scholarly journals The Role of Adaptive Surveillance as a Core Intervention to Achieve Malaria Elimination

2021 ◽  
Author(s):  
Arantxa Roca-Feltrer ◽  
Ann-Sophie Stratil ◽  
James K. Tibenderana
Keyword(s):  
Malaria Elimination ◽  
Surveillance Systems ◽  
National Programmes ◽  
Level Increase ◽  
Substantial Investment ◽  
Multi Level ◽  
Link Data ◽  
Operational Guidance ◽  
Case Based

Adaptive surveillance systems are essential for national programmes to achieve their malaria elimination goals. Core principles of surveillance systems including accurate diagnosis and reporting of malaria cases, integration of health data across administrative levels and the need to link data to a response are well defined by international guidelines. Nevertheless, while the requirements of surveillance systems along the transmission continuum are clearly documented, the operationalization remains challenging for national programmes. Firstly, because the multi-level increase of surveillance efforts demanding real-time and case-based data as well as the capacity of the health force to trigger locally customized responses, is resource intensive and requires substantial investment. Secondly, because there is a gap in international alignment on best tools and practices on how to operationally implement these requirements. Recently, several initiatives have started to address this gap in international coordination, aiming to establish the operational guidance for elimination programmes to successfully implement adaptive surveillance systems.

scholarly journals Sustainability of a mobile phone application-based data reporting system in Myanmar’s malaria elimination program: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Win Han Oo ◽  
Kaung Myat Thu ◽  
Julia C. Cutts ◽  
Win Htike ◽  
Kyawt Mon Win ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Malaria Elimination ◽  
User Satisfaction ◽  
Parallel Systems ◽  
Cost Effective ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
System Integrity ◽  
Case Based

Abstract Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis was undertaken using a qualitative descriptive approach. Results Technological and financial constraints such as inadequate internet access, software errors, and insufficient financial resources to support mobile phone-related costs have hampered users’ access to MCBR. Poor system integrity, unpredictable reporting outcomes, inadequate human resources for system management, and inefficient user support undermined the perceived quality of the system and user satisfaction, and hence its sustainability. Furthermore, multiple parallel systems with functions overlapping those of MCBR were in use. Conclusions Despite its effectiveness and efficiency in malaria surveillance, the sustainability of nationwide implementation of MCBR is uncertain. To make it sustainable, stakeholders should deploy a dedicated human workforce with the necessary technical and technological capacities; secure sustainable, long-term funding for implementation of MCBR; find an alternative cost-effective plan for ensuring sustainable system access by ICMVs, such as using volunteer-owned mobile phones for reporting rather than supporting new mobile phones to them; and find a solution to the burden of multiple parallel systems. Trial registration Not applicable.

scholarly journals Strengthening Surveillance Systems for Malaria Elimination by Integrating Molecular and Genomic Data

2019 ◽  
Vol 4 (4) ◽  
pp. 139 ◽  
Author(s):  
Christian Nsanzabana
Keyword(s):  
Malaria Elimination ◽  
Cost Effective ◽  
Morbidity And Mortality ◽  
Surveillance Systems ◽  
Computing Power ◽  
Routine Surveillance ◽  
Substantial Investment ◽  
Trained Staff ◽  
Polymerase Chain ◽  
Next Generation Sequencing Ngs

Unprecedented efforts in malaria control over the last 15 years have led to a substantial decrease in both morbidity and mortality in most endemic settings. However, these progresses have stalled over recent years, and resurgence may cause dramatic impact on both morbidity and mortality. Nevertheless, elimination efforts are currently going on with the objective of reducing malaria morbidity and mortality by 90% and malaria elimination in at least 35 countries by 2030. Strengthening surveillance systems is of paramount importance to reach those targets, and the integration of molecular and genomic techniques into routine surveillance could substantially improve the quality and robustness of data. Techniques such as polymerase chain reaction (PCR) and quantitative PCR (qPCR) are increasingly available in malaria endemic countries, whereas others such as sequencing are already available in a few laboratories. However, sequencing, especially next-generation sequencing (NGS), requires sophisticated infrastructure with adequate computing power and highly trained personnel for data analysis that require substantial investment. Different techniques will be required for different applications, and cost-effective planning must ensure the appropriate use of available resources. The development of national and sub-regional reference laboratories could help in minimizing the resources required in terms of equipment and trained staff. Concerted efforts from different stakeholders at national, sub-regional, and global level are needed to develop the required framework to establish and maintain these reference laboratories.

scholarly journals Sustainability of a Mobile Phone Application-Based Data Reporting System in Myanmar’s Malaria Elimination Program: A Qualitative Study

2021 ◽  
Author(s):  
Win Han Oo ◽  
Kaung Myat Thu ◽  
Julia Cutts ◽  
Win Htike ◽  
Kyawt Mon Win ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Mobile Phones ◽  
Malaria Elimination ◽  
User Satisfaction ◽  
Parallel Systems ◽  
Cost Effective ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
System Integrity ◽  
Case Based

Abstract Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis was undertaken using a qualitative descriptive approach. Results Technological and financial constraints such as inadequate internet access, software errors, and insufficient financial resources to support mobile phone-related costs have hampered users’ access to MCBR. Poor system integrity, unpredictable reporting outcomes, inadequate human resources for system management, and inefficient user support undermined the perceived quality of the system and user satisfaction, and hence its sustainability. Furthermore, multiple parallel systems with functions overlapping those of MCBR were in use. Conclusions Despite its effectiveness and efficiency in malaria surveillance, the sustainability of nationwide implementation of MCBR is uncertain. To make it sustainable, stakeholders should deploy a dedicated human workforce with the necessary technical and technological capacities; secure sustainable, long-term funding for implementation of MCBR; find an alternative cost-effective plan for ensuring sustainable system access by ICMVs, such as using volunteer-owned mobile phones for reporting rather than supporting new mobile phones to them; and find a solution to the burden of multiple parallel systems. Trial registration: Not applicable

Malaria elimination in India requires additional surveillance mechanisms

2021 ◽  
Author(s):  
Manju Rahi ◽  
Payal Das ◽  
Amit Sharma
Keyword(s):  
Real Time ◽  
Malaria Elimination ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Malaria Surveillance ◽  
Aggregated Data ◽  
Malaria Burden ◽  
The Core ◽  
Reporting Systems ◽  
Geographic Regions

Abstract Malaria surveillance is weak in high malaria burden countries. Surveillance is considered as one of the core interventions for malaria elimination. Impressive reductions in malaria-associated morbidity and mortality have been achieved across the globe, but sustained efforts need to be bolstered up to achieve malaria elimination in endemic countries like India. Poor surveillance data become a hindrance in assessing the progress achieved towards malaria elimination and in channelizing focused interventions to the hotspots. A major obstacle in strengthening India’s reporting systems is that the surveillance data are captured in a fragmented manner by multiple players, in silos, and is distributed across geographic regions. In addition, the data are not reported in near real-time. Furthermore, multiplicity of malaria data resources limits interoperability between them. Here, we deliberate on the acute need of updating India’s surveillance systems from the use of aggregated data to near real-time case-based surveillance. This will help in identifying the drivers of malaria transmission in any locale and therefore will facilitate formulation of appropriate interventional responses rapidly.

scholarly journals Improving 3D-3D facial registration methods: potential role of three-dimensional models in personal identification of the living

2021 ◽  
Author(s):  
Daniele Gibelli ◽  
Andrea Palamenghi ◽  
Pasquale Poppa ◽  
Chiarella Sforza ◽  
Cristina Cattaneo ◽  
...  
Keyword(s):  
Three Dimensional ◽  
3D Models ◽  
Personal Identification ◽  
Surveillance Systems ◽  
3D Registration ◽  
Three Dimensional Models ◽  
Point To Point ◽  
Point Distance ◽  
Male Subjects

AbstractPersonal identification of the living from video surveillance systems usually involves 2D images. However, the potentiality of three-dimensional facial models in gaining personal identification through 3D-3D comparison still needs to be verified. This study aims at testing the reliability of a protocol for 3D-3D registration of facial models, potentially useful for personal identification. Fifty male subjects aged between 18 and 45 years were randomly chosen from a database of 3D facial models acquired through stereophotogrammetry. For each subject, two acquisitions were available; the 3D models of faces were then registered onto other models belonging to the same and different individuals according to the least point-to-point distance on the entire facial surface, for a total of 50 matches and 50 mismatches. RMS value (root mean square) of point-to-point distance between the two models was then calculated through the VAM® software. Intra- and inter-observer errors were assessed through calculation of relative technical error of measurement (rTEM). Possible statistically significant differences between matches and mismatches were assessed through Mann–Whitney test (p < 0.05). Both for intra- and inter-observer repeatability rTEM was between 2.2 and 5.2%. Average RMS point-to-point distance was 0.50 ± 0.28 mm in matches, 2.62 ± 0.56 mm in mismatches (p < 0.01). An RMS threshold of 1.50 mm could distinguish matches and mismatches in 100% of cases. This study provides an improvement to existing 3D-3D superimposition methods and confirms the great advantages which may derive to personal identification of the living from 3D facial analysis.

scholarly journals The Pathogenic Role of PI3K/AKT Pathway in Cancer Onset and Drug Resistance: An Updated Review

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3949
Author(s):  
Federica Rascio ◽  
Federica Spadaccino ◽  
Maria Teresa Rocchetti ◽  
Giuseppe Castellano ◽  
Giovanni Stallone ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Akt Pathway ◽  
Invasion And Metastasis ◽  
Pathogenic Role ◽  
Multiple Cancer ◽  
Downstream Target ◽  
Cancer Types ◽  
Multi Level ◽  
Survival Mechanisms

The PI3K/AKT pathway is one of the most frequently over-activated intracellular pathways in several human cancers. This pathway, acting on different downstream target proteins, contributes to the carcinogenesis, proliferation, invasion, and metastasis of tumour cells. A multi-level impairment, involving mutation and genetic alteration, aberrant regulation of miRNAs sequences, and abnormal phosphorylation of cascade factors, has been found in multiple cancer types. The deregulation of this pathway counteracts common therapeutic strategies and contributes to multidrug resistance. In this review, we underline the involvement of this pathway in patho-physiological cell survival mechanisms, emphasizing its key role in the development of drug resistance. We also provide an overview of the potential inhibition strategies currently available.

scholarly journals Redefining the learning space: Developing peer mentoring in the enterprise curriculum

2020 ◽  
pp. 095042222098126
Author(s):  
Andrew P Hird
Keyword(s):  
Learning Environment ◽  
Peer Mentoring ◽  
Learning Space ◽  
Hygiene Factors ◽  
Multi Level ◽  
Considerable Strain

This account of practice seeks to demystify the entrepreneurship classroom and to provide practical insights into the successful introduction and embedding of a multi-level peer mentoring scheme. Over a 5-year period, peer mentoring has been embedded in an undergraduate enterprise curriculum. This has posed challenges to a number of taken-for-granted assumptions about the enterprise classroom. The role of the tutor in the classroom was redefined; the roles of both colleagues and students were questioned. The accepted rules and norms of the learning environment were placed under considerable strain. It was found that both colleagues and students had very clearly defined expectations of one another and their respective roles: these proved difficult to change. The article recounts the journey, and how the organisers learned to accept and embrace the difficulties faced. Hygiene factors such as timetabling and communication were highly important in allowing the interactions to take place, as were socialisation and facilitation. The mistakes made are also recounted so that they can be avoided by other practitioners.

scholarly journals Building Bridges: A Participatory Stakeholder Framework for Sustainable Urban Construction Logistics

2021 ◽  
Vol 13 (5) ◽  
pp. 2678
Author(s):  
Nicolas Brusselaers ◽  
Koen Mommens ◽  
Cathy Macharis
Keyword(s):  
Urban Areas ◽  
Sustainable Construction ◽  
Environmental Footprint ◽  
Implementation Barriers ◽  
Urban Construction ◽  
Multi Level ◽  
Negative Impacts ◽  
Roll Out ◽  
Construction Works

The urban built environment concentrates due to the growing urbanization trend, triggering construction and renovation works in urban areas. Although construction works often revitalize cities upon completion, the associated logistics activities engender a significant financial and environmental footprint if not handled appropriately. Cities have the largest potential to reduce negative impacts through requirements on construction logistics. However, today, there is a lack of knowledge within cities on how to set such demands and how to involve and manage the numerous and varying stakeholders in these processes. This paper presents a participatory decision-making framework for the governance of urban construction logistics on economic, environmental and societal levels, building further on the Multi-Actor Multi-Criteria Analysis (MAMCA). The framework was then implemented on a use case in the dense urban Brussels-Capital Region (Belgium), gathering a wide variety of stakeholders in the context of a sustainable Construction Logistics Scenario (CLS) evaluation. Special attention was paid on the identification of implementation barriers and the role of governments to facilitate the introduction and city-wide roll-out of novel CLS. Findings show how different processes are site-, actor- and condition-specific, thereby delivering a common built object which is often based on different motivations and concerns. The study proposes a flexible, replicable and upscalable framework both from an inter- and intracity perspective, which can serve to support (1) the management of processes and CLS, (2) the management of people and the community, and (3) the project and city, in the context of multi-level governance.

scholarly journals A new insight into role of phosphoketolase pathway in Synechocystis sp. PCC 6803

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anushree Bachhar ◽  
Jiri Jablonsky
Keyword(s):  
In Silico Analysis ◽  
Bioinformatic Analysis ◽  
Phosphoglycerate Mutase ◽  
Phosphoketolase Pathway ◽  
Multi Level ◽  
Silico Analysis ◽  
Insight Into ◽  
Synechocystis Sp ◽  
Pcc 6803

AbstractPhosphoketolase (PKET) pathway is predominant in cyanobacteria (around 98%) but current opinion is that it is virtually inactive under autotrophic ambient CO2 condition (AC-auto). This creates an evolutionary paradox due to the existence of PKET pathway in obligatory photoautotrophs. We aim to answer the paradox with the aid of bioinformatic analysis along with metabolic, transcriptomic, fluxomic and mutant data integrated into a multi-level kinetic model. We discussed the problems linked to neglected isozyme, pket2 (sll0529) and inconsistencies towards the explanation of residual flux via PKET pathway in the case of silenced pket1 (slr0453) in Synechocystis sp. PCC 6803. Our in silico analysis showed: (1) 17% flux reduction via RuBisCO for Δpket1 under AC-auto, (2) 11.2–14.3% growth decrease for Δpket2 in turbulent AC-auto, and (3) flux via PKET pathway reaching up to 252% of the flux via phosphoglycerate mutase under AC-auto. All results imply that PKET pathway plays a crucial role under AC-auto by mitigating the decarboxylation occurring in OPP pathway and conversion of pyruvate to acetyl CoA linked to EMP glycolysis under the carbon scarce environment. Finally, our model predicted that PKETs have low affinity to S7P as a substrate.

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