1,721,074 research outputs found
Presumptive treatment of fever cases as malaria: help or hindrance for malaria control?
Get PDFBACKGROUND: Malaria incidence has been reported to be falling in several countries in sub-Saharan Africa in recent years. This fall appears to have started before the widespread introduction of insecticide-treated nets. In the new era of calls to eliminate and eradicate malaria in sub-Saharan Africa, exploring possible causes for this fall seem pertinent. PRESENTATION OF THE HYPOTHESIS: The authors explore an argument that presumptive treatment of fever cases as malaria may have played a role in reducing transmission of malaria by the prophylactic effect of antimalarials and their widespread use. This strategy, which is already in practise is termed Opportunistic Presumptive Treatment (OPT). TESTING THE HYPOTHESIS: Further comparison of epidemiological indicators between areas with OPT and more targeted treatment is required. If data suggest a benefit of OPT, combining long acting antimalarials that have an anti-gametocyticidal activity component plus using high levels of vector control measures may reduce transmission, prevent resistant strains spreading and be easily implemented. IMPLICATIONS OF THE HYPOTHESIS: OPT is practised widely by presumptive treatment of fever in health facilities and home management of fever. Improving diagnosis using rapid diagnostic tests and thus reducing the number of doses of antimalarials given may have counter intuitive effects on transmission in the context of elimination of malaria in high to moderate transmission settings
Malaria knowledge and utilization of chemoprophylaxis in the UK population and in UK passengers departing to malaria-endemic areas.
Get PDFBACKGROUND: The burden of imported malaria is predominantly in travellers visiting friends and relatives (VFR) in sub-Saharan Africa. The failure of this group to use chemoprophylaxis is recognized as the most important risk factor for the high incidence of disease. Understanding the reasons for failure to follow national recommendations may relate to knowledge, risk perception, cost, and peer pressure. Research into these variables is critical to understand and change practices in this group and this study was designed to explore whether knowledge, risk perception and prophylaxis use differs between travellers' to various destinations and the rest of the UK population. METHODS: Two face-to-face questionnaire surveys were conducted to collect information on demographics, malaria knowledge, source, and quality of pre-travel advice, past travel experience and perceived malaria threat. One was an IPSOS survey of individuals representative of the UK population. The other was a departure lounge survey (Civil Aviation Authority (CAA)) of passengers departing to malarious regions detailing destinations and use of chemoprophylaxis. RESULTS: Around a quarter of the 1,991 UK population surveyed had previously travelled to a malarious area. Five-hundred departing passengers were interviewed, of which 80% travelled for leisure (56% VFR's) and 42% were travelling to West Africa. Malaria knowledge among the UK population (score 58.6) was significantly lower than that of individuals who had previously travelled or were travelling (63.8 and 70.7 respectively). Malaria knowledge was similar in individuals who had and had not sought pre-travel advice and travellers using and not using chemoprophylaxis for their journey. Leisure travellers to Ghana and Nigeria were predominantly VFRs (74%), whilst 66% of travellers to Kenya were tourists. Despite similar high knowledge scores and perceived (>90%) threat of the lethality of malaria in the three groups, chemoprophylaxis use in Nigerians (50%) was substantially lower than in passengers departing to Kenya (78%) and Ghana (82%). More frequent annual return visits were made to Nigeria (72%) than to Ghana (38%) or Kenya (23%). CONCLUSION: Travellers had more malaria knowledge than the non-travelled UK population. Malaria knowledge, perceived threat, travel experience, and quality of pre-travel advice appear unrelated to the use of chemoprophylaxis in passengers. Reducing malaria in VFR travellers will require strategies other than improving malaria knowledge and enhancing malaria risk awareness
"We learn from them, they learn from us": global health experiences and host perceptions of visiting health care professionals.
No full textPURPOSE: It is increasingly common for health care professionals from developed countries to travel to developing regions of the world to learn or teach. This project aimed to describe the perceptions held by health care professionals in a developing region toward those who visit their communities to learn or teach. METHOD: Semistructured interviews were conducted in July, 2011, with nine health care professionals from the University of Namibia School of Medicine. Questions revolved around participants' perceptions of benefits, harms, and ethical impressions of a health care professional visiting from a developed country. Interviews were tape-recorded, transcribed, and analyzed qualitatively using an inductive, iterative approach. RESULTS: The interview analysis identified three main narratives that shaped participant perceptions of visits: (1) culture, context, and concern, (2) expectations, intentions, and miscommunications, and (3) partnership and the desire to share and gain knowledge. CONCLUSIONS: Participants' comments supported actively seeking out information regarding cultural and environmental context before visiting, completing a needs assessment to ensure that activities are needed and relevant, attempting to formulate long-term sustainable relationships, and traveling with the appropriate attitude. These themes provide valuable insight into how international educational collaborations can be created in order to be mutually beneficial
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