Journal articles: 'Malaria prevention initiatives'

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Olapeju, Bolanle, Camille Adams, Gabrielle Hunter, Sean Wilson, Joann Simpson, Lyndsey Mitchum, TrishAnn Davis, et al. "Malaria prevention and care seeking among gold miners in Guyana." PLOS ONE 15, no. 12 (December 29, 2020): e0244454. http://dx.doi.org/10.1371/journal.pone.0244454.

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Despite being a priority population in malaria elimination, there is scant literature on malaria-related behavior among gold miners. This study explores the prevalence and factors influencing malaria prevention, care seeking and treatment behaviors in Guyana gold mining camps. A cross sectional survey was conducted among adult gold miners living in mining camps in the hinterland Regions 1 (Barima-Waini), 7 (Cuyuni-Mazaruni), and 8 (Potaro-Siparuni). Multivariable logistic regressions explored factors associated with miners’ self-report of mosquito net use, prompt care-seeking; self-medication; and testing for malaria. A third of miners used a mosquito net the night preceding the survey and net use was higher among those who believed that net use was the norm in their camp (aOR: 3.11; 95% CI:1.65, 5.88). Less than half (45%) of miners had a fever in the past 12 months, among whom 36% sought care promptly, 48% tested positive for malaria while 54% self-medicated before seeking care. Prompt care-seeking was higher among miners with high malaria knowledge (aOR: 1.44; 95% CI: 1.01, 2.05). Similarly, testing rates increased with secondary education (aOR: 1.71; 95% CI: (1.16, 2.51), high malaria knowledge (aOR: 1.45; 95% CI: 1.02, 2.05), positive beliefs regarding malaria transmission, threat, self-diagnosis, testing and treatment, and, trust in government services (aOR: 1.59; 95% CI (1.12, 2.27) and experience of a prior malaria episode (aOR: 2.62; 95% CI: 1.71, 4.00). Self-medication was lower among male miners (aOR: 0. 52; 95% CI: 0.32, 0.86). Malaria prevention and care seeking behaviors among miners are somewhat low and influenced by mosquito net usage, perceived norms, malaria knowledge and prior episode of confirmed malaria. Study findings have implications for malaria interventions in the hinterland regions of Guyana such as the mass and continuous distribution of insecticide treated nets as well as community case management initiatives using trained malaria testing and treatment volunteers to curb malaria transmission among remote gold mining populations. These include efforts to identify and address gaps in distributing mosquito nets to miners and address miners’ barriers to prompt care seeking, malaria testing and treatment adherence. Targeted social and behavior change messaging is needed on net acquisition, use and care, prompt care-seeking, malaria testing and treatment adherence. Additional efforts to ensure the overall sustainability of the community case management initiative include increased publicity of the community case management initiative among miners, use of incentives to promote retention rates among the community case management volunteer testers and public private partnerships between the Guyana Ministry of Health and relevant mining organizations.

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Danasekaran, Raja, Kalaivani Annadurai, and Geetha Mani. "National Vector Borne Disease Control Programme: Current Updates." Journal of Comprehensive Health 3, no. 1 (October 24, 2020): 9–16. http://dx.doi.org/10.53553/jch.v03i01.002.

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Vector-borne diseases are a group of communicable diseases transmitted by mosquitoes and other vectors. National Vector Borne Disease Control Programme is the programme for prevention & control of these diseases. Many new initiatives have been undertaken in the programme which includes National Programme for Prevention & Control of JE/AES, Strategic Plan for Malaria control in India (2012-2017), National Drug Policy on Malaria-2013, Environmental Codes of Practice, etc. in order to make India free from vector borne diseases with equitable access to quality health care.

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Macnab, Andrew J. "Global Health Initiatives to Reduce Malaria Morbidity in School-aged Children." GHMJ (Global Health Management Journal) 4, no. 1 (June 28, 2020): 5–20. http://dx.doi.org/10.35898/ghmj-41578.

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Background: To review global initiatives to reduce the burden of disease from malaria on school-aged children. The focus is on approaches with potential to reduce mortality and morbidity, improve the health and ability of children to attend school, avoid malaria impacting their potential academic achievement, and minimize the risk of short- and long-term cognitive impairment. Methods: Literature searches using defined terms related to malaria and education, and a scoping review of the key literature selected, to provide a narrative summary of the challenges and potential solutions identified. Results: There is robust evidence that school-aged children are particularly vulnerable to malaria, and need special measures to protect them; calls are widespread for better diagnostic approaches and program innovation because of current levels of malaria-related morbidity and mortality. School-based programs that educate children broadly on causation, prevention and care required can improve access to timely diagnosis and treatment; however, currently national malaria control interventions do not specifically target school-age children. The literature describes intervention strategies that include seasonal chemoprophylaxis, intermittent protective treatment and antimalarial therapy linked to mass drug administration for neglected tropical diseases. Recently, a community participatory intervention model based on WHO-endorsed diagnostic and treatment principles has taught teachers to screen all children sick at school using rapid point-of-care diagnostic testing and treat promptly with Artemesinin combination therapy; morbidity and absenteeism are significantly reduced. There is no consensus on the optimal intervention strategy; approaches will need to vary, but evidence of ‘what works and why’ exists to guide constructive implementation measures in each endemic region. Conclusion: Malaria exemplifies how health inequity negatively impacts a child’s health and ability to benefit from education, yet simple and effective school-based approaches exist that positively impact morbidity, provide access to WHO-endorsed diagnosis and treatment, are applicable worldwide and can increase the capacity of children to learn. Keywords: Absenteeism; Artemesinin Combination Therapy; Cognitive Impairment; Intermitient Protective Treatment; Rapid Diagnostic Testing; Seasonal Malaria Chemoprophylaxis; Teachers Received: 14 May 2020 Reviewed: 14 June 2020 Revised: 28 June 2020 Accepted: 28 June 2020 DOI: 10.35898/ghmj-41578

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Henderson, Susan J., Allison Belemvire, Roman Nelson, Anne Linn, Leah F. Moriarty, Emma Brofsky, Mamadou Diaw, and David Gittelman. "Advancing Malaria Prevention and Control in Africa Through the Peace Corps-US President’s Malaria Initiative Partnership." Global Advances in Health and Medicine 9 (January 2020): 216495612097610. http://dx.doi.org/10.1177/2164956120976107.

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Background Peace Corps is a US government volunteer service agency which provides trained Volunteers to assist host countries in addressing critical development challenges at the community level. The US President’s Malaria Initiative provides technical expertise and financial resources to reduce malaria morbidity and mortality in focus countries in sub-Saharan Africa. Objective We aim to describe the nature of the collaboration between Peace Corps and President’s Malaria Initiative (PMI) and highlight examples of the partnership in select countries. Methods We conducted an analysis of retrospective data obtained from Peace Corps and PMI for the years 2014–2019. Results Volunteers were able to learn about and work on malaria prevention and control with PMI in three key ways: a malaria-specific training program for staff and Volunteers; malaria-focused small grants; and extension of Volunteer assignments for a third year to support malaria projects. Successful Peace Corps projects supported by PMI, at the community level, were highlighted, with a focus on Rwanda, Benin, Zambia, Madagascar, and Senegal. In Fiscal Year 2019, 1408 Volunteers contributed to malaria prevention activities in 18 Peace Corps programs across Africa, of which 15 were PMI focus countries. While the majority of documented work by Volunteers has involved social and behavior change, there were many other ways to partner with PMI staff. Conclusion Each of the proven interventions that PMI supports for malaria prevention and control may have a role for Volunteer involvement. Combined with the technical expertise and the relationships that PMI staff have with national-level counterparts in PMI focus countries, the continued collaboration between Peace Corps and PMI can accelerate the fight against malaria.

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Steketee, Richard W., Misun Choi, Anne Linn, Lia Florey, Matthew Murphy, and Rajesh Panjabi. "World Malaria Day 2021: Commemorating 15 Years of Contribution by the United States President’s Malaria Initiative." American Journal of Tropical Medicine and Hygiene 104, no. 6 (June 2, 2021): 1955–59. http://dx.doi.org/10.4269/ajtmh.21-0432.

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Abstract.World Malaria Day 2021 coincides with the 15th anniversary of the United States President’s Malaria Initiative (PMI) and follows the first anniversary of the declaration of the coronavirus disease (COVID-19) pandemic. From 2006 to the present, the PMI has led to considerable country-managed progress in malaria prevention, care, and treatment in 24 of the highest-burden countries in sub-Saharan Africa and three countries in the Southeast Asia Greater Mekong subregion. Furthermore, it has contributed to a 29% reduction in malaria cases and a 60% reduction in the death rates in sub-Saharan Africa. In this context of progress, substantial heterogeneity persists within and between countries, such that malaria control programs can seek subnational elimination in some populations but others still experience substantial malaria disease and death. During the COVID-19 pandemic, most malaria programs have shown resilience in delivering prevention campaigns, but many experienced important disruptions in their care and treatment of malaria illness. Confronting the COVID-19 pandemic and building on the progress against malaria will require fortitude, including strengthening the quality and ensuring the safety and resiliency of the existing programs, extending services to those currently not reached, and supporting the people and partners closest to those in need.

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Cox, Sarah N., Kathryn E. Guidera, Molly J. Simon, Bareng Aletta Sanny Nonyane, William Brieger, Maria Susanna Bornman, and Philippus Stephanus Kruger. "Interactive Malaria Education Intervention and Its Effect on Community Participant Knowledge: The Malaria Awareness Program in Vhembe District, Limpopo, South Africa." International Quarterly of Community Health Education 38, no. 2 (December 28, 2017): 147–58. http://dx.doi.org/10.1177/0272684x17749573.

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Malaria is preventable and treatable, yet remains the most prevalent parasitic endemic disease in Africa. This article analyzes prospective observational data from the Malaria Awareness Program (MAP), an interactive malaria education initiative led by home-based care workers to improve participant knowledge of malaria as a precursor to increased uptake of malaria control interventions in the Vhembe District, Limpopo, South Africa. Between 2012 and 2016, 1,330 individuals participated in MAP. MAP's effectiveness was measured through pre- and post-participation surveys assessing knowledge in malaria transmission, symptoms, prevention, and treatment. The primary analysis assessed differences in knowledge between individuals who completed MAP ( n = 499) and individuals who did not complete MAP ( n = 399). The adjusted odds of correct malaria knowledge score versus partially correct or incorrect score among MAP completers was 3.3 and 2.8 times greater for transmission and prevention, respectively ( p values<.001). A subanalysis assessed knowledge improvement among participants who completed both pre- and post-MAP intervention surveys ( n = 266). There was a 21.4% and 10.5% increase in the proportion of participants who cited correct malaria transmission and prevention methods, respectively. Future research should assess behavioral changes toward malaria prevention and treatment as a result of an intervention and examine incidence changes in the region.

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Paul, Uttam Kumar, Pramukh Bhattacharyya, Rituparna Bhattacharyya, and Arup Bandyopadhyay. "Perceptions about malaria among the Bedia tribal people in Uttar-Dinajpur district of West Bengal, India." International Journal of Research in Medical Sciences 5, no. 8 (July 26, 2017): 3488. http://dx.doi.org/10.18203/2320-6012.ijrms20173547.

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Background: In a tropical country like India, malaria is a major vector borne disease ranging from highly urbanised to deep rural areas. Though lots of health activities are going on against it in urban areas it is difficult to penetrate the deep rural areas particularly the tribal based interior villages because of lack of initiative, huge illiteracy, gross poverty and language problems. Therefore, a study was ventured in a rural community in North Dinajpur district of West Bengal, India occupied by members of scheduled tribe called 'Bedia' whose mother tongue is a tribal language called 'Nagori'- to understand their knowledge and perceptions about malaria so that future actions can be taken to uplift their health status and awareness particularly in relation to malaria.Methods: Present study have conducted three focus group discussions (FGDs), one with male participants, one with females and the third one involving both the sexes. There were 9-11 participants per FGD and total of 28 participants were included in the study.Results: The transcripts were at first coded and then categories were framed. Total six categories, which are: perceived causes of malaria, perceived features of malaria, mode of spread, treatment, difficulties and modes of prevention. After the content analysis of the transcripts conclusion was drawn.Conclusions: Through our field work and the focus group discussions on the Bedia tribes we understood several misconceptions and lack of awareness of the tribal community about malaria. However, it was possible to create awareness and confidence among them that they could take all preventive measures and positive approaches towards malaria.

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Addo, Rebecca, Jane Hall, Stephen Goodall, and Marion Haas. "OP89 Using Economic Evidence To Set Priorities In Ghana: The Case Of Malaria." International Journal of Technology Assessment in Health Care 33, S1 (2017): 40–41. http://dx.doi.org/10.1017/s0266462317001635.

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INTRODUCTION:Malaria remains the number one cause of morbidity and mortality in Ghana. Since 1961, several malaria control strategies have been adopted, some of which were discontinued due to funding. In spite of the numerous malaria control strategies in place, its prevalence continues to rise. Priority setting using economic evidence has been proven to ensure efficient use of resources in a cost-effective manner (1). This study, therefore, sought to examine economic evaluation studies conducted on malaria in Ghana and their influence on malaria control policies.METHODS:A systematic search was conducted in databases including Medline and Embase to identify relevant Malaria economic evaluation studies conducted in Ghana up to December 2016. Malaria control policies formulated in Ghana over the years were also reviewed. The economic studies were examined alongside the policies to establish their influence on them.RESULTS:A total of eight studies were identified, all of which were conducted in response to a global directive on malaria control and funded by international agencies. All studies were cost-effective; five evaluating preventive measures and the remaining evaluating treatment. The studies used different methodological approaches, rendering the comparison between alternatives impossible.Most malaria control initiatives are funded by international agencies, hence its abandonment when funding ceases. Although the majority of economic studies addressed some of these policies, none of them directly influenced their adoption. These policies were rather influenced by global malaria control initiatives. Also, malaria chemoprophylaxis; demonstrated as cost-effective by three studies, is not on the Ghana malaria control policy (2,3).CONCLUSIONS:To ensure sustainability of malaria control strategies and subsequently reduce its prevalence, Ghana must invest financially into economic analysis for formulating and implementation of these policies. Also, the use of economic evidence by policy makers can be promoted, should researchers adopt a methodological guideline for its conduct that ensures comparability of results.

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Habonimana, Desire, Gideon Nimako, Jabulani Ncayiyana, Gabriel Ndayisaba, and Rohit Ramaswamy. "Improving long-lasting insecticidal nets use in Kayange community of north-western Burundi: a pilot study exploring the use of quality improvement methodologies in low-resource community settings." BMJ Open Quality 8, no. 3 (August 2019): e000540. http://dx.doi.org/10.1136/bmjoq-2018-000540.

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Quality improvement (QI) approaches have demonstrated a lot of promise in improving clinical care processes, both in high-resource and low-resource settings. However, most examples of QI initiatives in healthcare in low-income countries are clinic-based. The objective of this study was to demonstrate feasibility of applying QI methods in low-resource community settings by applying them to the problem of correct utilisation of long-lasting insecticidal nets (LLINs) in a rural community in Burundi. Correct utilisation of LLINs had been shown to be a cost-effective approach to malaria prevention. In Burundi, LLINs utilisation is low. The Model for Improvement, a well-known QI approach, was used to increase LLINs utilisation in a rural community in Burundi. In the baseline, LLINs ownership and weekly utilisation together with factors affecting LLINs non-use were documented for a period of 4 weeks before intervention. Improvement ideas were collaboratively developed by a quality improvement team (QIT) and tested using Plan-Do-Study-Act (PDSA) cycles. The first PDSA cycle consisted of the demonstration of how to mount LLINs, the second was an implementation of reminders done by household ‘watchdogs’, the third cycle consisted of conducting two community reminders every week and the last cycle was a combination of the last two PDSA cycles. The intervention lasted 4 weeks and data were collected weekly. LLINs utilisation was calculated each week and plotted on a run chart to demonstrate improvement trends. LLINs utilisation data were collected for another 3 weeks postintervention. Of 96 households, 83 (87%) households owned at least one LLIN. After intervention, the number of LLINs used increased from 32% to 75% (134% increase) and the number of persons (general population) sleeping under LLINs from 35% to 73% (108% increase). The number of children under 5 years sleeping under LLINs increased from 31% to 76% (145% increase) and the number of pregnant women who slept under LLINs from 43% to 73% (69% increase). Also, the averages of the number of nights in each week that the general population slept under LLINs increased from 2.13 to 5.11 (140% increase), children under 5 years from 1.68 to 4.78 (184% increase) and pregnant women from 1.56 to 4.47 (186% increase). Each of the 4 PDSA cycles led to a significant increase in outcome indicators and the trends appear to persist even after the implementation was complete. While it is impossible to draw generalisable conclusions from a small pilot study, QI approaches appear to be feasible to implement in low-resource community setting and have promise in producing results. More research at larger scale should be encouraged to validate our initial findings.

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Cheema, Harveer Singh, and Mitra Pal Singh. "Drug resistance in plasmodium, future malaria management strategies and importance of medicinal plants." Journal of Ayurvedic and Herbal Medicine 8, no. 2 (June 30, 2022): 107–12. http://dx.doi.org/10.31254/jahm.2022.8209.

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Malaria, the most common and destructive parasite disease in humans, take the lives of 1-2 million people every year. With the exception of artemisinin, resistance to most of the existing antimalarial agent classes has arisen, resulting in a new spike in malaria-related mortality, particularly in Africa. Southeast Asia has been a focal point for the development of drug resistance in Plasmodium falciparum since the late 1950s, when the first example of chloroquine resistance was discovered along the Thai-Combodian border. Despite the fact that the first incidence of quinine resistance had been documented far earlier in South America, the emergence of chloroquine resistance in Southeast Asia signalled the beginning of a new era in malaria history. Following the development of chloroquine resistance, Thailand and African countries shifted to a sulphadoxine-pyrimethamine combination as their first-line medication (SP). SP was subsequently superseded by mefloquine. Because of the quick development of resistance to this new medicine, artemisinin was introduced as a combination drug in the mid-1990s. Artimisinin resistance has been identified in several parts of the world, and if it continues, malaria control initiatives could be jeopardised, as there is now no substitute antimalarial medicine available. The purpose of this review is to summarise the current state of knowledge about drug-resistant malaria and to sketch out the evolving trends of resistance to antibiotics, such as its causal factors, current situation in various geographical areas, molecular markers, consequences for preventing the emergence and spread of drugresistant malaria, and the role of medicinal plants in the discovery of novel antimalarials.

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Szto, Courtney. "Saving Lives With Soccer and Shoelaces: The Hyperreality of Nike (RED)." Sociology of Sport Journal 30, no. 1 (March 2013): 41–56. http://dx.doi.org/10.1123/ssj.30.1.41.

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Product (RED) was launched in 2006 as an initiative to activate the corporate sector in the fight against HIV/AIDS in Africa. In 2009, Nike joined Product (RED)’s list of corporate partners with its “Lace Up, Save Lives” campaign. Nike (RED) directs 100% of its profits toward HIV/AIDS treatment and prevention through the Global Fund to Fight AIDS, Tuberculosis and Malaria and grassroots soccer programs in Africa. This case study questions the symbolism projected by Nike (RED) and its implications by applying Jean Baudrillard’s theories on consumption and hyperreality. The manner in which Nike (RED) represents Africa, HIV/AIDS, soccer, and sport for development and peace are all discussed as mediated simulations that position Nike as the producer of knowledge. Data analysis observes that Nike (RED) laces produce a hyperreality, whereby the origin of truth becomes, according to Baudrillard, indecipherable and soccer becomes more important than HIV/AIDS.

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FENWICK, A., J. P. WEBSTER, E. BOSQUE-OLIVA, L. BLAIR, F. M. FLEMING, Y. ZHANG, A. GARBA, et al. "The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002–2008." Parasitology 136, no. 13 (July 27, 2009): 1719–30. http://dx.doi.org/10.1017/s0031182009990400.

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SUMMARYSchistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available. In this article the following issues are discussed: the rationale, development and objectives of the Schistosomiasis Control Initiative (SCI)-supported programmes; the management approaches followed to achieve implementation by each country; mapping, monitoring and evaluation activities with quantifiable impact of control programmes; monitoring for any potential drug resistance; and finally exit strategies within each country. The results have demonstrated that morbidity due to schistosomiasis has been reduced by the control programmes. While challenges remain, the case for the control of schistosomiasis has been strengthened by research by SCI teams and the principle that a national programme using ‘preventive chemotherapy’ can be successfully implemented in sub-Saharan Africa, whenever the resources are available. SCI and partners are now actively striving to raise further funds to expand the coverage of integrated control of neglected tropical diseases (NTDs) in sub-Saharan Africa.

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Carr, Katherine Camacho, and Ruth White. "Focus Group and Health Teaching With Traditional Birth Attendants in Njeru, Uganda." International Journal of Childbirth 2, no. 1 (2012): 12–19. http://dx.doi.org/10.1891/2156-5287.2.1.12.

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The Safe Motherhood Initiative identifies the presence of skilled birth attendants at delivery as the single most critical intervention for safe motherhood. This article reports the findings from a focus group with traditional birth attendants (TBAs) conducted at the request of the Namwezi Health Center and the Njeru town council in Uganda as part of a community needs assessment. The purposes of the focus group included the identification of the problems encountered by the TBAs during antenatal, birth, and postpartum care for mother and newborn and how these problems were managed to assess the educational needs of the TBAs and plan for appropriate education and skills training for them. With a high prevalence of HIV, malaria, neonatal tetanus, and maternal morbidity and mortality in this region, TBAs were in need of education to promote hygiene, including hand washing, handling of bodily fluids, and disposal of the placenta; instruction on cord cutting, tying, and care; malaria prevention in pregnancy; and the management of common complications of childbirth and the newborn. “Too much bleeding” was identified as the primary maternal complication, and bleeding from the umbilical cord and preterm delivery were identified as the most common baby problems. Complication narratives from the TBAs indicated a need for continued training in the management of the common complications of childbirth and the neonatal period to improve maternal and newborn survival.

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Hermawan, Asep. "Utilisasi Kelambu Berinsektisida Pada Daerah Endemis Tinggi Malaria di Indonesia: Analisis Data Riset Kesehatan Dasar (Riskesdas) 2018." Buletin Penelitian Kesehatan 49, no. 1 (April 5, 2021): 9–20. http://dx.doi.org/10.22435/bpk.v49i1.3428.

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Malaria is still a global public health problem, especially in the tropical countries including Indonesia. The use of insecticide-treated bed nets (ITN’s) is an effective way to reduce the prevalence of malaria. However, the proportion of households that use ITN’s in low to high malaria edemic areas in Indonesia is still low (15.8%). The purpose of the analysis is to asses the determinants affecting the use of ITN’s in high endemic areas in Indonesia in 2018. The analysis uses the Basic Health Research (Riskesdas) 2018 data whose design is a cross-sectional study. The population is residents in 28 high malaria endemic districts/ cities with the number of samples interviewed were 33,001 people. The dependent variable was the habit of using ITN’s, while the independent variable is sociodemographic factors (relationship with household head, age group, education , occupations, and residential/ urban or rural areas) and the other ways to prevent mosquito bites. Data were analyzed using logistic regression test. The logistic regression analysis showed that the population with the characteristics of living in urban areas (aOR 2.55, 95% CI 2.38-2.74), parents (aOR 1.29, 95% CI 1.02-1.64), farmers (aOR 1.69, 95% CI 1.49-1.92) and completed Junior High (aOR 1.61, 95% CI 1.35-1.91), have the opportunity to use insecticide-treated bed nets, while the method of preventing mosquito bites others, most of them are protective of this habit. A new canal initiative is needed to increase people's knowledge about the importance of using insecticide-treated bed nets. Keyword: insecticide-treated bed nets, high malaria endemic areas Abstrak Malaria masih menjadi masalah kesehatan masyarakat global, terutama di daerah tropis termasuk Indonesia. Penggunaan kelambu berinsektisida merupakan cara efektif untuk mengurangi prevalensi malaria. Namun, proporsi rumah tangga yang menggunakan kelambu berinsektisida di daerah edemis rendah sampai tinggi di Indonesia masih rendah (15,8%). Tujuan analisis ini adalah untuk mengetahui determinan yang berpengaruh terhadap penggunaan kelambu berinsektisida di daerah endemis tinggi malaria di Indonesia pada 2018. Analisis ini menggunakan data Riset Kesehatan Dasar (Riskesdas) 2018 yang desainnya adalah studi potong lintang. Populasi pada studi ini adalah penduduk di 28 kabupaten/ kota dengan katagori endemis malaria tinggi dengan jumlah sampel yang diwawancara sebanyak 33.001 orang. Variabel dependen adalah kebiasaan penggunaan kelambu berinsektisida, sedangkan variabel independen adalah faktor sosiodemografi (hubungan dengan KRT, kelompok usia, tingkat pendidikan, jenis pekerjaan, dan wilayah tempat tinggal/ perkotaan atau pedesaan) dan cara pencegahan gigitan nyamuk. Data dianalisis menggunakan uji logistic regression. Hasil analisis logistic regression menunjukkan bahwa penduduk dengam dengan karakteristik tinggal di perkotaan (aOR 2,55, 95%CI2,38-2,74), orang tua (aOR1,29, 95%CI 1,02-1,64), petani (aOR1,69, 95%CI 1,49-1,92) dan tamat SLTP/MTS (aOR 1,61, 95%CI 1,35-1,91), berpeluang menggunakan kelambua berinsektisida, sedangkan cara pencegahan gigitan nyamuk lainnya, sebagian besar bersifat protektif terhadap kebiasaan ini. Perlu inisiatif kanal baru untuk meningkatkan pengetahuan penduduk tentang pentingnya utilisasi kelambu berinsektisida. Kata kunci: kelambu berinsektisida, daerah endemis malaria tinggi

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Dent, Jennifer, Katy Graef, Joseph Hargan-Calvopina, Analise LeJeune, Daniel Seymour, and Callie Weber. "African Access Initiative: A holistic, multi-sector approach to mitigating Africa’s cancer crisis." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): e19015-e19015. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e19015.

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e19015 Background: In a dramatic reversal of trends, cancer now kills more Africans each year than malaria. Should trends continue, Africa’s cancer burden is projected to double to over 2 million new cases and over 1.4 million deaths annually by 2040. Africa’s burgeoning cancer crisis is attributable to many factors, including insufficient preventive, diagnostic, and treatment services; inadequate clinical infrastructure; and shortages of trained healthcare personnel. Methods: BVGH launched the African Access Initiative (AAI) in 2017 to address Africa’s cancer crisis. Utilizing a holistic approach that establishes sustainable access to cancer medicines, strengthens healthcare infrastructure, and builds clinical oncology capacity, BVGH is eliminating or minimizing many of the challenges African clinicians face when diagnosing and treating cancer patients. Complementing its innovative approach, BVGH engages experts across sectors to build capacity and execute programs. African ministries of health and cancer leaders are engaged to ensure AAI activities are driven by their priorities and needs. AAI is not a donation-based program. Pharmaceutical companies are engaged to ensure access to quality, lifesaving cancer drugs in a sustainable and patient-focused manner. International cancer experts are enlisted in capacity building programs that directly align with their expertise and meet their global oncology goals. Results: BVGH is applying its multi-faceted, multi-sector model in Cameroon, Côte d'Ivoire, Kenya, Nigeria, Rwanda, and Senegal. In partnership with Nigeria’s Ministry of Health, BVGH held a cancer stakeholder meeting to define the country’s priority cancers, drugs, and treatment regimens. Following the meeting, BVGH launched an RFP to pharmaceutical companies and subsequently developed reports that forecast full treatment costs based on the companies’ offerings of deeply-discounted drug prices. While simultaneously coordinating drug access, BVGH began planning training refreshers to ensure recipient Nigerian hospitals were ready to use the prioritized cancer drugs successfully. Beyond Nigeria, BVGH has improved Rwanda’s ability to diagnose cancer efficiently; improved Côte d'Ivoire’s multidisciplinary approach to diagnosing and treating cancer patients; and helped Kenya refine its cancer patient sample referral mechanisms. Conclusions: This presentation will describe BVGH’s holistic, multi-sector approach to addressing Africa’s cancer crisis, including partners, activities, lessons learned, and best practices.

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Khan, Rahmat Ali, Syed Munib, Mohammad Shahzad, Mufti Baleegh, Liaqat Ali, Jehan Zeb, Mohammad Shahid, and Mohammad Asif. "Outcome of acute kidney injuries following chronic kidney disease: A systematic review in Nawaz Sharif kidney hospital Swat." American Journal of Health, Medicine and Nursing Practice 7, no. 1 (January 14, 2022): 11–17. http://dx.doi.org/10.47672/ajhmn.905.

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Background: Acute kidney injury may increase the risk for CKD and end-stage renal disease. In an attempt to summarize the literature and provide more compelling evidence, we conducted a systematic review comparing the risk for CKD (chronic kidney disease), AKI (Acute kidney injury), Acute gastroententeritis, postnatal AKI, Acute MI (myocardial infarction), AKI 2ndry to chemotherapy, AKI 2ndry to abstractive Nephropathy, AKI 2ndry to sepsis, AKI 2ndry to Drugs (NSAIDS and ARBS), AKI 2ndry to AGN (acute Glomerulonephritis), AKI 2ndry to Rhabdomyolysis, and lest AKI 2ndry to Malaria, death in patients with AKI,HD, CKD (chronic kidney disease). There have been several important developments in the literature recently regarding the association between acute kidney injury (AKI) and chronic kidney disease (CKD). First, when the National Kidney Foundation promulgated their highly influential Kidney Disease Outcomes Quality Initiative CKD guidelines in 2002, six chapters were devoted to the complications associated with decreased glomerular filtration rate (GFR) including hypertension, anemia, nutritional status, bone disease/disorders of calcium, and phosphorus metabolism, neuropathy Objective: To study the outcomecute kidney injury following chronic kidney disease; systematic review. Methods: This was a prospective observational study from January 2018 to December 2020. Patients visiting department of Nephrology Nawaz Sharif Kidney center Swat, number of patients included study 351. All ages and both sexes were considered. Patients treated elsewhere or who has undergone in this study. Complete medical history, detailed examination like age, sex, diagnosis, and outcome, of AKI, examination under microscope and investigations, and necessary blood investigations were carried out. Results: Three fifty one (351) patients were included in this study. The age distribution showed (75%) patients between 40-95 years and 25(25%) between 32-39 years. Mean age was 43 years with Standard Deviation of ± 35.66. Among 351 patients 162 (45%) patients were male and 189 (55%) patients were female. Duration of symptoms in 24(17%) was <4 months and 112(75%) had >4 months, with mean of 4 months and SD ± 2.315. Total 351 participants AKI 45(12%) postnatal AKI 33(9%) Acute MI 18(6%) AKI 2ndry chemotherapy 15(5.72%) AKI 2ndry to abstractive Nephropathy 55 (14%) AKI 2ndry to sepsis 63 (17%) AKI 2ndry to Drugs (NSAIDS and ARBS) 54 (14%) CKD (chronic kidney disease) 48 (15%) AKI 2ndry to Rhabdomylysis 18(6%) Conclusions: The study concludes that the acute kidney injury following CKD systematic reviewing among patients presenting with AKI,CHD ,AKI sepsis, ,AKI Drugs(NSIAD) in local hospital settings This can be reduced with proper health education in general public regarding prevention of the disease and hence its complications.

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Yang, Li. "Acute Kidney Injury in Asia." Kidney Diseases 2, no. 3 (2016): 95–102. http://dx.doi.org/10.1159/000441887.

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Background: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. Summary: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries. Epidemiological studies have revealed the huge medical and economic burden of AKI in Eastern Asian countries, whereas the true epidemiological picture of AKI in the tropical areas is still not well understood. In high-income Asian regions, the presentation of AKI resembles that in other developed countries in Europe and North America. In low-income regions and tropical areas, infections, environmental toxins, and obstetric complications remain the major culprits in most cases of AKI. Preventive opportunities are missed because of failure to recognize the risk factors and early signs of AKI. Patients often present late for treatment or are recognized late by physicians, which leads to more severe kidney injury, multiorgan involvement, and increased mortality. There is significant undertreatment of AKI in many regions, and medical resources for renal replacement therapy are not universally available. Key Messages: More efforts should be made to increase public awareness, establish preventive approaches in communities, educate health-care practitioner entities to achieve better recognition, and form specialist renal teams to improve the treatment of AKI. The choice of renal replacement therapy should fit patients' needs, and peritoneal dialysis can be practiced more frequently in the treatment of AKI patients. Facts from East and West: (1) More than 90% of the patients recruited in AKI studies using KDIGO-equivalent criteria originate from North America, Europe, or Oceania, although these regions represent less than a fifth of the global population. However, the pooled incidence of AKI in hospitalized patients reaches 20% globally with moderate variance between regions. (2) The lower incidence rates observed in Asian countries (except Japan) may be due to a poorer recognition rate, for instance because of less systematically performed serum creatinine tests. (3) AKI patients in South and Southeastern Asia are younger than in East Asia and Western countries and present with fewer comorbidities. (4) Asian countries (and to a certain extent Latin America) face specific challenges that lead to AKI: nephrotoxicity of traditional herbal and less strictly regulated nonprescription medicines, environmental toxins (snake, bee, and wasp venoms), and tropical infectious diseases (malaria and leptospirosis). A higher incidence and less efficient management of natural disasters (particularly earthquakes) are also causes of AKI that Western countries are less likely to encounter. (5) The incidence of obstetric AKI decreased globally together with an improvement in socioeconomic levels particularly in China and India in the last decades. However, antenatal care and abortion management must be improved to reduce AKI in women, particularly in rural areas. (6) Earlier nephrology referral and better access to peritoneal dialysis should improve the outcome of AKI patients.

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Munzhedzi, Mukhethwa, Elizabeth T. Rogawski McQuade, Jennifer L. Guler, Piper E. Shifflett, Sara Krivacsy, Rebecca Dillingham, and Pascal O. Bessong. "Community knowledge, attitudes and practices towards malaria in Ha-Lambani, Limpopo Province, South Africa: a cross-sectional household survey." Malaria Journal 20, no. 1 (April 17, 2021). http://dx.doi.org/10.1186/s12936-021-03724-z.

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Abstract Background Malaria remains a global health concern and is endemic in Limpopo, Mpumalanga and KwaZulu Natal Provinces of South Africa, which aims to eliminate malaria by 2025. Community engagement plays a significant role in improving the acceptability and effectiveness of programmes aimed at reducing malaria transmission. The success of such intervention efforts depends on the knowledge, attitudes and practices (KAP) of the community, and understanding the KAP of community residents may support malaria control efforts in the locality. In this context, a cross-sectional household survey to assess community KAP on malaria transmission and prevention in the Ha-Lambani village, Vhembe District, Limpopo Province was conducted. Methods Data were collected between November 2018 and May 2019 by questionnaire of 261 consenting adults (213 females and 48 males, aged between 18 and 95 years) selected from different households. Also, a focus group discussion among 13 randomly selected participants was conducted. Pearson’s Chi Square test was used to determine statistical differences by village. Results Study participants (100%, 261/261) were aware of the presence of malaria in their community and 95% associated it with mosquito bites. The local health clinic was the most prominent source of malaria information (85%). Only 22% correctly identified headache, chills and fever as the three most common symptoms of malaria. The majority of participants (98%) knew that effective medication for malaria is available and had a positive treatment-seeking behaviour. Knowledge of malaria prevention measures was high (82%); contrarily, 97% of respondents did not sleep under a bed net the previous night. The focus group data concurred with these results and also revealed that poor bed net use resulted from lack of access to bed nets because community residents could not afford them. Conclusions The study demonstrates that participants have appropriate knowledge about malaria transmission and a positive treatment-seeking behaviour. However, economic barriers are responsible for the inadequate use of bed nets. Therefore, distribution of bed nets to the community should be considered to improve practice of malaria prevention measures. Furthermore, knowledge of signs and symptoms and appropriate malaria treatment was limited, and initiatives to improve awareness on these topics should be continued.

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Cheng, Breagh, Saw Nay Htoo, Naw Pue Pue Mhote, and Colleen M. Davison. "A systematic review of factors influencing participation in two types of malaria prevention intervention in Southeast Asia." Malaria Journal 20, no. 1 (April 20, 2021). http://dx.doi.org/10.1186/s12936-021-03733-y.

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Abstract Background Multi-pronged malaria elimination strategies are increasingly being considered for accelerating efforts against malaria transmission in Southeast Asia. Two malaria prevention interventions used in in the region are insecticide-treated bed-nets (ITNs) and mass drug administration (MDA). Universal access to ITNs is recommended and high population coverage (e.g. above 80%) is needed during MDA initiatives to maximize the impact of these interventions. However, variability in ITN use and individual MDA participation exists. This systematic review aims to provide a summary and overview of literature discussing factors influencing uptake of these two malaria control strategies in Southeast Asian countries. Methods A search of OVID Embase, OVID MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, OpenGrey, ProQuest, and Google Scholar was undertaken in February 2020. English-language publications with any study design using data from any of the ten member countries of the Association of Southeast Asian Nations were eligible for inclusion. In addition, reference lists of identified articles were manually searched. Websites for relevant international agencies were also searched to identify related grey literature. Results The review identified thirty publications that met the inclusion and exclusion criteria. Most discussed ITN use (n = 18) and were relevant to populations in Myanmar (n = 14). All MDA studies were published after 2016, whereas included ITN studies spanned from 1998 to 2020. Seven main themes emerged across the studies. Knowledge of malaria and attitudes towards ITNs were emphasized as key factors associated with ITN use. For MDA participation, key factors included the importance of positive attitudes towards the program, the influence of indirect costs and incentives, and the tendency for group decision-making. Conclusions As countries in Southeast Asia continue to work towards becoming malaria-free by 2030, the knowledge and attitudes of local population sub-groups should be assessed and incorporated into the planning and implementation of malaria prevention activities. The role of incentives and group decision making should also be considered particularly as they relate to MDA. There is need for ongoing involvement of health educators, the continuation of implementation research and the prioritization of community engagement efforts alongside malaria interventions in the region.

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Sutcliffe, James F., and Shaoman Yin. "Effects of indoor air movement and ambient temperature on mosquito (Anopheles gambiae) behaviour around bed nets: implications for malaria prevention initiatives." Malaria Journal 20, no. 1 (October 30, 2021). http://dx.doi.org/10.1186/s12936-021-03957-y.

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Abstract Background Until recently, relatively little research has been done on how mosquitoes behave around the occupied bed net in the indoor environment. This has been partly remedied in the last few years through laboratory and field studies, most of these using video methods and mosquito flight tracking. Despite these recent advances, understanding of the mosquito-bed net environment system, and the principles that underlie mosquito behaviour within it, is limited. This project aimed to further understand this system by studying the effects of gently moving air (such as might be introduced through room design to make the indoor environment more comfortable and conducive to ITN use) and warmer vs. cooler ambient conditions on mosquito activity around ITNs and other bed nets. Methods The activity of colonized female Anopheles gambiae around an occupied untreated bed net set up in a mosquito-proof tent in a large laboratory space was recorded under different ambient conditions using a laser detection-video recording system. Conditions tested were ‘cool’ (23–25 °C) and ‘warm’ (27–30 °C) air temperatures and the presence or absence of a cross-flow produced by a small central processing unit (CPU) fan pointed at the side of the net so that it produced a ‘low-’ or ‘high-’ speed cross-draught (approx. 0.1 and 0.4 m/s, respectively). Near-net activity in recordings was measured using video image analysis. Results In cool, still air conditions, more than 80% of near-net activity by An. gambiae occurred on the net roof. Introduction of the low-speed or high-speed cross-draught resulted in an almost total drop off in roof activity within 1 to 2 min and, in the case of the high-speed cross-draught, a complementary increase in activity on the net side. In warm, still conditions, near-net activity appeared to be lower overall than in cool, still air conditions and to be relatively less focussed on the roof. Introduction of the high-speed cross-draught in warm conditions resulted in a decrease in roof activity and increase in side activity though neither effect was statistically significant. Conclusions Results are interpreted in terms of the flow of the stimulatory odour plume produced by the net occupant which, consistent with established principles of fluid dynamics, appears to rise quickly and remain more intact above the net occupant in cool, still air than in warm, still air. Cross-draught effects are ascribed to the changes they cause in the flow of the host odour plume as opposed to mosquito flight directly. The implications of these results for house designs that promote indoor air movement, on bed net design, and on other vector control measures are discussed. How mosquitoes approach a net is influenced both by indoor temperature and ventilation and their interaction. This system is in need of further study.

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Ng’ang’a, Peter N., Polycarp Aduogo, and Clifford M. Mutero. "Strengthening community and stakeholder participation in the implementation of integrated vector management for malaria control in western Kenya: a case study." Malaria Journal 20, no. 1 (March 19, 2021). http://dx.doi.org/10.1186/s12936-021-03692-4.

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Abstract Background Integrated vector management (IVM) is defined as a rational decision-making process for the optimal use of resources for vector control. The IVM approach is based on the premise that effective control of vectors and the diseases they transmit is not the sole preserve of the health sector. It requires the collaboration and participation of communities and other stakeholders in public and private sectors. Community participation is key to the success of IVM implementation at the local level. Case description The study was conducted in Nyabondo, a rural area of Kenya where malaria is endemic. The objective of the project was to promote adoption and sustainability of IVM and scale up IVM-related activities as well as increase community participation and partnership in malaria control through outreach, capacity-building and collaboration with other stakeholders in the area. Collaboration was pursued through forging partnership with various government departments and ministries, particularly the fisheries department, ministry of education, ministry of health, forestry department and the social services. In total, 33 community-based organizations working within the area were identified and their role documented. Through distribution of information, education and communication (IEC) materials alone, the project was able to reach 10,670 people using various social mobilization methods, such as convening of sensitization meetings—dubbed 'mosquito days'—mainly spearheaded by primary school pupils. A total of 23 local primary schools participated in creating awareness on malaria prevention and control during the project phase. The collaboration with other departments like fisheries led to stocking of more than 20 fishponds with a total of 18,000 fingerlings in the years 2017 and 2018. Fish ponds provided an opportunity for income generation to the community. In partnership with the county government health department, the project was able to re-train 40 CHVs on IVM and malaria case management in the area. Additionally, 40 fish farmers were re-trained on fish farming as part of income generating activity (IGA) while 10 CBOs made up of 509 members received both eucalyptus and Ocimum kilimandscharicum seedlings that were distributed to four CBOs composed of 152 members. Four primary schools made up of 113 health club members also received eucalyptus seedlings as part of IGA in addition to fish farming. In total, around 20,000 eucalyptus seedlings were distributed to the community as part of IGA initiatives. By the end of 2018, the project was able to reach 25,322 people in the community during its two-year advocacy and social mobilization initiatives. Conclusion Through advocacy and social mobilization, the IVM strategy improved inter-sectoral collaboration, enhanced capacity building and community participation. However, more IVM related activities are needed to effectively mobilize available resources and increase community participation in malaria control.

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Feng, Ning, Jeffrey Karl Edwards, Philip Odhiambo Owiti, Guo-Min Zhang, Zulma Vanessa Rueda Vallejo, Katrina Hann, Shui-Sen Zhou, et al. "Operational research capacity building through the Structured Operational Research Training Initiative (SORT-IT) in China: implementation, outcomes and challenges." Infectious Diseases of Poverty 10, no. 1 (June 1, 2021). http://dx.doi.org/10.1186/s40249-021-00865-w.

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Abstract Background Chinese Center for Disease Control and Prevention (China CDC) introduced the Structured Operational Research Training Initiative (SORT IT) into China to build a special capacity and equip public health professionals with an effective tool to support developing countries in strengthening their operational research. The paper aims to investigate and analyze the implementation, outcomes and challenges of the first cycle of SORT IT in China. Main text As a result of the successful implementation, SORT IT China, Cycle 1 has demonstrated fruitful outputs as exemplified by the 18-month follow-up to the post-training initiatives of the twelve participants, who all achieved the four milestones required by SORT IT. Eleven of twelve (92%) manuscripts generated that focused on the prevention and control of malaria, influenza, HIV/AIDS, hepatitis B, schistosomiasis, tuberculosis and Japanese encephalitis were published by peer-reviewed international journals with the impact factor ranging from 2.6 to 4.8. The most up-to-date citation count on February 19, 2021 was 53 times out of which 31 times were cited by Science Citation Index papers with 94.827 impact factor in total. Six senior professionals from China CDC also facilitated the whole SORT IT training scheme as co-mentors under the guidance of SORT IT mentors. The twelve participants who gained familiarity with the SORT IT courses and training principles are likely become potential mentors for future SORT IT, but they as the non-first language speakers/users of English also faced the challenge in thoroughly understanding the modules delivered in English and writing English academically to draft the manuscripts. Conclusion The outcomes from the first cycle of SORT IT in China have led to studies contributing to narrowing the knowledge gap among numerous public health challenges nationally and internationally. It is believed the researchers who participated will continue to apply the skills learned within their domain and help build the training capacity for future operational research courses both in China and in developing countries with similar needs. Graphic Abstract

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Diallo, Ousmane Oumou, Ifeoma D. Ozodiegwu, Alioune Camara, Beatriz Galatas, and Jaline Gerardin. "Factors associated with the ownership and use of insecticide-treated nets in Guinea: an analysis of the 2018 Demographic and Health Survey." Malaria Journal 22, no. 1 (January 26, 2023). http://dx.doi.org/10.1186/s12936-023-04463-z.

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Abstract Background Malaria is a leading cause of outpatient visits and deaths among children in Guinea. Despite several mass distribution campaigns of insecticide-treated nets (ITNs) in Guinea, ITN ownership and use remain low. Identifying the underlying factors affecting household ITN ownership and ITN usage among those with access will allow the Guinea National Malaria Control Programme to develop targeted initiatives to improve bed net ownership and usage. Methods To understand national and regional drivers of ITN ownership and use, multivariable binary logistic regression models were applied to data from the 2018 Demographic and Health Survey to identify risk factors of household ITN ownership and risk factors of ITN use among individuals with access. Akaike Information Criterion (AIC) was used for model parameter selection. Odds ratios were estimated with corresponding 95% confidence intervals. Results The proportion of households in Guinea with at least one ITN was 44%, ranging from a low of 25% in Conakry to a high of 54% in Labé. Use of ITNs among those with access was 66.1% nationally, ranging from 35.2% in Labé to 89.7% in N'zérékoré. Risk factors for household ITN ownership were household size, marital status of the household head, education level of the household head, and region. For ITN use among those with access, risk factors were age, wealth quintile, marital status, and region. In the seven regions of Guinea and capital of Conakry, risk factors for household ITN ownership were household size in Boké, Faranah, and Kankan; education level of the household head in Boké, Faranah, and N’zérékoré; age of the household head in Conakry and Labé; children under five in the household in Kankan; and wealth quintile in Mamou. For ITN use among those with access, risk factors were marital status in Conakry, Faranah, Kindia, Labé, Mamou, and N’zérékoré; place of residence in Labé; children under five in the household in Labé; wealth quintile in Mamou; and age in Faranah and N’zérékoré. Conclusions This analysis identified national and region-specific factors that affect ownership and use among those with access in Guinea. Future ITN and social-behavioural change campaigns in Guinea may particularly want to target larger households, households without children, and areas with lower perceived risk of malaria if universal coverage and usage are to be achieved for optimal malaria prevention.

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Hannah, Haylea A., Audrey Brezak, Audrey Hu, Simbarashe Chiwanda, Maayan S. Simckes, Debra Revere, Gerald Shambria, et al. "Field-based Evaluation of Malaria Outbreak Detection & Response, Mudzi and Goromonzi." Online Journal of Public Health Informatics 11, no. 1 (May 30, 2019). http://dx.doi.org/10.5210/ojphi.v11i1.9835.

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ObjectiveTo conduct a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.IntroductionInfectious disease outbreaks, such as the Ebola outbreak in West Africa, highlight the need for surveillance systems to quickly detect outbreaks and provide data to prevent future pandemics.1–3 The World Health Organization (WHO) developed the Joint External Evaluation (JEE) tool to conduct country-level assessments of surveillance capacity.4 However, considering that outbreaks begin and are first detected at the local level, national-level evaluations may fail to identify capacity improvements for outbreak detection. The gaps in local surveillance system processes illuminate a need for investment in on-the-ground surveillance improvements that may be lower cost than traditional surveillance improvement initiatives, such as enhanced training or strengthening data transfer mechanisms before building new laboratory facilities.5 To explore this premise, we developed a methodology for assessing surveillance systems with special attention to the local level and applied this methodology to the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.MethodsIn a collaboration between the Zimbabwe Field Epidemiology Training Program and the University of Washington, an interview guide was developed based on the Centers for Disease Control and Prevention’s (CDC) Updated Guidelines for Surveillance Evaluations and WHO’s JEE tool.4,6 The guide was tailored in country with input from key stakeholders from the Ministry of Health and Child Care and National Malaria Control Program. Interview guides included questions focused on outbreak detection, response, and control procedures, and surveillance system attributes (preparedness, data quality, timeliness, stability) and functionality (usefulness). The team utilized the tool to evaluate surveillance capacity in eleven clinics across two malaria-burdened districts of Mashonaland East, Mudzi and Goromonzi. Twenty-one interviews were conducted with key informants from the provincial (n=2), district (n=7), and clinic (n=12) levels. Main themes present in interviews were captured using standard qualitative data analysis methods.ResultsThe majority of key informants interviewed were nurses, nurse aids, or nurse officers (57%, 12/21). This evaluation identified clinic-level surveillance system barriers that may be driving malaria outbreak detection and response challenges. Clinics reported little opportunity for cross-training of staff, with 81% (17/21) mentioning that additional staff training support was needed. Only one clinic (10%, 1/11) had malaria emergency preparedness and response guidelines present, a resource recommended by the National Malaria Control Program for all clinics encountering malaria cases. A third of interviewees (33%, 7/21) reported having a standard protocol for validating malaria case data and 29% (6/21) reported challenges with data quality and validation, such as a duplication of case counts. While the surveillance system at all levels detects malaria outbreaks, clinics experience barriers to timely and reliable reporting of cases and outbreaks to the district level. Stability of resources, including transportation and staff capacity, presented barriers, with half (48%, 10/21) of interviewees reporting that their clinics were under-staffed. Additionally, the assessment revealed that the electronic case reporting system (a WHO-developed SMS application, Frontline) that is used to report malaria cases to the district was not functioning in either district, which was unknown at the provincial and national levels. To detect malaria outbreaks, clinics and districts use graphs showing weekly malaria case counts against threshold limit values (TLVs) based on historic five-year malaria case count averages; however, because TLVs are based on 5-year historic data, they are only relevant for clinics that have been in existence for at least five years. Only 30% (3/10) of interviewees asked about outbreak detection graphs reported that TLV graphs were up-to-date.ConclusionsThis surveillance assessment revealed several barriers to system performance at the clinic-level, including challenges with staff cross-training, data quality of malaria case counts, timeliness of updating outbreak detection graphs, stability of transportation, prevention, treatment, and human resources, and usefulness of TLVs for outbreak detection among new clinics. Strengthening these system barriers may improve staff readiness to detect and respond to malaria outbreaks, resulting in timelier outbreak response and decreased malaria mortality. This evaluation has some limitations. We interviewed key informants from a non-random sample covering 30% of all clinics in Mudzi and Goromonzi districts; thus, barriers identified may not be representative of all clinics in these districts. Secondly, evaluators did not interview individuals who may have been involved in outbreak detection and response but were not present at the clinic when interviews were conducted. Lastly, many of the evaluation indicators were based on self-reported information from key informants. Despite these limitations, convenience sampling is common to public health practice, and we reached a saturation of key informant themes with the 21 key informants included in this evaluation.7 By designing evaluation tools that focus on local-level knowledge and priorities, our assessment approach provides a framework for identifying and addressing gaps that may be overlooked when utilizing multi-national tools that evaluate surveillance capacity and improvement priorities at the national level.References1. World Health Organzation. International Health Regulations - Third Edition. Vol Third. Geneva, Switzerland; 2005. doi:10.1017/CBO9781107415324.004.2. Global Health Security Agenda. Implementing the Global Health Security Agenda: Progress and Impact from U.S. Government Investments.; 2018. https://www.ghsagenda.org/docs/default-source/default-document-library/global-health-security-agenda-2017-progress-and-impact-from-u-s-investments.pdf?sfvrsn=4.3. McNamara LA, Schafer IJ, Nolen LD, et al. Ebola Surveillance — Guinea, Liberia, and Sierra Leone. MMWR Suppl. 2016;65(3):35-43. doi:10.15585/mmwr.su6503a6.4. World Health Organization (WHO). Joint External Evaluation Tool: International Health Regulations (2005). Geneva; 2016. http://apps.who.int/iris/bitstream/10665/204368/1/9789241510172_eng.pdf.5. Groseclose SL, Buckeridge DL. Public Health Surveillance Systems: Recent Advances in Their Use and Evaluation. Annu Rev Public Health. 2017;38(1):57-79. doi:10.1146/annurev-publhealth-031816-044348.6. Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. MWWR. 2001;50(No. RR-13).7. Dworkin SL. Sample size policy for qualitative studies using in-depth interviews. Arch Sex Behav. 2012;41(6):1319-1320. doi:10.1007/s10508-012-0016-6.

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Keats, Emily C., Richard B. Kajjura, Anushka Ataullahjan, Muhammad Islam, Breagh Cheng, Ahalya Somaskandan, Kimberly D. Charbonneau, et al. "Malaria reduction drives childhood stunting decline in Uganda: a mixed-methods country case study." American Journal of Clinical Nutrition, February 14, 2022. http://dx.doi.org/10.1093/ajcn/nqac038.

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ABSTRACT Background Uganda has achieved a considerable reduction in childhood stunting over the past 2 decades, although accelerated action will be needed to achieve 2030 targets. Objectives This study assessed the national, community, household, and individual-level drivers of stunting decline since 2000, along with direct and indirect nutrition policies and programs that have contributed to nutrition change in Uganda. Methods This mixed-methods study used 4 different approaches to determine the drivers of stunting change over time: 1) a scoping literature review; 2) quantitative data analyses, including Oaxaca–Blinder decomposition and difference-in-difference multivariable hierarchical modeling; 3) national- and community-level qualitative data collection and analysis; and 4) analysis of key direct and indirect nutrition policies, programs, and initiatives. Results Stunting prevalence declined by 14% points from 2000 to 2016, although geographical, wealth, urban/rural, and education-based inequalities persist. Child growth curves demonstrated substantial improvements in child height-for-age z-scores (HAZs) at birth, reflecting improved maternal nutrition and intrauterine growth. The decomposition analysis explained 82% of HAZ change, with increased coverage of insecticide-treated mosquito nets (ITNs; 35%), better maternal nutrition (19%), improved maternal education (14%), and improved maternal and newborn healthcare (11%) being the most critical factors. The qualitative analysis supported these findings, and also pointed to wealth, women's empowerment, cultural norms, water and sanitation, dietary intake/diversity, and reduced childhood illness as important. The 2011 Uganda Nutrition Action Plan was an essential multisectoral strategy that shifted nutrition out of health and mainstreamed it across related sectors. Conclusions Uganda's success in stunting reduction was multifactorial, but driven largely through indirect nutrition strategies delivered outside of health. To further improve stunting, it will be critical to prioritize malaria-control strategies, including ITN distribution campaigns and prevention/treatment approaches for mothers and children, and deliberately target the poor, least educated, and rural populations along with high-burden districts.

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Rivera, MD, PhD, Pilarita T. "Editorial." Acta Medica Philippina 53, no. 4 (August 30, 2019). http://dx.doi.org/10.47895/amp.v53i4.55.

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The epidemiology of vector mosquito-borne diseases such as malaria and dengue defines the interface between mosquito to human, and that between human to mosquito, as well as multiple economic, social, cultural, political and behavioral factors that expose humans to the mosquito bite, resulting in infection. Environmental factors such as suitable mosquito breeding sites, tropical climate and topography, increase mosquito density and man biting behavior resulting in infection and transmission. Different interventions to kill vector mosquitoes (adulticides and larvicides), prevent the mosquito bite (insecticide treated nets, curtains, repellents), diagnosis (rapid tests) and treatment (ACTs for malaria), have been implemented, and have been shown to reduce morbidity and mortality particularly for malaria. But can disease control be realized and sustained? Can disease elimination and prevention of re-introduction be achieved? A better understanding of the epidemiology and control of vector-borne diseases clearly shows that the responsibility is not with key affected populations and the health sector only, but with all those sectors and stakeholders that impact on the disease, be it at the local and national levels. This is the basis of creating and implementing intersectoral collaborations (ISCs) for vector-borne diseases. The article was able to draw together and analyzed multi-country experiences on ISCs for malaria and dengue. The ISC structure, goals, inputs and outputs as well as outcomes of existing models were described. Gaps in planning and implementation were noted, and recommendations were added. The resulting data can be used to develop an enhanced ISC framework for more effective implementation and success. The Philippines had quite a number of malaria control initiatives built on partnerships with bilateral agencies- USAID, USNAMRU, WHO, JICA, AusAID, NGOs, private corporations, religious organizations, military, and that have contributed in disease control.1 Notable are the Palawan and Agusan del Sur experiences. In 1999, the Palawan provincial government and Pilipinas Shell Foundation, as its corporate social responsibility, established Kilusan Ligtas Malaria to control malaria in the island.2,3 The program’s multi-sectoral and social mobilization strategies that have been adopted by Global Fund have resulted in impressive decline of malaria cases and deaths, even to this time. High social capital may ensure the sustainability of these strategies.4,5 In 1995, Agusan del Sur, another malarious province, implemented the project “Implementation and Evaluation of a Self-Sustaining Community-Based Malaria Control Program in the Philippines” through the Australian International Development and Assistance Bureau. Initially a collaborative project of RITM and DOH-Malaria Control Services, it was gradually devolved to the Province of Agusan del Sur, which created its Provincial Technical Advisory Committee, Provincial Management Team and Community Trust Fund to implement and sustain malaria control.6 Last year, Agusan del Sur was declared malaria-free. How to be successful may not be elusive and enhanced Intersectoral Collaborations may be the winning formula in the fight against malaria and other vector-borne diseases.REFERENCES 1. Tongol-Rivera P. Milestones in the history of malaria research and control in the Philippines. In: Kano S, Tongol-Rivera P, eds. Malaria in Asia. Asian Parasitology Series Monograph The Federation of Asian Parasitologists. 2005; 6:135-166. 2. Angluben RU, Trudeau MR, Kano S, Tongol-Rivera P. Kilusan Ligtas Malaria: Advancing Social Mobilization towards Sustainable Malaria Control in the province of Palawan, the Philippines. Trop Med Health. 2008; 36(1):45-9. 3. Matsumoto-Takahashi ELA, Tongol-Rivera P, Villacorte EA, Angluben RU, Jimba M, Kano S. Bottom-up approach to strengthen community-based malaria control strategy from community health workers’ perceptions of their past, present, and future: a qualitative study in Palawan, Philippines. 2018. Trop Med Health. 2018; 46(1):24. 4. Tongol-Rivera P, Kano S, Saniel O, Solon JA, Villacorte E. Social Capital and Malaria Control in Palawan, the Philippines. 2010 (unpublished). 5. Valdecanas OC, Tuazon RR, Barcelona DR. Understanding Social Mobilization. In: The Philippine Experience, How Social Mobilization Works. UNICEF, the Philippines. 1996; pp. 9-19. 6. Linao RT. Finding and Funding Means: Beyond the Elimination of Malaria in Agusan del Sur. Foundation for the Development of Agusanons, Inc. 2014. Pilarita T. Rivera, MD, PhD Associate Editor Department of Parasitology College of Public Health University of the Philippines Manila REFERENCES 1. Tongol-Rivera P. Milestones in the history of malaria research and control in the Philippines. In: Kano S, Tongol-Rivera P, eds. Malaria in Asia. Asian Parasitology Series Monograph The Federation of Asian Parasitologists. 2005; 6:135-166.2. Angluben RU, Trudeau MR, Kano S, Tongol-Rivera P. Kilusan Ligtas Malaria: Advancing Social Mobilization towards Sustainable Malaria Control in the province of Palawan, the Philippines. Trop Med Health. 2008; 36(1):45-9.3. Matsumoto-Takahashi ELA, Tongol-Rivera P, Villacorte EA, Angluben RU, Jimba M, Kano S. Bottom-up approach to strengthen community-based malaria control strategy from community health workers’ perceptions of their past, present, and future: a qualitative study in Palawan, Philippines. 2018. Trop Med Health. 2018; 46(1):24.4. Tongol-Rivera P, Kano S, Saniel O, Solon JA, Villacorte E. Social Capital and Malaria Control in Palawan, the Philippines. 2010 (unpublished).5. Valdecanas OC, Tuazon RR, Barcelona DR. Understanding Social Mobilization. In: The Philippine Experience, How Social Mobilization Works. UNICEF, the Philippines. 1996; pp. 9-19. 6. Linao RT. Finding and Funding Means: Beyond the Elimination of Malaria in Agusan del Sur. Foundation for the Development of Agusanons, Inc. 2014.

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Lauria, Molly E., Kevin P. Fiori, Heidi E. Jones, Sesso Gbeleou, Komlan Kenkou, Sibabe Agoro, Abdourahmane Diparidé Agbèrè, Kelly D. Lue, and Lisa R. Hirschhorn. "Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: a pragmatic effectiveness-implementation study protocol." Implementation Science 14, no. 1 (October 16, 2019). http://dx.doi.org/10.1186/s13012-019-0921-3.

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Abstract Background Over the past decade, prevalence of maternal and child morbidity and mortality in Togo, particularly in the northern regions, has remained high despite global progress. The causes of under-five child mortality in Togo are diseases with effective and low-cost prevention and/or treatment strategies, including malaria, acute lower respiratory infections, and diarrheal diseases. While Togo has a national strategy for implementing the integrated management of childhood illness (IMCI) guidelines, including a policy on integrated community case management (iCCM), challenges in implementation and low public sector health service utilization persist. There are critical gaps to access and quality of community health systems throughout the country. An integrated facility- and community-based initiative, the Integrated Community-Based Health Systems Strengthening (ICBHSS) initiative, seeks to address these gaps while strengthening the public sector health system in northern Togo. This study aims to evaluate the effect and implementation strategy of the ICBHSS initiative over 48 months in the catchment areas of 21 public sector health facilities. Methods The ICBHSS model comprises a bundle of evidence-based interventions targeting children under five, women of reproductive age, and people living with HIV through (1) community engagement and feedback; (2) elimination of point-of-care costs; (3) proactive community-based IMCI using community health workers (CHWs) with additional services including family planning, HIV testing, and referrals; (4) clinical mentoring and enhanced supervision; and (5) improved supply chain management and facility structures. Using a pragmatic type II hybrid effectiveness-implementation study, we will evaluate the ICBHSS initiative with two primary aims: (1) determine effectiveness through changes in under-five mortality rates and (2) assess the implementation strategy through measures of reach, adoption, implementation, and maintenance. We will conduct a mixed-methods assessment using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. This assessment consists of four components: (1) a stepped-wedge cluster randomized control trial using a community-based household survey, (2) annual health facility assessments, (3) key informant interviews, and (4) costing and return-on-investment assessments for each randomized cluster. Discussion Our research is expected to contribute to continuous quality improvement initiatives, optimize implementation factors, provide knowledge regarding health service delivery, and accelerate health systems improvements in Togo and more broadly. Trial registration ClinicalTrials.gov, NCT03694366, registered 3 October 2018

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Al Khaja, Khalid A. J., and Reginald P. Sequeira. "Drug treatment and prevention of malaria in pregnancy: a critical review of the guidelines." Malaria Journal 20, no. 1 (January 23, 2021). http://dx.doi.org/10.1186/s12936-020-03565-2.

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Abstract Background Malaria caused by Plasmodium falciparum in pregnancy can result in adverse maternal and fetal sequelae. This review evaluated the adherence of the national guidelines drawn from World Health Organization (WHO) regions, Africa, Eastern Mediterranean, Southeast Asia, and Western Pacific, to the WHO recommendations on drug treatment and prevention of chloroquine-resistant falciparum malaria in pregnant women. Methods Thirty-five updated national guidelines and the President’s Malaria Initiative (PMI), available in English language, were reviewed. The primary outcome measures were the first-line anti-malarial treatment protocols adopted by national guidelines for uncomplicated and complicated falciparum malaria infections in early (first) and late (second and third) trimesters of pregnancy. The strategy of intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) was also addressed. Results This review evaluated the treatment and prevention of falciparum malaria in pregnancy in 35 national guidelines/PMI-Malaria Operational Plans (MOP) reports out of 95 malaria-endemic countries. Of the 35 national guidelines, 10 (28.6%) recommend oral quinine plus clindamycin as first-line treatment for uncomplicated malaria in the first trimester. As the first-line option, artemether–lumefantrine, an artemisinin-based combination therapy, is adopted by 26 (74.3%) of the guidelines for treating uncomplicated or complicated malaria in the second and third trimesters. Intravenous artesunate is approved by 18 (51.4%) and 31 (88.6%) guidelines for treating complicated malaria during early and late pregnancy, respectively. Of the 23 national guidelines that recommend IPTp-SP strategy, 8 (34.8%) are not explicit about directly observed therapy requirements, and three-quarters, 17 (73.9%), do not specify contra-indication of SP in human immunodeficiency virus (HIV)-infected pregnant women receiving cotrimoxazole prophylaxis. Most of the guidelines (18/23; 78.3%) state the recommended folic acid dose. Conclusion Several national guidelines and PMI reports require update revisions to harmonize with international guidelines and emergent trends in managing falciparum malaria in pregnancy. National guidelines and those of donor agencies should comply with those of WHO guideline recommendations although local conditions and delayed guideline updates may call for deviations from WHO evidence-based guidelines.

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Brabin, Bernard. "Analysing malaria events from 1840 to 2020: the narrative told through postage stamps." Malaria Journal 20, no. 1 (October 12, 2021). http://dx.doi.org/10.1186/s12936-021-03932-7.

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AbstractThe role played by postage stamps in the history of malaria control and eradication has largely gone unrecognized. Scientific investigators of malaria, especially Nobel laureates, were commemorated with special issues, but the work of the World Health Organization (WHO), which promoted an ambitious and global philatelic initiative in 1962 to support global eradication, is generally overlooked. This review examines the philatelic programme that helped to generate international commitment to the goal of malaria eradication in 1962 and established philatelic malaria icons that had worldwide recognition. Malaria-related postage stamps have continued to be issued since then, but the initial failure of malaria eradication and the changing goals of each new malaria programme, inevitably diluted their role. After the first Global Malaria Eradication Campaign was discontinued in 1969, few Nations released philatelic issues. Since the Spirit of Dakar Call for Action in 1996 a resurgence of postage stamp releases has occurred, largely tracking global malaria control initiatives introduced between 1996 and 2020. These releases were not co-ordinated by the WHO as before, were more commercialized and targeted stamp collectors, especially with attractive miniature sheets, often produced by photomontage. Having a different purpose, they demonstrated a much wider diversity in symbolism than the earlier stylized issues and at times, have been scientifically inaccurate. Nonetheless postage stamps greatly helped to communicate the importance of malaria control programmes to a wide audience and to some extent, have supported preventive health messages.

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Seun-Addie, Kehinde, and Ezebunwa E. Nwokocha. "The Influence of Acceptability of the Roll Back Malaria Programme on Maternal Health in Ibadan, Nigeria." Nigerian Journal of Sociology and Anthropology 16, no. 2 (November 1, 2018). http://dx.doi.org/10.36108/njsa/8102/61(0240).

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The Roll Back Malaria (RBM) initiative was conceived to bolster appreciable reduction in the impact of malaria on pregnant women through Intermittent Preventive Treatment (IPT) and the use of Insecticide-treated Net (ITN). This study examines the association between knowledge and acceptability of the RBM programme on maternal health in Ibadan classified among areas with records of high prevalence of malaria-implicated maternal mortality. A survey of 407 pregnant women attending antenatal clinics at various Primary Health Centres (PHCs) in six selected Local Government Areas (LGAs) in Ibadan was undertaken. This clinic based approach was adopted to ensure that selected respondents were among those exposed to the RBM programme as antenatal care clinic attendees. Results show that increase in the knowledge of RBM related activities led to a corresponding increase in acceptability of the initiative, which ultimately led to marked improvement in maternal health. Thus, there is need to ensure that more women become aware of the RBM project as the surest trajectory for positive disposition to the RBM intervention, with a predictable concomitant improvement in maternal health status of childbearing women in Ibadan, Nigeria.

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Rajvanshi, Harsh, Praveen K. Bharti, Sekh Nisar, Himanshu Jayswar, Ashok K. Mishra, Ravendra K. Sharma, Kalyan B. Saha, et al. "A model for malaria elimination based on learnings from the Malaria Elimination Demonstration Project, Mandla district, Madhya Pradesh." Malaria Journal 20, no. 1 (February 16, 2021). http://dx.doi.org/10.1186/s12936-021-03607-3.

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Abstract Background Malaria Elimination Demonstration Project (MEDP) was started as a Public-Private-Partnership between the Indian Council of Medical Research through National Institute of Research in Tribal Health, Govt. of Madhya Pradesh and Foundation of Disease Elimination and Control of India, which is a Corporate Social Responsibility (CSR) initiative of the Sun Pharmaceutical Industries Limited. The project’s goal was to demonstrate that malaria can be eliminated from a high malaria endemic district along with prevention of re-establishment of malaria and to develop a model for malaria elimination using the lessons learned and knowledge acquired from the demonstration project. Methods The project employed tested protocols of robust surveillance, case management, vector control, and capacity building through continuous evaluation and training. The model was developed using the learnings from the operational plan, surveillance and case management, monitoring and feedback, entomological investigations and vector control, IEC and capacity building, supply chain management, mobile application (SOCH), and independent reviews of MEDP. Results The MEDP has been operational since April 2017 with field operations from August 2017, and has observed: (1) reduction in indigenous cases of malaria by about 91 %; (2) need for training and capacity building of field staff for diagnosis and treatment of malaria; (3) need for improvement insecticide spraying and for distribution and usage of bed-nets; (4) need for robust surveillance system that captures and documents information on febrile cases, RDT positive individuals, and treatments provided; (5) need for effective supervision of field staff based on advance tour plan; (6) accountability and controls from the highest level to field workers; and (7) need for context-specific IEC. Conclusions Malaria elimination is a high-priority public health goal of the Indian Government with a committed deadline of 2030. In order to achieve this goal, built-in systems of accountability, ownership, effective management, operational, technical, and financial controls will be crucial components for malaria elimination in India. This manuscript presents a model for malaria elimination with district as an operational unit, which may be considered for malaria elimination in India and other countries with similar geography, topography, climate, endemicity, health infrastructure, and socio-economic characteristics.

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Moukoumbi Lipenguet, Gaëtan, Edgard Brice Ngoungou, Euloge Ibinga, Jean Engohang-Ndong, and Jérôme Wittwer. "Evaluation of direct costs associated with the management of clinical stage of malaria in children under five years old in Gabon." Malaria Journal 20, no. 1 (July 30, 2021). http://dx.doi.org/10.1186/s12936-021-03862-4.

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Abstract Background Malaria is one of the leading causes of morbidity and mortality in African countries. It is one of the leading causes of hospital visits and hospitalization in pediatric wards for children under 5 years old. Interestingly however, the economic burden of this disease remains unknown in these endemic countries including Gabon. The purpose of this study is to assess the direct hospital cost for the management of malaria in children under 5 years old at the Libreville University Hospital Centre (CHUL, Centre Hospitalier Universitaire de Libreville) in Gabon. Methods This research work is a retrospective study using a comprehensive review of medical records of patients seen at the CHUL over a two-year period extending from January 2018 through December 2019. The study focused on children under 5 years old, admitted for malaria in the paediatric ward of the CHUL. The analysis targeted specifically direct hospital costs, which excluded salary and wages of health care workers. The monetary currency used in this study was the CFA francs, as that currency is the one used in Central Africa (as reference, 1 Euro = 656 CFA francs). Results For the set timeframe, 778 patient records matched the study criteria. Thus, out of 778 admitted patients, 58.4% were male while 41.5% were female. Overall, the average age was 13.2 months (± 13.8 months). The total cost incurred by the hospital for the management of these 778 malaria patients was 94,922,925 CFA francs (144,699.58 €), for an average expense per patient topping at 122,008 CFA francs (185.99 €). The highest expenditure items were hospitalizations (44,200,000 CFA francs, 67,378.1 €), followed by drugs (26,394,425 CFA francs, 40,235.4 €) and biomedical examinations (14,036,000 CFA francs, 21,396.34 €). Conclusion The financial burden for managing malaria in the paediatric ward seems to be very high, not only for the hospital, but also for families in spite of the government medical insurance coverage in some cases. These findings bring new insights as to the urgency to develop policies that foster preventive initiatives over curative approaches in the management of malaria in children in endemic countries.

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Li, Zhuo, Junyi Shi, Na Li, Minmin Wang, Yinzi Jin, and Zhi-jie Zheng. "Temporal trends in the burden of non-communicable diseases in countries with the highest malaria burden, 1990–2019: Evaluating the double burden of non-communicable and communicable diseases in epidemiological transition." Globalization and Health 18, no. 1 (October 23, 2022). http://dx.doi.org/10.1186/s12992-022-00882-w.

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Abstract Background Non-communicable diseases (NCDs) are rapidly increasing in sub-Saharan African countries, where 96% of global malaria deaths occur. This study aimed to investigate the disease burden of NCDs in countries with the current highest malaria mortality. Methods Data for this study were obtained from the Global Burden of Disease 2019 study (1990–2019). We selected the ten countries with malaria’s highest age-standardised mortality rate (ASMR) and identified and ranked the five NCDs with the highest ASMR in each country. Measures of the NCDs disease burden included ASMR, age-standardised disability-adjusted life-years (DALY), years of life lost (YLL) and years lost due to a disability (YLD). The Estimated annual percentage change (EAPC) was used to examine the trends of the NCDs disease burden from 1990 to 2019. Results As of 2019, the ASMR of chronic liver disease, kidney disease, diabetes mellitus, Alzheimer’s disease and other dementias, hypertensive heart disease and stroke were higher than the global average. From 1990 to 2019, the ASMR for Alzheimer’s disease and other dementias, type II diabetes mellitus, and chronic kidney disease increased by 3.0%, 10.8%, 13.3%, and the age-standardised DALY rate increased by 3.7%, 27.6%, 6.3%, and the increases tended to be in younger populations. Conclusion The double burden of non-communicable and communicable diseases is crippling the health systems of many sub-Saharan African countries and is often neglected. The prevention, surveillance, and control of diseases require an integrated strategy, with governments and non-government organisations aligned and supported by the global initiative.

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Akinnawo, Ayodele, Kaali Seyram, Ellen Boamah Kaali, Samuel Harrison, David Dosoo, Matthew Cairns, and Kwaku Poku Asante. "Assessing the relationship between gravidity and placental malaria among pregnant women in a high transmission area in Ghana." Malaria Journal 21, no. 1 (August 20, 2022). http://dx.doi.org/10.1186/s12936-022-04252-0.

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Abstract Background Malaria infection during pregnancy can cause significant morbidity and mortality to a pregnant woman, her fetus and newborn. In areas of high endemic transmission, gravidity is an important risk factor for infection, but there is a complex relationship with other exposure-related factors, and use of protective measures. This study investigated the association between gravidity and placental malaria (PM), among pregnant women aged 14–49 in Kintampo, a high transmission area of Ghana. Methods Between 2008 and 2011, as part of a study investigating the association between PM and malaria in infancy, pregnant women attending antenatal care (ANC) clinics in the study area were enrolled and followed up until delivery. The outcome of PM was assessed at delivery by placental histopathology. Multivariable logistic regression analyses were used to investigate the association between gravidity and PM, identify other key risk factors, and control for potential confounders. Pre-specified effect modifiers including area of residence, socio-economic score (SES), ITN use and IPTp-SP use were explored. Results The prevalence of PM was 65.9% in primigravidae, and 26.5% in multigravidae. After adjusting for age, SES and relationship status, primigravidae were shown to have over three times the odds of PM compared to multigravidae, defined as women with 2 or more previous pregnancies [adjusted OR = 3.36 (95% CI 2.39–4.71), N = 1808, P < 0.001]. The association appeared stronger in rural areas [OR for PG vs. MG was 3.79 (95% CI 3.61–5.51) in rural areas; 2.09 (95% CI 1.17–3.71) in urban areas; P for interaction = 0.07], and among women with lower socio-economic scores [OR for PG vs. MG was 4.73 (95% CI 3.08–7.25) amongst women with lower SES; OR = 2.14 (95% CI 1.38–3.35) among women with higher SES; P for interaction = 0.008]. There was also evidence of lower risk among primigravidae with better use of the current preventive measures IPTp and LLIN. Conclusions The burden of PM is most heavily focused on primigravidae of low SES living in rural areas of high transmission. Programmes should prioritize primigravidae and young women of child-bearing age for interventions such as LLIN distribution, educational initiatives and treatment to reduce the burden of malaria in first pregnancy.

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"Global health and its role." Journal of Sheikh Zayed Medical College 12, no. 4 (February 16, 2022): 1–2. http://dx.doi.org/10.47883/jszmc.v13i01.211.

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Global health deals with the health of the populations in a worldwide context; it is defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide".1 A disease threat anywhere is a disease threat everywhere, and responding when and where health threats arise, disregarded to national borders, and the support is mainly from the multilateral donors. It deals with the problems which transcend the national borders or may have global political, and/or economic impact. So the global health is related with the improvement of worldwide health, which ranges from diarrheal diseases, respiratory infections including COVID-19, HIV/AIDS, and maternal health issues, among others. Such diseases have the potentials to produce disparities and global threats beyond the borders. Sometimes, global health is compared and confused with international health, which is actually a branch of public health dealing with support from the developed countries to the developing countries. Global health came outfrom the public health, and the international health, which earlier evolved from the hygiene and the tropical medicine. The key characteristics that have a role in making the definition of the global health are; equity in the health status of the communities and their access to healthcare; a global conceptualization as against to international or between the nations perspective; causes of the health problems; means and resources for the health interventions; conceptual source of the obligation i-e its the duty of privileged to help and take care of those with fewer resources; a multidisciplinary and interdisciplinary approach means involving other professions with the health profession for improving health; stakeholders or actors such as individuals or groups; reactive or proactive approach in the provision of health globally.2 The major organizations dealing with global health are World Health Organization (WHO), UNICEF, CDC, PAHO, and Bill and Melinda Gates Foundation among others. Sustainable Development Goals and their predecessor Millennium Development Goals were formulated by United Nation to enhance comprehensive and coordinated efforts across sectors to address the socioeconomic determinants, playing role in global health threats. Global Health is measured in terms of prevalence and incidence of some the diseases, mortality from the diseases, life expectancy, DALYs, and QALYs. The cooperation on Global Health initiatives for Global Health started with the establishment of the United Nations and the World Bank Group in 1945. Three years later in 1948, World Health Organization was formed. The concept of primary healthcare after the Alma Ata declaration in 1978 was another milestone. In the year 2000, fifteen years, eight Millennium Development Goals were formulated to address the main problems facing human development. Although these development goals were not achieved fully, nevertheless they provided the basis for accelerating a sustained human development, through 17 Sustainable Development Goals from 2015 to 2030. Among other key initiatives for Global Health included vaccine alliance GAVI in 2000, Global fund for AIDS, TB, and Malaria among others. Antimicrobial resistance, health equity, climate change, tobacco, and COVID-19 are some of the key focus areas in global health. Some of the Global Health threats the world is facing currently are;3 Air pollution and the climate change, which results in nine out of the ten persons are globally the breathing polluted air and it is killing about 7 million people yearly prematurely from the diseases such as stroke, cancer, heart, and the lung diseases. Nearly 90% of such deaths occur in the low to the middle income countries. Non communicable diseases, which collectively cause over 70% of all the deaths worldwide making a total of about 41 million people dying yearly. This also includes about 15 million persons who are dying prematurely. Again more than 85% of such premature deaths are occurring in the low to middle-income countries. Another threat to global health is the influenza pandemic, such as COVID-19 which needs aunique partnership among all the stakeholders and players to ensure effective and equitable access or availability to the diagnostic services, vaccines, and antivirals (treatments), especially in low resource developing countries. One of the important and key threats to global health is fragile and the vulnerable health system, and in fact about one fourth the global population resides in crisis areas due to famine, conflict, and so the population displacement, and the weak health services delivery force them to stay without access to even the basic care. A growing issue that global health is facing is antimicrobial resistance, which has the potential to send us to state when we were not able to treat common infections like respiratory tract infections including tuberculosis, and salmonellosis. Vaccine hesitancy, which is the reluctance or refusal to get a vaccine, due to cultural, religious, and other issues. There is the availability of the vaccines, but such hesitancy of any origin threatens to halt or even reverse the progress made in controlling and eliminating the vaccine-preventable diseases globally. Another threat to global health is dengue fever, which can be a very lethal disease and it kills up to 20% of the patients with the severe form of dengue. HIV/AIDS is one of the major threats to global health and the progress made against it is enormous, but the HIV epidemic continues to kill nearly a million person yearly. Last but not the least, Global health security which is highlighted by the COVID-19 pandemic, and there is an opportunity and ground for working together to deal with the global health-related disparities and threats. The aim of the Global Health Security Agenda is to strengthen and enhance the national and international potential and ability of prevention, identification, management of the global health threats.

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Kolekang, Augusta, Bismark Sarfo, Anthony Danso-Appiah, Duah Dwomoh, and Patricia Akweongo. "Are maternal and child health initiatives helping to reduce under-five mortality in Ghana? Results of a quasi-experimental study using coarsened exact matching." BMC Pediatrics 21, no. 1 (October 25, 2021). http://dx.doi.org/10.1186/s12887-021-02934-3.

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Abstract Background Despite a 53 % decline in under-five mortality (U5M) worldwide during the period of the Millennium Development Goals (MDGs), U5M remains a challenge. Under-five mortality decline in Ghana is slow and not parallel with the level of coverage of child health interventions. The interventions promoted to improve child survival include early initiation of breastfeeding, clean postnatal care, and skilled delivery. This study sought to assess the effectiveness of these interventions on U5M in Ghana. Methods A quasi-experimental study was conducted using secondary data of the 2008 and 2014 Ghana Demographic and Health Surveys. Coarsened Exact Matching and logistic regression were done. The interventions assessed were iron intake, early initiation of breastfeeding, clean postnatal care, hygienic disposal of stool, antenatal care visits, skilled delivery, intermittent preventive treatment of malaria in pregnancy, and tetanus toxoid vaccine. Results There were 2,045 children under-five years and 40 (1.9 %) deaths in 2008. In 2014, the total number of children under-five years was 4,053, while deaths were 53(1.2 %). In 2014, children less than one month old formed 1.6 % of all children under-five years, but 47.8 % of those who died. Mothers who attended four or more antenatal care visits were 78.2 % in 2008 and 87.0 % in 2014. Coverage levels of improved sanitation and water connection in the home were among the lowest, with 11.6 % for improved sanitation and 7.3 % for water connection in the home in 2014. Fifty-eight (58), 1.4 %, of children received all the eight (8) interventions in 2014, and none of those who received all these interventions died. After controlling for potential confounders, clean postnatal care was associated with a 66% reduction in the average odds of death (aOR = 0.34, 95 %CI:0.14–0.82), while early initiation of breastfeeding was associated with a 62 % reduction in the average odds of death (aOR = 0.38, 95 % CI: 0.21–0.69). Conclusions Two (clean postnatal care and early initiation of breastfeeding) out of eight interventions were associated with a reduction in the average odds of death. Thus, a further decline in under-five mortality in Ghana will require an increase in the coverage levels of these two high-impact interventions.

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Asad Saulat Fatimi and Omar Mahmud. "The costs of protecting health in the face of climate change - feasibility lies in proactivity." Journal of the Pakistan Medical Association, November 16, 2022. http://dx.doi.org/10.47391/jpma.6641.

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Climate change has and will continue to lead to unexpected weather patterns worldwide. These threaten to increase the risk of numerous diseases and disasters that negatively impact the health of populations. As a developing country, Pakistan must bolster its preparedness for such weather-related health problems by efficienty allocating resources to preventive measures and proactively implementing them. In recent history, torrential rainfall in areas such as Karachi, which usually receive meagre amounts of annual rainfall, has left many economic and health-related issues that harm the health of the population and disrupt healthcare delivery. For example, the massive accumulation of stagnant water following heavy rainfall acts is a breeding ground for mosquitoes. Thus, urban flooding is often accompanied by an increase in mosquito-related diseases such as dengue and malaria (1,2). Furthermore, the presence of airborne and allergenic fungal spores in the environment is positively correlated with increased amounts of rainfall (3). Heavy rain damages infrastructure, such as roads and electricity lines in urban areas. In addition to the disruption of transport and utilities, such damage leads to numerous hospitalizations and deaths in incidents such as motor accidents, burns, electrocution, falling into exposed gutters, drowning, and other similar tragedies (4). Beyond these direct effects on human health, healthcare delivery and resource mobilization are also hindered (5), further hampering the responsiveness and effectiveness of the healthcare system. While measures like disinfection drives may be useful in decreasing rain-related morbidity and mortality, a reactive approach must become an initiative-taking one. With comprehensive analyses of trends, such as those of hospitalizations during the monsoon season or the frequency of rain-related injury and disease in different areas, more informed preventive measures and “evidence-based anticipation” (5) of health burdens can be devised and deployed. Programmes to promote safety measures and awareness can be tailored to the needs of at-risk communities and burdened health-care centres. The allocation of precious resources can be made to those that need them most ahead of destructive weather. Climate change is a stark reality, as is the shortage of resources in developing countries like Pakistan. It is vital to acknowledge the profound impact of destructive weather on the public’s well-being and to act efficiently and proactively to mitigate it.

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Hemingway-Foday, Jennifer, Ousmane Souare, Eileen Reynolds, Boubacar Dialio, Marlyatou Bah, Almamy Karamokoba Kaba, Moussa Kone, et al. "Improving Integrated Disease Surveillance and Response Capacity in Guinea, 2015-2018." Online Journal of Public Health Informatics 11, no. 1 (May 30, 2019). http://dx.doi.org/10.5210/ojphi.v11i1.9837.

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ObjeciveThe objective is to discuss capacity building for Integrated Disease Surveillance and Response in Guinea and synthesize lessons learned for implementing the Global Health Security Agenda in similar settings.IntroductionThe 2014-2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system. The lack of public health workers adequately trained in Integrated Disease Surveillance and Response (IDSR) contributed to underreporting of cases and problems with data completeness, accuracy, and reliability. These data quality issues resulted in difficulty assessing the epidemic's scale and distribution and hindered the control effort (McNamara, 2016; Bell, 2016). In 2015, the Guinean Ministry of Health (MoH) recognized the importance of the IDSR framework as a tool for improving disease surveillance and emphasized IDSR strengthening as a priority activity in the post-Ebola transition (MoH, 2015).To support this strategic objective, we engaged with the MoH, CDC, and key surveillance partners to strengthen surveillance capacity through a national initiative to improve IDSR tools, including assistance with developing Guinea-specific IDSR technical guidelines, simplified and standardized case notification forms, and supportive job aids to facilitate appropriate IDSR implementation by health workers at all levels of the system.MethodsThe Ebola outbreak highlighted the need for streamlined and standardized case reporting tools that promote accurate application of standard case definitions, adherence to IDSR technical guidelines, and integration of data from clinical and laboratory sources (McNamara, 2016). We partnered with the MoH and CDC to update case notification forms and create job aids for improved IDSR implementation at all health levels. Using a One Health approach, we helped organize and facilitate a series of workshops between the MoH, Ministries of Agriculture and Environment, CDC, national laboratory, and other surveillance partners to review and update the Guinea-specific IDSR priority diseases. This resulted in the identification of 14 priority diseases and events, which are the focus of weekly epidemiological surveillance. By bringing together the Ministries of Health, Agriculture, and Environment, the workshops resulted in improved tools for zoonotic disease detection, reporting, and responses. This included agreement on 3 new zoonotic diseases (anthrax, brucellosis, and rabies) for weekly reporting, as well as recommendations for enhancing surveillance of zoonotic diseases already included in weekly surveillance, such as influenza and Ebola.To further promote collaboration, we helped establish a technical working group and implemented a series of workshops for the Ministries and surveillance partners to review and revise case notification forms for the 14 priority diseases and events. Within the MoH, we also solicited feedback from health workers at the national, regional, and district levels to identify needs throughout the health system. As a result, each form now has an agreed-upon data collection structure that is consistent with IDSR guidelines. Standardized sections were applied across forms for case identification, notification, hospitalization, actions taken, and feedback tracking. The standardization improves data consistency across forms and establishes familiarity with common data elements, which leads to more complete data capture. Additionally, each form promotes accurate case classification by collecting disease-specific information on risk factors, signs and symptoms, and laboratory analysis and results. The revised forms also use a logical data collection flow that follows the patient’s information from the site of identification, to higher levels of care (if required), laboratory, and the national level, thus improving data integration and completeness. The forms have been incorporated into the national DHIS2 electronic surveillance system, which allows data entry at the district, regional, national, and laboratory level and supports rapid and complete reporting.ResultsThe development of revised case notification forms demonstrates an effective, collaborative, One Health approach to IDSR. All three ministries participated in the development and revision of the forms and subsequently, approved and adopted the forms for surveillance of priority diseases. This One Health approach has provided the Government of Guinea with a framework for identifying and strengthening surveillance of its five zoonotic diseases of greatest public health concern, which enables measurement of progress towards achieving the objectives of the GHSA Zoonotic Disease Action Package.We collaborated with the MoH to launch nationwide training of trainers for the new case notification forms, including the use of DHIS2 to manage, report, analyze, and present data. The training of trainers produced a cadre of 55 trainers, representing the participating ministries, national laboratory, and key surveillance partners such as WHO. By the end of 2018, IDSR training will cover health workers at all levels of the system in all 38 of Guinea’s health districts.Incorporating DHIS2 as a platform for managing case data further demonstrates Guinea’s capacity to conduct event-based surveillance and track the 14 priority diseases and events in real-time, an essential indicator of the GHSA Real-time Surveillance Action Package.ConclusionsGuinea’s IDSR strengthening activities are an important step towards achieving the GHSA objective of establishing a functional public health surveillance system capable of detecting events of significance for public health, animal health, and health security. The updated case notification forms, coupled with the use of DHIS2 for real-time reporting, provide critical tools to promote more complete, accurate, and timely data; however, successful implementation will rely on effectively training health workers throughout the system and providing on-going supportive supervision. The multi-sectoral approach to developing IDSR tools helped establish a foundation for future collaboration across ministries using a One Health approach to strengthen Guinea’s national health surveillance system. While the IDSR activities have focused heavily on building capacity for human disease surveillance, it is critical that similar attention is given to animal health. The MoH and surveillance partners should continue to work with the Ministries of Agriculture and Environment to build surveillance capacity for detecting and controlling zoonotic threats while they are still in animal populations and to develop compatible human and animal surveillance data fields for more efficient, integrated data systems.References1. McNamara LA, Schafer IJ, Nolen LD, Gorina Y, Redd JT, Lo T, Ervin E, Henao O, Dahl BA, Morgan O, Hersey S, Knust B. Ebola surveillance – Guinea, Liberia, and Sierra Leone. MMWR Suppl. 2016; 65(3):35-43; http://dx.doi.org/ 10.15585/mmwr.su6503a62. Bell BP, Damon IK, Jernigan DB, et al. Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014–2016 Ebola Epidemic. MMWR Suppl. 2016;65(Suppl-3):4–11. DOI: http://dx.doi.org/10.15585/mmwr.su6503a23. Ministere de la Santé-République de Guinée, Direction Nationale de la Prevention et Santé Communautaire, Division Prevention et Lutte Contre la Maladie. Plan de Renforcement de la Surveillance des Maladies à Potentiel Epidémique en Guinée (2015-2017), August 2015.

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