scholarly journals Safety Monitoring Experience of Single-low Dose Primaquine Co-administered With Artemether-lumefantrine Among Providers and Patients in Routine Healthcare Practice: a Qualitative Study in Eastern Tanzania

2021 ◽  
Author(s):  
Dominic Mosha ◽  
Mwaka A Kakolwa ◽  
Muhidin K Mahende ◽  
Honorati Masanja ◽  
Salim Abdulla ◽  
...  
Keyword(s):  
Low Dose ◽  
Healthcare Providers ◽  
National Policy ◽  
Coastal Region ◽  
Control Program ◽  
Safety Monitoring ◽  
Transport Cost ◽  
Perceived Effectiveness ◽  
General Acceptance ◽  
Malaria Control Program

Abstract Background: Primaquine is a gametocytocidal drug recommended by the WHO in a single-low dose combined with artemisinin-based combination therapy (ACT) for the treatment and prevention of Plasmodium falciparum malaria transmission. Safety monitoring concern and the lack of universal validated and approved primaquine pharmacovigilance tool is a challenge for a national rollout in many countries. This study aimed explored acceptance, reliability and perceived effectiveness of the primaquine roll out monitoring pharmacovigilance tool (PROMPT). Methods: This study was conducted in three dispensaries in the Coastal region of Eastern Tanzania. The study held six in-depth interviews with healthcare providers and six participatory focus group discussions with malaria patients (3) and parents/guardians of sick children (3). Participants were purposively sampled. Thematic analysis was conducted with the aid of NVivo qualitative analysis software.Results: The respondents’ general acceptance and perceived effectiveness of the single-low dose primaquine and PROMPT was good. Screening procedure for treatment eligibility and explaining to patients about the possible adverse events was considered very useful for safety reasons. Crushing and dissolving of primaquine tablet to get the appropriate dose, particularly in children, was reported by all providers to be challenging. Transport cost and poor access to the health facility were the main reasons for a patient failing to return to the clinic for a scheduled follow-up visit. Treatment was perceived to be safe by both providers and patients and reported no case of a severe adverse event. Some providers were concern with the haemoglobin drop observed on day seven. Conclusion: Single-low dose primaquine was perceived to be safe and acceptable among providers and patients. PROMPT demonstrated to be a reliable and user-friendly tool among providers. Further validation of the tool by involving the National Malaria Control Program is pivotal to address key challenges and facilitate the adoption of primaquine in the national policy.

scholarly journals Safety monitoring experience of single-low dose primaquine co-administered with artemether–lumefantrine among providers and patients in routine healthcare practice: a qualitative study in Eastern Tanzania

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dominic Mosha ◽  
Mwaka A. Kakolwa ◽  
Muhidin K. Mahende ◽  
Honorati Masanja ◽  
Salim Abdulla ◽  
...  
Keyword(s):  
Low Dose ◽  
Healthcare Providers ◽  
National Policy ◽  
Coastal Region ◽  
National Malaria Control Programme ◽  
Safety Monitoring ◽  
Control Programme ◽  
World Health ◽  
Malaria Control Programme ◽  
Perceived Effectiveness

Abstract Background Primaquine is a gametocytocidal drug recommended by the World Health Organization (WHO) in a single-low dose combined with artemisinin-based combination therapy (ACT) for the treatment and prevention of Plasmodium falciparum malaria transmission. Safety monitoring concerns and the lack of a universal validated and approved primaquine pharmacovigilance tool is a challenge for a national rollout in many countries. This study aimed to explore the acceptance, reliability and perceived effectiveness of the primaquine roll out monitoring pharmacovigilance tool (PROMPT). Methods This study was conducted in three dispensaries in the Coastal region of Eastern Tanzania. The study held six in-depth interviews with healthcare providers and six participatory focus group discussions with malaria patients (3) and parents/guardians of sick children (3). Participants were purposively sampled. Thematic analysis was conducted with the aid of NVivo qualitative analysis software. Results The respondents’ general acceptance and perceived effectiveness of the single-low dose primaquine and PROMPT was good. Screening procedure for treatment eligibility and explaining to patients about the possible adverse events was considered very useful for safety reasons. Crushing and dissolving of primaquine tablet to get the appropriate dose, particularly in children, was reported by all providers to be challenging. Transport costs and poor access to the health facility were the main reasons for a patient failing to return to the clinic for a scheduled follow-up visit. Treatment was perceived to be safe by both providers and patients and reported no case of a severe adverse event. Some providers were concerned with the haemoglobin drop observed on day 7. Conclusion Single-low dose primaquine was perceived to be safe and acceptable among providers and patients. PROMPT demonstrated to be a reliable and user-friendly tool among providers. Further validation of the tool by involving the National Malaria Control Programme is pivotal to addressing key challenges and facilitating primaquine adoption in the national policy.

Financing employee healthcare: fusing the preferences of employees in decision-making

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
George Ouma Ochieng'a ◽  
Maurice Ogada
Keyword(s):  
Health Care ◽  
Cost Benefit Analysis ◽  
Healthcare Providers ◽  
Coastal Region ◽  
Probit Analysis ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Employee Preferences

Purpose Good health is important for the happiness and productivity of employees of any organization and a nation. With the declining government funding for public Universities in Kenya, providing health cover for employees is a real challenge. Thus, the universities have to explore widely acceptable and sustainable options. This study aims to explore the correlations of employee preferences for health care schemes and evaluated the cost implications of each of the available Schemes.Design/methodology/approach The study applied a multinomial probit analysis on cross-sectional data from Taita Taveta University (TTU) in Kenya's coastal region. Cost-benefit analysis was used to rank alternative healthcare schemes. For triangulation of information, individual interviews were supplemented with key informant interviews.Findings Two sets of factors, personal attributes of employees and the attributes of the health care provider, were found to drive employee preferences for health care schemes. Thus, the universities need to consider these attributes in their choice sets of health care schemes to gain employee support.Research limitations/implications The study was based on a cross-sectional survey that may not capture the dynamic elements in institutional management. Thus, future research may build panel data on the current one for further analysis.Practical implications The study found that household characteristics and the perceived attributes of the healthcare providers are key drivers of the preferences. Thus, it is important to consider the characteristics of the employees (for example, age, family sizes, etc.) and attributes of healthcare providers before selecting a healthcare scheme for the workersOriginality/value This is a pioneer study on the choice of healthcare scheme for institutions of higher learning in Kenya. Universities are made aware of what informs employee's preferences for health schemes. This is important for tailoring health care schemes to match employee preferences for greater satisfaction.

scholarly journals Effects of Socio-Environmental Factors on Malaria Infection in Pakistan: A Bayesian Spatial Analysis

2019 ◽  
Vol 16 (8) ◽  
pp. 1365 ◽  
Author(s):  
Muhammad Farooq Umer ◽  
Shumaila Zofeen ◽  
Abdul Majeed ◽  
Wenbiao Hu ◽  
Xin Qi ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Malaria Incidence ◽  
Meteorological Data ◽  
Random Effect ◽  
Control Program ◽  
Population Data ◽  
Mean Value ◽  
Malaria Control Program ◽  
Study Population ◽  
Bayesian Spatial Analysis

The role of socio-environmental factors in shaping malaria dynamics is complex and inconsistent. Effects of socio-environmental factors on malaria in Pakistan at district level were examined. Annual malaria cases data were obtained from Directorate of Malaria Control Program, Pakistan. Meteorological data were supplied by Pakistan Meteorological Department. A major limitation was the use of yearly, rather than monthly/weekly malaria data in this study. Population data, socio-economic data and education score data were downloaded from internet. Bayesian conditional autoregressive model was used to find the statistical association of socio-environmental factors with malaria in Pakistan. From 136/146 districts in Pakistan, >750,000 confirmed malaria cases were included, over a three years’ period (2013–2015). Socioeconomic status ((posterior mean value −3.965, (2.5% quintile, −6.297%), (97.5% quintile, −1.754%)) and human population density (−7.41 × 10−4, −0.001406%, −1.05 × 10−4 %) were inversely related, while minimum temperature (0.1398, 0.05275%, 0.2145%) was directly proportional to malaria in Pakistan during the study period. Spatial random effect maps presented that moderate relative risk (RR, 0.75 to 1.24) and high RR (1.25 to 1.99) clusters were scattered throughout the country, outnumbering the ones’ with low RR (0.23 to 0.74). Socio-environmental variables influence annual malaria incidence in Pakistan and needs further evaluation.

American Naval Preparations for War with Spain, 1896–1898

1968 ◽  
Vol 2 (1) ◽  
pp. 33-47 ◽  
Author(s):  
John A. S. Grenville
Keyword(s):  
American Foreign Policy ◽  
National Policy ◽  
The United States ◽  
The Philippines ◽  
American People ◽  
Spanish American War ◽  
Pressure Groups ◽  
General Acceptance ◽  
Rigorous Research ◽  
Mass Hysteria

The historical debate over the Spanish-American War of 1898 is being reopened on both sides of the Atlantic. Until comparatively recently historians gave confident answers to the questions of the causes and consequences of the war. Moral assumptions about America's true mission were never very far from the surface of the interpretations which had won general acceptance in the United States. America's involvement in world affairs and more especially the acquisition of an empire was viewed as a perversion of her mission. There existed a consensus of opinion among historians that President McKinley and his administration were not in control of policy; that they were swept forward by a tide of public feeling, by political considerations, and by Congressional pressures they found impossible to resist. It was believed that war had been foisted on the American people by those who manipulated public opinion, by mass hysteria cleverly fomented by sectional interests, by the newspapers, by business pressure groups, and by jingo senators. Responsibility for the acquisition of the Philippines was uncritically ascribed to a junior member of the administration, Theodore Roosevelt, who when Assistant Secretary of the Navy, it was alleged, had plotted the whole thing with his friend, Senator Henry Cabot Lodge. Rigorous research is challenging every one of these assumptions. The strategic aspects of American foreign policy, and more particularly the influence of naval officers on national policy, have been seriously studied by only a few historians, whose work has as yet little affected the ‘classical’ textbook versions of American policy before the war with Spain.

Post-Disaster Malaria in Costa Rica

1995 ◽  
Vol 10 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Rocio Sáenz ◽  
Richard A. Bissell ◽  
Francisco Paniagua
Keyword(s):  
Costa Rica ◽  
Malaria Control ◽  
Environmental Changes ◽  
Control Program ◽  
Costa Rican ◽  
Severe Injuries ◽  
Malaria Control Program ◽  
Richter Scale ◽  
Mosquito Breeding ◽  
Post Disaster

AbstractIntroduction:In recent years, controversy has surrounded the issue of whether infectious disease should be considered a serious potential consequence of natural disasters. This article contributes to this debate with evidence of a significant outbreak of malaria in Costa Rica's Atlantic region after the 1991 earthquake and subsequent floods.Methods:This study is an epidemiologic investigation of the incidence of malaria for the periods of 22 months before the April 1991 Limon earthquake and for 13 months afterward. Data were obtained from the Costa Rican Ministry of Health's malaria control program.Results:Some of the cantons in the region experienced increases in the incidence of malaria as high as 1,600% and 4,700% above the average monthly rate for the pre-earthquake period (p ≤0.01). Causal mechanisms are postulated as relating to changes in human behavior (increased exposure to mosquitoes while sleeping outside, and a temporary pause in malaria control activities), changes in the habitat that were beneficial to mosquito breeding (landslide deforestation, river damming, and rerouting), and the floods of August 1991.Conclusions:It is recommended that there be enhanced awareness of the potential consequences of disaster-wrought environmental changes.Date of Event: 22 April 1991; Type: Earthquake, 7.4 Richter scale; Location: Costa Rica; Number of deaths and casualties: 54 deaths and 505 moderate to severe injuries.

scholarly journals Barriers to the Prevention and Control of Hepatitis B and Hepatitis C in the Community of Southwestern China: A Qualitative Research

2019 ◽  
Vol 16 (2) ◽  
pp. 231 ◽  
Author(s):  
Tingting Li ◽  
Shu Su ◽  
Yong Zhao ◽  
Runze Deng ◽  
Mingyue Fan ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Health Education ◽  
Hepatitis B ◽  
Prevention And Control ◽  
Qualitative Data ◽  
Healthcare Providers ◽  
Control Program ◽  
Face To Face ◽  
And Control ◽  
Poor Cognition

Objective viral hepatitis is a big challenge in China. However, few studies have focused on mapping the difficulties from a broader view. This study aimed to identify the barriers to the prevention and control of hepatitis B and hepatitis C in communities from the perspectives of hepatitis patients, residents, and healthcare providers. A total of 26 participants were recruited through purposive sampling. Data were collected by in-depth face-to-face interviews from September 2015 to May 2016 in two communities from Chongqing and Chengdu, China. A thematic framework was applied to analyze the qualitative data from the interviews. The critical factors of barriers to hepatitis prevention and control in the districts included poor cognition of residents regarding hepatitis B and hepatitis C, severe stigma in society, inadequate health education, and the provision of unsatisfactory medical services. Strengthening health education and improving services for treating patients with hepatitis are suggested to make further progress. A substantial gap remains between the need and currently available services for hepatitis patients and residents. Delivering quality prevention and control health services, improving health education, and reducing stigma in society are recommended to improve the prevention and control program for hepatitis B and C in communities.

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