BACKGROUND: Although suicide is a leading cause of death, few studies have attempted to predict suicidal ideation prospectively using epidemiological samples or multivariate methods. METHOD: Discrete-time event history analysis was used to model the onset of thoughts of death or self-harm (TD/SH) in a population-based sample of female twins (N=2164) using variables from the demographic, psychopathological, childhood adversity, personality and life event domains. Univariate, multivariate-within domain and multivariate-across domain regression analyses were performed.
The need for enhanced biologic surveillance has led to the search for new sources of data. Beginning in September 2001, Emergency Medical Associates (EMA) of New Jersey, an emergency physician group practice, undertook a series of surveillance projects in collaboration with state and federal agencies. This paper examines EMA's motivations and concerns and discusses the collaborative opportunities available to data suppliers for syndromic surveillance.
Drawing upon a postcolonial lens, this project looks at how meanings of HIV/AIDS are discursively constructed within the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), which was launched in 2003 under the presidency of George W. Bush and has been heralded as the largest global public health intervention program in history.
Community health workers (CHWs) are an important element of many health systems and programmes for the promotion and delivery of a wide range of health interventions and disease surveillance. Understanding the motivation and retention of CHWs is recognized as essential but there are few data from sub-Saharan Africa.
OBJECTIVE: To assess the diffusion of the change of first line antimalarial drug from chloroquine (CQ) to sulphadoxine/pyrimethamine (SP) at household level in a rural district of Tanzania less than a year after the policy implementation. METHODS: Caretakers in 729 households were interviewed on knowledge of the new policy, home stocking of antimalarials, home-treatment practices of children younger than 5 years with fever, health-seeking behaviour and experience of SP. SP and CQ levels in blood were analysed from 328 children younger than 5 years in the households.
Surveillance of Plasmodium falciparum crt(K76T) [Pfcrt(K76T)], a resistance marker of chloroquine and, limitedly, amodiaquine, in >4,000 children in northern Ghana revealed a prevalence of 79%. Pfcrt(K76T) was heterogeneously distributed and associated with chloroquine use, low parasitemia, and the dry season. Widespread chloroquine resistance challenges the regional life span of amodiaquine as a partner drug in artemisinin combination therapy.
We conducted surveillance for multidrug-resistant Plasmodium falciparum in Cambodia during 2004-2006 by assessing molecular changes in pfmdr1. The high prevalence of isolates with multiple pfmdr1 copies found in western Cambodia near the Thai border, where artesunate-mefloquine therapy failures occur, contrasts with isolates from eastern Cambodia, where this combination therapy remains highly effective.
Monitoring and evaluation of malaria control in pregnancy is essential for assessing the efficacy and effectiveness of health interventions aimed at reducing the major burden of this disease on women living in endemic areas. Yet there is no currently integrated strategic approach on how this should be achieved. Malaria control in pregnancy is formulated in relation to epidemiological patterns of exposure.
BACKGROUND: Increased investment and commitment to malaria prevention and treatment strategies across Africa has produced impressive reductions in the incidence of this disease. Nevertheless, it is clear that further interventions will be necessary to meet the international target of a reversal in the incidence of malaria by 2015. This article discusses the prospective role of an innovative malaria control strategy - the community-based treatment of asymptomatic carriers of Plasmodium falciparum, with artemisinin-based combination therapy (ACT).
BACKGROUND: Previous efforts to eradicate malaria parasites, particularly Plasmodium falciparum, have failed in part due to the emergence of drug resistant parasites and mosquitoes resistant to insecticides. Using an artemisinin-based combination therapy (ACT) that kills parasites quickly, a strategy was designed to eliminate the source of transmission by mass treatment of human populations in malaria-endemic areas Cambodia. METHODS: A combination drug of artemisinin and piperaquine given with low doses of primaquine was used to eliminate all stages of parasites from human carriers.