Methodological issues raised from the coverage survey of the MSF nutritional programme. Madarounfa and Guidan Roumdji, Maradi region, Niger 2006.

Abstract Poster - Congress: Surveying Health in Complex Situations; Brussels; June 2007

Intra-household use and acceptability of Ready-to-Use-Supplementary-Foods distributed in Niger between July and December 2010.

Few studies have looked at consumption of Ready-to-Use-Supplementary-Foods (RUSFs) during a nutritional emergency. Here, we describe the use and acceptability of RUSF within households in four districts of the region of Maradi, Niger during large scale preventive distributions with RUSF in 2010 targeted at children 6-35months of age. Our study comprised both quantitative and qualitative components to collect detailed information and to allow in-depth interviews. We performed a cross-sectional survey in 16 villages between two monthly distributions of RUSF (October-November 2010). All households with at least one child who received RUSF were included and a total of 1842 caregivers were interviewed using a structured questionnaire. Focus groups and individual interviews of 128 caregivers were conducted in eight of the selected villages. On average, 24.7% of households reported any sharing of RUSF within the household. Sharing practices outside the household remained rare. Most of the sharing reported occurred among children under 5years of age living in the household. On average, 91% of caregivers in all districts rated the child's appreciation of the products as good or very good. Program planning may need to explicitly accounting for the sharing of products among children under 5 within household

Performance of Small Cluster Surveys and the Clustered LQAS Design to estimate Local-level Vaccination Coverage in Mali

<p>Abstract</p> <p>Background</p> <p>Estimation of vaccination coverage at the local level is essential to identify communities that may require additional support. Cluster surveys can be used in resource-poor settings, when population figures are inaccurate. To be feasible, cluster samples need to be small, without losing robustness of results. The clustered LQAS (CLQAS) approach has been proposed as an alternative, as smaller sample sizes are required.</p> <p>Methods</p> <p>We explored (i) the efficiency of cluster surveys of decreasing sample size through bootstrapping analysis and (ii) the performance of CLQAS under three alternative sampling plans to classify local VC, using data from a survey carried out in Mali after mass vaccination against meningococcal meningitis group A.</p> <p>Results</p> <p>VC estimates provided by a 10 × 15 cluster survey design were reasonably robust. We used them to classify health areas in three categories and guide mop-up activities: i) health areas not requiring supplemental activities; ii) health areas requiring additional vaccination; iii) health areas requiring further evaluation. As sample size decreased (from 10 × 15 to 10 × 3), standard error of VC and ICC estimates were increasingly unstable. Results of CLQAS simulations were not accurate for most health areas, with an overall risk of misclassification greater than 0.25 in one health area out of three. It was greater than 0.50 in one health area out of two under two of the three sampling plans.</p> <p>Conclusions</p> <p>Small sample cluster surveys (10 × 15) are acceptably robust for classification of VC at local level. We do not recommend the CLQAS method as currently formulated for evaluating vaccination programmes.</p

Burden of visceral leishmaniasis in villages of eastern gedaref state, Sudan: an exhaustive cross-sectional survey.

Since December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah

Performance of the 2007 WHO Algorithm to diagnose Smear-negative Pulmonary Tuberculosis in a HIV prevalent setting

The 2007 WHO algorithm for diagnosis of smear-negative pulmonary tuberculosis (PTB) including Mycobacterium tuberculosis (MTB) culture was evaluated in a HIV prevalent area of Kenya

Adherence to self-administered tuberculosis treatment in a high HIV-prevalence setting: a cross-sectional survey in Homa Bay, Kenya.

Good adherence to treatment is crucial to control tuberculosis (TB). Efficiency and feasibility of directly observed therapy (DOT) under routine program conditions have been questioned. As an alternative, Médecins sans Frontières introduced self-administered therapy (SAT) in several TB programs. We aimed to measure adherence to TB treatment among patients receiving TB chemotherapy with fixed dose combination (FDC) under SAT at the Homa Bay district hospital (Kenya). A second objective was to compare the adherence agreement between different assessment tools

Evidence that a very brief psychological intervention boosts weight loss in a weight loss program

Reducing morbidity and mortality associated with being overweight is a crucial public health goal. The aim of the present research was to test the efficacy of a very brief psychological intervention (a volitional help sheet) that could be used as an adjunct to standard weight loss programs to support increased weight loss in an overweight sample. Seventy-two overweight participants currently participating in a weight loss program were randomly allocated to either an intervention (volitional help sheet) condition or a control (distracter task) condition. The main outcome measure was weight at 1-month follow-up. Participants in both conditions lost significant amounts of weight, but those in the intervention condition lost significantly more than those in the control condition (d = 0.66). The findings support the efficacy of the volitional help sheet to promote additional weight loss in an overweight sample engaged in a weight loss program. The volitional help sheet therefore represents a very brief, low-cost intervention that could be used to supplement ongoing weight-loss programs

Mycobacterium ulcerans infection: control, diagnosis, and treatment.

The skin disease Buruli ulcer, caused by Mycobacterium ulcerans, is the third most common mycobacterial disease after tuberculosis and leprosy and mainly affects remote rural African communities. Although the disease is known to be linked to contaminated water, the mode of transmission is not yet understood, which makes it difficult to propose control interventions. The disease is usually detected in its later stages, when it has caused substantial damage and disability. Surgery remains the treatment of choice. Although easy and effective in the early stages of the disease, treatment requires extended excisions and long hospitalisation for the advanced forms of the disease. Currently, no antibiotic treatment has proven effective for all forms of M ulcerans infection and research into a new vaccine is urgently needed. While the scientific community works on developing non-invasive and rapid diagnostic tools, the governments of endemic countries should implement active case finding and health education strategies in their affected communities to detect the disease in its early stages. We review the diagnosis, treatment, and control of Buruli ulcer and list priorities for research and development

Analyse des données gravimétriques en forage d'un gisement de sulfures massifs volcanogènes dans un contexte géologique complexe

RÉSUMÉ Un code de modélisation et d’inversion a été développé pour étudier la capacité de la méthode de gravimétrie en forage à explorer les gisements de sulfures massifs volcanogènes dans la région de l’Abitibi, Québec. Deux difficultés importantes viennent entraver son développement : l’acquisition de données lente et coûteuse dans un contexte de forages en quantité limitée et la séparation de l’anomalie associée au gisement de celle causée par la géologie encaissante et par la structure régionale. L’objectif principal de ce projet de maitrise est d’analyser ces deux problèmes majeurs en modélisant et inversant les réponses d’un modèle synthétique. Les objectifs spécifiques sont l’optimisation de l’acquisition des données en forage et la séparation de la régionale et de la résiduelle. Pour calculer les réponses du modèle synthétique, la méthode de modélisation décrite par Li et Chouteau (1998) a été utilisée. L’inversion est basée sur l’inversion stochastique développée par Shamsipour et al. (2010) pour les données de surface, adaptée ici aux mesures en forage. Le modèle étudié est celui d’un gisement de sulfures massifs volcanogènes typique de la région de l’Abitibi. Lors de la prise de données, trois paramètres sont importants : le nombre de forages dans lesquels les réponses gravimétriques ont été mesurées, la position de ces forages par rapport au gisement, et l’intervalle des données dans les forages. Puisque la gravimétrie en forage est une méthode géophysique relativement coûteuse, il est important de bien connaître l’influence de ces paramètres pour pouvoir les optimiser. Un minimum de trois forages bien positionnés par rapport à la cible est requis pour bien positionner la structure recherchée. Lorsque quatre forages situés à portée du gisement sont utilisés celui-ci peut être positionné avec certitude. Dans le cas où la gravimétrie est utilisée pour évaluer un gisement, quatre forages au moins sont requis dont un forage interceptant le gisement, et des contraintes de densités ou de gradients fixes doivent être appliquées. Un pas de mesure de 10m est fortement recommandé. Si la position du gisement est connue, un bon compromis est d’utiliser un pas de mesure plus grand lorsque le forage est situé loin du gisement pour déterminer l’anomalie régionale et un pas de mesure de 10m lorsque le forage s’approche du gisement.----------ABSTRACT A forward modeling and an inversion code have been developed to study the use of the borehole gravity method for exploration of volcanogenic massif sulphides (VMS) deposits in the Abitibi region of Quebec. Two problems are associated with the gravity method: acquiring data can be a long and costly method in the context where there is a limited quantity of boreholes and the separation of the response caused by the immediate or local geology and the response of deeper and farther formations called the regional. The principal objective of this master’s project is to analyse those two major problems by modelling and inverting synthetic data. The specific objectives are the optimisation of the data acquisition settings and the regional-residual anomaly separation. The forward modeling method is based on the prismatic method described by Li and Chouteau (1998). A stochastic approach developed by Shamsipour et al. (2010) is chosen for the inversion and was adapted for borehole data. A density model of a typical VMS ore deposit was designed based on a number of well-known mines in the region of Rouyn-Noranda, Val-d’Or and Matagami. The data acquisition settings include the number of boreholes, their location and data collection sampling in the boreholes. Since the borehole gravity method is a costly geophysics method, it is best to know well the influence of the data acquisition settings to be able to optimise them. A minimum of three boreholes within appropriate distance from the target is required to locate any structure. When four boreholes situated at the detectability range of the deposit are used, it can be located with precision. In the scenario where the borehole gravity method is used to calculate the excess mass of a deposit and to define its structure, at least four boreholes should be used with one intercepting the deposit and fixed densities or gradient constraints must be applied. A 10m sampling interval is recommended. If the position of the deposit is known, a good compromise is to use a larger interval far from the deposit and use a 10m interval when the borehole is closer to the deposit

Characteristics of human encounters and social mixing patterns relevant to infectious diseases spread by close contact: a survey in Southwest Uganda.

BACKGROUND: Quantification of human interactions relevant to infectious disease transmission through social contact is central to predict disease dynamics, yet data from low-resource settings remain scarce. METHODS: We undertook a social contact survey in rural Uganda, whereby participants were asked to recall details about the frequency, type, and socio-demographic characteristics of any conversational encounter that lasted for ≥5 min (henceforth defined as 'contacts') during the previous day. An estimate of the number of 'casual contacts' (i.e. < 5 min) was also obtained. RESULTS: In total, 566 individuals were included in the study. On average participants reported having routine contact with 7.2 individuals (range 1-25). Children aged 5-14 years had the highest frequency of contacts and the elderly (≥65 years) the fewest (P < 0.001). A strong age-assortative pattern was seen, particularly outside the household and increasingly so for contacts occurring further away from home. Adults aged 25-64 years tended to travel more often and further than others, and males travelled more frequently than females. CONCLUSION: Our study provides detailed information on contact patterns and their spatial characteristics in an African setting. It therefore fills an important knowledge gap that will help more accurately predict transmission dynamics and the impact of control strategies in such areas