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NCT ID: NCT03862261 Not yet recruiting - Tuberculosis Clinical Trials

Integrating Pediatric TB Services Into Child Healthcare Services in Africa

Start date: March 15, 2019
Phase: N/A
Study type: Interventional

Under-diagnosis of TB in children is a critical gap to address. The INPUT study is a multinational stepped-wedge cluster-randomized intervention study aiming to assess the effect of integrating TB services into child healthcare services on TB diagnosis capacities in children under 5 years of age.

NCT ID: NCT03832023 Not yet recruiting - Tuberculosis Clinical Trials

Community-based Tuberculosis Tracing and Preventive Therapy

Start date: July 1, 2019
Phase: N/A
Study type: Interventional

The many gaps observed in the cascade of care of tuberculosis (TB) child contacts occur mostly in the screening, preventive therapy (PT) initiation and PT completion steps and the main drivers of these gaps are considered to be the health system infrastructure, limited worker resources and parents' reluctance to bring their children to the facility for screening. There would be great advantages of using a symptom-based screening at community level where only the symptomatic contacts are referred to hospital for further evaluation and asymptomatic contacts are started on PT in the community. Household or community-based screening is likely to improve the uptake and acceptability of child contact screening and management as well as adherence to PT and to reduce cost and workload at facility level. This study proposes to compare the cascade of care between two models for TB screening and management of household TB child contacts in two high TB burden and limited resource countries, Cameroon and Uganda. In the facility-based model, children will be screened at facility (Cameroon) or household level (Uganda) and preventive therapy initiation, refills of PT therapy and follow-up will be done at facility level. In the intervention group (community-based model), child contacts will be screened in the household by a community health worker (CHW). Those with symptoms suggestive of TB will be referred to the facility for TB investigations. Asymptomatic child contacts from high risk groups (under-5 years or HIV infected 5-14) will be initiated on PT (3 months isoniazid-rifampicin) in the household. Refills of PT therapy will also be done in the communities by the CHW. In both models, symptomatic children requiring further investigations for TB diagnosis will be referred to a health facility.

NCT ID: NCT03831906 Not yet recruiting - Tuberculosis Clinical Trials

TB-Speed Pneumonia

Start date: February 18, 2019
Phase: N/A
Study type: Interventional

Despite progress in reducing tuberculosis (TB) incidence and mortality in the past 20 years, TB is a top ten cause of death in children under 5 years worldwide. However, childhood TB remains massively underreported and undiagnosed, mostly because of the challenges in confirming its diagnosis due to the paucibacillary nature of the disease and the difficulty in obtaining expectorated sputum in children. Pneumonia is the leading cause of death in children under the age of 5 years worldwide. There is growing evidence that, in high TB burden settings, TB is common in children with pneumonia, with up to 23% of those admitted to hospital with an initial diagnosis of pneumonia later being diagnosed as TB. However, the current WHO standard of care (SOC) for young children with pneumonia considers a diagnosis of TB only if the child has a history of prolonged symptoms or fails to respond to antibiotic treatments. Hence, TB is often under-diagnosed or diagnosed late in children presenting with pneumonia. In this context, the investigators are proposing to assess the impact on mortality of adding the systematic early detection of TB using Xpert MTB/RIF Ultra, performed on NPAs and stool samples, to the WHO SOC for children with severe pneumonia, followed by immediate initiation of anti-TB treatment in children testing positive on any of the samples. TB-Speed Pneumonia is a multicentric, stepped wedge diagnostic trial conducted in six countries with high TB incidence: Cote d'Ivoire, Cameroon, Uganda, Mozambique, Zambia and Cambodia.

NCT ID: NCT03805646 Not yet recruiting - Wounds and Injury Clinical Trials

Mobile Phone-administered Triage Tool to Followup on Discharged Trauma Patients

Start date: February 4, 2019
Phase: N/A
Study type: Interventional

After being admitted to and then discharged from a hospital in Cameroon for having experienced an injury, there is no established way for the health system to check in on how the discharged person is doing. The investigators have developed a set of questions with the hope that asking these questions--over the phone--to those who have been discharged from the hospital will allow them to determine which post-discharge patients would benefit from further care. The investigators believe that asking these questions over the phone is a good way of determining which post-discharge trauma patients would benefit from further care.

NCT ID: NCT03747978 Completed - Hypertension Clinical Trials

Short-term Effects of Perindopril-amlodipine Versus Perindopril-indapamide in Type 2 Diabetes

Start date: October 1, 2016
Phase: Phase 4
Study type: Interventional

This was a double-blinded randomized controlled trial of 24-hour blood pressure control in sub Saharan type 2 diabetes patients, newly diagnosed for hypertension. They were allocated to receive either a fixed combination of perindopril + amlodipine or perindopril + indapamide for 42 days.

NCT ID: NCT03719066 Active, not recruiting - Clinical trials for Cholera Vaccination Reaction

Extended Dose Intervals With Oral Cholera Vaccine in Cameroon

Start date: October 23, 2018
Phase: Phase 2
Study type: Interventional

The primary aim of this project is to determine changes in the vibriocidal geometric mean titers (GMT) in subjects who receive the second dose of oral cholera vaccine (OCV) at different intervals: 2 weeks, 6 months, or 11 months following the first dose of vaccine. Secondary aims include a) vibriocidal antibody response rates in subjects who receive OCV at 2 weeks, 6 months, or 11 months following the first dose of vaccine, b) age specific serum vibriocidal GMTs following the second dose among participants given the second dose of OCV at intervals of 2 weeks, 6 months, or 11 months following the first dose of vaccine, c) GMT and antibody response rates of Immunoglobulin A (IgA) and Immunoglobulin G (IgG) anti-lipopolysaccharide (LPS) as measured by ELISA following the second dose among participants given the second dose of OCV at intervals of 2 weeks, 6 months, or 11 months following the first dose of vaccine. The hypothesis is that the vibriocidal GMT following the second dose, when given after 6 or 12 months will not be inferior to the response when the second dose is given according to the standard interval of two weeks.

NCT ID: NCT03303963 Recruiting - Clinical trials for Tuberculosis, Multidrug-Resistant

DIAgnostics for Multidrug Resistant Tuberculosis in Africa

Start date: May 4, 2017
Study type: Observational

Recent advances in molecular diagnostics of tuberculosis, especially the GeneXpert Mycobacterium tuberculosis/Rifampicin test have reduced the time to diagnose Rifampicin Resistant Tuberculosis (RR-TB) but only rifampicin resistance is diagnosed, leading to presumptive diagnosis of resistance to isoniazid and maybe other drugs. Thus in low and middle income countries, most drug sensitivity testing relies on phenotypic drug resistance testing, which takes up to 4 months. In addition, currently, culture on monthly sputum samples is recommended by the World Health Organization for follow-up of Rifampicin Resistant Tuberculosis patients under treatment. Unfortunately, culture is often not locally available and samples need to be transported from field to culture laboratories. The associated transport delays lead to high rates of contamination and false negative culture, particularly in laboratories in low resource settings. Many gaps for the diagnosis and management of RR-TB patients still need to be addressed and the DIAMA project (DIAgnostics for Multidrug resistant tuberculosis in Africa) study aims to address some of them.

NCT ID: NCT03248297 Recruiting - Clinical trials for Postpartum Endometritis

Antibiotic Prophlaxis for High-risk Laboring Women in Low Income Countries

Start date: January 12, 2018
Phase: Phase 4
Study type: Interventional

This study, performed over a course of 3 years in 5 collaborating hospitals in Cameroon, Africa, will randomize 750 women in labor with prolonged rupture of membranes ≥ 8 hours or prolonged labor ≥ 18 hours to identical oral regimens of 1 gram of azithromycin, 1 gram of azithromycin+2 grams of amoxicillin or placebo. Women will be followed to ascertain maternal infectious outcomes and perinatal outcomes.

NCT ID: NCT03231449 Active, not recruiting - Stroke Clinical Trials

A Survey of Hospitalizations in Cardiology Units in Sub-Saharan Africa

Start date: February 1, 2017
Study type: Observational

FEVRIER study is an observatory of hospitalizations in cardiology units in sub-Saharan Africa.

NCT ID: NCT03225794 Recruiting - Clinical trials for Simian Foamy Virus Infection (Disorder)

Simian Foamy Virus Transmission to Humans

Start date: November 1, 2010
Study type: Observational

About three quarters of the viral agents that have emerged recently in humans are considered to originate from other animals. These viruses have often evolved and spread into the human population through various mechanisms after the initial contact that resulted in interspecies transmission. However, knowledge of the initial stages of the emergence of viruses and associated diseases is still limited in many cases. Microbiological monitoring in populations at risk of transmission would provide insights into the initiation and early stages of the emergence process. Nonhuman primates (NHPs) share many genetic, physiological, and microbiological features with humans, and are potential sources of many infectious agents. This has been demonstrated for several simian retroviruses. HIV-1 and 2 are believed to have originated from chimpanzee and mangabey viruses, respectively, found in Central and West Africa. The current distribution of the various molecular subtypes of the HTLV-1 oncogenic retrovirus in Africa is mainly the result of numerous instances of interspecies transmission of STLV-1from NHP species in the distant past. Foamy viruses belong to the Retrovidae family and the Spumavirus genus. They are complex exogenous retroviruses and are very common in many animal species, including primates, cats, cattle, and horses, in which they cause persistent infections. The first aim of the work is to study the epidemiological and molecular aspects of the transmission of foamy viruses from monkeys to humans in populations at risk, such as the inhabitants (especially hunters) in the villages of the dense forests of southern Cameroon. It is an area in which NHPs are still very common, with a great diversity of species. The investigators have already shown that the prevalence of foamy viruses is very high in these monkeys and great apes (gorillas and chimpanzees). Contact between these monkeys and the villagers is very frequent, mainly during hunting. The second aim of the project is to study the clinical and biological features of infected people and investigate intrafamilial transmission from infected index cases.