scholarly journals The Immune Home: Domestic Enclaves, Diffuse Protections

2021 ◽  
Vol 36 (4) ◽  
Author(s):  
Ann H. Kelly ◽  
Javier Lezaun
Keyword(s):  
Global Health ◽  
Malaria Transmission ◽  
Malaria Control ◽  
Paradigm Shift ◽  
Malaria Prevention ◽  
Health Interventions ◽  
Domestic Spaces ◽  
Rural Tanzania ◽  
Spatial Repellents ◽  
Moral Ambivalence

This essay tracks a paradigm shift in the use of chemicals to control malaria: away from insecticidal approaches, focused on killing mosquitoes within private domestic dwellings, and toward the creation of protective communal atmospheres. An ongoing study of the efficacy of spatial repellents to reduce malaria transmission in rural Tanzania provides an opportunity to rethink the oikographic assumptions of malaria control—and of many global health interventions—and to foreground the specific relationalities of peri-domestic spaces. Yet a sense of moral ambivalence permeates this inquiry, as malaria prevention becomes untethered from any long-lasting material improvement in the house. We reflect on the power of chemicals to reveal chronic forms of neglect and, just possibly, conjugate new, if diffuse, forms of communitas.

scholarly journals Heterogeneous exposure and hotspots for malaria vectors at three study sites in Uganda

2018 ◽  
Vol 2 ◽  
pp. 32 ◽  
Author(s):  
Su Yun Kang ◽  
Katherine E. Battle ◽  
Harry S. Gibson ◽  
Laura V. Cooper ◽  
Kilama Maxwell ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Vector ◽  
Malaria Control ◽  
Negative Binomial ◽  
Indoor Residual Spraying ◽  
Housing Quality ◽  
Environmental Covariates ◽  
Vector Density ◽  
Vector Abundance ◽  
Study Sites

Background: Heterogeneity in malaria transmission has household, temporal, and spatial components. These factors are relevant for improving the efficiency of malaria control by targeting heterogeneity. To quantify variation, we analyzed mosquito counts from entomological surveillance conducted at three study sites in Uganda that varied in malaria transmission intensity. Mosquito biting or exposure is a risk factor for malaria transmission. Methods: Using a Bayesian zero-inflated negative binomial model, validated via a comprehensive simulation study, we quantified household differences in malaria vector density and examined its spatial distribution. We introduced a novel approach for identifying changes in vector abundance hotspots over time by computing the Getis-Ord statistic on ratios of household biting propensities for different scenarios. We also explored the association of household biting propensities with housing and environmental covariates. Results: In each site, there was evidence for hot and cold spots of vector abundance, and spatial patterns associated with urbanicity, elevation, or other environmental covariates. We found some differences in the hotspots in rainy vs. dry seasons or before vs. after the application of control interventions. Housing quality explained a portion of the variation among households in mosquito counts. Conclusion: This work provided an improved understanding of heterogeneity in malaria vector density at the three study sites in Uganda and offered a valuable opportunity for assessing whether interventions could be spatially targeted to be aimed at abundance hotspots which may increase malaria risk. Indoor residual spraying was shown to be a successful measure of vector control interventions in Tororo, Uganda.  Cement walls, brick floors, closed eaves, screened airbricks, and tiled roofs were features of a house that had shown reduction of household biting propensity. Improvements in house quality should be recommended as a supplementary measure for malaria control reducing risk of infection.

scholarly journals Risk of Plasmodium falciparum infection in south-west Burkina Faso - potential impact of expanding eligibility for seasonal malaria chemoprevention

2021 ◽  
Author(s):  
Anne L Wilson ◽  
Steve W Lindsay ◽  
Alfred Tiono ◽  
Jean Baptiste Yaro ◽  
Hilary Ranson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Plasmodium Falciparum ◽  
Burkina Faso ◽  
Malaria Transmission ◽  
Malaria Control ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
South West ◽  
Seasonal Malaria Chemoprevention ◽  
The Impact

Abstract Background Burkina Faso has one of the highest malaria burdens in sub-Saharan Africa despite the mass deployment of insecticide-treated nets (ITNs) and use of seasonal malaria chemoprevention (SMC) in children aged up to 5 years. Identification of risk factors for Plasmodium falciparum infection in rural Burkina Faso could help to identify and target malaria control measures. Methods A cross-sectional survey of 1,199 children and adults was conducted during the peak malaria transmission season in south-west Burkina Faso in 2017. Logistic regression was used to identify risk factors for microscopically confirmed P. falciparum infection. A malaria transmission dynamic model was used to determine the impact on malaria cases averted of administering SMC to children aged 5–15 year old. Results P. falciparum prevalence was 32.8% in the study population. Children aged 5 to < 10 years old were at 3.74 times the odds (95% CI = 2.68–5.22, p < 0.001) and children aged 10 to 15 years old at 3.14 times the odds (95% CI = 1.20–8.21, p = 0.02) of P. falciparum infection compared to children aged less than 5 years old. Administration of SMC to children aged up to 10 years is predicted to avert an additional 57 malaria cases per 1000 population per year (9.4% reduction) and administration to children aged up to 15 years would avert an additional 89 malaria cases per 1000 population per year (14.6% reduction) in the Cascades Region, assuming coverage of pyrethroid-piperonyl butoxide ITNs. Conclusion Malaria infections were high in all age strata, although highest in children aged 5 to 15 years, despite roll out of core malaria control interventions. Given the burden of infection in school-age children, extension of the eligibility criteria for SMC could help reduce the burden of malaria in Burkina Faso and other countries in the region.

Health

2016 ◽  
Author(s):  
Georgia Levenson Keohane
Keyword(s):  
Global Health ◽  
Research And Development ◽  
International Finance ◽  
Global Fund ◽  
Drug Research ◽  
Health Interventions ◽  
Investment Fund ◽  
Health Objectives ◽  
Market Shaping ◽  
Loan Forgiveness

Looks at the range of innovations that have emerged in recent years to improve financing for global health objectives, and examines various approaches, including global levies like UNITAID and UNITLIFE; an array of market shaping initiatives like prizes and challenges and the GAVI Alliance’s advanced market commitments; a variety of innovations related to debt, including loan forgiveness and ‘debt swaps’ administered through the Global Fund, Pledge Guarantee for Health, the International Finance Facility for Immunization (IFFIm)’s vaccine bonds; and equity investments—impact investment vehicles like the Global Health Investment Fund—that blend philanthropic and commercial capital for drug research and development and other health interventions.

scholarly journals Large Variations in Malaria Parasite Carriage by Afebrile School Children Living in Nearby Communities in the Central Region of Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Evans K. Obboh ◽  
Ruth E. Okonu ◽  
Linda E. Amoah
Keyword(s):  
Malaria Transmission ◽  
Central Region ◽  
Malaria Control ◽  
Filter Paper ◽  
Malaria Parasite ◽  
Molecular Evidence ◽  
Asymptomatic Malaria ◽  
Cape Coast ◽  
Malaria Parasites ◽  
Asymptomatic Infections

Background. Indicators of successful malaria control interventions include a reduction in the prevalence and densities of malaria parasites contained in both symptomatic and asymptomatic infections as well as a reduction in malaria transmission. Individuals harboring malaria parasites in asymptomatic infections serve as reservoirs for malaria transmission. This study determined the prevalence of asymptomatic malaria parasite carriage in afebrile children attending six different schools in two districts, the Cape Coast Metropolitan Assembly (CCMA) and the Komenda Edina Eguafo Abirem (KEEA) of the Central Region of Ghana. Methods. This cross sectional study recruited afebrile children aged between 3 and 15 years old from six randomly selected schools in the Central Region of Ghana. Finger-pricked blood was collected and used to prepare thick and thin blood smears as well as spot a strip of filter paper (Whatman #3). Nested PCR was used to identify Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax in DNA extracted from the filter paper spots. The multiplicity of P. falciparum infection was determined using merozoite surface protein 2 genotyping. Results. Out of the 528 children sampled, PCR identified 27.1% to harbor Plasmodium parasites in asymptomatic infections, whilst microscopy identified malaria parasites in 10.6% of the children. The overall PCR estimated prevalence of P. falciparum and P. malariae was 26.6% and 1.3%, respectively, with no P. ovale or P. vivax identified by PCR or microscopy. The RDT positivity rate ranged from 55.8% in Simiw to 4.5% in Kuful. Children from the Simiw Basic School accounted for 87.5% of all the asymptomatic infections. The multiplicity of P. falciparum infection was predominantly monoclonal and biclonal. Conclusions. The low prevalence of asymptomatic malaria parasite carriage by the children living in the Cape Coast Metropolis suggests that the malaria control interventions in place in CCMA are highly effective and that additional malaria control interventions are required for the KEEA district to reduce the prevalence of asymptomatic malaria parasite carriers. No molecular evidence of P. ovale and P. vivax was identified in the afebrile children sampled from the selected schools.

scholarly journals The Impact of 3 Years of Targeted Indoor Residual Spraying With Pirimiphos-Methyl on Malaria Parasite Prevalence in a High-Transmission Area of Northern Zambia

2019 ◽  
Vol 188 (12) ◽  
pp. 2120-2130 ◽  
Author(s):  
Marisa A Hast ◽  
Mike Chaponda ◽  
Mbanga Muleba ◽  
Jean-Bertin Kabuya ◽  
James Lupiya ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Control ◽  
Malaria Parasite ◽  
Control Measure ◽  
Indoor Residual Spraying ◽  
Parasite Prevalence ◽  
Organophosphate Insecticide ◽  
Malaria Burden ◽  
Pirimiphos Methyl ◽  
The Impact

Abstract Malaria transmission in northern Zambia has increased in the past decade, despite malaria control activities. Evidence-based intervention strategies are needed to effectively reduce malaria transmission. Zambia’s National Malaria Control Centre conducted targeted indoor residual spraying (IRS) in Nchelenge District, Luapula Province, from 2014 to 2016 using the organophosphate insecticide pirimiphos-methyl. An evaluation of the IRS campaign was conducted by the Southern Africa International Centers of Excellence for Malaria Research using actively detected malaria cases in bimonthly household surveys carried out from April 2012 to July 2017. Changes in malaria parasite prevalence after IRS were assessed by season using Poisson regression models with robust standard errors, controlling for clustering of participants in households and demographic, geographical, and climatological covariates. In targeted areas, parasite prevalence declined approximately 25% during the rainy season following IRS with pirimiphos-methyl but did not decline during the dry season or in the overall study area. Within targeted areas, parasite prevalence declined in unsprayed households, suggesting both direct and indirect effects of IRS. The moderate decrease in parasite prevalence within sprayed areas indicates that IRS with pirimiphos-methyl is an effective malaria control measure, but a more comprehensive package of interventions is needed to effectively reduce the malaria burden in this setting.

scholarly journals ‘I’m Not that Kind of Doctor’

2019 ◽  
Vol 26 (1) ◽  
pp. 12-20
Author(s):  
Erica Nelson
Keyword(s):  
Latin America ◽  
Global Health ◽  
Critical Reflection ◽  
Sexual And Reproductive Health ◽  
Status Quo ◽  
Health Interventions ◽  
Health Practice ◽  
Transformative Potential ◽  
The Status ◽  
Complex Relationships

Within multi-disciplinary global health interventions, anthropologists find themselves navigating complex relationships of power. In this article, I offer a critical reflection on this negotiated terrain, drawing on my experience as an embedded ethnographer in a four-year adolescent sexual and reproductive health research intervention in Latin America. I critique the notion that the transformative potential of ethnographic work in global health remains unfulfilled. I then go on to argue that an anthropological practice grounded in iterative, inter-subjective and self-reflexive work has the potential to create ‘disturbances’ in the status quo of day-to-day global health practice, which can in turn destabilise some of the problematic hubristic assumptions of health reforms.

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