IeDEA West Africa collaboration. HIV-infected patients were included in this study if they met the following inclusion criteria: aged 10-21 years while on ART; having initiated ART ≥ 200 days before the closure date of the clinic database; followed ≥ 15 days from ART initiation in clinics with ≥ 10 adolescents enrolled. Routine follow-up data were merged with those collected through a standardized ad hoc questionnaire on awareness of HIV status. Probability of retention (no death or loss-to-follow-up) was estimated with Kaplan-Meier method. Cox proportional hazard model with date of ART initiation as origin and a delayed entry at date of 10th birthday was used to identify factors associated with death or loss-to-follow-up. Results 650 adolescents were available for this analysis. Characteristics at ART initiation were: median age of 10.4 years; median CD4 count of 224 cells/mm³ (47% with severe immunosuppression), 48% CDC stage C/WHO stage 3/4. The median follow-up on ART after the age of 10 was 23.3 months; 187 adolescents (28.8%) knew their HIV status. The overall probability of retention at 36 months after ART initiation was 74.6% (95% confidence interval [CI]: 70.5-79.0) and was higher for those disclosed compared to those not: adjusted hazard ratio for the risk of being death or loss-to-follow-up = 0.23 (95% CI: 0.13-0.39). Conclusion About 2/3 of HIV-infected adolescents on ART were not aware of their HIV status in these ART clinics in West Africa but disclosed HIV status improved retention in care. The disclosure process should be thus systematically encouraged and organized in adolescent populations.

Published
2011

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