Self-reported adverse events associated with antimalarial chemoprophylaxis in peace corps volunteers

OBJECTIVES

To determine adverse events associated with the use of antimalarial chemoprophylaxis in Peace Corps volunteers who have served in malaria-endemic countries 6 months or longer.

METHODS

Survey of Peace Corps volunteers' adverse events associated with the use of antimalarial chemoprophylaxis between August 1, 2005 and July 31, 2006. Analyses were conducted in fall 2006.

RESULTS

Two thousand seven hundred and one surveys were received (43% response rate) from volunteers in malaria-endemic countries, with 1,731 (64%) in country for 6 months or longer (average 19 months). Nearly two thirds (62%) reported at least one adverse event. Those on mefloquine reported the most neuropsychologic adverse events; those on doxycycline reported the most gastrointestinal as well as skin and vaginal adverse events. Nearly one quarter of respondents (23%) changed their chemoprophylaxis regimen due to adverse events. Severe adverse events were reported by 9% of respondents, and 1% reported being hospitalized.

CONCLUSIONS

Adverse events were frequently reported among volunteers using antimalarial medications for more than 6 months, but very few were severe or required hospitalization. In light of the large number of adverse events, having multiple drug regimens available for the long-term traveler may be one method of maintaining adherence to antimalarial chemoprophylaxis.

From spectators to implementers: civil society organizations involved in AIDS programmes in China

Background Over the past 20 years, civil society organizations (CSOs) in China have significantly increased their involvement in the AIDS response. This article aims to review the extent of civil society participation in China AIDS programmes over the past two decades.

Methods A desk review was conducted to collect Chinese government policies, project documents and published articles on civil society participation of HIV/AIDS programmes in China over the past two decades. Assessment focused on five aspects: (i) the political environment; (ii) access to financial resources; (iii) the number of CSOs working on HIV/AIDS; (iv) the scope of work; and (v) the impact of CSO involvement on programmes.

Results The number of CSOs specificly working on HIV/AIDS increased from 0 before 1988 to over 400 in 2009. Among a sample of 368 CSOs, 135 (36.7%) were registered. CSOs were primarily supported by international programmes. Government financial support to CSOs has increased from USD248 000 in 2002 to USD1.46 million in 2008. Initially, civil society played a minimal role. It is now widely involved in nearly all aspects of HIV/AIDS-related prevention, treatment and care efforts, and has had a positive impact; for example, increased adherence of anti-retroviral treatment and HIV testing among hard-to-reach groups. The main challenges faced by CSOs include registration, capacity and long-term financial support.

Conclusion CSOs have significantly increased their participation and contribution to HIV/AIDS programmes in China. Policies for registration and financial support to CSOs need to be developed to enable them to play an even greater role in AIDS programmes.

Contributions of international cooperation projects to the HIV/AIDS response in China

BACKGROUND

For 20 years, China has participated in 267 international cooperation projects against the HIV/AIDS epidemic and received ∼526 million USD from over 40 international organizations. These projects have played an important role by complementing national efforts in the fight against HIV/AIDS in China.

METHODS

The diverse characteristics of these projects followed three phases over 20 years. Initially, stand-alone projects provided technical support in surveillance, training or advocacy for public awareness. As the epidemic spread across China, projects became a part of the comprehensive and integrated national response. Currently, international best practices encourage the inclusion of civil society and non-governmental organizations in an expanded response to the epidemic.

RESULTS

Funding from international projects has accounted for one-third of the resources provided for the HIV/AIDS response in China. Beyond this strong financial support, these programmes have introduced best practices, accelerated the introduction of AIDS policies, strengthened capacity, improved the development of grassroots social organizations and established a platform for communication and experience sharing with the international community. However, there are still challenges ahead, including integrating existing resources and exploring new programme models. The National Centre for AIDS/STD Control and Prevention (NCAIDS) in China is consolidating all international projects into national HIV prevention, treatment and care activities.

CONCLUSION

International cooperation projects have been an invaluable component of China's response to HIV/AIDS, and China has now been able to take this information and share its experiences with other countries with the help of these same international programmes.