Estimating the malaria risk of African mosquito movement by air travel

BACKGROUND: The expansion of global travel has resulted in the importation of African Anopheles mosquitoes, giving rise to cases of local malaria transmission. Here, cases of 'airport malaria' are used to quantify, using a combination of global climate and air traffic volume, where and when are the greatest risks of a Plasmodium falciparum-carrying mosquito being importated by air. This prioritises areas at risk of further airport malaria and possible importation or reemergence of the disease. METHODS: Monthly data on climate at the World's major airports were combined with air traffic information and African malaria seasonality maps to identify, month-by-month, those existing and future air routes at greatest risk of African malaria-carrying mosquito importation and temporary establishment. RESULTS: The location and timing of recorded airport malaria cases proved predictable using a combination of climate and air traffic data. Extending the analysis beyond the current air network architecture enabled identification of the airports and months with greatest climatic similarity to P. falciparum endemic regions of Africa within their principal transmission seasons, and therefore at risk should new aviation routes become operational. CONCLUSION: With the growth of long haul air travel from Africa, the identification of the seasonality and routes of mosquito importation is important in guiding effective aircraft disinsection and vector control. The recent and continued addition of air routes from Africa to more climatically similar regions than Europe will increase movement risks. The approach outlined here is capable of identifying when and where these risks are greatest

An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol

BACKGROUND: The global rise of Type 2 diabetes and its complications has drawn attention to the burden of non-communicable diseases on populations undergoing epidemiological transition. The life course approach of a birth cohort has the potential to increase our understanding of the development of these chronic diseases. In 1987 we sought to establish an Australian Indigenous birth cohort to be used as a resource for descriptive and analytical studies with particular attention on non-communicable diseases. The focus of this report is the methodology of recruiting and following-up an Aboriginal birth cohort of mobile subjects belonging to diverse cultural and language groups living in a large sparsely populated area in the Top End of the Northern Territory of Australia. METHODS: A prospective longitudinal study of Aboriginal singletons born at the Royal Darwin Hospital 1987–1990, with second wave cross-sectional follow-up examination of subjects 1998–2001 in over 70 different locations. A multiphase protocol was used to locate and collect data on 686 subjects with different approaches for urban and rural children. Manual chart audits, faxes to remote communities, death registries and a full time subject locator with past experience of Aboriginal communities were all used. DISCUSSION: The successful recruitment of 686 Indigenous subjects followed up 14 years later with vital status determined for 95% of subjects and examination of 86% shows an Indigenous birth cohort can be established in an environment with geographic, cultural and climatic challenges. The high rates of recruitment and follow up indicate there were effective strategies of follow-up in a supportive population

Proof of impact and pipeline planning: directions and challenges for social audit in the health sector

Social audits are typically observational studies, combining qualitative and quantitative uptake of evidence with consultative interpretation of results. This often falters on issues of causality because their cross-sectional design limits interpretation of time relations and separation out of other indirect associations

Three Book Reviews

This issue of the Archives contains reviews of three books: Robert Leestma and Herbert J. Walberg (Eds.), Japanese Educational Productivity, reviewed by Steven J. Fountaine, Thomas Sowell, Inside American Education: The Decline, the Deception, the Dogmas, reviewed by Susan Haag, Chester E. Finn Jr. and Theodor Rebarbar (Eds.), Education Reform in the '90s, reviewed by Kent Parades Scribne

Holographic Flavored Quark-Gluon Plasmas

Holography provides a novel method to study the physics of Quark Gluon Plasmas, complementary to the ordinary field theory and lattice approaches. In this context, we analyze the informations that can be obtained for strongly coupled Plasmas containing dynamical flavors, also in the presence of a finite baryon chemical potential. In particular, we discuss the jet quenching and the hydrodynamic transport coefficient

Adenocarcinoma of the jejunum : diagnostic value of push-type enteroscopy. A case report

Les adénocarcinomes de l'intestin grêle sont des tumeurs rares qui surviennent le plus souvent sur un terrain favorisant tel que la polypose de Peutz-Jeghers, la maladie coeliaque ou la maladie de Crohn. Les signes fonctionnels d'appel sont aspécifiques à type de douleurs, altération de l'état général, syndrome occlusif ou hémorragie digestive. Le transit baryté de l'intestin grêle est le plus souvent pathologique. L'entéroscopie constitue une avancée sur le plan diagnostique puisqu'elle permet le diagnostic histologique comme en témoigne l'observation rapportée. Le traitement curatif est chirurgical. La chimiothérapie ou la radiothérapie n'ont pas fait la preuve de leur intérêt. Le pronostic est médiocre en raison du fréquent retard diagnostique et de l'extension tumorale rapide