Freetown

Researchers are estimating the prevalence of high-risk human papillomavirus HR HPV infections among girls and women aged 9 to 50 years across eight countries in South Asia and sub-Saharan Africa. This study aims to understand HPV infection rates in low socio-economic populations and specific sub-groups, including sexually active young women, by conducting cross-sectional surveys and longitudinal studies. Additionally, qualitative sub-studies will explore how gender norms and stigma affect HPV burden and access to prevention and treatment services. The study uses a harmonized protocol across all participating countries with country-specific adaptations. Cross-sectional surveys will collect urine samples from girls and women in urban and rural areas to estimate HPV prevalence. Longitudinal studies will follow sexually active girls and women aged 15 to 35 years over 24 months, collecting vaginal swabs and urine samples to measure persistent HPV infection. Qualitative studies will include interviews and focus groups to understand social factors influencing HPV risks and healthcare access. Participants will provide samples and answer standardized questionnaires on demographics, sexual and reproductive history, HPV vaccination, cervical cancer screening, and related attitudes. Testing will occur at enrollment and every six months for two years in longitudinal studies. Researchers will monitor HPV infection rates, assess questionnaire responses, and analyze laboratory results. The study includes safety follow-up and detailed data collection to provide comprehensive insight into HPV prevalence, incidence, and social influences in these populations.

The ICU-related Out-of-Pocket Expenses ICOPE study is a multinational, prospective observational study conducted in African and Asian countries to understand the financial impact of ICU care on patients and their families. The study focuses on measuring out-of-pocket expenses and the occurrence of catastrophic health expenditure among patients who stay in the ICU for more than 24 hours, including those who receive mechanical ventilation and those who do not. The study addresses the rising cost burden related to ICU care in low- and middle-income countries LMICs and aims to identify factors contributing to financial hardship. Participants include all patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. The study compares groups of patients receiving invasive mechanical ventilation with those who do not, tracking their ICU-related expenses. The follow-up period extends from ICU admission to discharge, with additional assessments at 30 days and 6 months, spanning a total study duration of 18 months. During the study, researchers will collect detailed information about direct and indirect costs associated with ICU care, including medical and non-medical expenses. They will also examine how families cope with these costs and identify risk factors for catastrophic health expenditure. The primary outcomes include out-of-pocket cost per patient episode and the relative risk of catastrophic health expenditure by ICU discharge. Secondary outcomes include risk factors for catastrophic expenditure and the frequency of various coping strategies used by families.

Researchers are evaluating whether taking azithromycin as a preventive treatment can reduce the risk of death in adults with advanced HIV disease. This is a Phase 3, double-blind, placebo-controlled trial involving multiple centers. The study aims to understand if azithromycin prophylaxis can lower mortality compared to a placebo in this vulnerable population. Participants will be randomly assigned to receive either an oral azithromycin tablet or a matching placebo tablet once daily for 28 days. After this treatment period, they will be followed for 24 weeks to measure the main outcome of all-cause mortality. The total study participation will last 48 weeks to monitor both short-term and longer-term effects. During the study, participants will undergo assessments to track survival and hospitalizations at 12 and 24 weeks after starting the treatment. Researchers will closely monitor health outcomes and any hospital stays to evaluate the impact of azithromycin prophylaxis. Safety and adherence will be followed throughout the trial to ensure accurate measurement of results.