Researching the delivery of health and nutrition interventions for women and children in the context of armed conflict: Lessons on research challenges and strategies from BRANCH Consortium case studies of Somalia, Mali, Pakistan and Afghanistan

Background: The BRANCH Consortium recently conducted 10 mixed-methods case studies to investigate the provision of health and nutrition interventions for women and children in conflict-affected countries, aiming to better understand the dominant influences on humanitarian health actors\u27 programmatic decision-making and how such actors surmount intervention delivery barriers. In this paper, the research challenges encountered and the mitigating strategies employed by the case study investigators in four of the BRANCH case study contexts are discussed: Somalia, Mali, Pakistan and Afghanistan.Discussion: Many of the encountered research challenges were anticipated, with investigators adopting mitigation strategies in advance or early on, but others were unexpected, with implications for how studies were ultimately conducted and how well the original study aims were met. Insecurity was a fundamental challenge in all study contexts, with restricted geographical access and concerns for personal safety affecting sampling and data collection plans, and requiring reliance on digital communications, remote study management, and off-site team meetings wherever possible. The need to navigate complex local sociopolitical contexts required maximum reliance on local partners\u27 knowledge, expertise and networks, and this was facilitated by early engagement with a wide range of local study stakeholders. Severe lack of reliable quantitative data on intervention coverage affected the extent to which information from different sources could be triangulated or integrated to inform an understanding of the influences on humanitarian actors\u27 decision-making.Conclusion: Strong local partners are essential to the success of any project, contributing not only technical and methodological capacity but also the insight needed to truly understand and interpret local dynamics for the wider study team and to navigate those dynamics to ensure study rigour and relevance. Maintaining realistic expectations of data that are typically available in conflict settings is also essential, while pushing for more resources and further methodological innovation to improve data collection in such settings. Finally, successful health research in the complex, dynamic and unpredictable contexts of conflict settings requires flexibility and adaptability of researchers, as well as sponsors and donors

Evaluating Short-Term Patient Outcomes after HIV Care Interventions in a Low Resource Setting: Preparing for an HIV Vaccine Trial Site in Bamako, Mali

Poster Presentation From AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

A Decade of Partnering to Stop HIV in West Africa: GAIA VF Prevention, Education, Access to Care and Vaccine Trial Site Development in Bamako, Mali

Poster Presentation from AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

Knowledge/Attitude/Practices of HPV & Cervical Cancer, Willingness to Participate in Vaccine Trial in Preparation for HIV & HPV Vaccine Trials in Mali

Oral Presentation from AIDS Vaccine 2012 Boston, MA, USA. 9-12 September 201

Tuberculosis drug resistance in Bamako, Mali, from 2006 to 2014.

BACKGROUND: Although Drug resistance tuberculosis is not a new phenomenon, Mali remains one of the "blank" countries without systematic data. METHODS: Between 2006 and 2014, we enrolled pulmonary TB patients from local TB diagnostics centers and a university referral hospital in several observational cohort studies. These consecutive patients had first line drug susceptibility testing (DST) performed on their isolates. A subset of MDR was subsequently tested for second line drug resistance. RESULTS: A total of 1186 mycobacterial cultures were performed on samples from 522 patients, including 1105 sputa and 81 blood samples, yielding one or more Mycobacterium tuberculosis complex (Mtbc) positive cultures for 343 patients. Phenotypic DST was performed on 337 (98.3%) unique Mtbc isolates, of which 127 (37.7%) were resistant to at least one drug, including 75 (22.3%) with multidrug resistance (MDR). The overall prevalence of MDR-TB was 3.4% among new patients and 66.3% among retreatment patients. Second line DST was available for 38 (50.7%) of MDR patients and seven (18.4%) had resistance to either fluoroquinolones or second-line injectable drugs. CONCLUSION: The drug resistance levels, including MDR, found in this study are relatively high, likely related to the selected referral population. While worrisome, the numbers remained stable over the study period. These findings prompt a nationwide drug resistance survey, as well as continuous surveillance of all retreatment patients, which will provide more accurate results on countrywide drug resistance rates and ensure that MDR patients access appropriate second line treatment

Extension of mushroom shelf-life by ultrasound treatment combined with high pressure argon

Effects of ultrasound, high pressure argon, and treatments comprising their combinations on physicochemical and microbiological characteristics of white mushrooms were studied during 9 days of storage at 4°C. High pressure argon treatments were relatively effective in retaining firmness and were found to maintain the cell integrity. White mushrooms firmness after 9 days of storage was increased from 2.79 N for untreated mushrooms up to 3.01, 3.24, 3.58 N for ultrasound, treatments comprising ultrasound and high pressure argon, high pressure argon, respectively. Similarly, the loss of water, ascorbic acid and total soluble solid in fresh mushroom was also greatly reduced by the high pressure argon treatment. The ultrasound treatment followed by treatments comprising ultrasound and high pressure argon and high pressure argon, respectively exhibited a pronounced effect on retarding browning and in delaying mesophilic and psychrotrophic bacteria, yeasts and moulds growth in white mushroom, compared to the control during 9 days of cold storage. Treatments comprising ultrasound and high pressure argon treatment delayed pseudomonas growth, implying that it could extend shelf life of white mushrooms to 9 days at 4°C