Dalla Lana School of Public Health

Faculty Member

Monique van Lettow

Research Interests

Research interests include TB/HIV integration and the prevention of mother-to-child transmission of HIV.

Current Research Projects

2012-2016 Improving uptake and retention in PMTCT services through novel approaches in family supported care and in community peer-outreach support in Malawi. Co-investigators: Lighthouse: Sam Phiri (PI). Co-investigators: MoH: Frank Chimbwandira, Michael Eliya; Dignitas International: Fabian Cataldo, Monique van Lettow, Megan Landes,Alex Martiniuk; University of Caroloina: Mina Hosseinipour, Jacqueline Chinkonde-Nkhoma; Management Sciences for Health: Erik Schouten; University of Malawi: Levison Chiwaula, Atupele Kapito-Tembo.

Funding: WHO/CIDA

2011-2015 Optimising Clinical Care Strategies and laboratory monitoring for Cost-effective Roll-Out of Antiretroviral Therapy in Africa: The Lab-Lite Project. Co Principle Investigators: Fabian Cataldo (Dignitas International) and Diana M Gibb (MRC Clinical Trials Unit, UK). Co-investigators: Adrienne K. Chan, Sumeet Sodhi, Erik Schouten, Monique van Lettow, Raphael Piringu. (Dignitas International, University of Toronto, Management Science for Health, Malawi Ministry of Health)

Funding: MRC Clinical Trials Unit, UK

2011-2013 Assessing the Impact of HIV/AIDS Service Delivery in Zomba District, Malawi: The Zomba District Observational Cohort Study. Coinvestigators: Dignitas International, Zomba, Malawi: Sumeet Sodhi, Monique van Lettow, Michael Schull, Jean Bourgeois, Barry Burciul, Fabian Cataldo, Adrienne Chan; Department of HIV and AIDS, Ministry of Health Malawi: Andreas Jahn; Zomba Central Hospital: Martias Joshua.

Funding: CIHR

2011-2013 Collaboration/Partnership between IUATLD, their partners in Malawi and Dignitas International for Vital Registration enhancement and Operational Research in Tuberculosis, HIV and Health System Strengthening. Co-investigators: Dignitas International: Monique van Lettow. IUATLD: Prof Anthony D Harries.

Funding: IUATLD

Representative Publications

Pinto AD, van Lettow M, Rachlis B, Chan AK, Sodhi SK. Patient costs associated with accessing HIV/AIDS care in Malawi. Journal of the International AIDS Society 2013, 16:18055.

van Lettow M, Åkesson A, Martiniuk A, Ramsay A, Chan AK, Anderson S, Harries AD, Corbett E, Heydermann R, Zacharia R and Bedell R. Six month mortality among HIV-infected individuals presenting for antiretroviral therapy (ART) with unexplained weight loss, chronic fever or chronic diarrhea in Malawi. PLoS ONE 2012; 7(11): e48856

Puchalski Ritchie LM, Barnsley J, Schull MJ, Chan AK, van Lettow M, Martiniuk ALC, Joshua M, Chingayipe E, Makwakwa A and Zwarenstein M. Development of a knowledge translation intervention tailored to the needs of lay health workers to improve tuberculosis treatment adherence and outcomes in Malawi. Implementation Science (submitted March ’13)

Mwinjiwa E, Isaakidis P, Van Den Bergh R, Harries AD, Bezanson K, Thompson C, Joshua M, Akello H, Beyene T and van Lettow M. Burden, Characteristics, Management and Outcomes of HIV-infected patients with Kaposi’s sarcoma in Zomba, Malawi. Public Health Action (in press)

Argarwal M, Bourgeois J, Matengeni A, Bezanson K, van Schoor V and van Lettow M. Lessons learned from updating a database of patient level ART data covering multiple and remote facilities in Zomba District, Malawi. Public Health Action (in press)

Bedell RA, van Lettow M, Landes M. Women’s attitudes to HIV testing, disclosure and the involvement of male partners in a rural district of Malawi with high HIV prevalence AIDS Care, submitted

van Lettow M, Kapito-Tembo A, Kauna-Khanamwa B, Kanike E, Maosa S, Semba M, Joshua M, Ndovi L, and Cataldo F. Increasing the uptake of HIV Testing in Maternal Health in Malawi. CIGI 2012 http://www.cigionline.org/files/no5.pdf

Cataldo F, Felix Limbani F and van Lettow M. Policy Brief – Addressing the Low Uptake of HIV Testing in Maternal Health in Malawi. CIGI 2012 http://www.africaportal.org/files/CIGI-AI%20Policy%20Brief%203.pdf

Landes M, van Lettow M, Chan AK, Mayuni, I, Schouten E, and Bedel R. Mortality and health outcomes of HIV-exposed and unexposed children in a PMTCT cohort in Malawi. PLoS ONE 7(10): e47337

Landes M, van Lettow M, Bedell R, Mayuni I, Chan AK, Tenthani L,Schouten E. Mortality and health outcomes in HIV-infected and HIV-uninfected mothers at 18-20 months postpartum in Zomba District, Malawi; a matched Cohort Study.PLoS ONE 7(9): e44396

Puchalski Ritchie LM, van Lettow M, Barnsley J, Chan AK, Joshua M, Martiniuk ALC, Schull MJ, Zwarenstein M.Barriers and Facilitators to lay health workers supporting TB treatment adherence in Malawi. Int J Tuberc Lung Dis 2012 ; 16(11): 1492-1497

Bedell R, Anderson S, van Lettow M, Chan AK, Åkesson A, Kumwenda M, Harries AD, Ramsay A. High prevalence of tuberculosis and serious bloodstream infections in individuals presenting for antiretroviral therapy in Malawi. PlosOne 2012;7(6):e39347

Tenthani, L.,Cataldo F, Chan AK, Bedell R, Martiniuk A, and van Lettow M. Involving Expert Patients in Anti-Retroviral Treatment Provision in a Tertiary Referral Hospital HIV Clinic in Malawi. BMC Health Services Research.2012, 12:140.

van Lettow M, Bedell R, Chan A.K, Gawa L, Gatto S, Mayuni I, Chibuye P, Bisika S. Uptake and outcomes of a prevention-of mother-to-child transmission (PMTCT) programin Zomba district, Malawi. BMC Public Health 2011: 11: 426.

Negin J, van Lettow M, Semba M, Martiniuk A, Chan AC, Cumming R. Anti-retroviral treatment outcomes among older adults in Zomba District, Malawi. PLoS One. 2011;6(10):e26546. Epub 2011 Oct 21.

Chan AK, van Lettow M, Tenthani L, Gawa L, Kadzanja A, Mnthambala A, Kambanji M. Outcome Assessment of a Dedicated HIV Positive Health Care Worker Clinic at a Central Hospital in Malawi: A Retrospective Observational Study. PLoS One. 2011;6(5):e19789.

van Lettow M, Chan A.K, Ginsburg AS, Thweya H, Gareta D, Njala J, Kanyerere H, Phiri S, Idana I. Timing and uptake of ART during treatment for active tuberculosis in HIV co-infected adults in Malawi. Public Health Action 2011: 1(1):1-4

Gawa L, Reid ME, Edginton M, van Lettow.M, Joshua M, Harries AD. Diagnostic Management and Outcomes of Pulmonary Tuberculosis Suspects admitted to a Central Hospital in Malawi. Public Health Action 2011; 1:1, pp. 2-5(4)

Kumwenda M, Tom S, Chan AK, Mwinjiwa E, Sodhi S, Joshua M and van Lettow M. Reasons for accepting or refusing HIV services among TB patients at a TB-HIV integrated clinic in Malawi. Int J Tuberc Lung Dis 2011; 15(12):1663-9

Chan AK, Mateyu G, Jahn A, Schouten E, Mlotha W, Kambanji M, and van Lettow M. Outcome assessment of decentralization of ART provision in a rural district in Malawi using an integrated primary care model. Trop Med Int Health 2010; 15s1:90-97

van Lettow M, Whalen C. Tuberculosis. In: Semba RD, Bloem MW, eds. Nutrition and Health in Developing Countries. Totowa, NJ: Humana Press; second edition 2008; 275-306

Semba RD, Kumwenda J, Zijlstra EE, Ricks M, van Lettow M, Whalen CC, Clark TD, Jorgensen L, Kohler J, Kumwenda N, Taha TE, Harries AD. Micronutrient supplements and mortality of HIV-infected adults with pulmonary TB: a controlled clinical trial. Int J Tuberc Lung Dis. 2007; 11:854-9.

van Lettow M, van der Meer JJM, West C, van Crevel R, Semba RD. Interleukin-6 and HIV load, but not plasma leptin concentration, predict anorexia and wasting in adults with pulmonary tuberculosis in Malawi. J Clin Endocrinol Metab 2005; 90:4771-4776.

van Lettow M, West C, van der Meer JJM, Wieringa F, Semba RD. Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi. Eur J Clin Nutr 2005; 59:526-532.

van Lettow M, Harries AD, Kumwenda JJ, Zijlstra EE, Clark T, Taha TE, Semba RD. Micronutrient Malnutrition and wasting in Adults with Pulmonary Tuberculosis in Malawi. BMC Infect Dis 2004; 4:61

van Lettow M, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, Kumwenda N, Kang’ombe C, Semba RD.

Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis infection in Malawi. Int J Tuberc Lung Dis. 2004; 8:211-217.

van Lettow M, Fawzi WW, Semba RD. Triple Trouble: The role of malnutrition in tuberculosis and human immunodeficiency virus co-infection. Nutr Rev 2003; 61:81-90