scholarly journals Characterizing Mobility Patterns of Forest Goers in Southern Lao PDR using GPS Loggers.

2021 ◽  
Author(s):  
Francois Rerolle ◽  
Emily Dantzer ◽  
Toula Phimmakong ◽  
Andrew Lover ◽  
Bouasy Hongvanthong ◽  
...  
Keyword(s):  
High Risk ◽  
Clustering Algorithm ◽  
Lao Pdr ◽  
Malaria Vectors ◽  
Gradient Boosting ◽  
Mobility Patterns ◽  
Utilization Distribution ◽  
Control Programs ◽  
Number Of Children ◽  
High Risk Populations

Abstract Background: In the Greater Mekong Subregion (GMS), engaging in forest activities is a major risk factor for malaria. As countries focus their malaria control and elimination efforts on forest-going populations, a better understanding of their mobility patterns and risk associated with specific types of forest-going trips is essential. Methods: Between May and November 2018, we conducted a focal test and treat intervention (FTAT) in Champasak Province, southern Lao PDR, and recruited 2,904 forest-goers in our study. A subset of forest-goers were offered to carry a “i-Got-U” GPS logger for roughly two months, configured to collect GPS coordinates every 15 to 30 minutes. The utilization distribution (UD) surface around each GPS trajectory was used to extract trips to the forest and forest-fringes. Trips with shared mobility characteristics in terms of duration, timing and forest penetration were identified by a hierarchical clustering algorithm and clusters of trips with increased exposure to dominant malaria vectors in the region were further classified as high-risk. Finally, we used gradient boosting trees to assess which of the forest-goers’ socio-demographic and behavioral characteristics best predicted their likelihood to engage in such high-risk trips. Results: A total of 122 forest-goers accepted carrying a GPS logger resulting in the collection of 803 trips to the forest or forest-fringes. Six clusters of trips emerged, helping to classify 385 (48%) trips with increased exposure to malaria vectors based on high forest penetration and whether the trip happened overnight. Age, outdoor sleeping structures and number of children were the best predictors of forest-goers’ probability of engaging in high-risk trips. The probability of engaging in high-risk trips was high (~33%) in all strata of the forest-going population.Conclusion: This study characterized the heterogeneity within the mobility patterns of forest-goers and attempted to further segment their role in malaria transmission in southern Lao People’s Democratic Republic (PDR). These results are key for national control programs across the region to tailor their interventions and messaging to high-risk populations and meet their 2030 malaria elimination goals.

scholarly journals Characterizing Mobility Patterns of Forest Goers in Southern Lao PDR using GPS Loggers.

2021 ◽  
Author(s):  
Francois Rerolle ◽  
Emily Dantzer ◽  
Toula Phimmakong ◽  
Andrew Lover ◽  
Bouasy Hongvanthong ◽  
...  
Keyword(s):  
High Risk ◽  
Clustering Algorithm ◽  
Lao Pdr ◽  
Malaria Vectors ◽  
Gradient Boosting ◽  
Mobility Patterns ◽  
Utilization Distribution ◽  
Control Programs ◽  
High Risk Populations ◽  
National Control

Abstract Background In the Greater Mekong Subregion (GMS), forest-going populations are considered high-risk populations for malaria and are increasingly targeted by national control programs’ elimination efforts. A better understanding of forest-going populations’ mobility patterns and risk associated with specific types of forest-going trips is necessary for countries in the GMS to achieve their objective of eliminating malaria by 2030. Methods Between March and November 2018, as part of a focal test and treat intervention (FTAT), we recruited 2,904 forest-goers in southern Lao PDR. A subset of forest-goers carried an “i-Got-U” GPS logger for roughly two months, configured to collect GPS coordinates every 15 to 30 minutes. The utilization distribution (UD) surface around each GPS trajectory was used to extract trips to the forest and forest-fringes. Trips with shared mobility characteristics in terms of duration, timing and forest penetration were identified by a hierarchical clustering algorithm. Then, clusters of trips with increased exposure to dominant malaria vectors in the region were further classified as high-risk. Finally, we used gradient boosting trees to assess which of the forest-goers’ socio-demographic and behavioral characteristics best predicted their likelihood to engage in such high-risk trips. Results A total of 122 forest-goers accepted carrying a GPS logger resulting in the collection of 803 trips to the forest or forest-fringes. Six clusters of trips emerged, helping to classify 385 (48%) trips with increased exposure to malaria vectors based on high forest penetration and whether the trip happened overnight. Age, outdoor sleeping structures and number of children were the best predictors of forest-goers’ probability of engaging in high-risk trips. The probability of engaging in high-risk trips was high (~33%) in all strata of the forest-going population. Conclusion This study characterized the heterogeneity within the mobility patterns of forest-goers and attempted to further segment their role in malaria transmission in southern Lao People’s Democratic Republic (PDR). National control programs across the region can leverage these results to tailor their interventions and messaging to high-risk populations and accelerate malaria elimination.

scholarly journals Study protocol for a cluster-randomized split-plot design trial to assess the effectiveness of targeted active malaria case detection among high-risk populations in Southern Lao PDR (the AcME-Lao study)

2019 ◽  
Vol 3 ◽  
pp. 1730 ◽  
Author(s):  
Andrew A. Lover ◽  
Emily Dantzer ◽  
Sophia Hocini ◽  
Ronaldo Estera ◽  
Francois Rerolle ◽  
...  
Keyword(s):  
High Risk ◽  
Diagnostic Tests ◽  
Lao Pdr ◽  
High Sensitivity ◽  
Rapid Diagnostic Tests ◽  
Case Detection ◽  
Test And Treat ◽  
High Risk Populations ◽  
Cluster Randomized ◽  
Plot Design

Introduction: Novel interventions are needed to accelerate malaria elimination, especially in areas where asymptomatic parasitemia is common, and where transmission generally occurs outside of village-based settings. Testing of community members linked to a person with clinical illness (reactive case detection, RACD) has not shown effectiveness in prior studies due to the limited sensitivity of current point-of-care tests. This study aims to assess the effectiveness of active case finding in village-based and forested-based settings using novel high-sensitivity rapid diagnostic tests in Lao People’s Democratic Republic (Lao PDR). Methods and analysis: This study is a cluster-randomized split-plot design trial. The interventions include village-based mass test and treat (MTAT), focal test and treat in high-risk populations (FTAT), and the combination of these approaches, using high-sensitivity rapid diagnostic tests (HS-RDTs) to asses P. falciparum infection status. Within four districts in Champasak province, Lao PDR fourteen health center-catchment areas will be randomized to either FTAT or control; and within these HCCAs, 56 villages will be randomized to either MTAT or control. In intervention areas, FTAT will be conducted by community-based peer navigators on a routine basis, and three separate rounds of MTAT are planned. The primary study outcome will be PCR-based Plasmodium falciparum prevalence after one year of implementation. Secondary outcomes include malaria incidence; interventional coverage; operational feasibility and acceptability; and cost and cost- effectiveness. Ethics and dissemination: Findings will be reported on clinicaltrials.gov, in peer-reviewed publications and through stakeholder meetings with Ministry of Health and community leaders in Lao PDR and throughout the Greater Mekong Subregion. Trial registration: clinicaltrials.gov NCT03783299 (21/12/2018)

Treatment Interventions for PTSD in Difficult or High Risk Populations

2009 ◽  
Author(s):  
Keri Pinna ◽  
Maria Pacella ◽  
Norah Feeny ◽  
Brittain Lamoureux
Keyword(s):  
High Risk ◽  
Treatment Interventions ◽  
High Risk Populations

Overcoming the barriers to HPV vaccination in high-risk populations in the U.S.

2021 ◽  
Author(s):  
D. Teoh ◽  
E.K. Hill ◽  
W. Goldsberry ◽  
L. Levine ◽  
A. Novetsky ◽  
...  
Keyword(s):  
High Risk ◽  
Hpv Vaccination ◽  
High Risk Populations ◽  
The U.S

scholarly journals 8B.003 The value of drowning prevention programs for ‘high-risk’ populations in Australia

2021 ◽  
Author(s):  
Stacey Willcox-Pidgeon ◽  
Richard Franklin ◽  
Peter Leggat ◽  
Sue Devine ◽  
Justin Scarr
Keyword(s):  
High Risk ◽  
Prevention Programs ◽  
Drowning Prevention ◽  
High Risk Populations

scholarly journals Early Administration of Convalescent Plasma Improves Survival in Patients with Hematological Malignancies and COVID-19

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 436
Author(s):  
Monika Maria Biernat ◽  
Anna Kolasińska ◽  
Jacek Kwiatkowski ◽  
Donata Urbaniak-Kujda ◽  
Paweł Biernat ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Hematological Malignancies ◽  
Treated Group ◽  
Viral Clearance ◽  
Early Administration ◽  
Improved Outcomes ◽  
Historical Group ◽  
High Risk Populations ◽  
Diagnosis Of Infection

The use of convalescent plasma in the treatment of COVID-19 may lead to a milder course of infection and has been associated with improved outcomes. Determining optimal treatments in high risk populations is crucial, as is the case in those with hematological malignancies. We analyzed a cohort of 23 patients with hematological malignancies and COVID-19 who had received plasma 48–72 h after the diagnosis of infection and compared it with a historical group of 22 patients who received other therapy. Overall survival in those who received convalescent plasma was significantly higher than in the historical group (p = 0.03460). The plasma–treated group also showed a significantly milder course of infection (p = 0.03807), characterized by less severe symptoms and faster recovery (p = 0.00001). In conclusion, we have demonstrated that convalescent plasma is an effective treatment and its early administration leads to clinical improvement, increased viral clearance and longer overall survival in patients with hematological malignancies and COVID-19. To our knowledge, this is the first report to analyze the efficacy of convalescent plasma in a cohort of patients with hematological malignancies.

scholarly journals Sex-based outcomes in contemporary antiplatelet therapy trials

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001761
Author(s):  
Mirvat Alasnag ◽  
Tara L Jones ◽  
Yasmin Hanfi ◽  
Nicola Ryan
Keyword(s):  
High Risk ◽  
Antiplatelet Therapy ◽  
Bleeding Risk ◽  
Coronary Intervention ◽  
Representation Of Women ◽  
Percutaneous Coronary ◽  
Risk Patients ◽  
High Risk Populations ◽  
High Bleeding Risk ◽  
Randomised Controlled

Balancing ischaemic and bleeding risks in high-risk populations undergoing percutaneous coronary interventions has become an everyday dilemma for clinicians. It is particularly difficult to make decisions concerning combinations and duration of antiplatelet regimens in women given the poor representation of women in trials that have shaped current practice. Several contemporary landmark trials have recently been presented at the American College of Cardiology. The trials included the Harmonising Optimal Strategy for Treatment of coronary artery diseases-EXtended Antiplatelet Monotherapy, Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention and the TicAgrelor versus CLOpidogrel in Stabilised Patients With Acute Myocardial Infarction. In this article, we summarise the main findings of these trials and include the The Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk (LEADERS FREE) in search for evidence based best practices for women patients. Although some of these trials had prespecified a subanalysis of sex differences, women constituted only 17%–30% of participants making sex-specific analyses challenging. Data suggest that women benefit from de-escalation to both ticagrelor and clopidogrel monotherapy. However, given the increased bleeding risks observed in women further randomised controlled trials are necessary to determine the most appropriate combination and duration of dual antiplatelet therapy as well as maintenance single antiplatelet therapy.

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