Assessing the Impact of Misclassification Error on an Epidemiological Association between Two Helminthic Infections

Hookworm, roundworm, and whipworm are collectively known as soil-transmitted helminths. These worms are prevalent in most of the developing countries along with another parasitic infection called schistosomiasis. The tests commonly used to detect infection with these worms are less than 100% accurate. This leads to misclassification of infection status since these tests cannot always correctly indentify infection. We conducted an epidemiological study where such a test, the Kato-Katz technique, was used. In our study we tried to show how misclassification error can influence the association between soil-transmitted helminth infection and schistosomiasis in humans. We used a statistical technique to calculate epidemiological measures of association after correcting for the inaccuracy of the test. Our results show that there is a major difference between epidemiological measures of association before and after the correction of the inaccuracy of the test. After correction of the inaccuracy of the test, soil-transmitted helminth infection was found to be associated with increased risk of acquiring schistosomiasis. This has major public health implications since effective control of one worm can lead to reduction in the occurrence of another and help to reduce the overall burden of worm infection in affected regions

The Impacts of Work-Life-Balance (WLB) Challenges on Social Sustainability: The Experience of Nigerian Female Medical Doctors

Purpose: The purpose of this paper is to examine the implications of work-life-balance (WLB) challenges for Nigerian female medical doctors. This study focusses on Nigeria, which its peculiar socio-cultural, institutional and professional realities constitute WLB as well as social sustainability (SS) challenge for female medical doctors. Design/methodology/approach: Relying on qualitative, interpretivist approach and informed by institutional theory, this study explores how Nigeria's institutional environment and workplace realities engender WLB challenges, which consequently impact SS for female doctors. In total, 43 semi-structured interviews and focus group session involving eight participants were utilised for empirical analysis. Findings: The study reveals that factors such as work pressure, cultural expectations, unsupportive relationships, challenging work environment, gender role challenges, lack of voice/participation, and high stress level moderate the ability of female medical doctors to manage WLB and SS. It also identifies that socio-cultural and institutional demands on women show that these challenges, while common to female physicians in other countries, are different and more intense in Nigeria because of their unique professional, socio-cultural and institutional frameworks. Research limitations/implications: The implications of the WLB and SS requires scholarship to deepen as well as extend knowledge on contextual disparities in understanding these concepts from developing countries perspective, which is understudied. Originality/value: This study offers fresh insights into the WLB and SS concepts from the non-western context, such as Nigeria, highlighting the previously understudied challenges of WLB and SS and their implications for female doctors. © 2018, Emerald Publishing Limited

Disaster management in Bangladesh: developing an effective emergency supply chain network

YesThis study has addressed and identified the problems in managing the existing emergency supply chain of Bangladesh in all phases of operation in terms of the primary drivers of the supply chain. It has also attempted to conceptualize and suggest an effective emergency supply chain. In this context, a thorough field investigation in several districts was conducted among the employees of the organizations sharing common information with similar protocols and implications (interoperable). Information was collected from the employees of all the participating organizations involved in disaster management through a semi-structured questionnaire based survey. The respondents addressed and illustrated several interconnected reasons which are inhibiting proper forecasting, procurement, storage, identification of affected people, and distribution. The respondents pointed out that the mismatching of objectives in the different organizations resulted in non-interoperability among the participating organizations. These issues are related to the malfunctioning of management with multidimensional organizational conflicts. Reflecting those issues, an emergency supply chain for disaster management is proposed in this stud

A cross-sectional study of the prevalence of intensity of infection with Schistosoma japonicum in 50 irrigated and rain-fed villages in Samar Province, the Philippines

BACKGROUND: Few studies have described heterogeneity in Schistosoma japonicum infection intensity, and none were done in Philippines. The purpose of this report is to describe the village-to-village variation in the prevalence of two levels of infection intensity across 50 villages of Samar Province, the Philippines. METHODS: This cross-sectional study was conducted in 25 rain-fed and 25 irrigated villages endemic for S. japonicum between August 2003 and November 2004. Villages were selected based on irrigation and farming criteria. A maximum of 35 eligible households were selected per village. Each participant was asked to provide stool samples on three consecutive days. All those who provided at least one stool sample were included in the analysis. A Bayesian three category outcome hierarchical cumulative logit regression model with adjustment for age, sex, occupation and measurement error of the Kato-Katz technique was used for analysis. RESULTS: A total of 1427 households and 6917 individuals agreed to participate in the study. A total of 5624 (81.3%) participants provided at least one stool sample. The prevalences of those lightly and at least moderately infected varied from 0% (95% Bayesian credible interval (BCI): 0%–3.1%) to 45.2% (95% BCI: 36.5%–53.9%) and 0% to 23.0% (95% BCI: 16.4%–31.2%) from village-to-village, respectively. Using the 0–7 year old group as a reference category, the highest odds ratio (OR) among males and females were that of being aged 17–40-year old (OR = 8.76; 95% BCI: 6.03–12.47) and 11–16-year old (OR = 8.59; 95% BCI: 4.74–14.28), respectively. People who did not work on a rice farm had a lower prevalence of infection than those working full time on a rice farm. The OR for irrigated villages compared to rain-fed villages was 1.41 (95% BCI: 0.50–3.21). DISCUSSION: We found very important village-to-village variation in prevalence of infection intensity. This variation is probably due to village-level variables other than that explained by a crude classification of villages into the irrigated and non-irrigated categories. We are planning to capture this spatial heterogeneity by updating our initial transmission dynamics model with the data reported here combined with 1-year post-treatment follow-up of study participants

Legitimisation strategies and managerial capture: a critical discourse analysis of employment relations in Nigeria

YesIrrespective of the fundamental role of legitimacy in industrial relations as well as social and organisational life, little is known of the subtle meaning-making strategies through which organisational concepts, such as employment relations and engagement, are legitimised in modern world of work, particularly in developing countries such as Nigeria, which results in managerial capture. As a result, this paper explores the discursive legitimisation strategies used when making sense of employment relations in Nigeria’s conflictual, non-participatory employment relations terrain. Relying on Leeuwen’s (1995) legitimisation strategies, critical discourse analysis (CDA) and call by Bailey, Luck & Townsend (2009) and Legge (1995) to widen employment relations discourse, we explore interview, focus group and shadow report data, and distinguish and analyse five legitimisation strategies. The strategies include authorisation, moralisation, mythopoesis, rationalisation, and management. Therefore, we contend that while these specific legitimisation strategies appear in separate data source, their recurrent manifestation and application underscores legitimising discourse of managerial capture in Nigeria’s employment relations

Implementation of the Connective Tissue Screening Questionnaire in Northeast Pennsylvania to Identify Comorbidities of Connective Tissue Diseases in Subjects With Systemic Lupus Erythematosus

Previous studies have described an increased risk of developing an additional connective tissue disease (CTD) when one such ailment is present. We examine here the likelihood that individuals with systemic lupus erythematosus (SLE) screen positive for one or more of the following five autoimmune CTDs: Sjögren’s syndrome, scleroderma, rheumatoid arthritis, dermatomyositis/polymyositis, and mixed connective tissue disorder. Five hundred SLE-diagnosed subjects were asked to complete a CTD screening questionnaire (CSQ). The results were analyzed according to the set of diagnostic criteria given by the American College of Rheumatology to identify probable cases of each CTD. Significant standardized prevalence ratios and comorbidities indicate an increased risk for the other autoimmune CTDs. In all, 96% of the subjects screened positive for at least one additional CTD, and 13% screened positive for at least two additional CTDs. We see that the SLE-diagnosed population may benefit from further attention regarding the presence of additional CTDs, which may further inform treatment strategies. We also see the application of the CSQ as a potentially important tool for clinical practice, and we describe the present study’s limitations along with possible ways that these can be addressed

Dried fluid spots for peste des petits ruminants virus load evaluation allowing for non-invasive diagnosis and genotyping

International audienceBackground: Active surveillance of peste des petits ruminants (PPR) should ease prevention and control of this disease widely present across Africa, Middle East, central and southern Asia. PPR is now present in Turkey at the gateway to the European Union. In Bangladesh, the diagnosis and genotyping of PPR virus (PPRV) may be hampered by inadequate infrastructures and by lack of proper clinical material, which is often not preserved under cold chain up to laboratories. It has been shown previously that Whatman (R) 3MM filter paper (GE Healthcare, France) preserves the nucleic acid of PPRV for at least 3 months at 32 degrees C. Results: In this study, we demonstrate the performances of filter papers for archiving RNA from local PPRV field isolates for further molecular detection and genotyping of PPRV, at -70 degrees C combined with ambient temperature, for periods up to 16 months. PPR-suspected live animals were sampled and their blood and nasal swabs were applied on filter papers then air dried. Immediately after field sampling, RT-PCR amplifying a 448-bp fragment of the F gene appeared positive for both blood and nasal swabs when animals were in febrile stage and only nasal swabs were detected positive in non-febrile stage. Those tested positive were monitored by RT-PCR up to 10 months by storage at -70 degrees C. At 16 months, using real time RT-PCR adapted to amplify the N gene from filter paper, high viral loads could still be detected (similar to 2 x 10(7) copy numbers), essentially from nasal samples. The material was successfully sequenced and a Bayesian phylogenetic reconstruction achieved adequate resolution to establish temporal relationships within or between the geographical clusters of the PPRV strains. Conclusions: This clearly reveals the excellent capacity of filter papers to store genetic material that can be sampled using a non-invasive approach