December 2011 saw the publication of two peer-reviewed journal articles by I-TECH-affiliated authors:
Dr. Yves Lambert of I-TECH Haiti
“Rapid development and use of a nationwide training program for cholera management“ appeared in Emerging Infectious Disease, the journal of the US Centers for Disease Control and Prevention, and was co-authored by Dr. Yves Lambert of I-TECH Haiti. The article describes a cholera training package I-TECH Haiti rapidly developed to respond to the 2010 cholera outbreak in Haiti.
Abstract
When epidemic cholera appeared in Haiti in October 2010, the medical community there had virtually no experience with the disease and needed rapid training as the epidemic spread throughout the country. We developed a set of training materials specific to Haiti and launched a cascading training effort. Through a training-of-trainers course in November 14–15, 2010, and department-level training conducted in French and Creole over the following 3 weeks, 521 persons were trained and equipped to further train staff at the institutions where they worked. After the training, the hospitalized cholera patients’ case-fatality rate dropped from 4% to <2% by mid-December and was <1% by January 2011. Continuing in-service training, monitoring and evaluation, and integration of cholera management into regular clinical training will help sustain this success.
The second article, “Case management to improve adherence for HIV-infected patients receiving antiretroviral therapy in Ethiopia: A micro-costing study“ was authored by a team that includes multiple I-TECH faculty and staff, and appeared in the journal Cost Effectiveness and Resource Allocation.
Abstract
Background: Adherence to antiretroviral medication regimens is essential to good clinical outcomes for HIV-infected patients. Little is known about the costs of case management (CM) designed to improve adherence for patients identified as being at risk for poor adherence in resource-constrained settings. This study analyzed the costs, outputs, unit costs and correlates of unit cost variation for CM services in 14 ART sites in Ethiopia from October 2008 through September 2009.
Results: The CM program delivered 4,598 patient-quarters of services, serving 5,056 patients and 1,995 successful exits at a cost of $167,457 over 12 months, or $36 per patient-quarter, $33 per patient served and $84 per successful exit from the CM program. Among the 14 sites, mean costs were $11,961 (sd, $3,965) for the 12-month study period, and $51 (sd, $36) per patient-quarter; $48 (sd, $32) per patient served; and $183 (sd, $157) per successful exit. Unit costs varied inversely with scale (r, -0.70 for cost per patient-quarter versus patient-quarters of service) and with the service-volume to staff ratio (r, -0.68 for cost per patient-quarter versus staff per patient-quarter).
The citations and links for these articles are as follows:
- Tauxe RV, Lynch M, Lambert Y, Sobel J, Domerçant JW, Khan A. Rapid development and use of a nationwide training program for cholera management, Haiti, 2010. Emerg Infect Dis. 2011 Nov;17(11):2094-8.
Available from: http://dx.doi.org/10.3201/eid1711.110857 - Marseille E, Kevany S, Ahmed I, Feleke G, Graham B, Heller T, Kahn JG, and Reyes M. Case management to improve adherence for HIV-infected patients receiving antiretroviral therapy in Ethiopia: A micro-costing study. Cost Effectiveness and Resource Allocation. 2011; 9:18.
Available from: http://www.resource-allocation.com/content/9/1/18/abstract
