Research Topics
| Rony ZachariahSummaryCountry: Luxembourg Publications
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Publications
Practicing medicine without borders: tele-consultations and tele-mentoring for improving paediatric care in a conflict setting in Somalia?R Zachariah
Medecins Sans Frontieres, Brussels Operational Centre, Luxembourg, Belgium
Trop Med Int Health 17:1156-62. 2012..In a district hospital in conflict-torn Somalia, we assessed (i) the impact of introducing telemedicine on the quality of paediatric care, and (ii) the added value as perceived by local clinicians...
Language in tuberculosis services: can we change to patient-centred terminology and stop the paradigm of blaming the patients?R Zachariah
Medical Department, Medecins Sans Frontieres, Operational Centre Brussels, MSF Luxembourg, Luxembourg
Int J Tuberc Lung Dis 16:714-7. 2012..These terms are non-judgmental and patient-centred. We appeal to the global Stop TB Partnership to lead discussions on this issue and to make concrete steps towards changing the current paradigm...
Is operational research delivering the goods? The journey to success in low-income countriesRony Zachariah
Operational Centre Brussels, Medical Department, Medecins Sans Frontieres, Luxembourg, Luxembourg
Lancet Infect Dis 12:415-21. 2012..We also propose measures of success for operational research. Adoption and use of these measures could help to ensure that operational research better changes policy and practice and improves health-care delivery and disease programmes...
Antiretroviral therapy for HIV prevention: many concerns and challenges, but are there ways forward in sub-Saharan Africa?R Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Centre, Belgium
Trans R Soc Trop Med Hyg 104:387-91. 2010..In this paper, we highlight four key operational challenges linked to acceptability and feasibility and discuss possible ways forward to address them...
Scaling-up co-trimoxazole prophylaxis in HIV-exposed and HIV-infected children in high HIV-prevalence countriesRony Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, Brussels, Belgium
Lancet Infect Dis 7:686-93. 2007..We discuss some of the major barriers preventing the scale-up of co-trimoxazole prophylaxis for children in countries with a high prevalence of HIV and propose specific actions required to tackle these challenges...
Does antiretroviral treatment reduce case fatality among HIV-positive patients with tuberculosis in Malawi?R Zachariah
Medical Department Operational Research, Medecins Sans Frontieres, Brussels Operational Centre, Luxembourg
Int J Tuberc Lung Dis 11:848-53. 2007..Thyolo district, Malawi...
Acceptance of anti-retroviral therapy among patients infected with HIV and tuberculosis in rural Malawi is low and associated with cost of transportRony Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, Brussels, Belgium
PLoS ONE 1:e121. 2006....
Risk factors for high early mortality in patients on antiretroviral treatment in a rural district of MalawiRony Zachariah
Medecins Sans Frontieres, Operational Research, Brussels Operational Center, Belgium
AIDS 20:2355-60. 2006....
Community support is associated with better antiretroviral treatment outcomes in a resource-limited rural district in MalawiR Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, 68 Rue de Gasperich, L 1617, Luxembourg, Belgium
Trans R Soc Trop Med Hyg 101:79-84. 2007..The community might be an unrecognized and largely 'unexploited resource' that could play an important contributory role in countries desperately trying to scale up ART with limited resources...
Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan AfricaR Zachariah
Medecins Sans Frontieres, Medical Department, Brussels Operational Center, Rue de Gasperich, Luxembourg
Trans R Soc Trop Med Hyg 103:549-58. 2009..Task shifting should not undermine the primary objective of improving patient benefits and public health outcomes...
Payment for antiretroviral drugs is associated with a higher rate of patients lost to follow-up than those offered free-of-charge therapy in Nairobi, KenyaR Zachariah
Médecins Sans Frontières Brussels, Medical Department Operational Research, 68 Rue de Gasperich, L 1617, Luxembourg
Trans R Soc Trop Med Hyg 102:288-93. 2008..In resource-limited settings, ART should be offered free of charge in order to promote treatment compliance and prevent the emergence of drug resistance...
Very early mortality in patients starting antiretroviral treatment at primary health centres in rural MalawiRony Zachariah
Medecins Sans Frontieres, Medical Department, Brussels, Belgium
Trop Med Int Health 14:713-21. 2009..To report on the cumulative proportion of deaths occurring within 3 months of starting antiretroviral treatment (ART) and to identify factors associated with such deaths, among adults at primary health centres in a rural district of Malawi...
Operational research in low-income countries: what, why, and how?Rony Zachariah
Operational Research Unit, Medical Department, Brussels Operational Centre, Medecins Sans Frontieres, Brussels, Belgium
Lancet Infect Dis 9:711-7. 2009....
The published research paper: is it an important indicator of successful operational research at programme level?R Zachariah
Medecins Sans Frontieres, Operational Centre Brussels, 68 Rue de Gasperich, Luxembourg
Trop Med Int Health 15:1274-7. 2010..We present arguments to support publishing operational research from low-income countries; we highlight some of the main reasons for failure of publication at programme level and suggest ways forward...
Viewpoint: Why do we need a point-of-care CD4 test for low-income countries?R Zachariah
Medecins Sans Frontieres, Operational Centre Brussels, Operational Research Unit, Medical Department, MSF Luxembourg, Luxembourg
Trop Med Int Health 16:37-41. 2011..It is high-time that CD4 technology is simplified and adapted for wider use in low-income countries to change the current paradigm of restricted access once and for all...
Reduced tuberculosis case notification associated with scaling up antiretroviral treatment in rural MalawiR Zachariah
Médecins sans Frontières MSF, Medical Department Operational Research, MSF Luxembourg, Brussels Operational Centre, Luxembourg
Int J Tuberc Lung Dis 15:933-7. 2011..To report on the trends in new and recurrent tuberculosis (TB) case notifications in a rural district of Malawi that has embarked on large-scale roll-out of antiretroviral treatment (ART)...
Retention and attrition during the preparation phase and after start of antiretroviral treatment in Thyolo, Malawi, and Kibera, Kenya: implications for programmes?R Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, 68 Rue de Gasperich, L 1617, Luxembourg, Luxembourg
Trans R Soc Trop Med Hyg 105:421-30. 2011..Considerable attrition occurs during the preparation phase of ART, and programme evaluations confined to on-treatment analysis significantly underestimate attrition. This has important operational implications, which are discussed here...
The HIV/AIDS epidemic in sub-Saharan Africa: thinking ahead on programmatic tasks and related operational researchRony Zachariah
Medecins Sans Frontieres, Operational Centre Brussels, Medical Department, MSF Luxemburg, Luxemburg
J Int AIDS Soc 14:S7. 2011..From a programmatic perspective, we: a) highlight what needs to fundamentally change in our thinking and overall approach to the epidemic; and b) outline a number of key task areas for implementation and related operational research...
Building leadership capacity and future leaders in operational research in low-income countries: why and how?R Zachariah
Medical Department, Medecins Sans Frontieres, Operational Centre Brussels, MSF Luxembourg, Luxembourg
Int J Tuberc Lung Dis 15:1426-35, i. 2011....
Cotrimoxazole prophylaxis for HIV-positive TB patients in developing countriesR Zachariah
Medecins Sans Frontieres, Operational Research HIV TB, Medical Department, Brussels Operational Center, 68 Rue de Gaspench, L 1617 Luxemburg
Trop Doct 36:79-82. 2006..We review the current evidence on the above concerns and highlight the main operational considerations related to implementing CTX prophylaxis as a basic component of care for HIV-positive TB patients in developing countries...
Targeting CD4 testing to a clinical subgroup of patients could limit unnecessary CD4 measurements, premature antiretroviral treatment and costs in Thyolo District, MalawiR Zachariah
Medecins Sans Frontieres, Medical Department Operational Research HIV TB, Brussels Operational Center, 94 Rue Dupre, Brussels, Belgium
Trans R Soc Trop Med Hyg 100:24-31. 2006....
Voluntary counselling, HIV testing and adjunctive cotrimoxazole reduces mortality in tuberculosis patients in Thyolo, MalawiRony Zachariah
Medecins Sans Frontieres Luxembourg, Blantyre, Malawi
AIDS 17:1053-61. 2003....
Motives, sexual behaviour, and risk factors associated with HIV in individuals seeking voluntary counselling and testing in a rural district of MalawiR Zachariah
Medecins Sans Frontieres, Thyolo, Malawi
Trop Doct 33:88-91. 2003..There is a demand for VCT, and the service provides an opportunity for intensive education about HIV/AIDS prevention on a one-to-one basis. It could also be an entry point to prevention and care for those who are infected...
Passive versus active tuberculosis case finding and isoniazid preventive therapy among household contacts in a rural district of MalawiR Zachariah
Operational Research HIV TB, Medical Department, Médecins sans Frontières Brussels Operational Centre, Brussels, Belgium
Int J Tuberc Lung Dis 7:1033-9. 2003..Thyolo district, rural Malawi...
Acceptability and technical problems of the female condom amongst commercial sex workers in a rural district of MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Thyolo, Malawi
Trop Doct 33:220-4. 2003..This study would be useful in preparing the introduction of the female condom within known commercial sex establishments in Malawi...
Implementing joint TB and HIV interventions in a rural district of Malawi: is there a role for an international non-governmental organisation?R Zachariah
Operational Research HIV TB, Medecins Sans Frontieres, Medical Department, Brussels Operational Centre, Brussels, Belgium
Int J Tuberc Lung Dis 8:1058-64. 2004..This introduced a new dynamic of decentralised operational flexibility at the district level which improved access to care and support for people with TB-HIV...
Voluntary counselling, HIV testing and sexual behaviour among patients with tuberculosis in a rural district of MalawiR Zachariah
Medecins Sans Frontieres, Thyolo, Malawi
Int J Tuberc Lung Dis 7:65-71. 2003....
Vital registration in rural Africa: is there a way forward to report on health targets of the Millennium Development Goals?R Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, 68 Rue de Gasperich, L 1617, Luxembourg
Trans R Soc Trop Med Hyg 105:301-9. 2011....
Sexually transmitted infections among prison inmates in a rural district of MalawiRony Zachariah
Mission Malawi, Medecins Sans Frontieres Luxembourg, 70 rue de Gasperich, L 1617, Luxembourg
Trans R Soc Trop Med Hyg 96:617-9. 2002..The findings have implications for HIV transmission and might help in developing more rational policies on STI control and condom access within Malawi prisons...
Cotrimoxazole prophylaxis in HIV-infected individuals after completing anti-tuberculosis treatment in Thyolo, MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo, Thyolo District, Malawi
Int J Tuberc Lung Dis 6:1046-50. 2002..Thyolo, rural southern Malawi...
Can we get more HIV-positive tuberculosis patients on antiretroviral treatment in a rural district of Malawi?R Zachariah
Medical Department HIV TB Operational Research, Brussels Operational Centre, Medecins Sans Frontieres, Brussels, Belgium
Int J Tuberc Lung Dis 9:238-47. 2005..Decentralisation of ART from hospitals to health centres would greatly improve ART access...
Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early deathR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Malawi
Trans R Soc Trop Med Hyg 96:291-4. 2002..5% of the 767 patients with normal to mild malnutrition (odds ratio 1.8, 95% confidence interval 1.1-2.7). In patients with TB, BMI < 17.0 kg/m2 is associated with an increased risk of early death...
How can the community contribute in the fight against HIV/AIDS and tuberculosis? An example from a rural district in MalawiR Zachariah
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, Belgium
Trans R Soc Trop Med Hyg 100:167-75. 2006..Communities can play an important contributory role in reducing the burden of HIV/AIDS and TB and in mitigating its impact. Despite this, community resources in most settings are often under-exploited and their role remains undefined...
Behavioural characteristics, prevalence of Chlamydia trachomatis and antibiotic susceptibility of Neisseria gonorrhoeae in men with urethral discharge in Thyolo, MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Malawi
Trans R Soc Trop Med Hyg 96:232-5. 2002..trachomatis was not found to be a major pathogen. Antimicrobial susceptibility surveillance of N. gonorrhoeae is essential in order to prevent treatment failures and control the spread of resistant strains...
Changes in Escherichia coli resistance to co-trimoxazole in tuberculosis patients and in relation to co-trimoxazole prophylaxis in Thyolo, MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Malawi
Trans R Soc Trop Med Hyg 96:202-4. 2002....
Providing universal access to antiretroviral therapy in Thyolo, Malawi through task shifting and decentralization of HIV/AIDS careMarielle Bemelmans
Medecins Sans Frontieres, Blantyre, Malawi
Trop Med Int Health 15:1413-20. 2010..To describe how district-wide access to HIV/AIDS care was achieved and maintained in Thyolo District, Malawi...
Baseline characteristics, response to and outcome of antiretroviral therapy among patients with HIV-1, HIV-2 and dual infection in Burkina FasoKatie Harries
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, 68 Rue de Gasperich, L 1617, Luxembourg
Trans R Soc Trop Med Hyg 104:154-61. 2010..Reasons may include differences in age at baseline, lower intrinsic immune recovery in HIV-2, use of ineffective ART regimens (inappropriate prescribing) by clinicians, and poor drug adherence...
Unacceptable attrition among WHO stages 1 and 2 patients in a hospital-based setting in rural Malawi: can we retain such patients within the general health system?Katie Tayler-Smith
Medecins Sans Frontieres, Medical Department Operational Research, Brussels Operational Center, 68 Rue de Gasperich, L 1617, Luxembourg
Trans R Soc Trop Med Hyg 104:313-9. 2010..In a rural district hospital setting in Malawi, attrition of individuals in WHO stages 1 and 2 is unacceptably high, and specific operational strategies need to be considered to retain such patients in the health system...
Compliance with cotrimoxazole prophylaxis for the prevention of opportunistic infections in HIV-positive tuberculosis patients in Thyolo district, MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Malawi
Int J Tuberc Lung Dis 5:843-6. 2001....
WHO clinical staging of HIV infection and disease, tuberculosis and eligibility for antiretroviral treatment: relationship to CD4 lymphocyte countsR Teck
, Thyolo, Malawi
Int J Tuberc Lung Dis 9:258-62. 2005..It would thus be reasonable, in this or similar settings where CD4 counts are unavailable for clinical management, for all such patients to be considered eligible for antiretroviral therapy...
Weight loss after the first year of stavudine-containing antiretroviral therapy and its association with lipoatrophy, virological failure, adherence and CD4 counts at primary health care level in Kigali, RwandaJohan van Griensven
Medecins Sans Frontieres, Operational Centre Brussels, Medical Department, Duprestraat 94, 1090 Brussels, Belgium
Trans R Soc Trop Med Hyg 104:751-7. 2010..In low-income countries, measuring weight is a routine clinical procedure that could be used to filter out individuals with lipoatrophy on stavudine-based ART, after alternative causes of weight loss have been ruled out...
Stavudine- and nevirapine-related drug toxicity while on generic fixed-dose antiretroviral treatment: incidence, timing and risk factors in a three-year cohort in Kigali, RwandaJohan van Griensven
Medecins Sans Frontieres, Operational Centre Brussels, Medical Department, Duprestraat 94, 1090 Brussels, Belgium
Trans R Soc Trop Med Hyg 104:148-53. 2010..d4T is associated with significant long-term toxicity. d4T-dose reduction, increased access to safer ART in low-income countries and close monitoring for those at risk are all relevant strategies...
Mortality reduction associated with HIV/AIDS care and antiretroviral treatment in rural Malawi: evidence from registers, coffin sales and funeralsBeatrice Mwagomba
Thyolo District Health Services, Ministry of Health and Population, Thyolo, Malawi
PLoS ONE 5:e10452. 2010....
Clinical screening for HIV in a health centre setting in urban Kenya: an entry point for voluntary counselling, HIV testing and early diagnosis of HIV infection?V Arendt
Medecins Sans Frontieres, Mission Kenya, Brussels Operational Centre, Brussels, Belgium
Trop Doct 37:45-7. 2007....
Generic fixed-dose combination antiretroviral treatment in resource-poor settings: multicentric observational cohortAlexandra Calmy
MSF, Campaign for Access to Essential Medicines, 78 rue de Lausanne, 1205 Geneva, Switzerland
AIDS 20:1163-9. 2006..The use fixed-dose combination (FDC) is a critical tool in improving HAART. Studies on the effectiveness of combined lamivudine, stavudine and nevirapine (3TC/d4T/NVP) are scarce...
Monitoring the response to antiretroviral therapy in resource-poor settings: the Malawi modelAnthony D Harries
National Tuberculosis Control Programme, Ministry of Health and Population, P O Box 30377, Lilongwe, Malawi
Trans R Soc Trop Med Hyg 98:695-701. 2004....
High prevalence of lipoatrophy among patients on stavudine-containing first-line antiretroviral therapy regimens in RwandaJohan van Griensven
Medecins Sans Frontieres, Kimihurura, Kacyiru, 1361 Kigali, Rwanda
Trans R Soc Trop Med Hyg 101:793-8. 2007..Lipoatrophy appears to be an important long-term complication of WHO-recommended first-line ART regimens. These data highlight the urgent need for access to more affordable and less toxic ART regimens in resource-limited settings...
Task shifting for antiretroviral treatment delivery in sub-Saharan Africa: not a panaceaMit Philips
Analysis and Advocacy Unit, , Brussels Operational Centre, Belgium
Lancet 371:682-4. 2008
High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of actingM Manzi
Medecins Sans Frontieres Luxembourg, Thyolo District, Luxembourg, Malawi
Trop Med Int Health 10:1242-50. 2005..Thyolo District Hospital, rural Malawi...
Patient retention and attrition on antiretroviral treatment at district level in rural MalawiM Massaquoi
Medecins Sans Frontieres, Thyolo District, Thyolo, Malawi
Trans R Soc Trop Med Hyg 103:594-600. 2009..2, 95% CI 1.76-2.72, P<0.001). As Malawi continues to extend the coverage (and equity) of ART, including in rural areas, attention is needed to reduce losses to follow-up at hospital level and reduce mortality at primary care level...
Health seeking and sexual behaviour in patients with sexually transmitted infections: the importance of traditional healers in Thyolo, MalawiR Zachariah
Medecins Sans Frontieres, Luxembourg, Thyolo District, Malawi
Sex Transm Infect 78:127-9. 2002....
Sexually transmitted infections and sexual behaviour among commercial sex workers in a rural district of MalawiR Zachariah
Medecins Sans Frontieres Luxembourg, Thyolo District, Malawi
Int J STD AIDS 14:185-8. 2003..The high levels of STIs, particularly GUDs, and unprotected sex underlines the importance of developing targeted interventions for CSWs and their clients...
Safety, effectiveness, and outcomes of concomitant use of highly active antiretroviral therapy with drugs for tuberculosis in resource-poor settingsAnthony D Harries
HIV Unit, Ministry of Health, Lilongwe, Malawi
Lancet 367:944-5. 2006
Outcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in MalawiM Moses
Medecins Sans Frontieres, Thyolo District, Thyolo, Malawi
Int J Tuberc Lung Dis 14:197-202. 2010..Thyolo District Hospital, rural Malawi...
Reasons for loss to follow-up among mothers registered in a prevention-of-mother-to-child transmission program in rural MalawiL D Bwirire
Medecins Sans Frontieres, Thyolo District, Malawi
Trans R Soc Trop Med Hyg 102:1195-200. 2008..Mothers attending antenatal services need to be better informed and supported, at both community and health-provider level...
Treatment outcomes stratified by baseline immunological status among young children receiving nonnucleoside reverse-transcriptase inhibitor-based antiretroviral therapy in resource-limited settingsDaniel P O'Brien
AIDS Working Group, Medecins Sans Frontieres, Paris, France
Clin Infect Dis 44:1245-8. 2007..86-0.92), with no significant difference among children stratified on the basis of baseline immunological levels; 62% attained a CD4 cell percentage >25%, and 7% continued to have a CD4 cell percentage <15%...
Do aid agencies have an ethical duty to comply with researchers? A response to RennieRony Zachariah
Medecins Sans Frontieres, 68 Rue de Gasperich, L 1617, Gasperich, Luxembourg
Dev World Bioeth 6:78-80. 2006....
Abolishing user fees for children and pregnant women trebled uptake of malaria-related interventions in Kangaba, MaliFrederique Ponsar
Analysis and Advocacy Unit, Medecins Sans Frontieres, Brussels Operational Centre, Brussels, Belgium
Health Policy Plan 26:ii72-83. 2011..This would contribute to increasing the impact of interventions on population health and, in turn, the effectiveness of aid...
The Partec CyFlow Counter could provide an option for CD4+ T-cell monitoring in the context of scaling-up antiretroviral treatment at the district level in MalawiM Fryland
, Thyolo District, Malawi
Trans R Soc Trop Med Hyg 100:980-5. 2006..It could provide a new option for introducing routine CD4+ cell monitoring at the district level in the context of scaling-up antiretroviral therapy in Malawi...
In resource-limited settings good early outcomes can be achieved in children using adult fixed-dose combination antiretroviral therapyDaniel P O'Brien
AIDS Working Group, Medecins Sans Frontieres, Plantage Middenlaan 14, 1001 EA Amsterdam, The Netherlands
AIDS 20:1955-60. 2006..To (a) determine early treatment outcomes and (b) assess safety in children treated with adult fixed-dose combination (FDC) antiretroviral tablets...
Increased baseline body weight is a risk factor associated with virological failure while on antiretroviral treatmentJohan van Griensven
J Acquir Immune Defic Syndr 48:631-3. 2008
Evaluation of four rapid tests for diagnosis and differentiation of HIV-1 and HIV-2 infections in Guinea-Conakry, West AfricaPascale Chaillet
Medecins Sans Frontieres, Medical Department, Brussels Operational Center, Brussels, Belgium
Trans R Soc Trop Med Hyg 104:571-6. 2010..The use of SD Bioline HIV 1/2 3.0 (the current standard in Guinea-Conakry) as a discriminatory HIV test is poor and may be best replaced by Immunoflow HIV1-HIV2...
HIV prevalence and demographic risk factors in blood donorsR Zachariah
Medecins Sans Frontieres, Luxembourg, Blantyre, Malawi
East Afr Med J 79:88-91. 2002....
Cabergoline for suppression of puerperal lactation in a prevention of mother-to-child HIV-transmission programme in rural MalawiL Buhendwa
Medecins Sans Frontieres, Thyolo District, Malawi
Trop Doct 38:30-2. 2008..It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings...
Adapting the DOTS framework for tuberculosis control to the management of non-communicable diseases in sub-Saharan AfricaAnthony D Harries
Clinical HIV Unit, Ministry of Health, Lilongwe, Malawi
PLoS Med 5:e124. 2008
Dried blood spots are a useful tool for quality assurance of rapid HIV testing in Kigali, RwandaP Chaillet
Medecins Sans Frontieres, Medical Department, Brussels Operational Center, Belgium
Trans R Soc Trop Med Hyg 103:634-7. 2009....
