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NCT ID: NCT05946681 Recruiting - Stillbirth Clinical Trials

Sildenafil Citrate to Improve Maternal and Neonatal Outcomes in Low-resource Settings

PRISM
Start date: May 16, 2023
Phase:
Study type: Observational

The PRISM pilot feasibility study consists of two phases to determine: 1) to delivery practices, rates of primary and secondary outcomes, and feasibility of enrollment rates, and 2) to assess the feasibility and acceptability of the intervention and expected enrollment rates, and estimate the effect size of sildenafil citrate on maternal and neonatal outcomes in a low resource settings in preparation for the main RCT.

NCT ID: NCT05941052 Recruiting - Tuberculosis Clinical Trials

Assessing Diagnostics At Point-of-care for Tuberculosis

ADAPT
Start date: August 28, 2023
Phase: N/A
Study type: Interventional

Every year, more than 3 million people with TB remain undiagnosed and 1 million die. Better diagnostics are essential to reducing the enormous burden of TB worldwide. The Assessing Diagnostics At Point-of-care for Tuberculosis (ADAPT) study seeks to reduce the burden of TB worldwide by evaluating faster, simpler, and less expensive TB triage and diagnostic tests.

NCT ID: NCT05904145 Recruiting - Clinical trials for Pregnancy, High Risk

PRISMA Maternal and Newborn Health Study

PRiSMA-MNH
Start date: August 1, 2022
Phase:
Study type: Observational

Access to quality antenatal care (ANC) and postnatal care (PNC), including maternal, newborn, and infant services, is integral to reducing adverse pregnancy-related health outcomes and promoting positive birth experiences. The World Health Organization (WHO) recommends a total of eight ANC visits for pregnant women. However, the ANC coverage rate remains considerably lower among more vulnerable populations, and the quality of care that women receive is inconsistent, often poor, and frequently fails to detect risks in a timely fashion or adequately prepare women for the birth process. While rates of facility-based delivery are on the rise worldwide, disparities persist and the quality of care across facilities remains uneven. Even less information is available on PNC, where services beyond routine immunizations may not be widely available, especially in resource-poor regions. Additionally, limited evidence exists on innovative service delivery approaches and how to effectively scale tested maternal and newborn health (MNH) interventions. This coupled with the fragmented datasets from smaller studies limit our ability to advocate for policy change. The Pregnancy Risk Stratification Innovation and Measurement Alliance (PRiSMA) is implementing a harmonized open cohort study that seeks to evaluate pregnancy risk factors and their associations with adverse pregnancy outcomes, including stillbirth, neonatal mortality and morbidity, and maternal mortality and severe morbidity. The goals are to develop a harmonized data set to improve understanding of pregnancy risk factors, vulnerabilities, and morbidity and mortality and to estimate the burden of these risk factors and outcomes in LMICs. Ultimately, these data will inform development of innovative strategies to optimize pregnancy outcomes for mothers and their newborns.

NCT ID: NCT05902572 Recruiting - HIV Clinical Trials

DSD Models at Zambia Sentinel Sites (SENTINEL 2)

SENTINEL2ZA
Start date: June 1, 2021
Phase:
Study type: Observational

To achieve global goals for the treatment of HIV, many countries are piloting and scaling up differentiated service delivery models (DSD). A handful of efforts have been formally described and evaluated in the literature; many others are being implemented formally or informally under routine care, without a research or evaluation goal. For most countries however, we have little evidence on progress and challenges at the facility level-the number of patients actually participating in DSD models, health outcomes and non-health outcomes, effects on service delivery capacity and clinic efficiency and operations, and costs to providers and patients. Alternative Models of ART Delivery: Optimizing Benefits (AMBIT) is a set of data synthesis, data collection, and data analysis activities aimed at generating information for near- and long-term decision making and creating an approach and platform for ongoing evaluation of differentiated models of HIV treatment delivery. The first AMBIT protocol, "Gathering Records to Evaluate Antiretroviral Treatment" (GREAT, Zambia Ref. No. 2019-Sep-030), collects and analyzes comprehensive patient medical record data, allowing us to assess the effect of DSD models on patients' clinical outcomes and to evaluate uptake of DSD models at scale. The Sentinel-Zambia study, the second AMBIT protocol, is examining the effect of DSD models on patient and provider satisfaction, service delivery capacity and quality, costs to patients, and other outcomes for which data are not routinely collected in patient-level medical records. The first round of Sentinel-SA was conducted in 2021. The AMBIT 2.0 protocol will allow up to four additional annual rounds of data collection, in 2022-2025. We collected clinic aggregate data, conducted surveys of patients and providers, and observed operations at a selected set of 12 Zambian healthcare facilities and their affiliated DSD models in Round 1. Round 2 (2022) and later rounds will collect the same types of data at 12 facilities in Zambia and will expand the study's research questions to include differentiated models of HIV testing and linkage to care. Results are expected to inform Zambian policy makers and other local and international stakeholders on the actual implications of DSD models for patients, health system operations, and healthcare budgets.

NCT ID: NCT05839457 Recruiting - Clinical trials for Gender-based Violence

Addressing School-related Gender-based Violence as Part of the Keeping Girls in School Initiative in Zambia

Start date: May 8, 2023
Phase: N/A
Study type: Interventional

The objective of this mixed-methods study is to evaluate the effectiveness of a school-based safe-space program delivered to secondary school students in Zambia. The quantitative component of the study uses a randomized controlled trial to measure changes in students' experience of school-related gender-based violence (SRGBV), attitudes towards gender and SRGBV, socio-emotional well-being, and school climate, among other outcomes. Meanwhile, the qualitative component of the study aims to understand the prevailing norms around SRGBV in schools, the perception of the intervention and its impact, and the potential mechanisms through which the intervention generates its outcomes.

NCT ID: NCT05746819 Completed - Malaria Clinical Trials

An MRI Ancillary Study of a Malaria Fever Investigation

MRIA
Start date: January 2, 2021
Phase:
Study type: Observational

This study will seek consent from parents of children enrolled in the Malaria FEVER study to obtain neuroimaging and 12-month neuropsychiatric outcomes data and kidney function on their child. The imaging and evaluations for this observational study will occur after the child has recovered from the acute malaria infection and has otherwise completed the RCT intervention and safety evaluations.

NCT ID: NCT05746065 Active, not recruiting - HIV Infections Clinical Trials

A Cohort for Evaluation of Open-label PrEP Use and PreP Preferences Among African Women

INSIGHT
Start date: May 20, 2022
Phase:
Study type: Observational

INSIGHT is a Prospective, Observational, open-label cohort study on women in Sub-Saharan Africa on PrEP screening, informed choice, and compliance. There are no specific intervention arms or comparative treatment plans. We will follow and observe participants taking PrEP, not taking PrEP, as well as those who begin or end PrEP during the course of the observational period.

NCT ID: NCT05711485 Recruiting - Thrombocytopenia Clinical Trials

Platelet-Directed Whole Blood Transfusion Strategy for Malaria

PLATFORM
Start date: February 24, 2024
Phase: N/A
Study type: Interventional

Open-label randomized controlled trial to test the effectiveness of whole blood transfusion for improving survival in children with severe malaria complicated by thrombocytopenia.

NCT ID: NCT05694546 Active, not recruiting - HIV/AIDS Clinical Trials

Re-engagement at Discharge 2

ReCharge2
Start date: August 8, 2023
Phase: N/A
Study type: Interventional

Early post-discharge mortality is high among Zambians living with HIV admitted to the hospital. This may be due to missed opportunities in post-discharge care, such as inadequate follow-up and treatment. In this study the investigators will develop and pilot a new approach to post-discharge HIV care to improve care coordination and treatment adherence.

NCT ID: NCT05678660 Recruiting - Aging, Premature Clinical Trials

Study of Neurological Aging Among People Living With HIV

SNAP
Start date: July 6, 2022
Phase:
Study type: Observational

A prospective, exposure-control cohort study of older adults living with HIV comparing the neurological status of those who have had HIV infection for a longer period of time (long HIV group) to age, gender, and community-matched comparison group who have had HIV infection for a shorter period of time (short HIV group).