Response to malaria epidemics in Africa.

Malaria epidemics affect nonimmune populations in many highland and semi-arid areas of Africa. Effective prevention of these epidemics is challenging, particularly in the highlands where predictive accuracy of indicators is not sufficiently high to allow decisions involving expensive measures such as indoor residual spraying of insecticides. Advances in geographic information systems have proved useful in stratification of areas to guide selective targeting of interventions, including barrier application of insecticides in transmission foci to prevent spread of infection. Because rainfall is associated with epidemics in semi-arid areas, early warning methods based on seasonal climate predictions have been proposed. For most areas, response measures should focus on early recognition of anomalies and rapid mass drug administration. Vector control measures are useful if abnormal transmission is highly likely and if they can be selectively implemented at the early stages of an outbreak

Early warning systems for malaria in Africa: from blueprint to practice.

Although the development of early warning systems for malaria has been advocated by international agencies and academic researchers for many years, practical progress in this area has been relatively modest. In two recent articles, Thomson et al. provide new evidence that models of malaria incidence that incorporate monitored or predicted climate can provide early warnings of epidemics one to five months in advance in semi-arid areas. Although the potential benefits of these models in terms of improved management of epidemics are clear, several technical and practical hurdles still need to be overcome before the models can be widely integrated into routine malaria-control strategies

Spatial and temporal variations of malaria epidemic risk in Ethiopia: factors involved and implications.

The aim of this study was to describe spatial and temporal variations in malaria epidemic risk in Ethiopia and to examine factors involved in relation to their implications for early warning and interpretation of geographical risk models. Forty-eight epidemic episodes were identified in various areas between September 1986 and August 1993 and factors that might have led to the events investigated using health facility records and weather data. The study showed that epidemics in specific years were associated with specific geographical areas. A major epidemic in 1988 affected the highlands whereas epidemics in 1991 and 1992 affected highland-fringe areas on the escarpments of the Rift Valley and in southern and north-western parts of the country. Malaria epidemics were significantly more often preceded by a month of abnormally high minimum temperature in the preceding 3 months than based on random chance, whereas frequency of abnormally low minimum temperature prior to epidemics was significantly lower than expected. Abnormal increases of maximum temperature and rainfall had no positive association with the epidemics. A period of low incidence during previous transmission seasons might have aggravated the events, possibly due to low level of immunity in affected populations. Epidemic risk is a dynamic phenomenon with changing geographic pattern based on temporal variations in determinant factors including weather and other eco-epidemiological characteristics of areas at risk. Epidemic early warning systems should take account of non-uniform effects of these factors by space and time and thus temporal dimensions need to be considered in spatial models of epidemic risks

Effect of environmental variables and kdr resistance genotype on survival probability and infection rates in Anopheles gambiae (s.s.).

BACKGROUND: Environmental factors, especially ambient temperature and relative humidity affect both mosquitoes and malaria parasites. The early part of sporogony is most sensitive and is affected by high temperatures and temperature fluctuation immediately following ingestion of an infectious blood meal. The aim of this study was to explore whether environmental variables such as temperature, together with the presence of the kdr insecticide resistance mutations, have an impact on survival probability and infection rates in wild Anopheles gambiae (s.s.) exposed and unexposed to a pyrethroid insecticide. METHODS: Anopheles gambiae (s.s.) were collected as larvae, reared to adults, and fed on blood samples from 42 Plasmodium falciparum-infected local patients at a health facility in mid-western Uganda, then exposed either to nets treated with sub-lethal doses of deltamethrin or to untreated nets. After seven days, surviving mosquitoes were dissected and their midguts examined for oocysts. Prevalence (proportion infected) and intensity of infection (number of oocysts per infected mosquito) were recorded for each group. Mosquito mortality was recorded daily. Temperature and humidity were recorded every 30 minutes throughout the experiments. RESULTS: Our findings indicate that apart from the effect of deltamethrin exposure, mean daily temperature during the incubation period, temperature range during the first 24 hours and on day 4 post-infectious feed had a highly significant effect on the risk of infection. Deltamethrin exposure still significantly impaired survival of kdr homozygous mosquitoes, while mean daily temperature and relative humidity during the incubation period independently affected mosquito mortality. Significant differences in survival of resistant genotypes were detected, with the lowest survival recorded in mosquitoes with heterozygote L1014S/L1014F genotype. CONCLUSIONS: This study confirmed that the early part of sporogony is most affected by temperature fluctuations, while environmental factors affect mosquito survival. The impact of insecticide resistance on malaria infection and vector survival needs to be assessed separately for mosquitoes with different resistance mechanisms to fully understand its implications for currently available vector control tools and malaria transmission

Malaria Epidemics in Africa: Prediction, Detection and Response

Malaria kills at least one million people worldwide every year and 80% of the deaths occur in Africa south of the Sahara (RBM et al. 2005). According to a new estimate using a combination of epidemiological, geographical and demographic data, there were 515 million clinical episodes of Plasmodium falciparum malaria (range 300 million—660 million) in the year 2002, 50% more than those reported by the World Health Organization (WHO) (Snow et al. 2005). Malaria has become a major obstacle to economic growth in endemic developing countries (Gallup and Sachs 2001). In most endemic countries, there are inadequate human, logistics and financial resources and poor infrastructure to deal with the malaria problem. The Abuja Declaration issued by African Leaders in 2000 set a goal for the Roll Back Malaria (RBM) initiative to reduce malaria-related mortality in Africa by half by the year 2010, calling on governments, international organizations and communities to intensify the fight against this deadly disease (RBM 2000). To achieve this goal, it was recommended to significantly increase access to prompt and effective treatment and insecticidetreated nets (ITNs) by those most at risk, and to intermittent preventive treatment (IPT) for pregnant women. Whether this ambitious goal will be realized is yet to be seen but there is a renewed international effort mainly through the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to alleviate the problem of malaria in many countries (WHO/UNICEF 2003). Resistance to antimalarial drugs such as chloroquine and sulfadoxinepyrimethamine (SP) is a major problem in providing effective treatment in Africa. As a result, several African countries had changed their national drug policy and adopted the more effective artemisinin-based combination therapy (ACT) (RBM et al. 2005). However, the universal implementation of this policy is still at its early stages largely due to the imperative cost of these drugs which is about 10 times that of the traditional drugs. ITN distribution has increased, but the coverage is still very low in many countries. Many countries have also started implementing IPT for pregnant women (RBM et al. 2005)

Shifting Modalities: Providing K-5 Montessori Education Online during the Pandemic

At the first and only public Montessori charter school in New York City, teachers create learning environments, materials, and lessons that help students guide themselves to find information needed to arrive at a necessary learning outcome. The sudden shift to online instruction in March 2020 required parents, teachers, and administration to maintain business-as-usual in an unfamiliar modality—online instruction. This case study reflection article focuses on the planning strategies identified and implemented that shifted the school to teaching and learning online during the COVID-19 pandemic while working to keep the Montessori philosophy alive, despite the expansion to the online modality. Existing research, the process of shifting to the online modality, maintenance of the Montessori approach, and the inter-institutional support provided to the charter school by a community college are reviewed. Once mandated to move to online instruction, strategies employed show that maintaining students’ natural desire to learn and active discovery are central objectives in tandem with supporting the relationship-centered culture in the machine-oriented online-learning environment. This dual focus is critical because children’s development is maximized when they are engaged in secure, mutually collegial relationships (Greenfield & Suzuki, 1998). It was concluded that building community among children and teachers, as well as between administration, teachers, families, and a partnering community college were valued and deemed critical to sustaining the rigorous curriculum and relationship-based school culture during the pandemic crisis

The Role of Taboos in African Governance Systems

In Africa traditions permeate every aspect of life and are used to explain every phenomenon in day-to-day activities. However, this inimitable feature has been watered down and further pushed to the background by the influx of foreign religions such as Christianity and Islam, as well as modernity. Nevertheless, indigenous cultures survive as an undercurrent and recently the Indigenous Knowledge System (IKS) has been gaining prominence in the academia. In this paper taboos are classified and their role played in the governance system is analysed with the aim to raise awareness of the peculiar features of African traditional religions, with particular focus on the Akan of Ghana and their unique role in the local governance system

The Role of Taboos in African Governance Systems

In Africa traditions permeate every aspect of life and are used to explain every phenomenon in day-to-day activities. However, this inimitable feature has been watered down and further pushed to the background by the influx of foreign religions such as Christianity and Islam, as well as modernity. Nevertheless, indigenous cultures survive as an undercurrent and recently the Indigenous Knowledge System (IKS) has been gaining prominence in the academia. In this paper taboos are classified and their role played in the governance system is analysed with the aim to raise awareness of the peculiar features of African traditional religions, with particular focus on the Akan of Ghana and their unique role in the local governance system