Activities

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Descriptive or analytical observational studies

The Department conducts numerous observational studies, which often serve as the basis for subsequent evaluative studies or clinical trials.

HIV and TB

In the domain of HIV infection, Epicentre has long monitored and exploited the data from medical treatment programs by various MSF sections. This multicenter data, collected and monitored using the dedicated software program FUCHIA, enables the production of results based on a large number of patients, which are useful in medical decision-making: dashboards for patient cohort follow-up, validation of new treatment adherence indicators, modeling of immune restoration and mortality in patients on antiretroviral treatment, incidence and determinants of second-line treatment failure, and the long-term safety of antiretroviral drugs.

The emergence of resistance to anti-TB drugs (MDR-TB, XDR-TB) is cause for concern in Central Asia, Russia, China, and southern Africa. Epicentre analyzes the program data collected and monitored using the dedicated software program Koch 6, and monitors the emergence of population resistance via surveys on sensitivity and resistance to anti-TB drugs.

Tuberculosis is responsible for 450,000 deaths annually among children, for whom diagnosis is still very problematic, especially when they are coinfected with HIV. In Uganda, Epicentre is conducting two cohort studies for children who are suspected of having TB or in contact with TB patients, in order to better define the clinical features and diagnostic criteria.

Preventive TB treatment is now indicated for HIV-infected patients. Epicentre is helping to implement this recommendation in two MSF-Switzerland programs, in Swaziland and Myanmar.

Malaria

In a shifting epidemiological context, the malaria burden in the Mbarara district of Uganda – home of the Epicentre research base – is being re-evaluated using a population study together with an entomological study aimed at estimating malaria transmission.

Neglected tropical diseases

Visceral leishmaniasis (kala-azar) remains endemic in the Gedaref State of North Sudan, where MSF-Switzerland is working. Epicentre has launched a project in this region aimed at demonstrating that active screening followed by treatment of cases can reduce the incidence of the disease.

Finally, Epicentre continues to analyze the data on human African trypanosomiasis from various MSF sections, collected and monitored using the dedicated software program Epitryps.