Reviewing the literature on access to prompt and effective malaria treatment in Kenya: implications for meeting the Abuja targets

<p>Abstract</p> <p>Background</p> <p>Effective case management is central to reducing malaria mortality and morbidity worldwide, but only a minority of those affected by malaria, have access to prompt effective treatment.</p> <p>In Kenya, the Division of Malaria Control is committed to ensuring that 80 percent of childhood fevers are treated with effective anti-malarial medicines within 24 hours of fever onset, but this target is largely unmet. This review aimed to document evidence on access to effective malaria treatment in Kenya, identify factors that influence access, and make recommendations on how to improve prompt access to effective malaria treatment. Since treatment-seeking patterns for malaria are similar in many settings in sub-Saharan Africa, the findings presented in this review have important lessons for other malaria endemic countries.</p> <p>Methods</p> <p>Internet searches were conducted in PUBMED (MEDLINE) and HINARI databases using specific search terms and strategies. Grey literature was obtained by soliciting reports from individual researchers working in the treatment-seeking field, from websites of major organizations involved in malaria control and from international reports.</p> <p>Results</p> <p>The review indicated that malaria treatment-seeking occurs mostly in the informal sector; that most fevers are treated, but treatment is often ineffective. Irrational drug use was identified as a problem in most studies, but determinants of this behaviour were not documented. Availability of non-recommended medicines over-the-counter and the presence of substandard anti-malarials in the market are well documented. Demand side determinants of access include perception of illness causes, severity and timing of treatment, perceptions of treatment efficacy, simplicity of regimens and ability to pay. Supply side determinants include distance to health facilities, availability of medicines, prescribing and dispensing practices and quality of medicines. Policy level factors are around the complexity and unclear messages regarding drug policy changes.</p> <p>Conclusion</p> <p>Kenya, like many other African countries, is still far from achieving the Abuja targets. The government, with support from donors, should invest adequately in mechanisms that promote access to effective treatment. Such approaches should focus on factors influencing multiple dimensions of access and will require the cooperation of all stakeholders working in malaria control.</p

Exoplanet status report: Observation, characterization and evolution of exoplanets and their host stars

After the discovery of more than 400 planets beyond our Solar System, the characterization of exoplanets as well as their host stars can be considered as one of the fastest growing fields in space science during the past decade. The characterization of exoplanets can only be carried out in a well coordinated interdisciplinary way which connects planetary science, solar/stellar physics and astrophysics. We present a status report on the characterization of exoplanets and their host stars by reviewing the relevant space- and ground-based projects. One finds that the previous strategy changed from space mission concepts which were designed to search, find and characterize Earth-like rocky exoplanets to: A statistical study of planetary objects in order to get information about their abundance, an identification of potential target and finally its analysis. Spectral analysis of exoplanets is mandatory, particularly to identify bio-signatures on Earth-like planets. Direct characterization of exoplanets should be done by spectroscopy, both in the visible and in the infrared spectral range. The way leading to the direct detection and characterization of exoplanets is then paved by several questions, either concerning the pre-required science or the associated observational strategy