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Evaluation of scaling-up should take into account financial access; comment on: evaluating the scale-up for maternal and child survival: a common framework [correspondence]
No full textEstimating the prevalence of infections in vector populations using pools of samples
No full textSeveral statistical methods have been proposed for estimating the infection prevalence based on pooled samples, but these methods generally presume the application of perfect diagnostic tests, which in practice do not exist. To optimize prevalence estimation based on pooled samples, currently available and new statistical models were described and compared. Three groups were tested: (a) Frequentist models, (b) Monte Carlo Markov-Chain (MCMC) Bayesian models, and (c) Exact Bayesian Computation (EBC) models. Simulated data allowed the comparison of the models, including testing the performance under complex situations such as imperfect tests with a sensitivity varying according to the pool weight. In addition, all models were applied to data derived from the literature, to demonstrate the influence of the model on real-prevalence estimates. All models were implemented in the freely available R and OpenBUGS software and are presented in Appendix S1. Bayesian models can flexibly take into account the imperfect sensitivity and specificity of the diagnostic test (as well as the influence of pool-related or external variables) and are therefore the method of choice for calculating population prevalence based on pooled samples. However, when using such complex models, very precise information on test characteristics is needed, which may in general not be available
Facteurs d'adhésion au traitement recommandé pour le paludisme simple au Nord-Est de la République Démocratique du Congo
No full textThe purpose of this study was to identify the determinants of adherence to malaria treatment (co-blistered AS-AQ) among health care providers, medicine sellers and patients in the northeastern region of the Democratic Republic of Congo. A cross-sectional study was carried out on health care providers, medicine sellers and patients in 13 health zones between March and June 2009. Only 69% of the cases of uncomplicated malaria were treated with AS-AQ, including 62.3% of cases treated using the correct dosages. The availability of AS-AQ, the intention to prescribe AS-AQ, longer consultations, providing explanations to patients, working in rural areas, training on the new policy, and the availability of treatment guidelines were found to be significantly associated with treatment adherence among health care providers. The limited availability of AS-AQ, the adverse effects of the treatment, the use of low-quality AS-AQ and the availability of cheap illegal antimalarial drugs were the main factors associated with non-adherence. Among patients, non-adherence was related to the perceived adverse effects of malaria treatment. The results suggest that improving the accessibility and quality of AS-AQ and the quality of communication with patients, the provision of appropriate training to healthcare providers, the provision of treatment guidelines and appropriate supervision are needed to promote the use of AS-AQ
Predicted distribution of major malaria vectors belonging to the Anopheles dirus complex in Asia: ecological niche and environmental influences
No full textDeterminants of male involvement in maternal and child health services in sub-Saharan Africa: a review
No full textINTRODUCTION: Male participation is a crucial component in the optimization of Maternal and Child Health (MCH) services. This is especially so where prevention strategies to decrease Mother-to-Child Transmission (MTCT) of Human Immunodeficiency Virus (HIV) are sought. This study aims to identify determinants of male partners' involvement in MCH activities, focusing specifically on HIV prevention of maternal to child transmission (PMTCT) in sub-Saharan Africa. METHODS: Literature review was conducted using the following data bases: Pubmed/MEDLINE; CINAHL; EMBASE; COCHRANE; Psych INFORMATION and the websites of the International AIDS Society (IAS), the International AIDS Conference and the International Conference on AIDS in Africa (ICASA) 2011. RESULTS: We included 34 studies in this review, which reported on male participation in MCH and PMTCT services. The majority of studies defined male participation as male involvement solely during antenatal HIV testing. Other studies defined male involvement as any male participation in HIV couple counseling. We identified three main determinants for male participation in PMTCT services: 1) Socio-demographic factors such as level of education, income status; 2) health services related factors such as opening hours of services, behavior of health providers and the lack of space to accommodate male partners; and 3) Sociologic factors such as beliefs, attitudes and communication between men and women. CONCLUSION: There are many challenges to increase male involvement/participation in PMTCT services. So far, few interventions addressing these challenges have been evaluated and reported. It is clear however that improvement of antenatal care services by making them more male friendly, and health education campaigns to change beliefs and attitudes of men are absolutely needed
Utilización de los servicios del nivel primario de atención por los ancianos en tres policlínicos de Cuba
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