Continued Decline of Malaria in The Gambia with Implications for Elimination

BACKGROUND: A substantial decline in malaria was reported to have occurred over several years until 2007 in the western part of The Gambia, encouraging consideration of future elimination in this previously highly endemic region. Scale up of interventions has since increased with support from the Global Fund and other donors. METHODOLOGY/PRINCIPAL FINDINGS: We continued to examine laboratory records at four health facilities previously studied and investigated six additional facilities for a 7 year period, adding data from 243,707 slide examinations, to determine trends throughout the country until the end of 2009. We actively detected infections in a community cohort of 800 children living in rural villages throughout the 2008 malaria season, and assayed serological changes in another rural population between 2006 and 2009. Proportions of malaria positive slides declined significantly at all of the 10 health facilities between 2003 (annual mean across all sites, 38.7%) and 2009 (annual mean, 7.9%). Statistical modelling of trends confirmed significant seasonality and decline over time at each facility. Slide positivity was lowest in 2009 at all sites, except two where lowest levels were observed in 2006. Mapping households of cases presenting at the latter sites in 2007-2009 indicated that these were not restricted to a few residual foci. Only 2.8% (22/800) of a rural cohort of children had a malaria episode in the 2008 season, and there was substantial serological decline between 2006 and 2009 in a separate rural area. CONCLUSIONS: Malaria has continued to decline in The Gambia, as indicated by a downward trend in slide positivity at health facilities, and unprecedented low incidence and seroprevalence in community surveys. We recommend intensification of control interventions for several years to further reduce incidence, prior to considering an elimination programme

Perinatal asphyxia: current status and approaches towards neuroprotective strategies, with focus on sentinel proteins

Delivery is a stressful and risky event menacing the newborn. The mother-dependent respiration has to be replaced by autonomous pulmonary breathing immediately after delivery. If delayed, it may lead to deficient oxygen supply compromising survival and development of the central nervous system. Lack of oxygen availability gives rise to depletion of NAD+ tissue stores, decrease of ATP formation, weakening of the electron transport pump and anaerobic metabolism and acidosis, leading necessarily to death if oxygenation is not promptly re-established. Re-oxygenation triggers a cascade of compensatory biochemical events to restore function, which may be accompanied by improper homeostasis and oxidative stress. Consequences may be incomplete recovery, or excess reactions that worsen the biological outcome by disturbed metabolism and/or imbalance produced by over-expression of alternative metabolic pathways. Perinatal asphyxia has been associated with severe neurological and psychiatric sequelae with delayed clinical onset. No specific treatments have yet been established. In the clinical setting, after resuscitation of an infant with birth asphyxia, the emphasis is on supportive therapy. Several interventions have been proposed to attenuate secondary neuronal injuries elicited by asphyxia, including hypothermia. Although promising, the clinical efficacy of hypothermia has not been fully demonstrated. It is evident that new approaches are warranted. The purpose of this review is to discuss the concept of sentinel proteins as targets for neuroprotection. Several sentinel proteins have been described to protect the integrity of the genome (e.g. PARP-1; XRCC1; DNA ligase IIIα; DNA polymerase β, ERCC2, DNA-dependent protein kinases). They act by eliciting metabolic cascades leading to (i) activation of cell survival and neurotrophic pathways; (ii) early and delayed programmed cell death, and (iii) promotion of cell proliferation, differentiation, neuritogenesis and synaptogenesis. It is proposed that sentinel proteins can be used as markers for characterising long-term effects of perinatal asphyxia, and as targets for novel therapeutic development and innovative strategies for neonatal care

Review of municipal solid waste management options in Malaysia, with an emphasis on sustainable waste-to-energy options

A beautiful and clean environment is the desire of every society. Malaysia is facing an uncontrolled increase in municipal solid waste (MSW) generation due to population growth, economic advancement, and industrialization, but the current, most common waste disposal practice of landfilling is not sustainable. The increasing standard of living also saps more energy from the power generation systems in which fossil fuels are the major source of fuel for the plants. Malaysia generates about 0.5–1.9 kg/capita/day of MSW; a total of about 25,000 tonnes/day of MSW is currently generated and is estimated to exceed 30,000 tonnes/day by 2020. Malaysian MSW is mainly composed of 45 % food waste, 24 % plastic, 7 % paper materials, 6 % metal, 4 % wood and 3 % glass, which are commingled, and is thus characterised by 52–66 % moisture content. Currently, 80–95 % of collected MSW is landfilled and 5 % is recycled, while composting and energy recovery are rarely practiced. This paper reviews the solid waste practice in Malaysia and looks into alternative management options for sustainability. Malaysia MSW represents recyclable power and energy potential if properly sorted. This study considered the practice of sorting at the source and the use of combustible MSW components as fuel to generate heat for a hybrid solar, flue gas, chimney power plant

A review on adoption of novel techniques in construction waste management and policy

The purpose of this study is to review extensively the literature associated with the adoption of different novel techniques in Construction Waste Management and Policy (CWMP) to find out the state and development of the construction waste stream and to reveal gaps for further investigations through the exploration of several publications which have emphasis on construction waste management. A cross-referencing examination was performed to ensure the comprehensiveness of the study. All references cited by the selected papers were searched manually, and then the titles of potentially related articles were aggregated into an Excel table to avoid replication. Following a systematic evaluation of the retrieved papers, two characteristic classification criteria of the current literature were revealed as waste management and waste regulatory or policy. The findings show that there is a substantial growth in the number of studies associated with construction waste which attempts to reveal comprehensive results in the adoption of numerous methods from various perspectives. Nevertheless, there are several areas which need further research in both theoretical and intensive approaches in the empirical aspect to experiment the real application of the proposed methods. This study shows that reuse and recycle rates of construction waste is still minimal which continue to impact the environmental well-being. This review presents future direction and research gaps as well as recommendations on CWMP adoption which will be helpful to academics and professionals that are working or intend to operate in the related area