Collaborative Efforts and Strategies for Cholera Outbreak Control in Garissa County, Kenya: Implementation of Water Quality Monitoring Interventions

A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Research Priorities for Preventing Unsafe Abortions in the WHO Africa Region

Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.

Research Priorities for Addressing Gender Based Violence in the WHO Africa Region

Background: There is an increasing emphasis on conducting research to identify gender based violence issues to enable development of appropriate programs and interventions. However, these efforts are mixed in quality and often raise ethical questions. The increased pressure on policy makers to move to a more evidence-based approach in addressing gender based issues creates the need for this research prioritization activity. Inadequate evaluative evidence in this area poses a challenge in the planning for responsive interventions especially in resource limited settings. The purpose of this paper is to present gender based violence research priority areas for the WHO Africa Region. Methods: We utilized a modified version of the Child Health and Nutrition Research Initiative approach to reach consensus on research priorities on the thematic area of gender based violence. In three phases, we first conducted an online survey with sexual and reproductive health and rights experts in academia, ministries of health, non-governmental organizations and other health actors with a wide range of experiences. These questions were consolidated by three experts from World Health Organization headquarters into themes. Secondly, experts were invited in a meeting in Cape Town South Africa to analyze and generate relevant areas of research based on the themes. Finally, a smaller group of experts prioritized research areas based on agreed criteria. Results: A list of 10 priority research questions for addressing gender based violence were scored and ranked. Four priority research questions scored 30 points out of the possible 30 points and were thus ranked as the highest priority. These included questions that “engage young adolescents in behavioral interventions to influence gender roles”, “determinants of gender based violence analysis”, “both long and short term complications of gender based violence on survivors” and “assessment of men’s involvement in addressing gender-based violence against women”. The second most highly ranked question was on the assessment of the extent and strategies to prevent gender-based violence in the context of humanitarian crises. Conclusions: Priority research questions for addressing gender based violence were identified. This exercise provides a three year investment case for research with high potential of effectively identifying interventions with high impact on addressing gender based violence.

Setting Research Priorities for Cervical Cancer Prevalence, Prevention and Treatment in WHO Africa Region

Background: Cervical cancer has been ranked among the leading causes of deaths among women in Africa. Despite this, priority setting mechanisms used in planning for programmes and interventions that respond to sexual and reproductive health and rights services particularly in cervical cancer prevalence, prevention and treatment have not adequately taken into account research based evidence to respond appropriately. Methods: We adapted the Child Health and Nutrition Research Initiative method. A wide range of stakeholders identified potential research areas in an online survey. A technical working group comprising of 67 participants reviewed the questions for modification and removal of out scope questions. Finally, scoring and ranking was done to provide the top ten priorities questions. Results: “Cost-benefit analysis of systematic human papillomavirus vaccination compared to the current cost of cervical cancer in public health care systems” scored 27. This was followed by two research questions ranked at 24 points: “assessment of women’s and girls’ knowledge on the importance of early cervical cancer screening,” and “human papilloma virus vaccination and contributions of new technologies to the supply and storage of vaccines, including human papillomavirus vaccine”. Conclusion: The study identified 10 priority research questions that can guide the agenda for cervical cancer prevalence, prevention and treatment in the WHO Africa region. The identified priorities will be of use to policy makers, researchers and programmers and other stakeholders who can invest in areas that greatly affect cervical cancer prevalence, prevention and treatment.

Research Priorities for mHealth and Innovative Strategies in Sexual and Reproductive Health and Rights in the WHO Africa Region

Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.

Setting Regional Research Priorities for Sexual and Reproductive Health and Rights Services in Humanitarian Settings

Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.

Proportionate Target Population Estimates Used by National Immunization Programmes in Sub-Saharan Africa and Comparison with Values from an External Source

Background: In order to effectively plan the delivery of immunization services, manage stock and supply levels and target interventions, national immunization programmes (NIP) must have an estimate of the target population they serve. To overcome challenges with target population estimation, some NIPs apply “rule-of-thumb” conversion factors to total population estimates. We compare these proportionate target population values with those from an external source. Methods: Using data reported by national immunization programmes in sub-Saharan Africa, we computed the proportionate target population as the number of births, surviving infants and children under 5 years of age, respectively, as a proportion of the total population size. We compared these values with those estimates computed from United Nations Population Division (UNPD) data. We then recomputed NIP target population sizes using the proportionate target population values from the UNPD applied to the total population size reported by NIP. Results: Data were available from 47 sub-Saharan Africa countries. Births as a proportion of the total population were greater within reports from NIP (median, 0.0400;IQR: 0.350 - 0.0437) compared to values from UNPD estimates (median, 0.0364;IQR: 0.0332 - 0.0406). Similar patterns were observed for surviving infants (median: NIP, 0.0360;UNPD, 0.0337) and children under 5 years of age (median: NIP, 0.1735;UNPD, 0.1594). The percent difference in proportionate target population ratios between reports from NIPs and the UNPD was >10% in 23 countries for births, in 18 countries for surviving infants, in 15 countries for children under 5 years of age. After re-computing target populations using UNPD proportionate target population values applied to NIP reported total population, recomputed administrative coverage levels for the third dose of DTP containing vaccine were higher in 32 of the 47 countries compared to reported administrative coverage levels. Conclusion: Because childhood immunization-related target populations are among the more difficult ones to accurately estimate and project, immunization programmes in sub-Saharan Africa are encouraged to include a critical assessment of the target population values, in conjunction with their national statistics system, as part of the on-going programme monitoring process.

The WHO African Region: Research Priorities on Sexual and Reproductive Health and Rights

Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.

Review of the malaria epidemiology and trends in Zambia

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.

Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria

Background: Assessment of the safety profile of the new rotavirus vaccines in Africa requires base-line epidemiological data on intussusception. Hence, this study was aimed at describing the prevalence and associated factors of intussusception in under-five children in Enugu, Southeast, Nigeria. Methods: This was a retrospective descriptive study involving the sixty reported cases of intussusception in under-five children admitted in a hospital in Enugu between 2007 and 2012. Cases of intussusception were selected using the Brighton collaboration intussusception working group level I diagnostic criteria. Information sought from the patients’ folders included demographic characteristics and clinical manifestations including history of previous rotavirus vaccination, duration of illness prior to presentation, diarrhoea, vomiting, passage of red currant jelly-like stool, abdominal mass and distension, method of diagnosis, treatment option(s) employed and their outcomes. The data was analyzed using SPSS version 17.0. Results: The majority of the cases were aged less than one year (53;88.3%) while the average incidence of intussusception was 0.1 per 1000. None of the cases had received rotavirus vaccinations. The common clinical presentations were vomiting, 55 (17.2%), passage of red currant stool 50 (15.6%), fever 50 (15.6%) and abnormal/absent bowel sound 43 (15.9%). Diagnosis was essentially with the aid of abdominal ultrasonography, 38 (63.3%) while surgery (laparotomy) was the treatment of choice in most cases 48 (80.0%). The case fatality rate was 3 (5.0%). Conclusion: None of the cases studied could be directly linked to rotavirus vaccinations. But seasonal peak incidence coincided with rotavirus diarrhea peak incidence. Efforts should be made to institute post-rotavirus vaccine licensure prospective surveillance study in order to fully determine any relationship between rotavirus vaccination and intussusception in Enugu, South east, Nigeria.

Erratum to “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria” [World Journal of Vaccines Vol.4 No.3 (August 2014) 123-132]

The original online version of this article (Tagbo, B. N., et al. 2014 “Retrospective Evaluation of Intussusception in Under-Five Children in Nigeria”, 2014, 4, 123-132, http://dx.doi.org/10.4236/wjv.2014.43015) was published in August 2014. The author wishes to correct the author’s name and the Table 3 in the text.

Quantity and Trends in Streamflows of the Malewa River Basin,Kenya

Freshwater availability in sufficient quantity and quality is necessary for both people and nature.Environmental flow data is useful in the management and allocation of water resources.This study aimed at quantifying stream flows and their trends in the Malewa Basin rivers in central rift valley,Kenya.Daily stream flow data(1960-2013)in four gauges(2GB01,2GB05,2GB0708 and 2GC04)were subjected to exploratory data analysis,fixed interval method of baseflow separation and Mann Kendall trend test.The results shows that on average,the Malewa river at Gauge 2GB01 discharge(excluding abstractions)about 191.2 million cubic metres of water annually,equivalent to a discharge of 6.06 m3/s.While discharges had not experienced a step change,huge annual fluctuations were noted suggesting periodicity with changes in climatic conditions.No trend was noted in annual stream data for the four gauges assessed.However,extreme low and high flows,median flows and baseflows for daily data showed either positive or negative trends.The baseflow index for daily flows showed trends:2GB01(Z=4.519),2GB05(Z=-6.861),2GB0708(Z=-16.326)and 2GC04(Z=5.593).The findings suggest that Malewa rivers are likely experiencing effects of extreme climatic conditions and land cover changes.Land cover degradation seems to create conditions of increased flow,although the intensity varies from sub-catchment to another.The data also seems to suggest that stream discharge is much dependent on baseflows.There is need to regulate water use,improve soil cover and manage or adapt to the adverse effects of climate change.Key words:Streamflow,baseflow,trend,discharge.1.Introduction?Freshwater availability in sufficient quantity and quality is necessary for both people and nature.The concept of environmental flows has been the subject of study and consideration[1-5].Environmental flow information guides on how water is managed and allocated to different competing uses.The need for improved water efficiency in the allocation has led to increasing focus on environmental flows or environmental water allocations[6],although national and international policies have not yet accounted for them[7].Streamflow volumes and trends are important for decision making on water allocation.As reported by Kundzewicz,W.Z.,et al.[8],changes in?

Indirect costs associated with deaths from the Ebola virus disease in West Africa

Background:By 28 June 2015,there were a total of 11,234 deaths from the Ebola virus disease(EVD)in five West African countries(Guinea,Liberia,Mali,Nigeria and Sierra Leone).The objective of this study was to estimate the future productivity losses associated with EVD deaths in these West African countries,in order to encourage increased investments in national health systems.Methods:A cost-of-illness method was employed to calculate future non-health(NH)gross domestic product(GDP)(NHGDP)losses associated with EVD deaths.The future non-health GDP loss(NHGDPLoss)was discounted at 3%.Separate analyses were done for three different age groups(<=14 years,15–44 years and=>45 years)for the five countries(Guinea,Liberia,Mali,Nigeria,and Sierra Leone)affected by EVD.We also conducted a one-way sensitivity analysis at 5 and 10%discount rates to gauge their impacts on expected NHGDPLoss.Results:The discounted value of future NHGDPLoss due to the 11,234 deaths associated with EVD was estimated to be Int$(international dollars)155,663,244.About 27.86%of the loss would be borne by Guinea,34.84%by Liberia,0.10%by Mali,0.24%by Nigeria and 36.96%by Sierra Leone.About 27.27%of the loss is attributed to those aged under 14 years,66.27%to those aged 15–44 years and 6.46%to those aged over 45 years.The average NHGDPLoss per EVD death was estimated to be Int$17,473 for Guinea,Int$11,283 for Liberia,Int$25,126 for Mali,Int$47,364 for Nigeria and Int$14,633 for Sierra Leone.Conclusion:In spite of alluded limitations,the estimates of human and economic losses reported in this paper,in addition to those projected by the World Bank,show that EVD imposes a significant economic burden on the affected West African countries.That heavy burden,coupled with human rights and global security concerns,underscores the urgent need for increased domestic and external investments to enable Guinea,Liberia and Sierra Leone(and other vulnerable African countries)to develop resilient health systems,including core capacities to detect,assess,notify,verify and report events,and to respond to public health risks and emergencies.

Drought Adaptation and Coping Strategies Among the Turkana Pastoralists of Northern Kenya

This study highlights drought characteristics and the many responses to drought stresses employed by Turkana pastoralists of northwestern Kenya. Multiple data sources, including socioeconomic interviews with 302 households, focus group discussions, and informal interviews with pastoralists were used to capture various aspects of drought and drought adaptation and coping practices.Standardized precipitation index derived from long-term rainfall data obtained from the Kenya Meteorological Service was used to quantify different degrees of drought intensity between 1950 and 2012. Results revealed that extreme drought events were increasingly frequent, and have impacted negatively on pastoral livelihoods. In order to adapt to or cope with climatic anomalies, households are using a variety of strategies. In addition to the traditional short-term coping mechanisms, the long-term adaptation strategies used include diversification of livelihood sources; livestock mobility to track forage and water resources;diversification of herd composition to benefit from the varied drought and disease tolerance, as well as fecundity of diverse livestock species; and sending children to school for formal education as a long term investment expected to pay back through income from employment. Policies anddevelopment interventions that reduce risks, diminish livelihood constraints, and expand opportunities for increased household resilience to drought are critical complements to the existing pastoral strategies.

Impact of five annual rounds of mass drug administration with ivermectin on onchocerciasis in Sierra Leone

Background:Onchocerciasis is endemic in 12 of the 14 health districts of Sierra Leone.Good treatment coverage of community-directed treatment with ivermectin was achieved between 2005 and 2009 after the 11-year civil conflict.Sentinel site surveys were conducted in 2010 to evaluate the impact of five annual rounds of ivermectin distribution.Methods:In total,39 sentinel villages from hyper-and meso-endemic areas across the 12 endemic districts were surveyed using skin snips in 2010.Results were analyzed and compared with the baseline data from the same 39 villages.Results:The average microfilaridermia(MF)prevalence across 39 sentinel villages was 53.10%at baseline.The MF prevalence was higher in older age groups,with the lowest in the age group of 1-9 years(11.00%)and the highest in the age group of 40-49 years(82.31%).Overall mean MF density among the positives was 28.87 microfilariae(mf)/snip,increasing with age with the lowest in the age group of 1-9 years and the highest in the age group of 40-49 years.Males had higher MF prevalence and density than females.In 2010 after five rounds of mass drug administration,the overall MF prevalence decreased by 60.26%from 53.10%to 21.10%;the overall mean MF density among the positives decreased by 71.29%from 28.87 mf/snip to 8.29 mf/snip;and the overall mean MF density among all persons examined decreased by 88.58%from 15.33 mf/snip to 1.75 mf/snip.Ten of 12 endemic districts had>50%reduction in MF prevalence.Eleven of 12 districts had≥50%reduction in mean MF density among the positives.Conclusions:A significant reduction of onchocerciasis MF prevalence and mean density was recorded in all 12 districts of Sierra Leone after five annual MDAs with effective treatment coverage.The results suggested that the onchocerciasis elimination programme in Sierra Leone was on course to reach the objective of eliminating onchocerciasis in the country by the year 2025.Annual MDA with ivermectin should continue in all 12 districts and further evaluations are needed across the country to assist the NTDP with programme decision making.

2010-2015年全球实验室网络支持的消除麻疹和风疹工作的进展

2012年,世界卫生大会（World Health Assembly）签署全球疫苗行动计划（Global Vaccine Action Plan,GVAP）,该计划旨在2020年前消除世界卫生组织（World Health Qrganization,WHO）5个区域的麻疹和风疹。2013年9月,WHO 6个区域的所有国家都已确立消除麻疹的目标,其中3个区域还确立了消除风疹和先天性风疹综合征的目标.

Molluscicidal effectiveness of Luo-Wei,a novel plant-derived molluscicide,against Oncomelania hupensis,Biomphalaria alexandrina and Bulinus truncatus

Background:Control of snail intermediate hosts has been proved to be a fast and efficient approach for interrupting the transmission of schistosomiasis.Some plant extracts have shown obvious molluscicidal activity,and a new compound Luo-Wei,also named tea-seed distilled saponin(TDS),was developed based on the saponins extracted from Camellia oleifera seeds.We aimed to test the molluscicidal activity of 4%TDS against the intermediate host snails in China and Egypt,and evaluate its environmental safety to non-target organisms.Methods:In the laboratory,Oncomelania hupensis,Biomphalaria alexandrina and Bulinus truncatus were exposed to 4%TDS,and the median lethal concentration(LC5o)was estimated at 24,48 and 72 h.In the field,snail mortalities were assessed 1,2,3 and 7 d post-immersion with 2.5 g/m34%TDS and 1,3,7 and 15 d post-spraying with 5 g/m24%TDS.in addition,the acute toxicity of 4%TDS to Japanese quail(Coturnixjaponica),zebrafish(Brachydanio rerio)and freshwater shrimp(Macrobrachium nipponense)was assessed by estimations of LC5o or median lethal dose(LD5o).Results:In the laboratory,the LC5o values of 4%TDS for O.hupensis were 0.701,0.371 and 0.33 mg/L at 24,48 and 72 h,respectively,and 4%TDS showed a 0.33 mg/L 24 h LC5o against B.alexandrina,and a 1.396 mg/L 24 h LCs0 against B.truncatus.Across all study regions,the pooled mortalities of O.hupensis were 72,86,94 and 98%at 1,2,3 and 7 d,following field immersion of 4%TDS at a dose of 2.5 g/m3,and were 69,77,85 and 88%at 1,3,7 and 15 d,following field spraying at 5 g/m2,respectively.4%TDS had moderate toxicity to Japanese quail(7 d LD5o>60 mg/kg)and to shrimp(96 h LCs0=6.28 mg/L;95%CI:3.53-11.2 mg/L),whereas its toxicity to zebrafish was high(96 h LCso--0.15 mg/L;95%CI:0.14-0.17 mg/L).Conclusions:4%TDS is active against O.hupensis,B.alexandrina and B.truncatus under laboratory and field conditions,and it may be a candidate molluscicide of plant origin.

Soil-transmitted helminth infection in school age children in Sierra Leone after a decade of preventive chemotherapy interventions

Background:Baseline mapping of soil-transmitted helminth(STH)infections among school age children(SAC)in 2008-2009 found high or moderate prevalence in 13 of the 14 districts in Sierra Leone.Following these surveys,mass drug administration(MDA)of mebendazole/albendazole was conducted biannually at national level targeting pre-school children(PSC)aged 12-59 months and intermittently at sub-national level targeting SAC.In addition,MDA with ivermectin and albendazole for eliminating lymphatic filariasis(LF)has been conducted nationwide since 2010 targeting individuals over 5 years of age.Each MDA achieved high coverage,except in 2014 when all but one round of MDA for PSC was cancelled due to the Ebola emergency.The objective of the current study was to determine the prevalence and intensity of STH infections among SAC after a decade of these deworming campaigns.Methods:Seventy-three schools in 14 districts were purposefully selected,including 39 schools from the baseline surveys,with approximately two sites from each of low,moderate and high prevalence categories at baseline per district.Fresh stool samples were collected from 3632 children aged 9-14 years(male 51%,female 49%)and examined using the Kato Katz technique.Results:The prevalence of STH infections in Sierra Leone decreased in 2016 compared to 2008:Ascaris lumbricoides 4.4%(95%confidence interval[CI]:3.7-5.1%)versus 6.6%(95%CI:0-25%),Trichuris trichiura 0.7%(95%CI:0.5-1.1%)versus 1.8%(95%CI:0-30.2%),hookworm 14.9%(95%CI:13.8-16.1)versus 38.5%(95%CI:5.4-95.1%),and any STH 18.3%(95%CI:17.0-19.5%)versus 48.3%(CI:5.4-96.3%),respectively.In 2016,no district had high hookworm prevalence and four districts had moderate prevalence,compared with eight and four districts respectively in 2008.In 2016,the arithmetic mean hookworm egg count in all children examined was light:45.5 eggs per gram(EPG)of faeces,(95%CI:\35.96-55.07 EPG);three(0.08%)children had heavy infections and nine(0.25%)children had moderate infections.Conclusions:Sierra Leone has made considerable progress toward controlling STH as a public health problem among SAC.As LF MDA phases out(between 2017 and 2021),transition of deworming to other platforms and water and sanitation strategies need to be strengthened to maintain STH control and ultimately interrupt transmission.