259 research outputs found
Procrangonyx , Schellenberg 1934
No full textGenus Procrangonyx Schellenberg, 1934 Procrangonyx Schellenberg, 1934: 217 –218.— Bousfield, 1977: 306.— Holsinger, 1977: 248 (in discussion).— Barnard & Barnard, 1983: 444 –445.— Holsinger, 1986: 542.— Holsinger, 1989: 956.— Stock & Jo, 1990: 119 (as an unavailable name without type species designation).— Tomikawa & Shinoda, 2016: 584 –585 (as an unavailable name). Eocrangonyx Schellenberg, 1937a: 37 (type species: Eucrangonyx japonicus Uéno, 1930, fixed by monotypy).— Barnard & Barnard, 1983: 444 (as a junior synonym of Procrangonyx).— Bousfield, 1983: 272.— Stock & Jo, 1990: 121. Eocrangonyx Schellenberg, 1934 (sic).— Ishimaru, 1994: 41 (attribution only, without corresponding reference).— Tomikawa & Morino, 2012: 41 (attribution only, without corresponding reference). Eocrangonyx Schellenberg, 1936 (sic).— Holsinger, 1977: 248 (in discussion, as a junior synonym of Procrangonyx).— Holsinger, 1989: 956 (as a junior synonym of Procrangonyx).— Sidorov & Barabanschikov, 2010: 70 (in discussion, as a junior synonym of Procrangonyx).— Tomikawa & Shinoda, 2016: 584.—Tomikawa et al., 2016: 200 (in discussion). Type species: Eucrangonyx japonicus Uéno, 1930, fixed by monotypy. Nomenclatural history. C.S. Bate (1859) —the citation of Charles Spence Bateherein follows Clark (2018) — established a new genus, Crangonyx C.S. Bate, 1859, for a single new subterranean species, C. subterraneus C.S. Bate, 1859, which was collected from Ringwood, U.K. The type species of Crangonyx was thereby fixed as C. subterraneus by monotypy, but C.S. Bate provided no morphological details of the uropods. Later, Stebbing (1899) erected a new Crangonyx -like genus, Eucrangonyx Stebbing, 1899, for subterranean amphipods with a biramous uropod 3, i.e., with both inner and outer rami. He included five species in this new genus but did not designate its type species; one of the originally included five species, Crangonyx gracilis Smith in Smith & Verrill, 1871, was subsequently designated as the type species of Eucrangonyx by Chevreux & Fage (1925). Much later, Uéno (1930) described a Japanese subterranean amphipod collected from Tokyo as Eucrangonyx japonicus Uéno, 1930. He highlighted the fact that its uniramous (with outer ramus only) uropod 3 was uniarticulate, contrary to the condition in the Asian subterranean amphipod genus Pseudocrangonyx Akatsuka & Komai, 1922, whose authors had diagnosed it by the uniramous but biarticulate uropod 3. Schellenberg (1932) examined non-type material of the British C. subterraneus and reported that this species has a rudimentary inner ramus on uropod 3, which is therefore biramous. Referring to this work again two years later, Schellenberg (1934) concluded that the generic name Eucrangonyx is a junior subjective synonym of Crangonyx, the latter being diagnosed by a biramous uropod 3. At the same time he proposed a new generic name, Procrangonyx Schellenberg, 1934 (p. 217), for the species with a uniramous uropod 3 that had been previously classified under Eucrangonyx. Throughout the (German) text, he referred to these uniramous “species” in the plural (i.e., as “Arten”), which indicates that his concept of the genus comprised more than one species. Schellenberg (1934) did not designate a type species for Procrangonyx, but he did explicitly mention a single species, E. japonicus (cited as Procrangonyx japonicus), as “an example” of such a uniramous species (p. 218): ‘ … ist er bei anderen Arten, z. B. Procrangonyx japonicus (Uéno, p. 22), Pseudocrangonyx (l. c.) einästig, ….’ Although Schellenberg did not cite Eucrangonyx japonicus in its original combination, there can be no doubt about the identity of the species involved. He explicitly attributed Procrangonyx japonicus to Uéno (1930), whose work includes on page 22 a figure showing the uniramous uropod 3 of E. japonicus and the description of this uropod. Schellenberg (1934) also listed Uéno’s (1930) work in his references section. Three years after the initial proposal of Procrangonyx, Schellenberg himself (1937a) established a new genus, Eocrangonyx Schellenberg, 1937a, with a detailed diagnosis. He included one species in it, Eocrangonyx japonicus (Uéno, 1930) cited as follows (p. 37): ‘ E. japonicus (Uéno) 9 mm, Wasserwerk Tokyo.’ Eucrangonyx japonicus was thereby fixed as the type species of Eocrangonyx, by monotypy. Schellenberg (1937a) never mentioned Procrangonyx. When erecting the new family Pseudocrangonyctidae consisting of Pseudocrangonyx and Procrangonyx, Holsinger (1989) treated Eocrangonyx as an objective junior synonym of Procrangonyx and stated that the type species of Procrangonyx is Eucrangonyx japonicus Uéno, 1930 fixed by monotypy. Holsinger’s contentions were, however, not supported by explicit citations of relevant provisions of the Code. In contrast, Stock & Jo (1990: 120– 121) pointed out that the expression “z. B.” (i.e., “zum Beispiel”, meaning “for example”) in the original description of Procrangonyx cannot be regarded as a type species designation according to Article 67(c) of the International Code of Zoological Nomenclature, Third Edition (International Commission on Zoological Nomenclature 1985). They judged the generic name Procrangonyx to be unavailable because, as they saw it, the genus was erected without a type species after 1930, contrary to the Third Code’s Article 67(c)(1). In place of Procrangonyx Stock & Jo (1990) used the available name Eocrangonyx for the Japanese species, and they also described a new Far-East Russian species as Eocrangonyx primoryensis Stock & Jo, 1990. After 2000, Hou & Li (2003) and Sidorov & Holsinger (2007) each described a new subterranean amphipod species with a uniramous and uniarticulate uropod 3, the two species being placed in Procrangonyx as P. limpidus Hou & Li, 2003 and P. stygoedincus Sidorov & Holsinger, 2007. Neither work referred to Stock & Jo (1990). Later, Sidorov & Barabanschikov (2010: 70–71) cited Stock & Jo (1990) and argued that the earlier name Procrangonyx was valid. Additionally, they treated P. stygoedincus as a subjective junior synonym of P. primoryensis (Stock & Jo, 1990), the latter being shifted to this genus from Eocrangonyx. Tomikawa & Shinoda (2016) redescribed Eucrangonyx japonicus Uéno, 1930. Citing relevant provisions of the current Fourth Edition of the Code (International Commission on Zoological Nomenclature 1999), they reaffirmed Stock & Jo’s (1990) nomenclatural conclusion on the invalidity [sic; unavailability was meant] of Procrangonyx and used the binomen Eocrangonyx japonicus (pp. 584–585). Following Tomikawa & Shinoda (2016), all species assigned to Procrangonyx were placed under Eocrangonyx in the influential web resource WoRMS—in which amphipod records are sourced from World Amphipoda Database (= WAD) (Horton et al. 2018a)—, the former genus being treated there as an invalid name without type species designation. In accordance with the manual for editors of WoRMS (Available from: http://www.marinespecies.org/aphia.php?p=manual#top; see also Horton et al. 2017), Procrangonyx was treated in the same way as the “present literature” does, i.e., as an “unaccepted” (= “invalid”) name that lacks a type species designation; however, a note acknowledged the ongoing disagreement on this latter point. Nomenclatural conclusion. In considering the potential availability and validity of Procrangonyx, it is necessary to clearly distinguish the two concepts of type species “fixation” (Article 67.4 of the Code) and type species “designation” (Article 67.5). The nomenclatural arguments of both Stock & Jo (1990) and Tomikawa & Shinoda (2016) were partially correct in that Schellenberg (1934) did not “designate” Eucrangonyx japonicus as the type species of Procrangonyx in a manner recognized by Article 67.5 of the Code. Under Article 67.2.1 and Article 68.3, however, because Procrangonyx japonicus (Uéno, 1930) was the only available nominal speciesgroup taxon originally included in Procrangonyx, this species (Eucrangonyx japonicus in its original combination) was fixed by Schellenberg (1934) as the type species of Procrangonyx. [N.B.: Under Recommendation 67B of the Code, the name of a type species should be cited by its original binomen.] Since a type species was “fixed” in the original publication, even if not explicitly “designated”, and a diagnostic character for the genus was proposed in the same work, Procrangonyx Schellenberg, 1934 is available and is the valid name of the genus. Eocrangonyx Schellenberg, 1937a, with the same type species, is then a junior objective synonym of Procrangonyx, and as such is invalid. Holsinger (1989) was unquestionably correct about the availability and the type species fixation of Procrangonyx, despite his lack of rigorous reference to the Code. The erroneous status of Procrangonyx and Eocrangonyx in WAD should be emended promptly to avoid additional confusion about which generic name to use for the species now assigned to these genera. The nomenclatural disorder concerning the availability, and thus the validity, of Procrangonyx highlights the common error of confusing the two terms “ type fixation” and “ type designation”. Zoologists are generally aware that to be available, every new genus-group name proposed after 1930 must be accompanied by type species “fixation”, but, like Stock & Jo (1990) they tend to misunderstand this to mean “original designation” by the author of the genus. Indeed, explicit designation is probably best practice, but several other permissible means of type species fixation are also listed in Article 68 of the Code: monotypy, absolute tautotomy and “Linnean tautotomy”. In the present instance, type species fixation occurred by monotypy in the original publication.Published as part of Nakano, Takafumi, Tomikawa, Ko & Grygier, Mark J., 2018, Rediscovered syntypes of Procrangonyx japonicus, with nomenclatural consideration of some crangonyctoidean subterranean amphipods (Crustacea: Amphipoda: Allocrangonyctidae, Niphargidae, Pseudocrangonyctidae) in Zootaxa 4532 (1), DOI: 10.11646/zootaxa.4532.1.4, http://zenodo.org/record/261506
Contribution to the knowledge of alien amphipods off the Turkish coast: Gammaropsis togoensis (Schellenberg, 1925)
No full textA total of 236 specimens of the Gammaropsis togoensis (Schellenberg, 1925) were collected in Iskenderun Bay, SE Turkey during 2005-2006. Already known from the Mediterranean coast of Israel, this is the first record of this alien amphipod from Turkey. © 2007 The Author(s)
Measuring Access and Practice: Designing a Survey Methodology for the Hygiene, Sanitation and Water Sector
No full textAccess to safe water and sanitary means of excreta disposal are essential elements of
human development and poverty alleviation. It is estimated that one in four people in
the developing world lacks access to water while over half the population has no
access to sanitation. From the Alma-Ata declaration in 1978 to the recent Millennium
Development Goals, efforts to improve this situation have been hampered by the lack
of meaningful indicators to measure hygiene, sanitation and water coverage and
establish progress towards the goals and targets set out by the international
community.
This thesis aims to determine if measuring prevalence of access to water~ sanitation
and the practice of hygienic behaviour in hous~hold surveys can be.improved. With
no indicators available in current international' laws and targets, various aspects of
access and practice were examined to design indicators for field-testing. By using
- existing data sets, the research established that there is a high geographic clustering of
the measures of interest, which results in large design effects (deff) and rates of
homogeneity (roh) in cluster surveys. Based on the calculated roh optimum numbers
ofcluster and sample size were calculated for the field trials. This requires
introducing survey costs in the sample size calculations. The high clustering of water
and sanitation indicator require large sample sizes, resulting in large amounts of data
which organisations in the four field trials in Kosovo, South Africa, Kenya and Laos
found difficult to handle. Practical problems in the implementation of the survey
method resulted in non-sampling errors and could cause reluctance in adoption the
methodology. The research improved water and sanitation indicators but found that
for individual behaviour such as hygiene the household is not a suitable sampling unit.
It also showed that observation among interviewers have to be better standardised to
reduce the inter-surveyor.variation. Representative sampling is the current bottleneck
in the development of such a survey method. Current method requires a good
understanding of sampling theory as well as reliable sample frames, which are rarely
available to implementing organisations. Alternative sampling methods are
suggested, and recommendations are made for the further development ofthe survey
method designed in this research, which to date may be too complex for widespread
use
Quadrimaera serrata Schellenberg 1938
No full text<i>Quadrimaera serrata</i> (Schellenberg, 1938) <p>(Fig. 43)</p> <p> <i>Maera tenella</i>.— Walker, 1904: 224, pl. 5, fig. 31.— Tattersall, 1922: 8.— Pirlot, 1936: 309 (<i>fide</i> Sivaprakasam 1968).</p> <p> <i>Maera</i> sp.— K.H. Barnard, 1937: 124.</p> <p> <i>Maera inaequipes serrata</i> Schellenberg, 1938: 41, fig. 18.— J.L. Barnard, 1962: 99.— J.L. Barnard, 1965: 510.— Ledoyer, 1967: 127, fig. 9.— Sivaprakasam, 1968: 100.— Surya Rao, 1972: 194.</p> <p> <i>Maera serrata</i>.— Sivaprakasam, 1970: 35.— Ruffo, 1969: 25.— J.L. Barnard, 1970: 155, figs 96–97.— J.L. Barnard, 1971: 77, figs 38, 40–41.— J.L. Barnard, 1972b: 107.— Ledoyer, 1972: 229, pl. 46.— Ledoyer, 1978: 279.—Ledoyer, 1982: 544, fig. 207.— Griffiths, 1973: 286.— Ledoyer, 1978: 229.— Ortiz, 1978: 8.— Berents, 1983: 131, fig. 24.— Myers, 1985: 117, fig. 92.— Myers, 1989: 66.— Myers, 1995: 38.— Myers, 1997: 109.— Ren, 1998: 207, fig. 8.— Ren, 2012: 251, fig. 110.</p> <p> <i>Quadrimaera serrata</i>.— Krapp-Schickel & Ruffo, 2000: 195.— Lowry & Stoddart, 2003: 187 (catalogue).</p> <p> <b>Material examined.</b> Cocos (Keeling) Islands. 1 specimen, AM P.82202, dive site "Rose Wall", near Horsburgh Island, 12°05'45"S, 96°50'32"E, 13.8 m, green calcareous alga <i>Halimeda</i> sp., coll. K.B. Attwood, 12 October 2008, MI WA 827; 7 specimens, AM P.82203, dive site "Rose Wall", near Horsburgh Island, 12°05'45"S, 96°50'32"E, 11 m, rubble some green calcareous alga <i>Halimeda</i> sp., coll. L.E. Hughes, 12 October 2008, MI WA 830; 1 specimen, AM P.82200, off West Island Jetty, 12°05'15"S, 96°50'14"E, 1.5 m, rubble, coll. L.E. Hughes, 14 October 2008, MI WA 843; 1 specimen, AM P.82201, off West Island Jetty, 12°05'15"S, 96°50'14"E, 0 m, brown alga <i>Turbinaria</i> sp. as floating wrack, coll. L.E. Hughes, 14 October 2008, MI WA 844; 2 specimens, AM P.82204, off West Island Jetty, 12°05'15"S, 96°50'14"E, 2 m, brown alga <i>Padina</i> sp., coll. L.E. Hughes and J.K. Lowry, 14 October 2008, MI WA 841.</p> <p> Western Australia. 2 specimens, WAM C47855, Long Reef, The Kimberley, 13°53'S, 125°44'E, 2 m, 20 October 2010, coll. Andrew Hosie, Woodside Kimberley Survey 2010, 44/K10-T1; 1 specimen, WAM C47856, Cassini Island, The Kimberley, 13°55'S, 125°37'E, 2 m, 16 October 2010, coll. Andrew Hosie, Woodside Kimberley Survey, 32/K10-T1; 1 specimen, AM P.98058, inner lagoon, Ningaloo Reef, 21°53'9"S, 113°59'26"E, 1.5 m, brown alga <i>Lobophora</i> sp., 18 June 2008, coll. L.E. Hughes MI WA 987, NR 18; 1 specimen, AM P.83824, Shenton Bluff, Cygnet Bay, Cape Leveque, 16°28'37"S, 12°32'38"E, 5.1 m, brown algae <i>Sargassum</i> sp. on rubble, 22 May 2010, coll. K.B. Attwood, MI WA 1080; 2 specimens, AM P.83825, emerging lagoon at low tide near Shenton Bluff, Cygnet Bay, Cape Leveque, 16°28'58"S, 12°32'40"E, 6.9 m, brown algae <i>Sargassum</i> sp., 23 May 2010, coll. K.B. Attwood, MI WA 1090; 3 specimens, AM P.83826, Riddell Point, Cygnet Bay, Cape Leveque, 16°27'59"S, 12°31'41"E, 9.9 m, rubble, 25 May 2010, coll. K.B. Attwood, MI WA 1127; 2 specimens, AM P.83827, Jackson Island site A, Cape Leveque, 16°25'19"S, 12°35'19"E, 5.8 m, rubble, 27 May 2010, coll. L.E. Hughes, MI WA 1148.</p> <p> Northern Territory: 2 specimens, AM P.78314, patch reef on north side of New Year Island, 10°54'S, 13°32'E, 10 m, hydroids on coral, 14 October 1982, coll. G.C.B. Poore, NT 17; 1 specimen, AM P.78316, south end of McCluer Island, 11°06'S, 133°E, 8 m, had coral <i>Acropora</i> sp. base, 17 October 1982, coll. P. Horner, NT 59; 13 specimens, AM P.78315, bommies at north-west end of McCluer Island, 11°2'S, 132°58'E, 8 m, <i>Stylophora</i> bases, 16 October 1982, coll. P. Horner, NT 36; 11 specimens, AM P.78317, south end of McCluer Island, 11°6'S, 133°00'E, 8 m, coral <i>Seriatopora hystrix</i>, 17 October 1982, coll. J.K. Lowry, NT 61.</p> <p> Queensland: 1 specimen, AM P.75800, largest bommie in lagoon at the 'Entrance', One Tree Island, 23°29'16"S, 15°24'46"E, 4.1 m, 25 October 2006, coral rubble, coll. J.K. Lowry and L.E. Hughes, QLD 1946; many specimens, AM P.75799, centre bommie, First Lagoon, One Tree Island, 23°30'12"S, 15°25'19"E, 1.7 m, dead coral with epiphytes, 29 October 2006, coll. L.E. Hughes and J.K. Lowry, QLD 2006; many specimens, AM P.80624, Cockle Bay, Magnetic Island, 19°11'S, 146°49'E, depth unknown, seagrasses <i>Cymodocea serrulata</i>, <i>Halodule uninervis</i> and <i>Halophila ovalis</i>, 17 February 1999, coll. D.W. Klumpp and S.N. Kwak, Original Vial Label Data: 290499; many specimens, AM P.80625, Cockle Bay, Magnetic Island, 19°11'S, 146°49'E, depth unknown, seagrasses <i>Cymodocea serrulata</i>, <i>Halodule uninervis</i> and <i>Halophila ovalis,</i> 17 February 1999, coll. D.W. Klumpp and S.N. Kwak, Original Vial Label Data: 170299.</p> <p> Norfolk Island: 1 male, 9 mm, dissected, 3 slides, AM P.92512, Fig Valley reef, 29°3'20"S, 167°55'44"E, 18.7 m, red coralline algae <i>Amphiroa anceps</i> and other mixed red algae, 19 May 2008, coll. L.E. Hughes, MI NFK 71;1 b female, 6.4 mm, dissected, 1 slide, AM P.92513, Fig Valley reef, 29°3'20"S, 167°55'44"E, 18.7 m, red coralline algae <i>Amphiora anceps</i> and other mixed red algae, 19 May 2008, coll. L.E. Hughes, MI NFK 71; 1 c male, 6 mm, AM P.92514, Fig Valley reef, 29°3'20"S, 167°55'44"E, 18.7 m, red coralline algae <i>Amphiora anceps</i> and other mixed red algae, 19 May 2008, coll. L.E. Hughes, MI NFK 71; 3 specimens, AM P.81503, Fig Valley reef, 29°3'20"S, 167°55'44"E, 18.7 m, red coralline algae <i>Amphiroa anceps</i> and other mixed red algae, 19 May 2008, coll. L.E. Hughes, MI NFK 71; 1 specimen, AM P.81505,Fig Valley reef, 29°3'20"S, 167°55'44"E, 20 m, red sponge like algae, 19 May 2008, coll. L.E. Hughes, MI NFK 69; 10 specimens, AM P.81502,dive site ‘The Wall’, Nepean Island, 29°4'17"S, 167°57'40"E, 17 m, green algae <i>Halimeda</i> sp., 15 May 2008, coll. J.K. Lowry, MI NFK 45.</p> <p>Lord Howe Island. Many specimens, AM P.98059, north end of Old Settlement Beach, 31°31'12"S, 15°93'36"E, under intertidal rocks, 11 May 1977, coll. G.D. Fenwick and J.K. Lowry, LHA 13.</p> <p> <b>Type locality.</b> Kiribati, 140'S, 17922'W.</p> <p> <b>Distribution.</b> South Pacific Ocean: Australia: Queensland: Lizard Island, One Tree Island, Magnetic Island, (Berents 1983; Krapp-Schickel 2009; current study); Northern Territory: New Year Island, McCluer Island (current study); Tasman Sea: Norfolk Island; Lord Howe Island (current study). Marshall Islands and Kiribati (Schellenberg 1938; J.L. Barnard 1965); Fiji (Schellenberg 1938; Myers 1985). Indian Ocean: Australia: Western Australia: Long Reef, Cassini Island, The Kimberley; Cape Leveque (current study); Cocos (Keeling) Islands (current study); Mauritius (Appadoo <i>et al.</i> 2002); Madagascar (Ledoyer 1967, 1983); South Africa (Griffiths 1973); Red Sea (Ruffo 1969); India (Sivaprakasam 1968). North Pacific Ocean: Hawaii (Schellenberg 1938; J.L. Barnard 1970).</p>Published as part of <i>Hughes, Lauren E., 2015, Maeridae from the Indo-Pacific: Elasmopus, Leeuwinella gen. nov., Maeropsis, Pseudelasmopus and Quadrimaera (Amphipoda: Crustacea), pp. 201-256 in Zootaxa 4059 (2)</i> on pages 245-247, DOI: 10.11646/zootaxa.4059.2.1, <a href="http://zenodo.org/record/232164">http://zenodo.org/record/232164</a>
CRITIQUE - OF “FACTORS INFLUENCING NITROGEN ACQUISITION BY PLANTS; ASSIMILATION AND FATE OF REDUCED NITROGEN”
No full textAn Estimation of the Entomological Inoculation Rate for Ifakara: A Semi-Urban Area in a Region of Intense Malaria Transmission in Tanzania.
No full textAn entomological study on vectors of malaria and their relative contribution to Plasmodium falciparum transmission in the semi-urban area of Ifakara, south-eastern Tanzania, was conducted. A total of 32 houses were randomly sampled from the area and light trap catches (LTC) performed in one room in each house every 2 weeks for 1 year. A total of 147 448 mosquitoes were caught from 789 LTC; 26 134 Anopheles gambiae s.l., 615 A. funestus, 718 other anophelines and 119 981 culicines. More than 60% of the total A. gambiae s.l. were found in five (0.6%) LTCs, with a maximum of 5889 caught in a single trap. Of 505 A. gambiae s.l. speciated by polymerase chain reaction, 91.5% were found to be A. arabiensis. Plasmodium falciparum sporozoite enzyme-linked immunosorbent assay tests were performed on 10 108 anopheles mosquitoes and 39 (0.38%) were positive. Entomological inoculation rate (EIR) estimates were generated using a standard method and an alternative method that allows the calculation of confidence intervals based on a negative binomial distribution of sporozoite positive mosquitoes. Overall EIR estimates were similar; 31 vs. 29 [95% confidence interval (CI): 19, 44] infectious bites per annum, respectively. The EIR ranged from 4 (95% CI: 1, 17) in the cool season to 108 (95% CI: 69, 170) in the wet season and from 54 (95% CI: 30, 97) in the east of the town to 15 (95% CI: 8, 30) in the town centre. These estimates show large variations over short distances in time and space. They are all markedly lower than those reported from nearby rural areas and for other parts of Tanzania
Towards a new method for evaluating large-scale maternal health programmes: measuring implementation strength of focused antenatal care and emergency obstetric care in Tanzania
No full textMeasuring the strength of public health programmes may reveal whether and how some programmes have an impact on target populations and others do not. Programme implementation strength (also known as programme intensity) refers to quantitative measure reflecting programme inputs, processes, and their duration. Measuring programme strength requires an understanding of how programmes work and involves defining measurable concepts, identifying sources of programme data and close programme follow-up. There are no standardized methods for measuring programme strength.
This thesis developed and tested an approach for estimating programme strength for use in evaluating large-scale maternal health programmes in low- and middle-income countries. It used focused antenatal care (FANC) and emergency obstetric care (EmOC) as tracer programmes, with WHO’s health-system-building blocks as programme components. The thesis used mixed methods including: developing a weighting scheme through opinions from maternal health experts, collecting FANC and EmOC data from 23 districts on programme strength, programme coverage, and programme contextual factors, using government official statistics, and using routine data from a central database. The thesis also tested the content and face validity of the approach.
Results from experts showed that, even though all six WHO blocks were required in programme implementation, human resources was given relatively higher weights than the other programme components. While the overall programme strength in districts scored an average of 41% (FANC) and 40% (EmOC), the overall programme coverage scored an average of 80% (FANC) and 64% (EmOC). Contextual factors significantly associated with the programmes included: total fertility rate, female literacy, water, sanitation, and famine. The content and face validity were both rated “very good”. This work aims to contribute towards an efficient way of evaluating large-scale maternal health programmes in low- and middle-income countries. The approach could also be of interest especially to district health management authorities for improving health programmes
Exploring the context and potential benefits of implementing an Intermittent Preventive Treatment for malaria in infants (IPTi) in Papua New Guinea
No full textSummary: Background
Intermittent preventive treatment (IPTi) is an intervention aiming to reduce the
risk of malaria in infants. Its concept is to deliver a full treatment course of
antimalarial drugs to infants, three or four times during the first year of life,
following the expanded program of immunization (EPI) schedule and regardless
of clinical malaria episodes.
Mainly Sulphadoxine/pyrimthamine (SP) was studied and demonstrated to
reduce the risk of malaria by 30% in Africa, where Plasmodium falciparum (Pf) is
the predominant species. No study has been carried out in regions of the world
with a significant burden of non-Pf infections. There is therefore a need to
investigate the potential benefits of IPTi in areas, such as Papua New Guinea
(PNG), highly endemic for Plasmodium vivax (Pv) malaria.
Apart from efficacy, which is the corner stone of an intervention, it is essential to
have a clear picture of the context in which such an intervention might be
implemented. Indeed, determinants of effectiveness such as the malaria context
(epidemiology and case management), the acceptability and the access to the
intervention need to be investigated prior to the implementation of IPTi.
The present study investigates the efficacy of IPTi in PNG as well as some key
aspects of infant’s health in PNG that might help to understand the context in
which IPTi could be implemented.
Methods
Randomized controlled trial investigating the protective efficacy of 4 doses of SP
associated to 3 days of artesunate (SP-AS3) or 3 days of amodiaquine (SP-AQ3)
given at 3-month intervals during the first year of life. Most of infants were
followed-up for an additional 12 months. The study took place in Madang and
Maprik (PNG) from 2006 to 2010, but only the Madang cohort was used for the
IPTi efficacy analyses.
Making use of the morbidity passive case detection of the trial, the following
aspects of infant’s health in PNG were investigated:
· Effectiveness of treating infants with a unified treatment
(artemther/lumefantrine, AL) for Pf & Pv malaria based on the result of the
rapid diagnostic test (RDT)
· The incidence of common illnesses based on RDT and syndromic
definitions of diseases and the impact of IPTi on them.
· The performances of the integrated management childhood illness (IMCI)
supplemented with RDT & IPTi for the management of common
syndromes/diseases in PNG.
The acceptability of IPTi was also assed alongside the drug trial.
Findings
1605 infants 3 months old were enrolled in the IPTi trial, 1125 in Madang and 480
in Maprik. The intention-to-treat relative risk (RR) at 15 months of age (Madang
site only) was 0.72 (95%CI, 0.57 - 0.90) on all malaria episodes with SP-AQ3 and
0.88 (95%CI, 0.70 - 1.10) with SP-AS3, overall p=0.017. Using SP-AQ3, the RR
was 0.63 (95%CI, 0.45 - 0.88) on Pf and 0.78 (95%CI, 0.60 - 1.01) on Pv. No
difference was observed in the incidence of overall morbidity, severe diseases
and non-malarial illnesses between the placebo and IPTI intervention arms.
Fewer deaths were observed in the treatment arms compared to placebo:
placebo=8, SP-AQ3=1 and SP-AS3=3.
7223 fever episodes occurred (in Madang and Maprik) during the study and 5670
had a negative RDT result. Out of them, 133 (3.4%) re-attended the clinic within
7 days for fever, and 1 died of lower respiratory tract infection (LRTI). 23 (0.6%)
infants re-presented with a severe illness (4 with positive BS and/or RDT). 1728
children with positive RDT results were treated with artemether/lumefantrine (AL).
30 (1.7%) re-attended within 7 days for fever, none died.
Out of the total cohort, incidence rates (episodes/child/year) for common
syndromes/diseases were: 0.85 (95%CI, 0.81-0.90) for LRTI, 0.72 (95%CI, 0.65-
0.93) for gastroenteritis (GI), 0.62 for malaria (95%CI, 0.58 - 0.66) and 0.08
(95%CI, 0.07-0.09) for otitis.
The introduction of RDT led to a high accuracy of “on site” malaria diagnosis (К
=0.99). On the opposite, the clinical diagnosis accuracy for others syndromes
was poor: К=0.47 for LRTI, К=0.52 for GI and К= 0.52 for otitis.
25% of illness episodes were inappropriately treated: 6% did not receive
antibiotics when they should have and 19% received antibiotics when they should
not have (according to recommendations). The prescription’s rate of antibiotics
was 56% when the RDT for malaria was negative and 16% when the RDT was
positive (p<0.001). The acceptability of IPTi appears to be good in Melanesian
populations.
Conclusion
The use of RDT and artemether/lumefantrine is a safe and effective strategy for
the management of malaria cases in PNG and could be implemented very easily.
IPTi has demonstrated its efficacy to reduce both Pf and Pv episodes. However,
the apparent absence of benefit on the overall morbidity and on severe illnesses
is a concern and mitigates the interest of implementing this intervention in PNG.
Furthermore, other factors such as a low EPI coverage and rapidly changing
malaria endemicity due to the recent introduction in PNG of insecticide treated
nets (ITN) and artemisinin combination therapies (ACT) are likely to jeopardize
the potential benefits of IPTi in PNG. ---------- Zusammenfassung:
Hintergrund
Intermittent preventive treatment in infants (IPTi) ist eine Intervention mit dem
Ziel, das Risiko von Malaria bei Kleinkindern zu reduzieren. Sein Konzept ist den
Säuglingen Behandlung mit Malariamedikamenten, drei oder viermal während
des ersten Lebensjahres, nach dem Zeitplan des Erweitertens Programms der
Immunisierung (EPI) und unabhängig von klinischen Malaria Episoden.
Haupsächlich Sulfadoxin/pyrimthamine (SP) wurde studiert und zeigte, dass das
Risiko von Malaria um 30% in Afrika reduziert wurde, wo Plasmodium falciparum
(Pf) die vorherrschende Spezies ist. Keine Studie wurde in den Regionen der
Welt mit einer signifikanten Belastung durch nicht-Pf-Infektionen durchgeführt. Es
besteht daher ein Bedarf, die potenziellen Vorteile der IPTi in Bereichen wie
Papua-Neuguinea (PNG), hoch endemisch für Plasmodium vivax (Pv) Malaria,
zu untersuchen.
Abgesehen von Wirksamkeit, die der Grundstein für eine Intervention ist, ist es
wichtig, ein klares Bild des Kontextes zu haben, in dem ein solcher Eingriff
durchgeführt werden könnte. Tatsächlich, Determinante der Wirksamkeit wie der
Malariakontext (Epidemiologie und Case Management), die Akzeptanz und der
Zugang auf die Intervention, muss vor der Durchführung von IPTi untersucht
werden.
Die vorliegende Studie untersucht die Wirksamkeit von IPTi in PNG sowie einige
der wichtigsten Aspekte der kindlichen Gesundheit von Kleinkindern in PNG, die
helfen könnten, den Kontext, in dem IPTi implementiert werden könnte, zu
verstehen.
Methoden
Randomisierte kontrollierte Studie, die die schützende Wirkung untersucht von
vier Dosen von SP und 3 Tagen von Artesunat (SP-AS3) oder 3 Tage von
Amodiaquin (SP-AQ3) in 3-monatigen Abständen, gegeben während des ersten
Lebensyahres. Die meisten Kinder wurden für weitere 12 Monate beobachtet.
Die Studie fand in Madang und Maprik (PNG) von 2006 bis 2010 statt, aber nur
die Madang Kohorte wurde für die IPTi Wirksamkeit Analyse verwendet.
Folgende Aspekte der Gesundheit der Kleinkinder in PNG wurden untersucht,
indem die passiven Fälle der Studie registriert wurden:
• Wirksamkeit der Behandlung von Säuglingen mit einer einheitlichen
Behandlung (artemther / Lumefantrin, AL) für Pf & Pv Malaria, dem Ergebnis des
rapid diagnostic test (RDT) nach.
• Die Inzidenz von gewöhnlichen Krankheiten nach RDT und syndromalen
Definitionen von Krankheiten und die Auswirkungen von IPTi auf ihnen.
• Die Leistungen des integrierten Managementsystems Kinderkrankheiten (IMCI)
ergänzt mit RDT & IPTi für die Bewirtschaftung der gewöhnlichen Syndrome / in
PNG.
Die Akzeptanz von IPTi wurde während dieser Studie bestimmt .
Resultate
1605 3-Monate alt Säuglinge wurden in die IPTi Studie eingezogen, 1125 in
Madang und 480 in Maprik. Intention-to-treat relative Risiko (RR) bei 15 Monaten
alt betrug 0.72 (95% CI, 0.57 bis 0.90) auf allen Malariaepisoden mit SP-AQ3
und 0.88 (95% CI, 0.70 bis 1.10) mit SP-AS3, Insgesamt p = 0.017. Mit SP-AQ3
wurde das RR 0.63 (95% CI, 0.45 bis 0.88) auf Pf und 0.78 (95% CI, 0.60 bis
1.01) auf Pv. Es wurde kein Unterschied in der Inzidenz von insgesamter
Morbidität, schwere Erkrankungen und nicht-Malaria-Erkrankungen zwischen der
Placebo-und IPTi Intervention Arme beobachtet. Nur wenige Todesfälle wurden
in den Behandlungsgruppen im Vergleich zu Placebo beobachtet: Placebo = 8,
SP-AQ3 = 1 und SP-AS3 = 3 ist.
7223 Fieberepisode (in Madang und Maprik) sind während der Studie
aufgetreten und 5670 hatten einen negativen RDT. Aus ihnen, 133 (3.4%)
besuchten die Klinik innerhalb von 7 Tagen bei Fieber wieder und 1 starb an
unteren Atemwegeinfektion (LRTI). 23 (0.6%) Säuglinge kamen erneut mit einer
schweren Krankheit (4 mit positiven BS und / oder RDT). 1728 Kinder mit
positiven RDT Ergebnissen wurden mit Artemether / Lumefantrin (AL) behandelt.
30 (1.7%) besuchten die klinik innerhalb von 7 Tagen bei Fieber wieder, keiner
starb.
Von der insgesamten Kohorte waren Inzidenzraten (Episode / Kind / Jahr) für
gemeinsame Syndrome / Krankenheiten : 0.85 (95% CI, 0.81-0.90) für LRTI, 0.72
(95% CI, 0.65-0.93) für Gastroenteritis (GI), 0.62 f!ur malaria (95%CI, 0.58 - 0.66)
und 0.08 (95% CI, 0.07-0.09) für Otitis.
Die Einführung von RDT führte zu einer hohen Genauigkeit von "on site"
Malaria-Diagnose (К = 0.99). Im gegenteil, war die Genauigkeit klinischer
Diagnose für andere Syndrome schlecht : К = 0.47 für LRTI, К = 0.52 für GI und
К = 0.52 für Otitis.
25% der Krankheitsepisoden wurden unsachgemäß behandelt: 6% erhielten
keine Antibiotica, wenn sie sie haben sollten und 19% erhielten Antibiotika, wenn
sie sie nicht haben sollten (den Empfehlungen nach). Die Verschreibung von
Antibiotika war 56% wenn der RDT für Malaria negative war und 16% wenn der
RDT postiv war (p <0.001). Die Akzeptanz für IPTi scheint in melanesischen
Bevölkerung gut zu sein.
Schlussvolgernd
Die Verwendung von RDT und Artemether / Lumefantrin ist eine sichere und
wirksame Strategie für die Verwaltung der Malariafälle in PNG und könnte sehr
leicht realisiert werden. IPTi hat seine Wirksamkeit demonstriet, sowohl Pf und
Pv Episoden zu reduzieren. Allerdings ist die offensichtliche Abwesenheit von
Vorteilen auf die gesamte Morbidität und auf schwere Krankheiten ein Anliegen,
und mildert das Interesse der Durchführung dieser Intervention in PNG. Darüber
hinaus gibt es andere Faktoren, wie eine niedrige EPI Berichterstattung und die
sich rasch verändernde Malaria endemizität durch die kürzliche Einführung in
PNG von Insektiziden behandelte Moskitonetze (ITN) und Artemisinin-
Kombinationstherapien (ACT), die die potenziellen Vorteile der IPTi in PNG
gefährden könnten
The Changing Epidemiology of Malaria in Ifakara Town, Southern Tanzania.
No full textBetween 1995 and 2000 there were marked changes in the epidemiology of malaria in Ifakara, southern Tanzania. We documented these changes using parasitological and clinical data from a series of community- and hospital-based studies involving children up to the age of 5 years. There was a right shift and lowering in the age-specific parasite prevalence in the community-based cohort studies. The incidence of clinical malaria in placebo-receiving infants in additional study cohorts dropped from 0.8 in 1995 to 0.43 episodes per infant per year in 2000, an incidence rate ratio of 0.53 (95% confidence interval: 0.404, 0.70, P<0.0001). At the same time, there was an increase in the total number of malaria admissions and a marked right shift in the age pattern of these admissions (median age in 1995 1.55 years vs. 2.33 in 2000, P<0.0001). However, the burden of malaria deaths remained in infants. We discuss how these dramatic changes in the epidemiology of malaria may have arisen from the use of currently available malaria control tools. Caution is required in the interpretation of hospital-based data as it is likely to underestimate the impact of anaemia on mortality in the community, where most paediatric deaths occur. Even in low/moderate malaria transmission settings, where older children suffer most malaria episodes, targeting effective malaria control at infants may produce important reductions in infant mortality caused by malaria
Paul: Appearance and Health
No full textThis is the author accepted manuscript. The final version is available from Bloomsbury via the link in this recor
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