scholarly journals Genetic surveillance in the Greater Mekong subregion and South Asia to support malaria control and elimination

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Christopher G Jacob ◽  
Nguyen Thuy-Nhien ◽  
Mayfong Mayxay ◽  
Richard J Maude ◽  
Huynh Hong Quang ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Resistance ◽  
International Development ◽  
Malaria Control ◽  
Large Scale ◽  
Local Level ◽  
Detailed Knowledge ◽  
Resistance Markers ◽  
Multiple Drugs ◽  
Greater Mekong Subregion

Background:National Malaria Control Programmes (NMCPs) currently make limited use of parasite genetic data. We have developed GenRe-Mekong, a platform for genetic surveillance of malaria in the Greater Mekong Subregion (GMS) that enables NMCPs to implement large-scale surveillance projects by integrating simple sample collection procedures in routine public health procedures.Methods:Samples from symptomatic patients are processed by SpotMalaria, a high-throughput system that produces a comprehensive set of genotypes comprising several drug resistance markers, species markers and a genomic barcode. GenRe-Mekong delivers Genetic Report Cards, a compendium of genotypes and phenotype predictions used to map prevalence of resistance to multiple drugs.Results:GenRe-Mekong has worked with NMCPs and research projects in eight countries, processing 9623 samples from clinical cases. Monitoring resistance markers has been valuable for tracking the rapid spread of parasites resistant to the dihydroartemisinin-piperaquine combination therapy. In Vietnam and Laos, GenRe-Mekong data have provided novel knowledge about the spread of these resistant strains into previously unaffected provinces, informing decision-making by NMCPs.Conclusions:GenRe-Mekong provides detailed knowledge about drug resistance at a local level, and facilitates data sharing at a regional level, enabling cross-border resistance monitoring and providing the public health community with valuable insights. The project provides a rich open data resource to benefit the entire malaria community.Funding:The GenRe-Mekong project is funded by the Bill and Melinda Gates Foundation (OPP11188166, OPP1204268). Genotyping and sequencing were funded by the Wellcome Trust (098051, 206194, 203141, 090770, 204911, 106698/B/14/Z) and Medical Research Council (G0600718). A proportion of samples were collected with the support of the UK Department for International Development (201900, M006212), and Intramural Research Program of the National Institute of Allergy and Infectious Diseases.

scholarly journals Genetic surveillance in the Greater Mekong Subregion and South Asia to support malaria control and elimination

2020 ◽  
Author(s):  
Christopher G Jacob ◽  
Nguyen Thuy-Nhien ◽  
Mayfong Mayxay ◽  
Richard J Maude ◽  
Huynh Hong Quang ◽  
...  
Keyword(s):  
Malaria Control ◽  
Large Scale ◽  
Sample Collection ◽  
Published Evidence ◽  
Resistance Markers ◽  
Resistant Strains ◽  
Species Markers ◽  
Study Sites ◽  
Multiple Drugs ◽  
Greater Mekong Subregion

ABSTRACTThe use of parasite genetic data by National Malaria Control Programmes (NMCPs) is currently limited, and typically focused on specific genetic features or a small number of study sites. We have developed GenRe-Mekong, a platform for genetic surveillance of malaria in the Greater Mekong Subregion (GMS). By integrating simple sample collection procedures in the routine operations of public health facilities, GenRe-Mekong enables NMCPs to conduct large-scale surveillance project in endemic regions. Samples are processed by the SpotMalaria platform, which uses high-throughput technologies to produce a broad set of genotypes, including most known drug resistance markers, species markers and a genomic barcode. Through the application of heuristics based on published evidence, GenRe-Mekong delivers Genetic Report Cards, a compendium of genotypes and phenotype predictions that are used to map prevalence of resistance to multiple drugs. To date, GenRe-Mekong has worked with NMCPs in five countries, and with several large-scale research projects, processing 9,623 samples from clinical cases. The monitoring of resistance markers has been especially valuable for NMCPs tracking the recent rapid spread of DHA-piperaquine resistant parasites across the region. In Vietnam and Laos, data from GenRe-Mekong have provided novel knowledge about the spread of these resistant strains in provinces previously thought to be unaffected. GenRe-Mekong facilitates data sharing by aggregating at regional level results from different countries, providing cross-border views of the spread of resistant strains.

scholarly journals Leishmaniasis and Climate Change—Case Study: Argentina

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Oscar Daniel Salomón ◽  
María Gabriela Quintana ◽  
Andrea Verónica Mastrángelo ◽  
María Soledad Fernández
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Large Scale ◽  
Local Level ◽  
Point Of View ◽  
Mitigation Strategies ◽  
Vector Borne Diseases ◽  
Scale Models ◽  
Vector Borne

Vector-borne diseases closely associated with the environment, such as leishmaniases, have been a usual argument about the deleterious impact of climate change on public health. From the biological point of view interaction of different variables has different and even conflicting effects on the survival of vectors and the probability transmission of pathogens. The results on ecoepidemiology of leishmaniasis in Argentina related to climate variables at different scales of space and time are presented. These studies showed that the changes in transmission due to change or increase in frequency and intensity of climatic instability were expressed through changes in the probability of vector-human reservoir effective contacts. These changes of contact in turn are modulated by both direct effects on the biology and ecology of the organisms involved, as by perceptions and changes in the behavior of the human communities at risk. Therefore, from the perspective of public health and state policy, and taking into account the current nonlinear increased velocity of climate change, we concluded that discussing the uncertainties of large-scale models will have lower impact than to develop-validate mitigation strategies to be operative at local level, and compatibles with sustainable development, conservation biodiversity, and respect for cultural diversity.

scholarly journals The Malaria TaqMan Array Card Includes 87 Assays for Plasmodium falciparum Drug Resistance, Identification of Species, and Genotyping in a Single Reaction

2017 ◽  
Vol 61 (5) ◽  
Author(s):  
Suporn Pholwat ◽  
Jie Liu ◽  
Suzanne Stroup ◽  
Shevin T. Jacob ◽  
Patrick Banura ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Plasmodium Falciparum ◽  
Large Scale ◽  
Limit Of Detection ◽  
Artemisinin Resistance ◽  
Clinical Samples ◽  
Content Type ◽  
Antimalarial Resistance ◽  
Resistance Markers ◽  
Taqman Array

ABSTRACT Antimalarial drug resistance exacerbates the global disease burden and complicates eradication efforts. To facilitate the surveillance of resistance markers in countries of malaria endemicity, we developed a suite of TaqMan assays for known resistance markers and compartmentalized them into a single array card (TaqMan array card, TAC). We included 87 assays for species identification, for the detection of Plasmodium falciparum mutations associated with chloroquine, atovaquone, pyrimethamine, sulfadoxine, and artemisinin resistance, and for neutral single nucleotide polymorphism (SNP) genotyping. Assay performance was first optimized using DNA from common laboratory parasite lines and plasmid controls. The limit of detection was 0.1 to 10 pg of DNA and yielded 100% accuracy compared to sequencing. The tool was then evaluated on 87 clinical blood samples from around the world, and the malaria TAC once again achieved 100% accuracy compared to sequencing and in addition detected the presence of mixed infections in clinical samples. With its streamlined protocol and high accuracy, this malaria TAC should be a useful tool for large-scale antimalarial resistance surveillance.

Malaria Reports, a new journal

2011 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Niko Speybroeck
Keyword(s):  
Public Health ◽  
Malaria Control ◽  
Large Scale ◽  
Indoor Residual Spraying ◽  
Public Health Problem ◽  
Bed Nets ◽  
Major Public Health Problem ◽  
The Past ◽  
Combination Treatments ◽  
International Funding

International funding for malaria control has raised significantly in the past decade, leading to large-scale indoor residual spraying campaigns, to the distribution of insecticidetreated bed nets, and to the introduction of artemisinin-based combination treatments. An encouraging reduction of malaria cases has been reported in a number of countries, but malaria remains a major public health problem worldwide (WHO, 2010). People living in the poorest countries are the most vulnerable. Therefore, it remains a challenge to ensure that high levels of coverage and caution are maintained and that efforts aimed at developing an effective and affordable vaccine would be amplified.

Integrated Plan to Augment Surge Capacity

2008 ◽  
Vol 23 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Christopher Dayton ◽  
Jamil Ibrahim ◽  
Michael Augenbraun ◽  
Steven Brooks ◽  
Kiaran Mody ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Medical Care ◽  
Large Scale ◽  
Local Level ◽  
New York State ◽  
Federal State ◽  
Medical Care System ◽  
Surge Capacity ◽  
Mass Casualty Event

AbstractIntroduction:Surge capacity is defined as a healthcare system's ability to rapidly expand beyond normal services to meet the increased demand for appropriate space, qualified personnel, medical care, and public health in the event of bioterrorism, disaster, or other large-scale, public health emergencies. There are many individuals and agencies, including policy makers, planners, administrators, and staff at the federal, state, and local level, involved in the process of planning for and executing policy in respect to a surge in the medical requirements of a population. They are responsible to ensure there is sufficient surge capacity within their own jurisdiction.Problem:The [US] federal government has required New York State to create a system of hospital bed surge capacity that provides for 500 adult and pediatric patients per 1 million population, which has been estimated to be an increase of 15–20% in bed availability. In response, the New York City Department of Health and Mental Hygiene (NYC DOH) has requested that area hospitals take an inventory of available beds and set a goal to provide for a 20% surge capacity to be available during a mass-casualty event or other conditions calling for increased inpatient bed availability.Methods:In 2003, under the auspices of the NYC DOH, the New York Institute of All Hazard Preparedness (NYIHP) was formed from four unaffiliated, healthcare facilities in Central Brooklyn to address this and other goals.Results:The NYIHP hospitals have developed a surge capacity plan to provide necessary space and utilities. As these plans have been applied, a bed surge capacity of approximately 25% was identified and created for Central Brooklyn to provide for the increased demand on the medical care system that may accompany a disaster. Through the process of developing an integrated plan that would engage a public health incident, the facilities of NYIHP demonstrate that a model of cooperation may be applied to an inherently fractioned medical system.

scholarly journals Ethics and Antimalarial Drug Resistance

2020 ◽  
pp. 55-73
Author(s):  
Phaik Yeong Cheah ◽  
Michael Parker ◽  
Nicholas P. J. Day
Keyword(s):  
Drug Resistance ◽  
Effective Treatment ◽  
Malaria Control ◽  
Malaria Elimination ◽  
Antimalarial Drug ◽  
Ethical Issues ◽  
Antimalarial Drug Resistance ◽  
The Past ◽  
Greater Mekong Subregion ◽  
Related Mortality

Abstract There has been impressive progress in malaria control and treatment over the past two decades. One of the most important factors in the decline of malaria-related mortality has been the development and deployment of highly effective treatment in the form of artemisinin-based combination therapies (ACTs). However, recent reports suggest that these gains stand the risk of being reversed due to the emergence of ACT resistance in the Greater Mekong Subregion and the threat of this resistance spreading to Africa, where the majority of the world’s malaria cases occur, with catastrophic consequences. This chapter provides an overview of strategies proposed by malaria experts to tackle artemisinin-resistant malaria, and some of the most important practical ethical issues presented by each of these interventions. The proposed strategies include mass antimalarial drug administrations in selected populations, and mandatory screening of possibly infected individuals prior to entering an area free of artemisinin-resistant malaria. We discuss ethical issues such as tensions between the wishes of individuals versus the broader goal of malaria elimination, and the risks of harm to interventional populations, and conclude by proposing a set of recommendations.

Characterization of seawater reverse osmosis fouled membranes from large scale commercial desalination plant

2019 ◽  
Author(s):  
Chem Int
Keyword(s):  
Reverse Osmosis ◽  
Large Scale ◽  
Retention Rate ◽  
Local Level ◽  
Microscopic Analysis ◽  
Transmembrane Pressure ◽  
Hydraulic Permeability ◽  
Seawater Reverse Osmosis ◽  
A Chain

The objective of this work is to study the ageing state of a used reverse osmosis (RO) membrane taken in Algeria from the Benisaf Water Company seawater desalination unit. The study consists of an autopsy procedure used to perform a chain of analyses on a membrane sheet. Wear of the membrane is characterized by a degradation of its performance due to a significant increase in hydraulic permeability (25%) and pressure drop as well as a decrease in salt retention (10% to 30%). In most cases the effects of ageing are little or poorly known at the local level and global measurements such as (flux, transmembrane pressure, permeate flow, retention rate, etc.) do not allow characterization. Therefore, a used RO (reverse osmosis) membrane was selected at the site to perform the membrane autopsy tests. These tests make it possible to analyze and identify the cause as well as to understand the links between performance degradation observed at the macroscopic scale and at the scale at which ageing takes place. External and internal visual observations allow seeing the state of degradation. Microscopic analysis of the used membranes surface shows the importance of fouling. In addition, quantification and identification analyses determine a high fouling rate in the used membrane whose foulants is of inorganic and organic nature. Moreover, the analyses proved the presence of a biofilm composed of protein.

Strategy and Control of Antimicrobial Therapy Program Implementation at the B.V. Petrovsky National Research Center of Surgery

2020 ◽  
Vol 65 (9-10) ◽  
pp. 44-50
Author(s):  
M. A. Chukina ◽  
N. V. Vistovskaya ◽  
M. V. Lukina ◽  
M. V. Zhuravleva
Keyword(s):  
Drug Resistance ◽  
Program Implementation ◽  
Local Level ◽  
Resistance Index ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Research Center ◽  
Case Histories ◽  
Medical Organization ◽  
Therapy Program

The introduction of local programs for the rational use of antibiotics in a multidisciplinary hospital is aimed at reducing the level of antibiotic resistance and the frequency of healthcare associated infections (HAI). The aim of the study was to analyze the frequency of infectious complications caused by pathogens with multidrug resistance and the level of resistance at the B.V. Petrovsky National Research Center of Surgery based on the implementation of the SCAT program. Material and methods. A retrospective analysis of the SCAT program implementation results on the basis of the B.V. Petrovsky National Research Center of Surgery was carried out. 1850 case histories of the surgical profile for 2018 were analyzed (male —1095, average age 56.2±14.9 years; female — 755, average age 53.7±11.9 years) and 1502 case histories for the January–October period for 2019 (male — 1114, average age 58.3±12.1 years, and female — 388, average age 55.4±12.6 years). Results. The incidence of HAI in 2018 and 2019 was 354 and 159 cases, respectively. Of these, the incidence of nosocomial pneumonia (NP) was 64 cases (61.5%) and 40 cases (38.5%); skin and soft tissue infection (SSTI) — 93 cases (57.4%) and 69 cases (42.6%); surgical site infections (SSI) — 69 cases (82.1%) and 15 cases (17.9%) in 2018 and 2019, respectively. The drug resistance index (DRI) for the most clinically significant strains of the causative agents of HAI was: Klebsiella pneumoniae — 0.14, Acinetobacter baumannii — 0.22, Klebsiella spp. — 0.11, Enterobacter cloacae — 0.15, Enterococcus faecalis — 0.18, Enterococcus faecium — 0.21. Conclusion. The proposed measures for the implementation of the SCAT program at the level of a medical organization reduce the incidence of HAI and the local level of the drug resistance index.

The Swiss Prison Study (SWIPS): Protocol for Establishing a Public Health Registry of Prisoners in Switzerland (Preprint)

2020 ◽  
Author(s):  
Thomas Gaisl ◽  
Naser Musli ◽  
Patrick Baumgartner ◽  
Marc Meier ◽  
Silvana K Rampini ◽  
...  
Keyword(s):  
Public Health ◽  
Medical History ◽  
Large Scale ◽  
International Classification Of Diseases ◽  
Disease Prevalence ◽  
Vulnerable Population ◽  
International Classification ◽  
Classification Of Diseases ◽  
Health Registry

BACKGROUND The health aspects, disease frequencies, and specific health interests of prisoners and refugees are poorly understood. Importantly, access to the health care system is limited for this vulnerable population. There has been no systematic investigation to understand the health issues of inmates in Switzerland. Furthermore, little is known on how recent migration flows in Europe may have affected the health conditions of inmates. OBJECTIVE The Swiss Prison Study (SWIPS) is a large-scale observational study with the aim of establishing a public health registry in northern-central Switzerland. The primary objective is to establish a central database to assess disease prevalence (ie, International Classification of Diseases-10 codes [German modification]) among prisoners. The secondary objectives include the following: (1) to compare the 2015 versus 2020 disease prevalence among inmates against a representative sample from the local resident population, (2) to assess longitudinal changes in disease prevalence from 2015 to 2020 by using cross-sectional medical records from all inmates at the Police Prison Zurich, Switzerland, and (3) to identify unrecognized health problems to prepare successful public health strategies. METHODS Demographic and health-related data such as age, sex, country of origin, duration of imprisonment, medication (including the drug name, brand, dosage, and release), and medical history (including the International Classification of Diseases-10 codes [German modification] for all diagnoses and external results that are part of the medical history in the prison) have been deposited in a central register over a span of 5 years (January 2015 to August 2020). The final cohort is expected to comprise approximately 50,000 to 60,000 prisoners from the Police Prison Zurich, Switzerland. RESULTS This study was approved on August 5, 2019 by the ethical committee of the Canton of Zurich with the registration code KEK-ZH No. 2019-01055 and funded in August 2020 by the “Walter and Gertrud Siegenthaler” foundation and the “Theodor and Ida Herzog-Egli” foundation. This study is registered with the International Standard Randomized Controlled Trial Number registry. Data collection started in August 2019 and results are expected to be published in 2021. Findings will be disseminated through scientific papers as well as presentations and public events. CONCLUSIONS This study will construct a valuable database of information regarding the health of inmates and refugees in Swiss prisons and will act as groundwork for future interventions in this vulnerable population. CLINICALTRIAL ISRCTN registry ISRCTN11714665; http://www.isrctn.com/ISRCTN11714665 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/23973

scholarly journals Are Norwegian Municipality policies enabling intersectoral collaboration in migration health?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Nordström ◽  
B Kumar
Keyword(s):  
Public Health ◽  
Social Determinants ◽  
Local Level ◽  
Good Health ◽  
Migrant Health ◽  
Intersectoral Collaboration ◽  
Health Work ◽  
Integration Policy ◽  
Intersectoral Action ◽  
The Social

Abstract Issue Sporadic accounts of initiatives, interventions and good practices in Migrant Health at the Municipality level account for Norways' lower score on “Measures to achieve change” in the Migrant Integration Policy Index (MIPEX). While the structure and organization at the municipality level should enable intersectoral action (as all under one umbrella), the municipal counties say lack of intersectoral collaboration is one of the main barriers for long-term public health work. Description of the Problem 51 municipalities have an immigrant population larger than the national average 17,8% (2019). In a recent Country Assessment (part of Joint Action on Health Equity Europe), limited inter-sectoral action on the social determinants of health including migration was observed. Although multiple agencies are engaged in attempts to address these issues. While there is a drive to promote public health and primary health care in municipalities, these initiatives do not pay special attention to migrants. In the first stage of this project, we have reviewed municipal policy documents to map policy and measures on public health, migrant health and intersectoral collaboration. In the second stage, municipalities will be contacted to engage them in the implementation of intersectoral actions. Results The desk review and mapping show that only 8 of the “top” 32 municipalities mention “intersectoral” in the municipal master plan (5 were not available online), its mentioned in 9 action program/budgets, but not necessarily by the same municipalities. 15 of the municipalities mention migrants, but rarely in relation to health. We observe that, the size of the municipality, financial resources and support from the County are factors that may play a significant role in prioritising migrant health and intersectoral collaboration. Lessons Advocating for and supporting the local/municipal level for intersectoral action is highly relevant, timely and essential. Key messages Intersectoral action on the social determinants of migrants’ health needs to be implemented through municipal policies to reduce inequities in migrants’ health. Implementation on the local level is the main arena for good public health work and is crucial to ensure good health for migrants.

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