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Childs L, Adrien P, Minta AA, François J, Phaïmyr Jn Charles N, Blot V, Rey-Benito G, Vanden Eng JL, Tohme RA. Prevalence of Chronic Hepatitis B Virus Infection among Children in Haiti, 2017. Am J Trop Med Hyg 2020; 101:214-219. [PMID: 31115298 DOI: 10.4269/ajtmh.19-0117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In 2016, the World Health Assembly endorsed the Global Health Sector Strategy on Viral Hepatitis, which calls for elimination of hepatitis B virus (HBV) by 2030 (definition: ≤ 0.1% hepatitis B surface antigen [HBsAg] prevalence among children aged 5 years). The burden of chronic HBV infection among children in Haiti is unknown. We conducted a nationally representative cross-sectional serological survey among 5- to 7-year-old children based on a two-stage cluster design with two strata: West (includes metropolitan Port-au-Prince) and non-West (all other departments). We collected demographic, socioeconomic, and vaccination history data and tested for HBsAg using a rapid point-of-care test. We estimated HBsAg prevalence and evaluated the association of HBV infection with vaccination history, demographics, and socioeconomic characteristics. Of the 1,152 children, seven (0.5%, 95% CI: 0.2-1.2) were HBsAg positive. The HBsAg prevalence varied by region (West: 0.1%, 95% CI: 0.01-0.9; non-West: 0.7%, 95% CI: 0.2-1.9) (P = 0.1), gender (males: 0.7%, 95% CI: 0.2-2.4; females: 0.2%, 95% CI: 0.05-1.1) (P = 0.3), and caregiver's education level (none: 0.8%, 95% CI: 0.2-3.1; some or completed primary: 0.5%, 95% CI: 0.1-1.8; some secondary: 0.4%, 95% CI: 0.1-1.8; secondary and higher: 0.0%, 95% CI: 0-0), although the differences were not statistically significant. None of the HBsAg-positive children had documented vaccination with hepatitis B vaccine (HepB). Haiti's chronic HBV infection prevalence among children is low; however, it is above the elimination target. To reach elimination, Haiti needs to achieve high coverage with the three HepB doses and introduce a HepB birth dose.
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Affiliation(s)
- Lana Childs
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention, Atlanta, Georgia.,Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul Adrien
- Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Anna A Minta
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jeannot François
- Expanded Program on Immunization, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | | | - Valery Blot
- Institut Haïtien de l'Enfance, Pétion-Ville, Haiti
| | | | - Jodi L Vanden Eng
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rania A Tohme
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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Minta AA, Andre-Alboth J, Childs L, Nace D, Rey-Benito G, Boncy J, Adrien P, François J, Jn Charles NP, Blot V, Vanden Eng JL, Priest JW, Rogier E, Tohme RA. 2771. Seroprotection against Measles, Rubella, Tetanus, and Diphtheria Among Children in Haiti—2017. Open Forum Infect Dis 2019. [PMCID: PMC6810738 DOI: 10.1093/ofid/ofz360.2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Measles, rubella, and maternal and neonatal tetanus have been verified to be eliminated in Haiti, but a diphtheria outbreak has been ongoing since 2014. To evaluate progress toward maintaining vaccine preventable disease (VPD) elimination and control, we conducted the first survey to estimate immunity to these VPDs among children in Haiti. Methods We conducted a nationally representative, two-stage cluster survey in 2017, stratifying Haiti into 2 regions: (1) West Region, the highly urban West department that includes one-third of Haiti’s population; (2) Non-West Region (all other departments). We sampled 4,286 households to recruit at least 910 children aged 5–7 years. We obtained vaccination history and dried blood spots from one eligible child per household. Antibody concentrations to VPDs were measured on a multiplex bead assay. We compared seroprotection and vaccination coverage estimates. Results Among 1146 enrolled children, tetanus (83%, 95% CI: 80%–86%) and diphtheria (83%, 95% CI: 81%–85%) seroprotection were higher than coverage with ≥3 doses of tetanus and diphtheria containing vaccine (DTP3) (68%, 95% CI: 61%–74%). No participants had antibody concentrations consistent with long-term immunity to tetanus or diphtheria. Measles (87%, 95% CI: 85%–89%) and rubella (84%, 95% CI: 81%–87%) seroprotection were higher than or similar to coverage with at least one dose of measles-rubella (MR) vaccine (84%, 95% CI: 80%–87%) (Figure 1). MR second-dose coverage was 20% (95% CI: 16%–24%). Seroprotection in the West Region was lower than in the non-West region for all VPDs. Conclusion Discordance between DTP3 coverage and seroprotection might be due to underestimating vaccination coverage by recall. Lack of long-term protection against tetanus or diphtheria is consistent with declining antibody concentrations by school-age after the primary DTP series, indicating the need for a booster dose. Seroprotection against measles and rubella viruses was lower than levels needed to prevent transmission, particularly in the West region; re-introduction of either virus could lead to an epidemic. Haiti should reach ≥95% DTP3 and two-dose MR coverage and add tetanus and diphtheria vaccine booster doses per global recommendations. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Anna A Minta
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Lana Childs
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Jacques Boncy
- National Public Health Laboratory, Port-au-Prince, Ouest, Haiti
| | | | | | | | - Valery Blot
- Haitian Institute for Children, Port-au-Prince, Ouest, Haiti
| | | | | | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rania A Tohme
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Vanden Eng JL, Mathanga DP, Landman K, Mwandama D, Minta AA, Shah M, Sutcliffe J, Chisaka J, Lindblade KA, Steinhardt L. Assessing bed net damage: comparisons of three measurement methods for estimating the size, shape, and distribution of holes on bed nets. Malar J 2017; 16:405. [PMID: 29017537 PMCID: PMC5635507 DOI: 10.1186/s12936-017-2049-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/30/2017] [Indexed: 11/23/2022] Open
Abstract
Background Measuring the physical condition of long-lasting insecticidal nets (LLINs) under field conditions is of great importance for malaria control programmes to guide decisions on how frequently to replace LLINs. Current guidelines by the World Health Organization Pesticide Evaluation Scheme (WHOPES) propose a proportionate hole index (pHI) for assessing LLIN condition by counting the number of holes the size of a thumb, fist, head, and larger than a head. However, this method does not account for irregular hole shapes or exact hole sizes which could result in inaccurate decisions about when to replace LLINs. Methods LLINs were collected during a 2013 health facility-based malaria case control study in Machinga District, Malawi. To evaluate the accuracy of the pHI, the physical condition of 277 LLINs was estimated by the WHOPES method and then compared with two more thorough measurement methods: image analysis of digital photographs of each LLIN side; and for 10 nets, ruler measurements of the length, width, and location of each hole. Total hole counts and areas per net were estimated by each method, and detailed results of hole shapes and composite pictures of hole locations were generated using image analysis. Results The WHOPES method and image analysis resulted in similar estimates of total hole counts, each with a median of 10 (inter-quartile range (IQR) 4–24 and 4–23, respectively; p = 0.004); however, estimated hole areas were significantly larger using the WHOPES method (median 162 cm2, IQR 28–793) than image analysis (median 13 cm2, IQR 3–101; p < 0.0001). The WHOPES method classified fewer LLINs in ‘good condition’ compared to image analysis (42% vs 74%). The ruler method detected significantly more holes than image analysis did (p = 0.002) in 10 LLINs; however, total hole area was not significantly different (p = 0.16). Most holes were not circular but roughly 2–5 times longer in one direction. The lower quarter of LLIN sides was found to have the most holes. Conclusions The WHOPES method overestimated total hole area, likely because holes are elongated rather than circular, suggesting further adjustments to the pHI formula may be warranted when considering LLIN replacement strategies. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-2049-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jodi L Vanden Eng
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
| | - Don P Mathanga
- Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi
| | - Keren Landman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Dyson Mwandama
- Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi
| | - Anna A Minta
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Monica Shah
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - James Sutcliffe
- Entomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Joseph Chisaka
- Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi
| | - Kim A Lindblade
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
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Minta AA, Landman KZ, Mwandama DA, Shah MP, Eng JLV, Sutcliffe JF, Chisaka J, Lindblade KA, Mathanga DP, Steinhardt LC. The effect of holes in long-lasting insecticidal nets on malaria in Malawi: results from a case-control study. Malar J 2017; 16:394. [PMID: 28969632 PMCID: PMC5625742 DOI: 10.1186/s12936-017-2033-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-lasting insecticidal nets (LLINs) are a cornerstone of malaria prevention. Holes develop in LLINs over time and compromise their physical integrity, but how holes affect malaria transmission risk is not well known. METHODS After a nationwide mass LLIN distribution in July 2012, a study was conducted to assess the relationship between LLIN damage and malaria. From March to September 2013, febrile children ages 6-59 months who consistently slept under LLINs (every night for 2 weeks before illness onset) were enrolled in a case-control study at Machinga District Hospital outpatient department. Cases were positive for Plasmodium falciparum asexual parasites by microscopy while controls were negative. Digital photographs of participants' LLINs were analysed using an image-processing programme to measure holes. Total hole area was classified by quartiles and according to the World Health Organization's proportionate hole index (pHI) cut-offs [< 79 cm2 (good), 80-789 cm2 (damaged), and > 790 cm2 (too torn)]. Number of holes by location and size, and total hole area, were compared between case and control LLINs using non-parametric analyses and logistic regression. RESULTS Of 248 LLINs analysed, 97 (39%) were from cases. Overall, 86% of LLINs had at least one hole. The median number of holes of any size was 9 [interquartile range (IQR) 3, 22], and most holes were located in the lower halves of the nets [median 7 (IQR 2, 16)]. There were no differences in number or location of holes between LLINs used by cases and controls. The median total hole area was 10 cm2 (IQR 2, 125) for control LLINs and 8 cm2 (IQR 2, 47) for case LLINs (p = 0.10). Based on pHI, 109 (72%) control LLINs and 83 (86%) case LLINs were in "good" condition. Multivariable modeling showed no association between total hole area and malaria, controlling for child age, caregiver education, and iron versus thatched roof houses. CONCLUSIONS LLIN holes were not associated with increased odds of malaria in this study. However, most of the LLINs were in relatively good condition 1 year after distribution. Future studies should examine associations between LLIN holes and malaria risk with more damaged nets.
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Affiliation(s)
- Anna A Minta
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. .,Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA.
| | - Keren Z Landman
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Dyson A Mwandama
- Malaria Alert Centre, University of Malawi College of Medicine, Private Bag 360, Blantyre, Malawi
| | - Monica P Shah
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Jodi L Vanden Eng
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - James F Sutcliffe
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Joseph Chisaka
- Malaria Alert Centre, University of Malawi College of Medicine, Private Bag 360, Blantyre, Malawi
| | - Kim A Lindblade
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
| | - Don P Mathanga
- Malaria Alert Centre, University of Malawi College of Medicine, Private Bag 360, Blantyre, Malawi
| | - Laura C Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA
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Vanden Eng JL, Chan A, Abílio AP, Wolkon A, Ponce de Leon G, Gimnig J, Morgan J. Correction: Bed Net Durability Assessments: Exploring a Composite Measure of Net Damage. PLoS One 2015; 10:e0133105. [PMID: 26171973 PMCID: PMC4501801 DOI: 10.1371/journal.pone.0133105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Vanden Eng JL, Chan A, Abílio AP, Wolkon A, Ponce de Leon G, Gimnig J, Morgan J. Bed Net Durability Assessments: Exploring a Composite Measure of Net Damage. PLoS One 2015; 10:e0128499. [PMID: 26047494 PMCID: PMC4457879 DOI: 10.1371/journal.pone.0128499] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 04/27/2015] [Indexed: 11/18/2022] Open
Abstract
Background The durability of Long Lasting Insecticidal Nets (LLINs) in field conditions is of great importance for malaria prevention and control efforts; however, the physical integrity of the net fabric is not well understood making it challenging to determine overall effectiveness of nets as they age. The 2011 World Health Organization Pesticide Evaluation Scheme (WHOPES) guidelines provide a simple, standardized method using a proportional hole index (PHI) for assessing net damage with the intent to provide national malaria control programs with guidelines to assess the useful life of LLINS and estimate the rate of replacement. Methods We evaluated the utility of the PHI measure using 409 LLINs collected over three years in Nampula Province, Mozambique following a mass distribution campaign in 2008. For each LLIN the diameter and distance from the bottom of the net were recorded for every hole. Holes were classified into four size categories and a PHI was calculated following WHOPES guidelines. We investigate how the size, shape, and location of holes influence the PHI. The areas of the WHOPES defined categories were compared to circular and elliptical areas based on approximate shape and actual measured axes of each hole and the PHI was compared to cumulative damaged surface area of the LLIN. Results The damaged area of small, medium, large, and extra-large holes was overestimated using the WHOPES categories compared to elliptical areas using the actual measured axes. Similar results were found when comparing to circular areas except for extra-large holes which were underestimated. (Wilcoxon signed rank test of differences p< 0.0001 for all sizes). Approximating holes as circular overestimated hole surface area by 1.5 to 2 times or more. There was a significant difference in the mean number of holes < 0.5 cm by brand and there were more holes of all sizes on the bottom of nets than the top. For a range of hypothetical PHI thresholds used to designate a “failed LLIN”, roughly 75 to 80% of failed LLINs were detected by considering large and extra-large holes alone, but sensitivity varied by brand. Conclusions Future studies may refine the PHI to better approximate overall damaged surface area. Furthermore, research is needed to identify whether or not appropriate PHI thresholds can be used to deem a net no longer protective. Once a cutoff is selected, simpler methods of determining the effective lifespan of LLINs can help guide replacement strategies for malaria control programs.
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Affiliation(s)
- Jodi L. Vanden Eng
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- * E-mail:
| | - Adeline Chan
- Entomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Ana Paula Abílio
- Instituto Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Adam Wolkon
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Gabriel Ponce de Leon
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - John Gimnig
- Entomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Juliette Morgan
- Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
- United States President’s Malaria Initiative, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Wei SC, Vanden Eng JL, Patterson AE, Doumbia S, Kleinbaum DG, Ryman TK, Touré MB, McMorrow ML. Validity of Expanded Program on Immunization Contact Method health behavior estimates in Mali. J Infect Dis 2012; 205 Suppl 1:S112-9. [PMID: 22315378 DOI: 10.1093/infdis/jir797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In the developing world, household surveys provide high-quality health behavior data integral to public health program management. The Expanded Program on Immunization Contact Method (EPI-CM) is a proposed, less resource-intensive method in which health center staff incorporate health behavior questions into routine vaccination activities. No systematic evaluation of EPI-CM validity has yet been conducted. METHODS We used concurrent household survey and EPI-CM to collect data on 4 infant health behaviors in Mali at 2 time points (8 total comparisons). Studied health behaviors were bednet use, obtaining care for fever, obtaining care for a respiratory complaint, and using oral rehydration solution for diarrhea. Household survey and EPI-CM estimates were considered equivalent if a 95% confidence interval about the difference in estimated proportions fell within the interval (-.10, .10). RESULTS EPI-CM estimates were higher than household survey estimates for 7 of 8 unadjusted paired estimates; estimates of bednet use in 2009 met a priori equivalence criteria in a setting of high bednet use (90.5%). When we restricted household survey data to infants up-to-date on vaccinations, estimates for behaviors other than bednet use remained substantially different. CONCLUSIONS We were unable to demonstrate that EPI-CM, as implemented, consistently produces data comparable with household survey data.
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Affiliation(s)
- Stanley C Wei
- Preventive Medicine Residency Program, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Wei SC, Vanden Eng JL, Patterson AE, Doumbia S, Kleinbaum DG, Ryman TK, Touré MB, McMorrow ML. Effect of the Expanded Program on Immunization Contact Method of data collection on health behaviors in Mali. J Infect Dis 2012; 205 Suppl 1:S103-11. [PMID: 22315377 PMCID: PMC5893864 DOI: 10.1093/infdis/jir798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2024] Open
Abstract
BACKGROUND The Expanded Program on Immunization Contact Method (EPI-CM) is a proposed monitoring and program management tool for developing countries. The method involves health workers tallying responses to questions about health behaviors during routine immunizations and providing targeted counseling. We evaluated whether asking caretakers about health behaviors during EPI visits led to changes in those behaviors. METHODS We worked in 2 districts in Mali: an intervention district where during immunization visits workers asked about 4 health behaviors related to bed net use, fever, respiratory disease, and diarrhea, and a control district where workers conducted routine immunization activities without health behavior questions. To evaluate the effect of EPI-CM, we conducted a cross-sectional household survey at baseline and 1 year postintervention. We used multivariate logistic regression to compare between districts the change over 1 year in 4 health behaviors: use of insecticide-treated nets, appropriate fever treatment, care-seeking for respiratory complaints, and appropriate diarrhea treatment. RESULTS There were no significant differences between the 2 districts in the change in the 4 health behaviors when controlling for age, sex, maternal education and occupation, immunization history, and wealth. CONCLUSIONS We found no evidence that EPI-CM increases healthy behaviors. Further evaluation of other potential benefits and costs of EPI-CM is warranted.
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Affiliation(s)
- Stanley C Wei
- Preventive Medicine Residency Program, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Goodson JL, Kulkarni MA, Vanden Eng JL, Wannemuehler KA, Cotte AH, Desrochers RE, Randriamanalina B, Luman ET. Improved equity in measles vaccination from integrating insecticide-treated bednets in a vaccination campaign, Madagascar. Trop Med Int Health 2012; 17:430-7. [DOI: 10.1111/j.1365-3156.2011.02953.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wolkon A, Vanden Eng JL, Morgah K, Eliades MJ, Thwing J, Terlouw DJ, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hightower AW, Lama M, Thawani N, Slutsker L, Hawley WA. Rapid scale-up of long-lasting insecticide-treated bed nets through integration into the national immunization program during child health week in Togo, 2004. Am J Trop Med Hyg 2010; 83:1014-9. [PMID: 21036829 DOI: 10.4269/ajtmh.2010.09-0599] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
In December 2004, Togo was the first country to conduct a nationwide free insecticide-treated net (ITN) distribution as part of its National Integrated Child Health Campaign. Community-based cross-sectional surveys were conducted one and nine months post-campaign as part of a multidisciplinary evaluation of the nationwide distribution of ITNs to children 9-59 months of age to evaluate ITN ownership, equity, and use. Our results demonstrated that at one month post-campaign, 93.1% of all eligible children received an ITN. Household ITN ownership and equity increased significantly post-campaign. Nine months post-campaign, 78.6% of households with a child eligible to participate in the campaign retained at least one campaign net. Use by eligible children was 43.5% at one month post-campaign (during the dry season) and 52.9% at nine months post-campaign (during the rainy season). Household ownership of at least one ITN increased from 8.0% pre-campaign to 62.5% one month post-campaign. Together, these findings demonstrate that in this setting, increased household ITN ownership, equity, and retention can be achieved on a national scale through free ITN distribution during an integrated campaign.
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Affiliation(s)
- Adam Wolkon
- National Center for Infectious Diseases, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Vazquez-Prokopec GM, Vanden Eng JL, Kelly R, Mead DG, Kolhe P, Howgate J, Kitron U, Burkot TR. The risk of West Nile Virus infection is associated with combined sewer overflow streams in urban Atlanta, Georgia, USA. Environ Health Perspect 2010; 118:1382-8. [PMID: 20529765 PMCID: PMC2957916 DOI: 10.1289/ehp.1001939] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Accepted: 06/08/2010] [Indexed: 05/12/2023]
Abstract
BACKGROUND At present, the factors favoring transmission and amplification of West Nile Virus (WNV) within urban environments are poorly understood. In urban Atlanta, Georgia, the highly polluted waters of streams affected by combined sewer overflow (CSO) represent significant habitats for the WNV mosquito vector Culex quinquefasciatus. However, their contribution to the risk of WNV infection in humans and birds remains unclear. OBJECTIVES Our goals were to describe and quantify the spatial distribution of WNV infection in mosquitoes, humans, and corvids, such as blue jays and American crows that are particularly susceptible to WNV infection, and to assess the relationship between WNV infection and proximity to CSO-affected streams in the city of Atlanta, Georgia. MATERIALS AND METHODS We applied spatial statistics to human, corvid, and mosquito WNV surveillance data from 2001 through 2007. Multimodel analysis was used to estimate associations of WNV infection in Cx. quinquefasciatus, humans, and dead corvids with selected risk factors including distance to CSO streams and catch basins, land cover, median household income, and housing characteristics. RESULTS We found that WNV infection in mosquitoes, corvids, and humans was spatially clustered and statistically associated with CSO-affected streams. WNV infection in Cx. quinquefasciatus was significantly higher in CSO compared with non-CSO streams, and WNV infection rates among humans and corvids were significantly associated with proximity to CSO-affected streams, the extent of tree cover, and median household income. CONCLUSIONS Our study strongly suggests that CSO-affected streams are significant sources of Cx. quinquefasciatus mosquitoes that may facilitate WNV transmission to humans within urban environments. Our findings may have direct implications for the surveillance and control of WNV in other urban centers that continue to use CSO systems as a waste management practice.
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Vanden Eng JL, Wolkon A, Frolov AS, Terlouw DJ, Eliades MJ, Morgah K, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hawley WA, Hightower AW. Use of handheld computers with global positioning systems for probability sampling and data entry in household surveys. Am J Trop Med Hyg 2007; 77:393-9. [PMID: 17690421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
We introduce an innovative method that uses personal digital assistants (PDAs) equipped with global positioning system (GPS) units in household surveys to select a probability-based sample and perform PDA-based interviews. Our approach uses PDAs with GPS to rapidly map all households in selected areas, choose a random sample, and navigate back to the sampled households to conduct an interview. We present recent field experience in two large-scale nationally representative household surveys to assess insecticide-treated bed net coverage as part of malaria control efforts in Africa. The successful application of this method resulted in statistically valid samples; quality-controlled data entry; and rapid aggregation, analyses, and availability of preliminary results within days of completing the field work. We propose this method as an alternative to the Expanded Program on Immunization cluster sample method when a fast, statistically valid survey is required in an environment with little census information at the enumeration area level.
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Affiliation(s)
- Jodi L Vanden Eng
- Division of Parasitic Diseases, Center for Infectious Diseases, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA.
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Vanden Eng JL, Eliades MJ, Terlouw DJ, Takpa V, Morgah K, Frolov AS, Wolkon A, Hightower AW, Hawley WA, Sodahlon YK, Dare A, Doumanou Y. Use of Handheld Computers with Global Positioning Systems for Probability Sampling and Data Entry in Household Surveys. Am J Trop Med Hyg 2007. [DOI: 10.4269/ajtmh.2007.77.393] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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