Freetown

Researchers are conducting a large multi-country project to estimate the prevalence of high-risk human papillomavirus (HPV) infections among girls and women aged 9 to 50 years in South Asia and sub-Saharan Africa. The study also aims to understand the incidence of persistent HPV infection over two years among sexually active young women. Alongside these surveys, qualitative studies will explore how gender norms and stigma affect HPV risk and access to prevention and treatment services. The study uses two main approaches: cross-sectional surveys (CSS) and longitudinal studies (LS). The CSS will enroll girls and women aged 9-50 from urban and rural areas, collecting urine samples for HPV testing and gathering data on demographics, sexual history, and HPV awareness. The LS will follow sexually active girls and women aged 15-35 for up to 24 months, testing for persistent HPV infection every six months using self-collected vaginal swabs and urine samples. In some countries, blood samples may also be collected. Qualitative sub-studies involving interviews and focus groups will be conducted in selected countries to better understand risk factors and barriers. Participants will provide samples and complete questionnaires on demographics, sexual and reproductive history, HPV vaccination, and screening. The study will measure HPV prevalence at a single time point and the incidence of infections lasting six months or longer. Safety and ethical considerations include informed consent for adults or assent with guardian consent for minors. The study is planned to run from late 2023 through 2026, with ongoing data collection and analysis across multiple countries and populations.

Researchers are conducting a multinational, prospective observational study called the ICU-related Out-of-Pocket Expenses (ICOPE) study in African and Asian countries. This study aims to measure the financial burden on patients and families related to ICU care, focusing on out-of-pocket expenses and catastrophic health expenditure. The study includes both ventilated and non-ventilated patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. Participants are followed during their ICU stay, which averages about 7 days, and additional follow-ups occur at 30 days and 6 months after admission. The study compares costs between patients receiving invasive mechanical ventilation and those who are not ventilated. It also investigates risk factors for catastrophic health expenditure and documents how families cope with the financial demands of ICU care. Throughout the study, researchers collect data on patient expenses, including direct medical and non-medical costs, as well as indirect costs such as income loss. The main outcomes measured are the out-of-pocket cost per patient episode until ICU discharge and the relative risk of catastrophic health expenditure. The total study duration spans 18 months, allowing for comprehensive assessment of financial impact and coping strategies over time.

Researchers are conducting a Phase 3, double-blinded, placebo-controlled, multicenter trial to assess whether azithromycin taken as a preventive treatment can reduce death rates in adults with advanced HIV disease. Participants eligible for the study must have confirmed HIV infection with low CD4 counts or specific treatment histories, reflecting advanced immunosuppression. The trial aims to better understand mortality outcomes related to this preventive approach in this population. Participants will be randomly assigned to receive either azithromycin tablets or placebo tablets for 28 days. All participants will be followed for 24 weeks after randomization to measure the main outcome of death from any cause, with total follow-up lasting 48 weeks. The study compares the effects of azithromycin prophylaxis against an inactive placebo to evaluate its impact on survival. During the study, participants will be monitored regularly to track health outcomes, particularly mortality. They must be able to start or adjust antiretroviral therapy within four weeks of joining the trial. Researchers will closely observe for any adverse effects, treatment adherence, and overall health status throughout the follow-up period to assess the safety and effectiveness of the intervention.