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An industrial robot today uses measurements of its joint positions and models of its kinematics and dynamics to estimate and control its end-effector position. Substantially better end-effector position estimation and control performance would be obtainable if direct measurements of its end-effector position were also used. The subject of this paper is extended Kalman filtering for precise estimation of the position of the end-effector of a robot using, in addition to the usual measurements of the joint positions, direct measurements of the end-effector position. The estimation performances of extended Kalman filters are compared in applications to a planar two-axis robotic arm with very flexible links. The comparisons shed new light on the dependence of extended Kalman filter estimation performance on the quality of the model of the arm dynamics that the extended Kalman filter operates with. KEY WORDS—extended Kalman filter, estimation, flexible links, robot 1

Provider-initiated HIV/AIDS counselling and testing at healthcare facilities in Thailand: a cluster-randomisation trial

The World Health Organization and UNAIDS advocate that healthcare providers worldwide consider provider-initiated HIV counselling and testing for clients attending healthcare facilities. However, there is a lack of evidence needed to support policy decisions, concerning the effectiveness of such interventions in Thailand and other settings with large outbreaks of the HIV epidemic. As a result, a cluster-randomisation trial with pre-test and post-test design was conducted to assess the effectiveness of healthcare provider-initiated voluntary HIV counselling and testing compared with the current practice in which HIV testing is provided only upon the client's request. Sixteen district hospitals (clusters) with high and low HIV prevalence were randomly assigned to either use the new intervention or to continue with the current practice with a 1:1 allocation ratio. Patients aged between 13 and 64 years, receiving ambulatory care in the participating hospitals, were eligible. The main outcome measures were the acceptance rate of HIV testing and the HIV detection rate. During the first eight-week baseline period, there were no significant differences between the control and experimental clusters on the acceptance rate and HIV detection. However, after the eight-week intervention period, the acceptance rate and HIV detection rate in the experimental clusters was significantly higher than those of the control clusters. The results from the generalised estimating equations and multilevel modelling also confirmed the findings. Economic appraisal alongside this study suggested that the new intervention is very cost-effective under the Thai healthcare setting.HIV/AIDS, counselling and testing, provider-initiated HIV counselling and testing, cluster-randomised trial, Thailand,

Leveraging geo-referenced malaria information to increase domestic financial support for malaria elimination in Thailand.

Thailand's National Malaria Elimination Strategy 2017-2026 seeks to increase domestic support and financing for malaria elimination. During 2018-2020, through a series of training sessions, public health officials in Thailand utilized foci-level malaria data to engage subdistrict-level government units known as Local Administrative Organizations (LAOs) with the aim of increasing their understanding of their local malaria situation, collaboration with public health networks, and advocacy for financial support of targeted interventions in villages within their jurisdictions. As a result of these efforts, total LAO funding support for malaria nearly doubled from the 2017 baseline to 2020. In 2021, a novel "LAO collaboration" feature was added to Thailand's national malaria information system that enables tracking and visualization of LAO financial support of malaria in areas with transmission, by year, down to the subdistrict level. This case study describes Thailand's experience implementing the LAO engagement strategy, quantifying and monitoring the financial support mobilized from LAOs, and results from a qualitative study in five high-performance provinces examining factors and approaches that foster successful local collaboration between LAOs, public health networks, and communities for malaria prevention and response. Results from the study showed that significant malaria endemicity or local outbreaks helped spur collaboration in multiple provinces. Increases in LAO support and involvement were attributable to four approaches employed by public health officials: (a) strengthening malaria literacy and response capacity of LAOs, (b) organizational leadership in response to outbreaks, (c) utilization of structural incentives, and (d) multisectoral involvement in malaria response. In two provinces, capacity building of LAOs in malaria vector control, following a precedent set by Thailand's dengue programme, enabled LAO personnel to play both funding and implementation roles in local malaria response. Wider replication of the LAO engagement strategy across Thailand may sustain gains and yield efficiencies in the fight against malaria as the vector-borne disease workforce declines. Lessons from Thailand's experience may be useful for malaria programmes in other geographies to support the goals and sustainability of elimination and prevention of re-establishment by improving financing through local collaboration between the health system and elected officials

Progress and challenges of integrated drug efficacy surveillance for uncomplicated malaria in Thailand

Abstract Background Integrated drug efficacy surveillance (iDES) was formally introduced nationally across Thailand in fiscal year 2018 (FY2018), building on a history of drug efficacy monitoring and interventions. According to the National Malaria Elimination Strategy for Thailand 2017–2026, diagnosis is microscopically confirmed, treatment is prescribed, and patients are followed up four times to ensure cure. Methods Routine patient data were extracted from the malaria information system for FY2018–FY2020. Treatment failure of first-line therapy was defined as confirmed parasite reappearance within 42 days for Plasmodium falciparum and 28 days for Plasmodium vivax. The primary outcome was the crude drug efficacy rate, estimated using Kaplan–Meier methods, at day 42 for P. falciparum treated with dihydroartemisinin–piperaquine plus primaquine, and day 28 for P. vivax treated with chloroquine plus primaquine; day 60 and day 90 efficacy were secondary outcomes for P. vivax. Results The proportion of patients with outcomes recorded at day 42 for P. falciparum malaria and at day 28 for P. vivax malaria has been increasing, with FY2020 follow-up rates of 61.5% and 57.2%, respectively. For P. falciparum malaria, day 42 efficacy in FY2018 was 92.4% (n = 249), in FY2019 93.3% (n = 379), and in FY2020 98.0% (n = 167). Plasmodium falciparum recurrences occurred disproportionally in Sisaket Province, with day 42 efficacy rates of 75.9% in FY2018 (n = 59) and 49.4% in FY2019 (n = 49), leading to an update in first-line therapy to pyronaridine–artesunate at the provincial level, rolled out in FY2020. For P. vivax malaria, day 28 efficacy (chloroquine efficacy) was 98.5% in FY2018 (n = 2048), 99.1% in FY2019 (n = 2206), and 99.9% in FY2020 (n = 2448), and day 90 efficacy (primaquine efficacy) was 94.8%, 96.3%, and 97.1%, respectively. Conclusions In Thailand, iDES provided operationally relevant data on drug efficacy, enabling the rapid amendment of treatment guidelines to improve patient outcomes and reduce the potential for the spread of drug-resistant parasites. A strong case-based surveillance system, integration with other health system processes, supporting biomarker collection and molecular analyses, and cross-border collaboration may maximize the potential of iDES in countries moving towards elimination