Cotonou

This research aims to improve how appendicitis, a common emergency surgery condition, is managed worldwide by studying different emergency care systems. Appendicitis requires quick diagnosis and treatment to avoid complications. Using appendicitis as a marker, the study looks at access, quality, and efficiency across hospitals in various countries, including low- and middle-income regions, to find ways to enhance emergency surgical care. The study collects data from about 500 hospitals globally between February and May 2025, focusing on patients undergoing appendicectomy using any surgical method, including open, laparoscopic, or robotic approaches. Hospitals will record information for consecutive patients over 14-day periods. The study includes two sub-studies one on sustainability and waste management in operating rooms and another on the financial impact of surgery on patients, especially in resource-limited settings. Participants will have their care observed through routine health records without extra follow-up visits. Researchers will measure key factors such as time from symptoms to surgical assessment, rates of minimally invasive surgery, complications within 30 days, and hospital stay length. This data will help identify gaps and guide improvements in emergency surgical care worldwide, aiming to make treatment safer, faster, and more affordable.

Researchers are evaluating the safety and effectiveness of a new short 6-week daily rifapentine treatment compared to the standard 12-16 week rifamycin-based treatments for latent Mycobacterium tuberculosis infection LTBI. This trial focuses on people at higher risk of developing active tuberculosis TB and is conducted in locations with varying TB rates where LTBI treatment is routinely provided. The study aims to determine if the shorter treatment is not less safe or effective than the longer standard treatments. Participants are randomly assigned to one of two treatment groups the experimental group receives 600 mg of rifapentine daily for 6 weeks, while the control group receives one of three standard regimens lasting 12 to 16 weeks, including combinations of rifapentine, isoniazid, and rifampin. Dose adjustments are made based on patient weight following established guidelines. Treatments are given according to random assignment and participants are followed for 24 months to assess outcomes. During the study, researchers monitor treatment completion rates, adverse drug reactions, and new cases of active tuberculosis. Safety assessments include tracking serious side effects and drug discontinuation rates. Effectiveness is measured by the occurrence of culture-confirmed or clinical TB within 24 months of enrollment. The study involves regular evaluations and follow-up visits over two years to collect data on treatment tolerability, safety, and TB prevention outcomes.

This research aims to find out if wearable sensors can help detect early signs of health problems after major surgery. The study focuses on surgical patients who might become critically ill after their operations. It evaluates if continuous monitoring of vital signs like heart rate and oxygen levels using wearable devices can identify patient deterioration sooner than standard care. The study is observational and involves multiple countries including Benin, Ghana, Guatemala, India, Mexico, Nigeria, Rwanda, and the United Kingdom. Participants will wear wireless sensors on their chest and fingers before, during, and after surgery for up to 10 days. These sensors record vital signs continuously but do not affect patient care, as clinical teams will not access the data during the study. The first two stages of the study involved testing device usability with healthcare workers, while this third stage collects real-time sensor and clinical event data to explore links between physiological changes and patient complications. During the study, participants will have their vital signs monitored with wearable devices while also receiving standard clinical observations. Researchers will collect cardiovascular, respiratory, and temperature data alongside routine care information and clinical events. They will follow patients for 10 days of monitoring plus an additional 30-day follow-up to observe complications. The goal is to gather data to help design future algorithms for early detection of postoperative problems without changing current treatment practices.

Researchers are investigating red blood cell disorders through a program called GR-Ex, supported by the French Ministry of Higher Education and Research. This program seeks to enhance understanding of how red blood cells, erythropoiesis, and iron metabolism function in both healthy and diseased states. The goal is to develop new therapeutic methods that offer innovative benefits for patients with these conditions. Participants include affected patients and their non-affected relatives. The study involves collecting various biological samples such as blood, saliva, urine, hair, and surgical leftovers like skin or tumor tissue. These samples help researchers study markers related to spleen function, inflammation in sickle cell disease, hemolysis after treatment, transfusion efficiency, neutrophil behavior, mitochondrial removal during red blood cell formation, and iron metabolism in specific anemia types. During the study, participants provide these biological samples for detailed analysis. Researchers will monitor markers of disease and treatment effects over a long period, up to 20 years, to better understand the underlying processes. The study is observational, meaning no treatment is given, and the involvement mainly consists of sample collection and medical record review to measure important biological outcomes related to red blood cell disorders.

Researchers are conducting implementation trials in Benin to evaluate different ways of delivering post-discharge malaria chemoprevention PDMC to children under 10 years old who were hospitalized with severe anaemia or severe malaria. The study aims to find effective delivery methods and adherence support to reduce hospital readmissions and deaths after discharge. This trial is a phase 4 cluster randomized study designed to provide evidence to support national health policies and scaling up PDMC in malaria-endemic areas. Participants will receive three courses of a 3-day PDMC treatment with dihydroartemisinin-piperaquine at weeks 2, 6, and 10 after hospital discharge. The study compares two community delivery strategies one where caregivers receive all PDMC drugs at discharge with monthly home visit reminders, and another where community health workers deliver the drugs at home with SMS or phone reminders. A control group will receive the drugs at discharge without additional adherence support. All children also receive standard hospital care for severe anaemia or malaria during admission. Throughout the 14 weeks following discharge, children will be monitored for adherence to PDMC and health outcomes including hospital readmissions, clinic visits, and mortality. Researchers will collect data through household visits, passive surveillance, and unannounced home visits to check medication adherence. The study also includes economic, acceptability, and feasibility evaluations to assess cost-effectiveness, stakeholder views, and practical aspects of implementing PDMC delivery methods. The total study duration spans 36 months, including preparation, recruitment, follow-up, and data analysis.

Researchers are evaluating shorter and safer treatment regimens for latent Tuberculosis Infection TB using an adaptive Phase 2 randomized open-label trial design. The study aims to compare the safety, completion, and tolerability of at least three new daily self-administered Tuberculosis Preventive Treatment TPT regimens against the standard 4 months of Rifampin at 10 mgkgday 4R10 in adults and children aged 5 years and older. The goal is to identify regimens lasting two months or less that are not inferior in safety and adherence to the standard treatment, with plans to test the best regimen further in a Phase 3 trial. The trial begins with three treatment groups the standard 4R10 rifampin regimen, 2 months of Rifampin at 20 mgkgday 2R20, and 1 month of daily levofloxacin and rifapentine 1LP. If either experimental regimen fails to meet safety and tolerability criteria, it may be dropped and replaced by another new 1-2 month regimen, such as 1 month of Isoniazid plus rifapentine 1HP. Participants are randomized and monitored closely, with visits scheduled at 2 weeks, during treatment, and after completion. Safety evaluations include clinical assessments, blood tests, and pharmacokinetic sampling. Participants may switch to the standard regimen if intolerability symptoms occur. During the study, participants complete symptom questionnaires, pill counts, and telephone follow-ups to monitor adherence and side effects. After treatment, they are contacted every 3 months for up to 26 months to check for signs of active TB. The primary outcome is the occurrence of severe treatment-related adverse events from the start of treatment until two weeks after completion. Secondary outcomes include treatment completion rates, tolerability, patient preferences, drug exposure, costs, and incidence of active TB. Safety analyses will be regularly conducted to ensure participant well-being throughout the trial.