Objectives Worldwide, rotavirus infections cause approximately 453 000 child deaths annually. Two licensed vaccines could be life- and cost-saving in low-income countries where the disease burden is highest. The aim of our study was to estimate the total cost of implementing the rotavirus vaccine in the national immunisation programme of a low-income country. Furthermore, the aim was to examine the relative contribution of different components to the total cost. Methods Following the World Health Organization guidelines, we estimated the resource use and costs associated with rotavirus vaccine implementation, using Malawi as a case.
Author Archives: Tropical Med and Intl Health
Objective International migration has changed the global distribution of Chagas disease, with the emerging importance of non-endemic regions. We aimed at better documenting the Australia and New Zealand risk of Chagas disease and needs for interventions. Methods We reviewed Chagas disease-related evidences, policies and practices in Australia and New Zealand and calculated the estimated prevalence. Results Australia hosts a rapidly growing population at risk and had 1928 infected residents in 2011; New Zealand had 98 in 2006. These figures underestimate the real situation, as they do not consider non-permanent residents.
Adherence interventions are a recommended strategy to salvage failing antiretroviral therapy without regimen change. We assessed the durability of resuppression when using this approach. Of 300 patients who resuppressed on the same regimen (41% of all those with virologic failure), 148 (45%) remained suppressed during follow-up for a median of 2.4 years (interquartile range [IQR]: 1.1, 4.0). Resuppression can be durable following viraemia without a switch in antiretroviral therapy regimen.
Objectives To examine the spatial and temporal patterns of the recent expansion of dengue transmission area in Brazil (2001–2012) with the aim to identify pathways and constraints to dengue diffusion. Methods Synthetic indicators were calculated to characterise timing (year of first dengue outbreak), permanence (number of years with dengue outbreaks) and intensity (outbreak occurrence). The indicators were used to map dengue diffusion and compare cities within different climatic zones, with varying population densities. Results Currently, a large portion of the country comprises a dengue transmission area, but cities situated in the mesothermal zone, in the south, and remote areas, in the north, are relatively exempt. Diffusion waves are spread from metropolitan areas towards medium and small cities generating outbreaks in their influence region
Objective To report cutaneous leishmaniasis (CL) in Polonnaruwa, Sri Lanka. Methods The study population included all patients with CL reported from Polonnaruwa district from January 2008 through April 2012. Data were collected in the dermatology unit of Polonnaruwa General Hospital and the regional epidemiology unit of Polonnaruwa. Results Four hundred and forty six patients with leishmaniasis were detected; clinical details were available for 362.
This article is from: Integrating public health research trials into health systems in Africa: individual or cluster…
Objectives To determine the capacity of black soldier fly larvae (BSFL) (Hermetia illucens) to convert fresh human faeces into larval biomass under different feeding regimes, and to determine how effective BSFL are as a means of human faecal waste management. Methods Black soldier fly larvae were fed fresh human faeces. The frequency of feeding, number of larvae and feeding ratio were altered to determine their effects on larval growth, prepupal weight, waste reduction, bioconversion and feed conversion rate (FCR). Results The larvae that were fed a single lump amount of faeces developed into significantly larger larvae and prepupae than those fed incrementally every 2 days; however, the development into pre-pupae took longer. The highest waste reduction was found in the group containing the most larvae, with no difference between feeding regimes
Objectives The objective of this study was to investigate the quality of on-plot piped water and rainwater at the point of consumption in an area with rapidly expanding coverage of improved’ water sources. Methods Cross-sectional study of 914 peri-urban households in Kandal Province, Cambodia, between July–August 2011. We collected data from all households on water management, drinking water quality and factors potentially related to post-collection water contamination. Drinking water samples were taken directly from a subsample of household taps (n = 143), stored tap water (n = 124), other stored water (n = 92) and treated stored water (n = 79) for basic water quality analysis for Escherichia coli and other parameters.
The Diarrhoeal Disease Surveillance System of icddr,b noted increasing number of patients 60 years at urban Dhaka and rural Matlab from 2001 to 2012. Shigella and Vibrio cholerae were more frequently isolated from elderly people than children under 5 years and adults aged 5–59 in both areas. The resistance observed to various drugs of Shigella in Dhaka and Matlab was trimethoprim–sulphamethoxazole (72–63%), ampicillin (43–55%), nalidixic acid (58–61%), mecillinam (12–9%), azithromycin (13–0%), ciprofloxacin (11–13%) and ceftriaxone (11–0%). Vibrio cholerae isolated in Dhaka and Matlab was resistant to trimethoprim–sulphamethoxazole (98–94%), furazolidone (100%), erythromycin (71–53%), tetracycline (46–44%), ciprofloxacin (3–10%) and azithromycin (3–0%).
Objective To evaluate the contributions of the INDEPTH Network of health and demographic surveillance system (HDSS) members to research efforts and interventions on reproductive health in low- and middle-income countries (LMICs). Methods Review of peer-reviewed published papers on sexual and reproductive health (SRH) that use the HDSS framework through (i) an online search for publications using terminology related to HDSS, HIV, Maternal health, adolescent sexual and reproductive health, family planning/contraceptives and fertility, and (ii) asking INDEPTH member centres for information on their published papers on SRH publications that used the HDSS framework. A paper was included in the review only if it used HDSS data, dealt with SRH issues, and had been published in a peer-reviewed international journal. Results Most of the papers in the review focused on HIV, maternal health, family planning and adolescent sexual and reproductive health (ASRH).
Objectives To estimate the prevalence, spatial patterns and clustering in the distribution of soil-transmitted helminth (STH) infections, and factors associated with hookworm infections in a tribal population in Tamil Nadu, India. Methods Cross-sectional study with one-stage cluster sampling of 22 clusters. Demographic and risk factor data and stool samples for microscopic ova/cysts examination were collected from 1237 participants. Geographical information systems mapping assessed spatial patterns of infection.
Objective Differential diagnosis of infection with Trypanosoma cruzi or T. rangeli is relevant for epidemiological studies and clinical practice as both species infect humans, but only T. cruzi causes Chagas’ disease. Their common antigen determinants complicate the distinction between both species, while current PCR assays used for differentiation show some drawbacks. We developed and validated a generic PCR discriminating the species by restriction fragment length polymorphism (RFLP) analysis and a duplex PCR specifically amplifying a differently sized fragment of both species. Methods The assays are based upon a partial region of the heat-shock protein 70 gene (hsp70). The analytical sensitivity and specificity were determined for both PCRs.
Objective To determine the conditions under which the immunoagglutination assay to detect Chagas disease, obtained from a novel latex-(chimeric recombinant antigen) complex, shows greater discrimination between the responses of a positive control serum and a negative control serum. Methods The following variables were determined: (i) the sensitisation mechanism, (ii) the emulsifier employed for protein desorption, (iii) the reaction time, (iv) the ionic strength of the reaction medium, (v) the particle concentration, (vi) the presence of blocking agents, (vii) the presence of polyethyleneglycol as potentiator of reaction and (viii) the antigen and antibody concentrations. The search of optimal conditions was investigated by varying one variable at a time. To this effect, monodisperse latex particles sensitised with a recombinant chimeric protein (CP1) were subjected to different conditions. The agglutination reaction was followed by measuring the changes in the optical absorbance by turbidimetry
Objectives The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana. Methods Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively. Results Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit.