scholarly journals Effectiveness of Joint 3+1 Malaria Strategy Along China-Myanmar Cross Border Areas

2020 ◽  
Author(s):  
Zu-rui Lin ◽  
Shi-gang Li ◽  
Xiao-dong Sun ◽  
Xiang-rui Guo ◽  
Zhi Zheng ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Prevalence Rate ◽  
Indoor Residual Spraying ◽  
Parasite Prevalence ◽  
Pilot Project ◽  
Vector Surveillance ◽  
Buffer Area ◽  
Cross Border ◽  
Border Malaria ◽  
Significant Difference

Abstract Background: Cross-border malaria in Laiza City of Myanmar seriously compromised the achieving goal of malaria elimination in Yingjiang County of China. A pilot project on 3+1 strategy of joint cross-border malaria prevention and control was carried out in building border malaria buffer area in the both sides since 2017; Here, 3 was the three preventive lines in Yingjiang County to strengthen targeted measures of elimination malaria in China and +1 was a defined border area in Laiza City to adopt the integrated measures of malaria control in Myanmar. Methods: A retrospective analysis from 2015 to 2019 was conducted and the descriptive statistics was used to analyze and compare the data of malaria case detection, parasite prevalence and vector surveillance. Results: In +1 area of Myanmar from 2015 to 2019, the average of annual parasite incidence was (59.11±40.73) / 1000 and plasmodium vivax accounted for 96.27 % of total confirmed cases. After the pilot project, the annual parasite incidence, microscopic parasite prevalence rate and density of An. Minimus reduced by 89%,100% and 93.93% respectively, but the submicroscopic parasite prevalence rate was no significant difference between the two surveys (p =0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The average of annual importation rate from 2015 to 2019 was (0.47±0.15)/1000. After the pilot project, it reduced by 53% of whole county, 67% of the first preventive line, 52% of the second preventive line and 36% of the third preventive line respectively. Conclusion: The pilot project on 3+1 strategy has made remarkable effectiveness and a buffer area of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China. The combined use and expanded coverage of indoor residual spraying and long-lasting insecticidal nets (LLINs) was more effective than only use of LLINs in reducing the transmission of plasmodium vivax caused by An. Minimus. It is necessary to adopt submicroscopic infection interventions to eliminate potential sources of infection in Laiza City of Myanmar.

scholarly journals Effectiveness of Joint 3+1 Malaria Strategy Along China-Myanmar Cross Border Areas

2020 ◽  
Author(s):  
Zu-rui Lin ◽  
Shi-gang Li ◽  
Xiao-dong Sun ◽  
Xiang-rui Guo ◽  
Zhi Zheng ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Prevalence Rate ◽  
Indoor Residual Spraying ◽  
Parasite Prevalence ◽  
Pilot Project ◽  
P Value ◽  
Buffer Area ◽  
Cross Border ◽  
Border Malaria ◽  
Significant Difference

Abstract Background: Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised the national malaria elimination goal. A pilot project on 3+1 strategy of joint cross-border malaria prevention and control was carried out in building border malaria buffer area in the both sides since 2017; Here, 3 was the three preventive lines in Yingjiang County to strengthen targeted measures of elimination malaria in China and +1 was a defined border area in Laiza City to adopt the integrated measures of malaria control in Myanmar.Methods: A retrospective analysis from 2015 to 2019 was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence in +1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An.Minimus were statistically significant indictors to assess the effect of the joint interventions.Results: In +1 area of Myanmar from 2015 to 2019, the average of annual parasite incidence was (59.11±40.73) / 1000 and plasmodium vivax accounted for 96.27 % of total confirmed cases. After the pilot project, the annual parasite incidence, microscopic parasite prevalence rate and density of An. Minimus reduced by 89%,100% and 93.93% respectively, but the submicroscopic parasite prevalence rate was no significant difference between the two surveys (p =0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The average of annual importation rate from 2015 to 2019 was (0.47±0.15)/1000. After the pilot project, it reduced by 53% of whole county, 67% of the first preventive line, 52% of the second preventive line and 36% of the third preventive line respectively. The density of An. Minimus in the first preventive line reduced by 94.51% and did not have significant difference between that of+1 area of Myanmar (Z value=-1.18，p value=0.24). Conclusion: The pilot project on 3+1 strategy has made remarkable effectiveness and a buffer area of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China. The combined use and expanded coverage of indoor residual spraying and long-lasting insecticidal nets (LLINs) was more effective than only use of LLINs in reducing the transmission of plasmodium vivax caused by An. Minimus. It is necessary to adopt submicroscopic infection interventions to eliminate potential sources of infection in Laiza City of Myanmar.

scholarly journals Effectiveness of joint 3 + 1 malaria strategy along China–Myanmar cross border areas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zu-rui Lin ◽  
Shi-gang Li ◽  
Xiao-dong Sun ◽  
Xiang-rui Guo ◽  
Zhi Zheng ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Prevalence Rate ◽  
Parasite Prevalence ◽  
Pilot Project ◽  
Vector Surveillance ◽  
Trap Night ◽  
Cross Border ◽  
Border Malaria ◽  
Significant Difference ◽  
Border Areas

Abstract Background Cross-border malaria in Laiza City of Myanmar seriously affected Yingjiang County of China and compromised reaching the goal of malaria elimination by 2020. Since 2017, a pilot project on 3 + 1 strategy of joint cross-border malaria prevention and control was carried out for building a malaria buffer in these border areas. Here, 3 were the three preventive lines in China where different focalized approaches of malaria elimination were applied and + 1 was a defined border area in Myanmar where the integrated measures of malaria control were adopted. Methods A 5-year retrospective analysis (2015 to 2019) was conducted that included case detection, parasite prevalence and vector surveillance. Descriptive statistics was used and the incidence or rates were compared. The annual parasite incidence and the parasite prevalence rate in + 1 area of Myanmar, the annual importation rate in Yingjiang County of China and the density of An. minimus were statistically significant indictors to assess the effectiveness of the 3 + 1 strategy. Results In + 1 area of Myanmar from 2015 to 2019, the averaged annual parasite incidence was (59.11 ± 40.73)/1000 and Plasmodium vivax accounted for 96.27% of the total confirmed cases. After the pilot project, the annual parasite incidence dropped 89% from 104.77/1000 in 2016 to 12.18/1000 in 2019, the microscopic parasite prevalence rate dropped 100% from 0.34% in 2017 to zero in 2019 and the averaged density of An. Minimus per trap-night dropped 93% from 1.92 in June to 0.13 in September. The submicroscopic parasite prevalence rate increased from 1.15% in 2017 to 1.66% in 2019 without significant difference between the two surveys (P = 0.084). In Yingjiang County of China, neither indigenous nor introduced case was reported and 100% cases were imported from Myanmar since 2017. The averaged annual importation rate from 2015 to 2019 was (0.47 ± 0.15)/1000. After the pilot project, the annual importation rate dropped from 0.59/1000 in 2016 to 0.28/1000 in 2019 with an overall reduction of 53% in the whole county. The reduction was 67% (57.63/1000 to 18.01/1000) in the first preventive line, 52% (0.20/1000 to 0.10/1000) in the second preventive line and 36% (0.32/1000 to 0.22/1000) in the third preventive line. The averaged density of An. Minimus per trap-night in the first preventive line dropped 94% from 2.55 in June to 0.14 in September, without significant difference from that of + 1 area of Myanmar (Z value = − 1.18, P value = 0.24). Conclusion The pilot project on 3 + 1 strategy has been significantly effective in the study areas and a buffer zone of border malaria was successfully established between Laiza City of Myanmar and Yingjiang County of China.

scholarly journals Imported Plasmodium falciparum and locally transmitted Plasmodium vivax: cross-border malaria transmission scenario in northwestern Thailand

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Patchara Sriwichai ◽  
Stephan Karl ◽  
Yudthana Samung ◽  
Kirakorn Kiattibutr ◽  
Jeeraphat Sirichaisinthop ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Plasmodium Vivax ◽  
Malaria Transmission ◽  
Cross Border ◽  
Border Malaria ◽  
Northwestern Thailand

scholarly journals Gametocyte carriage of Plasmodium falciparum (pfs25) and Plasmodium vivax (pvs25) during mass screening and treatment in West Timor, Indonesia: a longitudinal prospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ayleen Kosasih ◽  
Cristian Koepfli ◽  
M. Sopiyudin Dahlan ◽  
William A. Hawley ◽  
J. Kevin Baird ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Plasmodium Vivax ◽  
Mass Screening ◽  
Parasite Prevalence ◽  
Mosquito Vector ◽  
Gametocyte Density ◽  
Time Points ◽  
Significant Difference ◽  
Before And After ◽  
Insignificant Difference

Abstract Background A goal of malaria epidemiological interventions is the detection and treatment of parasite reservoirs in endemic areas—an activity that is expected to reduce local transmission. Since the gametocyte is the only transmissible stage from human host to mosquito vector, this study evaluated the pre and post presence of gametocytes during a mass screening and treatment (MST) intervention conducted during 2013 in East Nusa Tenggara, Indonesia. Methods RT-qPCR targeting pfs25 and pvs25 transcripts—gametocyte molecular markers for Plasmodium falciparum and Plasmodium vivax, respectively, was performed to detect and quantify gametocytes in blood samples of P. falciparum and P. vivax-infected subjects over the course of the MST study. The presence of both asexual and sexual parasites in microscopic and submicroscopic infections was compared from the start and end of the MST, using proportion tests as well as parametric and non-parametric tests. Results Parasite prevalence remained unchanged for P. falciparum (6% = 52/811 versus 7% = 50/740, p = 0.838), and decreased slightly for P. vivax (24% = 192/811 versus 19% = 142/740, p = 0.035) between the MST baseline and endpoint. No significant difference was observed in gametocyte prevalence for either P. falciparum (2% = 19/803 versus 3% = 23/729, p = 0.353, OR = 1.34, 95%CI = 0.69–2.63), or P. vivax (7% = 49/744 versus 5% = 39/704, p = 0.442, OR = 0.83, 95%CI = 0.52–1.31). Even though there was an insignificant difference between the two time points, the majority of parasite positive subjects at the endpoint had been negative at baseline (P. falciparum: 66% = 29/44, P. vivax: 60% = 80/134). This was similarly demonstrated for the transmissible stage—where the majority of gametocyte positive subjects at the endpoint were negative at baseline (P. falciparum: 95% = 20/21, P. vivax: 94% = 30/32). These results were independent of treatment provided during MST activities. No difference was demonstrated in parasite and gametocyte density between both time points either in P. falciparum or P. vivax. Conclusion In this study area, similar prevalence rates of P. falciparum and P. vivax parasites and gametocytes before and after MST, although in different individuals, points to a negligible impact on the parasite reservoir. Treatment administration based on parasite positivity as implemented in the MST should be reevaluated for the elimination strategy in the community. Trial registration Clinical trials registration NCT01878357. Registered 14 June 2013, https://www.clinicaltrials.gov/ct2/show/NCT01878357.

Speech Methodologies in Cleft Palate Assessment: A Pilot Project to Compare Two Phonetically Different Sentence Sets

2013 ◽  
Vol 20 (1) ◽  
pp. 49-72
Author(s):  
Jennie Smith ◽  
Tim Pring ◽  
Debbie Sell
Keyword(s):  
Cleft Palate ◽  
Pilot Project ◽  
Wilcoxon Test ◽  
Consecutive Series ◽  
Video Recordings ◽  
Significant Difference ◽  
The Difference ◽  
Audio Video ◽  
Age Range ◽  
The Impact

Objective: To investigate the impact of the phonetic content of two sentence sets on speech outcomes, specifically the effects of nasal phonemes. Method: Audio-video recordings of a consecutive series of 15 participants (age range 4–22 years), with cleft palate (syndromic or non-syndromic), with and without velopharyngeal dysfunction were taken. Participants repeated Sentence Set 1 (with nasals across sentences) and Sentence Set 2 (without nasals except the three nasal target sentences) during a routine speech recording. Two experienced Specialist Speech and Language Therapists, blinded to the study’s purpose, analyzed participants’ speech using the Cleft Audit Protocol for Speech-Augmented (CAPS-A). On day 1, recordings included Sentence Set 1. On day 2, 23 days later, recordings included Sentence Set 2. Main results: The difference between Sentence Set 1 and Sentence Set 2 ‘total scores’ (sum of scores on all CAPS-A parameters) was significant. The Pearson Product Moment showed high correlation. A Wilcoxon test revealed a significant difference between Sets 1 and 2 on the hypernasality parameter, and this alone accounted for the significant difference in total scores. Conclusion: The inclusion or exclusion of nasal consonants in the sentence set significantly affected perceptual ratings of hypernasality but none of the other CAPS-A parameters, highlighting the need for further investigation into perceptual nasality ratings.

scholarly journals Gastrointestinal Parasitism in Miranda Donkeys: Epidemiology and Selective Control of Strongyles Infection in the Northeast of Portugal

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 155
Author(s):  
Sérgio Ramalho Sousa ◽  
Sofia Anastácio ◽  
Miguel Nóvoa ◽  
Adolfo Paz-Silva ◽  
Luís Manuel Madeira de Carvalho
Keyword(s):  
Prevalence Rate ◽  
Negative Binomial ◽  
Control Program ◽  
Parasite Prevalence ◽  
Gastrointestinal Parasites ◽  
Selective Treatment ◽  
Control Approach ◽  
Native Breed ◽  
Parasite Biodiversity ◽  
Gastrointestinal Parasitism

In Portugal, equine parasitism in pasture animals is characterized by high parasitic burden and high helminthic biodiversity; both factors are potentially pathogenic for their hosts. The decrease in the number of donkeys over the last years in Portugal, their importance in rural lowland and mountain ecosystems and pastures and the scarce information regarding their parasitism led to this research, which aimed to evaluate the parasitological status of a Miranda donkey breed population, a native breed mainly located in the northeast of Portugal. This study provides better knowledge of their gastrointestinal parasitism, particularly strongyles, and the assessment of a targeted selective treatment (TST) as an alternative control approach of their parasitism. A longitudinal observational study was developed during a period of five years in a population of 62 Miranda donkeys. At first, strategic deworming of these animals was performed every semester, but this was progressively replaced by a TST approach according to the levels of Eggs per Gram (EPG). This new deworming strategy was conducted in association with a regular parasitological monitoring of the animals every three months, being dewormed with ivermectin when egg shedding was higher than 500 EPG. Over the study period, a decrease of the annual prevalence rate of infection by gastrointestinal strongyles was observed, from 35.5% to 19.4%, as well as a negative binomial distribution of parasitic strongyles in donkeys submitted to selective anthelminthic control. The prevalence rate of infection was higher in females (39.5%), in individuals under four years (46.7%) and in those presenting a lower body condition (40.8%). The egg output was higher in animals younger than four years (589.3 EPG) than in those older than 10 years (533.6 EPG) (p < 0.05). However, no differences were observed according to sex during the study period. Results from this study allowed to note the influence of swampy pastures and of the weather changes in the epidemiology of strongylosis in Miranda donkeys. Moreover, it was possible to establish the annual epidemiological curve of strongyle egg shedding, with June being the month with the highest EPG, December having the lowest EPG and March and September showing intermediate numbers. Overall, a lower biodiversity of gastrointestinal parasites was observed. Cyathostomum sensu lato was the most prevalent genus and Strongylus vulgaris was the most observed large strongyle of the Strongylidae family. Trichostrongylus axei and Parascaris sp. were other nematodes with a minor frequency. The higher prevalence of strongyles at the beginning of the study showed a progressive decrease throughout the research period, and also for parasite biodiversity. Therefore, a targeted selective treatment seems to be a rational anthelminthic control approach in Miranda donkey strongyle infection and in other gastrointestinal parasites, since it reduces the antiparasitic treatments, the parasite’ prevalence and the EPG level. However, a loss of parasite biodiversity was noted at the end of the study period, as Cyathostominae were the only isolated strongyles. This can be a challenging situation in the long run, taking the ability of these nematodes to adapt easily to any deworming program, meaning that fecal EPG monitoring should be kept as a rule to a rational parasite control program.

scholarly journals Early Detection and Intervention for Patients with Delirium Admitted to the Department of Internal Medicine: Lessons from a Pilot Initiative

2021 ◽  
pp. 134-139
Author(s):  
Ron Oliven ◽  
Meital Rotfeld ◽  
Sharon Gino-Moor ◽  
Elad Schiff ◽  
Majed Odeh ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Early Detection ◽  
Emergency Room ◽  
Early Mobilization ◽  
Pilot Project ◽  
Medical Emergency ◽  
Medical Patients ◽  
Geriatric Unit ◽  
Retrospective Comparison ◽  
Significant Difference

<b><i>Introduction:</i></b> Older patients who arrive to the emergency room with delirium have a worse prognosis than others. Early detection and treatment of this problem has been shown to improve outcome. We have launched a project at our hospital to improve the care of patients who arrive delirious to the medical emergency room. The present article describes lessons that can be learned from this pilot initiative. <b><i>Methods:</i></b> All patients older than 70 years admitted to the department of internal medicine were screened for delirium in the emergency room using the 4AT screening tool. Data of patients with a 4AT score ≥5 (or with incomplete score) were transferred to the geriatric unit of the hospital. On the ward, the presence of delirium was confirmed by a geriatric nurse that validated that the patient could walk with support and ordered mobilization and physiotherapy (M&amp;P). <b><i>Results:</i></b> Over the 2 and a half years (10 quarters) allocated for the pilot project, 1,078 medical patients with delirium were included in this survey. In 59.3%, the diagnosis of delirium could be confirmed only after admission. Due to budgetary constraints, only 54.7% received the allocated specific intervention – early M&amp;P. Since it was decided that randomization was not appropriate for our initiative, we found that patients who received M&amp;P had lower (better) 4AT scores on admission, and lower mortality. No significant difference was found between the patients who received M&amp;P and the others in length of hospitalization and discharge to nursing homes. Retrospective comparison of the two groups did not enable to determine whether M&amp;P was given to the patients for whom it was most effective. <b><i>Conclusions:</i></b> It is often not possible to verify in the emergency room that the cognitive decline is indeed new, that is, is due to delirium, and measures must be taken to verify this point as soon as possible after admission. Due to numerous constraints, the availability of early M&amp;P is often insufficient. Whenever resources are scarce and randomization is avoided, adequate criteria should be found for allocating existing dedicated staff to patients for whom early mobilization is likely to be most beneficial.

scholarly journals The occurrence of Contracaecum sp. larvae (Nematoda : Anisakidae) in the catfishClarias gariepinus (Burchell) from Lake Chivero, Zimbabwe

2004 ◽  
Vol 71 (1) ◽  
Author(s):  
M. Barson
Keyword(s):  
Significant Relationship ◽  
Condition Factor ◽  
Clarias Gariepinus ◽  
Parasite Prevalence ◽  
Body Cavity ◽  
The Body ◽  
Nematode Parasites ◽  
Significant Difference ◽  
Third Stage ◽  
Males And Females

Clarias gariepinus were collected from Lake Chivero, Zimbabwe, and examined for nematode parasites from November 2000 to May 2002. Of the 202 specimens collected, 42.6 % were infected with third-stage larvae of Contracaecum sp. in the body cavity. The intensity of the infection was 1-7 worms per fish (mean intensity = 2.2). Seasonal variation in the prevalence of the parasite was not obvious and there was no significant difference in the prevalence of infection between males and females (c2 = 2.228; P > 0.05). No significant relationship between host size and prevalence was established. There was also no significant relationship between intensity and the body condition factor (r = 0.11; P > 0.05). The low parasite prevalence may have been caused by the disruption of the infection cycle since piscivorous birds, which are the final hosts of the parasite, do not feed on C. gariepinus in Lake Chivero.

scholarly journals The Effect of Sonophoresis on Topical Anesthesia: A Pilot Project

2013 ◽  
Vol 60 (2) ◽  
pp. 37-41 ◽  
Author(s):  
Joseph L. Packer ◽  
Barry Krall ◽  
Ali Makki ◽  
Mahmoud Torabinejad
Keyword(s):  
Stratum Corneum ◽  
Pain Perception ◽  
Pilot Project ◽  
Control Device ◽  
Topical Anesthesia ◽  
Needle Puncture ◽  
Topical Anesthetic ◽  
Novel Device ◽  
Needle Penetration ◽  
Significant Difference

Abstract The dental anesthesia sonophoresis device (DASD) is a novel device that is intended to reduce the discomfort associated with intraoral mucosa needle puncture. The DASD produces ultrasonic energy that provides a sonophoretic effect on the oral mucosa, generating microchannels through the lipids between the keratinized cells that make up the stratum corneum. Once the topical anesthetic has permeated the stratum corneum, it quickly diffuses through the soft tissue, desensitizing the nerve endings and reducing the perception of pain caused by needle penetration. The aim of this study is to evaluate whether topical anesthesia applied using the DASD will reduce the discomfort of the needle puncture when compared to the control device. A split-mouth model, using 50 healthy subjects with puncture site at the maxillary canine vestibule, was used for this study. Subjects received a needle puncture on both sides of the mouth. Prior to the needle puncture, there was randomized application of 5% lidocaine with the DASD and a control device. Subjects rated their discomfort after needle punctures utilizing the visual analog scale pain scoring system. There was no statistically significant difference in the pain perception using the DASD versus the control device.

scholarly journals Gender Differences in Prevalence of Somatoform Disorders in Patients Visiting Primary Care Centers

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Bener
Keyword(s):  
Health Care ◽  
Gender Differences ◽  
Primary Health Care ◽  
Prevalence Rate ◽  
Somatoform Disorders ◽  
Somatic Symptoms ◽  
Clinical Interview ◽  
Primary Health ◽  
Significant Difference ◽  
Depressive Reaction

Objective:The aim of this study was to examine the gender differences in the prevalence of somatoform disorders among a sample of Qatari patients who were visiting primary health care (PHC) centres and to investigate the severity of most frequent somatic symptoms in these patients.Method:The first stage of the study was conducted with the help of general practitioners (GPs), using the 12-item General Health Questionnaire (GHQ-12). the second stage was carried out by a psychiatrist using the Clinical Interview Schedule (CIS). the survey was conducted among patients presenting to the primary health care centres over the period from January to July, 2007. 2320 subjects were approached and a total of 1689 patientsagreed to participate and responded to the questionnaire. among the screened Qatari patients, 404 patients, 211 males (52.2%) and 193 females (47.8%), were identified for clinical interview.Results:The prevalence rate of somatoform disorders among the total screened sample was 23.9%. the prevalence rate was slightly higher in women (24.2%) than in men (23.7%). Prolonged depressive reaction was significantly higher in women compared to men (p=0.003). There was a significant gender difference in certain psychiatric diagnostic categories such as depressive episode, recurrent depressive disorder, dysthymia and brief depressive reaction. Backache was the most common reported symptom in men, while headache was more common in women.Conclusion:Prevalence of somatoform disorders was slightly higher in Qatari women than in men. There was a significant difference found between men and women in certain diagnosis categories and somatic symptoms.

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