Multiple studies have identified links between climate and West Nile virus disease since the virus arrived in North America. Here we sought to extend these results by developing a Health Impact Function (HIF) to gener...Multiple studies have identified links between climate and West Nile virus disease since the virus arrived in North America. Here we sought to extend these results by developing a Health Impact Function (HIF) to generate county-level estimates of the expected annual number of West Nile neuroinvasive disease (WNND) cases based on the county’s historical WNND incidence, annual average temperature, and population size. To better understand the potential impact of projected temperature change on WNND risk, we used the HIF to project the change in expected annual number of WNND cases attributable to changing temperatures by 2050 and by 2090 using data from five global climate models under two representative concentration pathways (RCP4.5 and RCP8.5). To estimate the costs of anticipated changes, as well as to enable comparisons with other public health impacts, projected WNND cases were allocated to nonfatal and fatal outcomes, then monetized using a cost-of-illness estimate and the U.S. Environmental Protection Agency’s value of a statistical life, respectively. We found that projected future temperature and population changes could increase the expected annual number of WNND cases to ≈2000 - 2200 cases by 2050 and to ≈2700 - 4300 cases by 2090, from a baseline of 970 cases. Holding population constant at future levels while varying temperature from a 1995 baseline, we estimated projected temperature change alone is responsible for ≈590 and ≈960 incremental WNND cases in 2050 and 2090 (respectively) under the RCP4.5 scenario, and ≈820 and ≈2500 cases in 2050 and 2090 (respectively) for the RCP8.5 scenario, with substantial regional variation. The monetized impact of these temperature-attributable incremental cases is estimated at $0.5 billion in 2050 and $1.0 billion in 2090 under the RCP4.5 scenario, and $0.7 billion in 2050 and $2.6 billion in 2090 under the RCP8.5 scenario (undiscounted 2015 U.S. dollars).展开更多
The WHO World Health Assembly, and the most recent WHO World Health Report, have called for all health systems to move toward universal coverage. However, low-income countries have made little progress in this respect...The WHO World Health Assembly, and the most recent WHO World Health Report, have called for all health systems to move toward universal coverage. However, low-income countries have made little progress in this respect. We use existing evidence to describe the evolution of community-based health insurance in low-income countries through the three stages of basic model, enhanced model, and nationwide model. We have concluded that community-based health insurance development is a potential strategy to meet the urgent need for health financing in low-income countries. With careful planning and implementation, it is possible to adopt such evolutionary approach to achieve universal coverage by extending tax-based financing/social insurance characteristics to community-based health insurance schemes.展开更多
A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control.This review considered ...A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control.This review considered data from the National Health Information Management System,Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages.Data showed three distinct epidemiological strata after a notable malaria reduction(66%)in in-patient cases and deaths,particularly between 2000-2008.These changes occurred following the(re-)introduction and expansion of indoor residual spraying up to 90%coverage,scale-up of coverage of long-lasting insecticidetreated nets in household from 50%to 70%,and artemisin-based combination therapy nationwide.However,malaria cases and deaths re-surged,increasing in 2009-2010 in the northern-eastern parts of Zambia.Delays in the disbursement of funds affected the implementation of interventions,which resulted in resurgence of cases and deaths.In spite of a decline in malaria disease burden over the past decade in Zambia,a reversal in impact is notable in the year 2009-2010,signifying that control gains are fragile and must be sustained toeliminate malaria.展开更多
Objective:To investigate insects visiting sun exposed and shaded decomposing rabbit carcasses and to establish the relationship between insects and carcasses which may be of forensic importance in Harare.Methods:Two r...Objective:To investigate insects visiting sun exposed and shaded decomposing rabbit carcasses and to establish the relationship between insects and carcasses which may be of forensic importance in Harare.Methods:Two rabbits weighing 2.3 kg and 2.5 kg were killed by sharp blows on the head.One was exposed to the sun while the other was placed under shade.The carcasses were allowed to decompose and insects were collected twice a day for the first week and thereafter once a day up to the end of the 7 weeks.Maggots were also collected from the decomposing carcasses and reared.Results:Five dipteran families(Galliphoridae,Muscidae,Sarcophagidae,Phoridae and Drosophilidae)were identified from the sun-exposed carcass.Species collected included Lucilia cuprina(L.cuprina),Chrysomya albiceps(C.albiceps),Musca domestica,Sarcophaga sp.and Drosophila sp.Four families(Calliphoridae,Muscidae,Phoridae,Anthomyiidae)were identified from the shaded carcass.Representatives of these families included L cuprina,C.albiceps,Musca domestica,and Hydrotaea sp.Three Coleopteran families(Histeridae,Cleridae and Dermestidae)were identified from hodt carcasses.The observed species were Saprinus sp,Necrobia rufipes and Dermestes sp.Fomicidae(Hymenoptera)was represented by only one species(Pheidoie sp.)Flies which emerged from the rearing units were L cuprina,Lucilia sp.,C.albiceps,Sarcophaga sp.and Sepsis sp.).Conclusions:Of the dipteran species collected during the study,L cuprina and C.albiceps could be important for further forensic studies since they were collected from the carcasses and also observed from the rearing units.展开更多
The world is changing exponentially-never before in the history of human kind have we experienced such change.There is an unprecedented opportunity to connect creatively disruptive innovations to transform the world f...The world is changing exponentially-never before in the history of human kind have we experienced such change.There is an unprecedented opportunity to connect creatively disruptive innovations to transform the world for the better.One such creative disruption is blockchain technology.Blockchain is a decentralized distributed ledger,which is immutable and unhackable.In August 2016,the World Economic Forum released a report calling blockchain technology a 'mega-trend' that will shape society in the next decade,predicting that blockchains could store as much as 10% of global GDP by 2027 [1].展开更多
Context: Recent publications on WHO recommended methods for estimating the survival of LLINs are good guidelines for assessing the performance of long-lasting insecticidal nets (LLINs). Thus, this field trial study wa...Context: Recent publications on WHO recommended methods for estimating the survival of LLINs are good guidelines for assessing the performance of long-lasting insecticidal nets (LLINs). Thus, this field trial study was undertaken to evaluate the durability of the Yorkool? LN mosquito net distributed during the 2017 campaign in Benin. Methods: The monitoring of Yorkool? LN nets was carried out in two districts (Djougou III and Barienou) in Djougou, department of Donga, northern Benin from October 2017 to March 2019. A representative sample of 250 households that had received the Yorkool? LN polyester LLINs during the 2017 campaign was selected in the rural and urban areas of each district and monitored for 6, 12 and 18 months. An evaluation of the survival of Yorkool? LN nets was conducted based on the rate of loss and physical condition of the surviving nets as measured by the proportional hole index (pHI). Finally, the chemical efficacy of these LLINs during each period was determined using the WHO cone tests. Results: Survival of Yorkool? LN nets was similar in both rural and urban areas, although there was a difference in survival between the 6-month (95.3%), 12-month (89.7%), and 18-month follow-up periods (74.4%). A difference in survival was also observed between the NetCalc model (84%) compared to the Yorkool? LN nets of this study (74.4%). The attrition rate was 29.6% for LLINs at 18 months. Surprisingly, the physical integrity of the LLINs was minimally affected in the municipality. Indeed, the proportion of mosquito nets in good condition without a hole was 51.8% compared to 56.8% with a hole after 18 months. Only 7.8% of the LLINs in the two districts were damaged compared to 2.6% which needed to be replaced. The washing frequency, location of the LLINs and the frequency of use are some factors contributing to the appearance of the holes in LLINs. The bio-efficacy results of LLINs based on the cone test were good with mortality rates of 74%, 66%, 72% and 58% respectively after baseline, 6, 12 and 18 months of use. Conclusions: The observed differences in the survival of Yorkool? LN nets are due to community living conditions and movements and not to the equipment used to manufacture LLINs. However, the estimated median survival has shown that Yorkool? LN nets would have an average lifespan of 2 years 8 months despite their fairly good physical condition. These results may be useful to the National Malaria Control Program (NMCP) during the period of replacement of these nets on the field.展开更多
文摘Multiple studies have identified links between climate and West Nile virus disease since the virus arrived in North America. Here we sought to extend these results by developing a Health Impact Function (HIF) to generate county-level estimates of the expected annual number of West Nile neuroinvasive disease (WNND) cases based on the county’s historical WNND incidence, annual average temperature, and population size. To better understand the potential impact of projected temperature change on WNND risk, we used the HIF to project the change in expected annual number of WNND cases attributable to changing temperatures by 2050 and by 2090 using data from five global climate models under two representative concentration pathways (RCP4.5 and RCP8.5). To estimate the costs of anticipated changes, as well as to enable comparisons with other public health impacts, projected WNND cases were allocated to nonfatal and fatal outcomes, then monetized using a cost-of-illness estimate and the U.S. Environmental Protection Agency’s value of a statistical life, respectively. We found that projected future temperature and population changes could increase the expected annual number of WNND cases to ≈2000 - 2200 cases by 2050 and to ≈2700 - 4300 cases by 2090, from a baseline of 970 cases. Holding population constant at future levels while varying temperature from a 1995 baseline, we estimated projected temperature change alone is responsible for ≈590 and ≈960 incremental WNND cases in 2050 and 2090 (respectively) under the RCP4.5 scenario, and ≈820 and ≈2500 cases in 2050 and 2090 (respectively) for the RCP8.5 scenario, with substantial regional variation. The monetized impact of these temperature-attributable incremental cases is estimated at $0.5 billion in 2050 and $1.0 billion in 2090 under the RCP4.5 scenario, and $0.7 billion in 2050 and $2.6 billion in 2090 under the RCP8.5 scenario (undiscounted 2015 U.S. dollars).
文摘The WHO World Health Assembly, and the most recent WHO World Health Report, have called for all health systems to move toward universal coverage. However, low-income countries have made little progress in this respect. We use existing evidence to describe the evolution of community-based health insurance in low-income countries through the three stages of basic model, enhanced model, and nationwide model. We have concluded that community-based health insurance development is a potential strategy to meet the urgent need for health financing in low-income countries. With careful planning and implementation, it is possible to adopt such evolutionary approach to achieve universal coverage by extending tax-based financing/social insurance characteristics to community-based health insurance schemes.
基金Supported by the World Health Organization,grant No.:AF/ZAM/BBE/005/XL/10/M
文摘A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control.This review considered data from the National Health Information Management System,Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages.Data showed three distinct epidemiological strata after a notable malaria reduction(66%)in in-patient cases and deaths,particularly between 2000-2008.These changes occurred following the(re-)introduction and expansion of indoor residual spraying up to 90%coverage,scale-up of coverage of long-lasting insecticidetreated nets in household from 50%to 70%,and artemisin-based combination therapy nationwide.However,malaria cases and deaths re-surged,increasing in 2009-2010 in the northern-eastern parts of Zambia.Delays in the disbursement of funds affected the implementation of interventions,which resulted in resurgence of cases and deaths.In spite of a decline in malaria disease burden over the past decade in Zambia,a reversal in impact is notable in the year 2009-2010,signifying that control gains are fragile and must be sustained toeliminate malaria.
基金Funded by the Department of Anatomy,College of Health Sciences,University of Zimbabwe(Grant No.Jato 35)
文摘Objective:To investigate insects visiting sun exposed and shaded decomposing rabbit carcasses and to establish the relationship between insects and carcasses which may be of forensic importance in Harare.Methods:Two rabbits weighing 2.3 kg and 2.5 kg were killed by sharp blows on the head.One was exposed to the sun while the other was placed under shade.The carcasses were allowed to decompose and insects were collected twice a day for the first week and thereafter once a day up to the end of the 7 weeks.Maggots were also collected from the decomposing carcasses and reared.Results:Five dipteran families(Galliphoridae,Muscidae,Sarcophagidae,Phoridae and Drosophilidae)were identified from the sun-exposed carcass.Species collected included Lucilia cuprina(L.cuprina),Chrysomya albiceps(C.albiceps),Musca domestica,Sarcophaga sp.and Drosophila sp.Four families(Calliphoridae,Muscidae,Phoridae,Anthomyiidae)were identified from the shaded carcass.Representatives of these families included L cuprina,C.albiceps,Musca domestica,and Hydrotaea sp.Three Coleopteran families(Histeridae,Cleridae and Dermestidae)were identified from hodt carcasses.The observed species were Saprinus sp,Necrobia rufipes and Dermestes sp.Fomicidae(Hymenoptera)was represented by only one species(Pheidoie sp.)Flies which emerged from the rearing units were L cuprina,Lucilia sp.,C.albiceps,Sarcophaga sp.and Sepsis sp.).Conclusions:Of the dipteran species collected during the study,L cuprina and C.albiceps could be important for further forensic studies since they were collected from the carcasses and also observed from the rearing units.
文摘The world is changing exponentially-never before in the history of human kind have we experienced such change.There is an unprecedented opportunity to connect creatively disruptive innovations to transform the world for the better.One such creative disruption is blockchain technology.Blockchain is a decentralized distributed ledger,which is immutable and unhackable.In August 2016,the World Economic Forum released a report calling blockchain technology a 'mega-trend' that will shape society in the next decade,predicting that blockchains could store as much as 10% of global GDP by 2027 [1].
基金funded by US Agency for International Development
文摘Context: Recent publications on WHO recommended methods for estimating the survival of LLINs are good guidelines for assessing the performance of long-lasting insecticidal nets (LLINs). Thus, this field trial study was undertaken to evaluate the durability of the Yorkool? LN mosquito net distributed during the 2017 campaign in Benin. Methods: The monitoring of Yorkool? LN nets was carried out in two districts (Djougou III and Barienou) in Djougou, department of Donga, northern Benin from October 2017 to March 2019. A representative sample of 250 households that had received the Yorkool? LN polyester LLINs during the 2017 campaign was selected in the rural and urban areas of each district and monitored for 6, 12 and 18 months. An evaluation of the survival of Yorkool? LN nets was conducted based on the rate of loss and physical condition of the surviving nets as measured by the proportional hole index (pHI). Finally, the chemical efficacy of these LLINs during each period was determined using the WHO cone tests. Results: Survival of Yorkool? LN nets was similar in both rural and urban areas, although there was a difference in survival between the 6-month (95.3%), 12-month (89.7%), and 18-month follow-up periods (74.4%). A difference in survival was also observed between the NetCalc model (84%) compared to the Yorkool? LN nets of this study (74.4%). The attrition rate was 29.6% for LLINs at 18 months. Surprisingly, the physical integrity of the LLINs was minimally affected in the municipality. Indeed, the proportion of mosquito nets in good condition without a hole was 51.8% compared to 56.8% with a hole after 18 months. Only 7.8% of the LLINs in the two districts were damaged compared to 2.6% which needed to be replaced. The washing frequency, location of the LLINs and the frequency of use are some factors contributing to the appearance of the holes in LLINs. The bio-efficacy results of LLINs based on the cone test were good with mortality rates of 74%, 66%, 72% and 58% respectively after baseline, 6, 12 and 18 months of use. Conclusions: The observed differences in the survival of Yorkool? LN nets are due to community living conditions and movements and not to the equipment used to manufacture LLINs. However, the estimated median survival has shown that Yorkool? LN nets would have an average lifespan of 2 years 8 months despite their fairly good physical condition. These results may be useful to the National Malaria Control Program (NMCP) during the period of replacement of these nets on the field.
