Has COVID19 derailed Bhutan’s national malaria elimination goal? A commentary

AbstractThe COVID-19 pandemic has resulted in massive global disruptions with considerable impact on the delivery of health services and national health programmes. Since the detection of the first COVID-19 case on 5th March 2020, the Royal Government of Bhutan implemented a number of containment measures including border closure and national lockdowns. Against the backdrop of this global COVID-19 pandemic response, there was a sudden surge of locally-transmitted malaria cases between June to August 2020. There were 20 indigenous cases (zero Plasmodium falciparum and 20 Plasmodium vivax) from a total of 49 cases (seven P. falciparum and 42 P. vivax) in 2020 compared to just two from a total of 42 in 2019. Over 80% of the cases were clustered in malaria endemic district of Sarpang. This spike of malaria cases was attributed to the delay in the delivery of routine malaria preventive interventions due to the COVID-19 pandemic. As a result, Bhutan is unlikely to achieve the national goal of malaria elimination by 2020.

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Significance of training, monitoring and assessment of malaria workers in achieving malaria elimination goal of Malaria Elimination Demonstration Project

Malaria Journal ◽

10.1186/s12936-020-03534-9 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Harsh Rajvanshi ◽

Sekh Nisar ◽

Praveen K. Bharti ◽

Himanshu Jayswar ◽

Ashok K. Mishra ◽

...

Keyword(s):

Case Management ◽

Vector Control ◽

Malaria Elimination ◽

Disease Surveillance ◽

Training Session ◽

Central India ◽

Malaria Diagnosis ◽

Demonstration Project ◽

National Goal ◽

Health Delivery

Abstract Background The Malaria Elimination Demonstration Project (MEDP) maintained a workforce of 235 Village Malaria Workers (VMWs) and 25 Malaria Field Coordinators (MFCs) to conduct disease surveillance, case management, IEC/BCC activities, capacity building, and monitoring of vector control activities in 1233 villages of Mandla, a high malaria endemic district of Madhya Pradesh in central India. Methods The induction training was conducted for 3 days on malaria diagnosis, treatment, prevention, and ethics. All trainings were assessed using a pre and post-training assessment questionnaire, with 70% marks as qualifying threshold. The questionnaire was divided into three thematic areas viz. general knowledge related to malaria (KAP), diagnosis and treatment (DXRX), and vector control (PVC). Results In 2017, the project trained 330 candidates, followed by 243 and 247 candidates in 2018 and 2019, respectively. 94.3% candidates passed after a single training session. Almost all (95%) candidates showed improvement in knowledge after the training with 4% showing no effect and 1% showing deterioration. Progressive improvement in scores of 2017 cohort was seen along with significant improvement in performance of candidates in 2019 after the introduction of systematic monitoring and ‘shadowing’ training exercises. Conclusion The project has successfully demonstrated the value of recruitment of workers from the study area, outcome of training, and performance evaluation of field staff in malaria elimination programme. This careful strategy of recruitment and training resulted in a work-force that was capable of independently conducting surveillance, case management, vector control, and Information Education Communication/Behaviour Change Communication (IEC/BCC). The learnings of this study, including the training modules and monitoring processes, can be used to train the health delivery staff for achieving national goal for malaria elimination by 2030. Similar training and monitoring programmes could also be used for other public health delivery programmes.

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Micro-Stratification for Malaria Transmission Risk in a High Burden Area of Honduras

10.21203/rs.3.rs-418870/v1 ◽

2021 ◽

Author(s):

José Orlinder Nicolas ◽

Denis Escobar ◽

Engels Banegas ◽

José Ramón Valdez ◽

Rosa Elena Mejía Torres ◽

...

Keyword(s):

Malaria Elimination ◽

Malaria Incidence ◽

Epidemiological Data ◽

Transmission Risk ◽

Who Guidelines ◽

Demographic Information ◽

Health System Improvement ◽

System Improvement ◽

Endemic Areas ◽

Elimination Goal

Abstract Background As Malaria cases are continuously reported across the globe, epidemiological and integral approaches should be considered for an optimal stratification on endemic areas for elimination goal. In Central America, a 75% reduction in malaria incidence has been reported between 2000 and 2015, similarly, in Honduras, more than 75% of total cases in 2016 were concentrated in 7 municipalities, mainly in Gracias Dios department. Achieve malaria elimination in Honduras demands the implementation of strategies to identify main hotspots. Methods Based on WHO guidelines, local malaria epidemiological data from case-based surveillance system of the Ministry of Health between January and December 2016 were analysed. Furthermore, on field evaluations were carried out in Puerto Lempira municipality, Gracias a Dios department to an analysis validation. Finally, a set of epidemiological components were generated and proposed together with risk-factor description and proposed actions for health system improvement. Results On 2016, Gracias a Dios reported 61% of total malaria cases in Honduras; based on our analysis, 12 micro-areas were identified, including epidemiological, entomological, and socio-demographic information from local technicians. Conclusions Malaria elimination in endemic areas urges implementation of different strategies, here we show the on-field micro-stratification process of 12 “micro-areas” carried out in one endemic department of Honduras. This information provides a more targeted strategy for diagnosis, treatment, and vector control interventions for malaria elimination goal in Honduras.

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Low uptake of preventive interventions among malaria cases in Swaziland: towards malaria elimination

Public Health Action ◽

10.5588/pha.17.0016 ◽

2018 ◽

Vol 8 (1) ◽

pp. S29-S33

Author(s):

K. Makadzange ◽

N. Dlamini ◽

Z. Zulu ◽

S. Dlamini ◽

S. Kunene ◽

...

Keyword(s):

Malaria Elimination ◽

Preventive Interventions

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Forest malaria: the prevailing obstacle for malaria control and elimination in India

BMJ Global Health ◽

10.1136/bmjgh-2021-005391 ◽

2021 ◽

Vol 6 (5) ◽

pp. e005391

Author(s):

Raju Ranjha ◽

Amit Sharma

Keyword(s):

Malaria Control ◽

Malaria Elimination ◽

Indian Population ◽

Public Health Problem ◽

Mortality And Morbidity ◽

Significant Public Health Problem ◽

Significant Public Health ◽

Elimination Programme ◽

Forested Areas ◽

Elimination Goal

Despite the decrease in malaria mortality and morbidity, it remains a significant public health problem in India. India is targeting malaria elimination from the country by 2030. Different areas in India are in different phases of malaria elimination. The emerging resistance in vectors as well parasite have added necessity to accelerate the malaria elimination programme. Forested areas remain the foci for malaria transmission due to favourable human and environmental factors. Here, we analysed the longitudinal data from 2000 to 2019 to see the trends in forest malaria in India. Population living in forested areas are major malaria contributors. From 2000 to 2019, ~32% of malaria cases and 42% of malaria related deaths were reported from forested districts which represent only ~6.6% of the total Indian population. Increasing insecticide resistance, a high percentage of submicroscopic infections and challenging to test and treat communities are the crucial components of the prevailing obstacles of forested malaria. To achieve the elimination goal, efforts should be intensified with more resources diverted to the forested areas. Malaria control in forested areas will bring fruitful results for malaria control in India.

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An Overview of the Covid-19 Crisis Management in Cameroon: Decentralised Governance Response Needed

Annals of Disaster Risk Sciences ◽

10.51381/adrs.v3i2.34 ◽

2020 ◽

Vol 3 (2) ◽

Author(s):

Henry Ngenyam Bang

Keyword(s):

Crisis Management ◽

Health Workers ◽

National Level ◽

Control Measures ◽

Infection Control Measures ◽

Framework Approach ◽

Containment Measures ◽

Pandemic Response ◽

The Government ◽

Administrative Units

This article provides insights into Cameroon’s crisis management of the coronavirus pandemic via an exploratory and descriptive qualitative research. Thematic analysis of data was done using a framework approach; the Comprehensive Pandemic Risk Management System (CPRMS) underpins the research and provided structure, order, and clarity to the article. From the findings, one can deduce that the government is working hard to mitigate the potentially awful consequences of the coronavirus pandemic. The authorities implemented temporary containment and infection control measures to stem virus spread and have relied heavily on international and humanitarian organisations for financial/technical help to operationalise the pandemic response. Attempts to control the spread of the virus, however, have been challenging. Deficiencies abound in many areas including slowness to institute containment measures after the first infected cases; Cameroon’s fragile/weak health infrastructure; insufficient critical care units and health workers disproportionately distributed in the country; safety concerns with insufficient protective equipment for health workers; overly centralised pandemic response at the national level to the detriment of the regions and lower administrative units; government politicising the response by refusing contributions/donations from opposition parties; high cost for COVID-19 treatment limiting access to healthcare and insufficient trust in health systems ability to deal with COVID-19. Recommendations are supplied on how to improve the coronavirus response as infections skyrocket. The recommendations also address enhancing later epidemics/pandemics and Cameroon’s health system.

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New concepts in the delivery of health services: a challenge to dental schools

Journal of Dental Education ◽

10.1002/j.0022-0337.1968.32.4.tb00119.x ◽

1968 ◽

Vol 32 (4) ◽

pp. 381-384

Author(s):

JM Frankel

Keyword(s):

Health Services ◽

New Concepts ◽

Dental Schools ◽

Delivery Of Health Services

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Preventive Interventions for Conduct Disorders: A Review

Child and Adolescent Psychiatric Clinics of North America ◽

10.1016/s1056-4993(18)30507-8 ◽

1994 ◽

Vol 3 (2) ◽

pp. 405-420 ◽

Cited By ~ 4

Author(s):

Laurie S. Miller

Keyword(s):

Conduct Disorders ◽

Preventive Interventions

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Inflammational Animal Models for Schizophrenia

Zeitschrift für Psychologie ◽

10.1027/2151-2604/a000216 ◽

2015 ◽

Vol 223 (3) ◽

pp. 157-164 ◽

Cited By ~ 1

Author(s):

Georg Juckel

Keyword(s):

Animal Model ◽

Animal Models ◽

Immune Activation ◽

Microglial Activation ◽

Treatment Options ◽

Early Adulthood ◽

Brain Regions ◽

Synaptic Connections ◽

Preventive Interventions ◽

Immunological System

Abstract. Inflammational-immunological processes within the pathophysiology of schizophrenia seem to play an important role. Early signals of neurobiological changes in the embryonal phase of brain in later patients with schizophrenia might lead to activation of the immunological system, for example, of cytokines and microglial cells. Microglia then induces – via the neurotoxic activities of these cells as an overreaction – a rarification of synaptic connections in frontal and temporal brain regions, that is, reduction of the neuropil. Promising inflammational animal models for schizophrenia with high validity can be used today to mimic behavioral as well as neurobiological findings in patients, for example, the well-known neurochemical alterations of dopaminergic, glutamatergic, serotonergic, and other neurotransmitter systems. Also the microglial activation can be modeled well within one of this models, that is, the inflammational PolyI:C animal model of schizophrenia, showing a time peak in late adolescence/early adulthood. The exact mechanism, by which activated microglia cells then triggers further neurodegeneration, must now be investigated in broader detail. Thus, these animal models can be used to understand the pathophysiology of schizophrenia better especially concerning the interaction of immune activation, inflammation, and neurodegeneration. This could also lead to the development of anti-inflammational treatment options and of preventive interventions.

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