Michael Rich, MD

Michael Rich, MD replied to "Handling of ARVs in DOT-HAART" in the Adherence & Retention community.

I work in a Partners In Health Project in Rwanda. We have been using a DOTS-HAART model which we call “a daily accompaniment model” for the past three years. Three thousand patients are presently enrolled. We have had similar discussions around this issue. One solution is to leave a one day dose with the patient and tell them to only take if the CHW does not show up and come the very same day to ...

Michael Rich, MD replied to "Creative Solutions for Rural CHWs" in the Adherence & Retention community.

I work in a Partners In Health Project in Rwanda. We have been using a DOTS-HAART model which we call “a daily accompaniment model” for the past three years. Three thousand patients are presently enrolled. Our CHWs also often go beyond their duties by helping in difficult social-economic hardships. However, we are very up front with the patient and the CHW that the CHWs role is not to be the patients own personal worker. We ...

Michael Rich, MD started a discussion "How long can one use a disposable personal respiratory protection (masks)" in the TB Infection Control community.

Can we recommend to facilities in resource poor areas that disposable respirators (masks) be used as long as they are in good condition, including the seal intact? They obviously should be kept outside the ward or clinic in a place where the inside is unlikely to get contaminated with bacilli on the inside of the mask. In our clinics in Peru and Rwanda we recommend the masks be kept on pegs hanging outside the wards, ...