Models for malaria control optimization—a systematic review

Background: Despite advances made in curbing the global malaria burden since the 2000s, progress has stalled, in part due to a plateauing of the financing available to implement needed interventions. In 2020, approximately 3.3 billion USD was invested globally for malaria interventions, falling short of the targeted 6.8 billion USD set by the GTS, increasing the financial gap between desirable and actual investment. Models for malaria control optimization are used to disentangle the most efficient interventions or packages of interventions for inherently constrained budgets. This systematic review aimed to identify and characterise models for malaria control optimization for resource allocation in limited resource settings and assess their strengths and limitations. Methods: Following the Prospective Register of Systematic Reviews and Preferred reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive search across PubMed and Embase databases was performed of peer-reviewed literature published from inception until June 2024. The following keywords were used: optimization model; malaria; control interventions; elimination interventions. Editorials, commentaries, opinion papers, conference abstracts, media reports, letters, bulletins, pre-prints, grey literature, non-English language studies, systematic reviews and meta-analyses were excluded from the search. Results: The search yielded 2950 records, of which 15 met the inclusion criteria. The studies were carried out mainly in countries in Africa (53.3%), such as Ghana, Nigeria, Tanzania, Uganda, and countries in Asia (26.7%), such as Thailand and Myanmar. The most used interventions for analyses were insecticide-treated bed nets (93.3%), IRS (80.0%), Seasonal Malaria Chemoprevention (33.3%) and Case management (33.3%). The methods used for estimating health benefits were compartmental models (40.0%), individual-based models (40.0%), static models (13.0%) and linear regression model (7%). Data used in the analysis were validated country-specific data (60.0%) or non-country-specific data (40.0%) and were analysed at national only (40.0%), national and subnational levels (46.7%), or subnational only levels (13.3%). Conclusion: This review identified available optimization models for malaria resource allocation. The findings highlighted the need for country-specific analysis for malaria control optimization, the use of country-specific epidemiological and cost data in performing modelling analyses, performing cost sensitivity analyses and defining the perspective for the analysis, with an emphasis on subnational tailoring for data collection and analysis for more accurate and good quality results. It is critical that the future modelling efforts account for fairness and target at risk malaria populations that are hard-to-reach to maximize impact. Trial registration: PROSPERO Registration number: CRD4202343696

Estudio de la relación entre características antropométricas, atractivo facial y calidad seminal

RESUMEN La valoración del atractivo facial parece estar estrechamente relacionada con la selección de pareja. Si lo que se considera atractivo en una cara masculina es una señal fiable de calidad fenotípica, se podría plantear que la valoración del atractivo facial se correlaciona con la calidad reproductiva. Asimismo, se ha observado que ciertos parámetros de las caras masculinas resultan atractivos y se consideran como señales honestas de calidad fenotípica. Además, los aspectos relativos al atractivo se han relacionado con el nivel de simetría de diversos caracteres, tanto en el hombre como en diversas especies animales. El objetivo central de este estudio fue analizar si la valoración del atractivo facial, dado por grupos independientes de mujeres y hombres de distintas razas y procedencia geográfica, se correlacionaba con los parámetros seminales determinados en dos muestras de individuos seleccionados de la población estudiantil de la Universitat de València. Además, se analizó si determinados parámetros antropométricos faciales, absolutos y de simetría, estaban relacionados con la valoración del atractivo dada en los estudios anteriores. A los individuos seleccionados se les tomó dos fotografías de la cara, en posición frontal y del lateral derecho, y se les solicitó una muestra de semen. Una vez obtenidas las copias en papel de las fotografías se digitalizaron mediante un escáner. Para la medición de los parámetros faciales se utilizó el programa NIH Image. Se midieron 13 parámetros faciales y 11 parámetros bilaterales de simetría en las fotografías frontales. Para el análisis del semen se siguieron los criterios de la OMS (1999), e incluyó el análisis de la movilidad, la morfología y la concentración espermática. Además, se realizó un análisis de componentes principales para agrupar las tres variables seminales en una componente denominada índice espermático. Para la valoración del atractivo facial, las imágenes digitalizadas de la fotografía frontal y lateral derecho de cada individuo se transfirieron a un archivo PowerPoint y fueron mostradas, a los diferentes grupos de evaluadores, durante 20 segundos, a través de un monitor de televisión, seguido por un sonido neutro y la exposición de una imagen en negro durante 3 segundos. Las mujeres valoraron el atractivo facial masculino, medido por la puntuación que daban a cada individuo como pareja estable sobre una escala de 10 puntos. Los hombres también valoraron el atractivo facial según la misma escala, pero medido de acuerdo a la estimación que darían las mujeres a cada individuo como pareja estable. En cada uno de los grupos de evaluadores se obtuvieron las medianas de las valoraciones para cada individuo. Los resultados obtenidos indican que las mujeres de diferentes localidades geográficas, de la misma raza, o de razas y ambientes culturales distintos muestran un gran acuerdo en la valoración del atractivo facial y que esta valoración se correlaciona de forma significativa con tres de los cuatro parámetros seminales analizados: la movilidad, la morfología y el índice espermático. Asimismo, la correlación entre la valoración del atractivo facial dado por los hombres y la de las mujeres de la misma localización o ambiente cultural fue altamente significativa. En conclusión, se podría plantear que en el Homo sapiens persiste la capacidad de reconocimiento de aquellos individuos con buena capacidad reproductiva, a partir del uso de información facial, y que esta capacidad se muestra independiente de elementos raciales, culturales o de género, al menos en cuanto a las poblaciones estudiadas. Sin embargo, no se puede aseverar que los parámetros antropométricos faciales analizados puedan explicar el grado de atractivo, aunque, en general, se observó una tendencia a valorar como más atractivas las caras más estrechas, al igual que aquellas que muestran un predominio de los caracteres faciales del lado derecho. ____________________________________________________________________________________________________ SUMMARY Facial attractiveness appear to be reliably associated with mate choice. If what is deemed attractive about a males face is an honest signal of phenotypic quality, one might anticipate that facial attractiveness judgments would be correlated with reproductive quality. The main objective of this study was to analyse if the assessment of facial attractiveness, give by independent groups of women and men from different races and geographical location, was correlated with the seminal parameters performed in two samples of student selected from Universitat de València. Also, it has been analysed if certain anthropometric parameters, both facial parameters and asymmetry, were correlated with the evaluation of facial attractiveness. Each individual provides a semen sample, and frontal and lateral photographs were taken. In the frontal photographs were measured 13 facial parameters and 11 bilateral asymmetry parameters. Semen analysis was made according to standard WHO (1999) guidelines for morphology, motility, and concentration. Moreover, a Sperm Index (SI) was calculated as the principal component of these parameters. Women rated the attractiveness, as a possible permanent couple, of pictures. Men also rated the images for attractiveness measured as mens perception of what women would choose as sexual partners. The obtained results show than women of different geographical location, of the same race or from different race, and cultural background show a great agreement in the facial attractiveness assessment and this assessment is significantly correlated with the seminal parameters: motility, morphology and SI. In the same way, the correlation between the facial attractiveness given by men and by women of the same location or cultural background was highly significant. In conclusion, it could be said than in Homo sapiens still remains the capacity of identify the individuals with good reproductive capacity, based in facial information, independently of raters race, cultural background or gender, al least in the analysed populations. However, it can not be said than the facial anthropometric parameters analysed could explain the attractiveness, even though, usually, it was observed a tendency to judge as more attractive masculine faces that are narrower, as well as those showing a predominance of right side facial characters

Smoked cocaine in socially-depressed areas

Background: The main objectives of this study are to describe the smoked cocaine user's profile in socially-depressed areas and their needs from a harm-reduction perspective, to investigate their use of smoking crack and compare the acute effects between injecting and smoking consumption. Methods: The study took place in SAPS, Barcelona, Spain. Two focus group sessions were undertaken with a total of 8 drug users. Secondly, the 8 participants answered a structured questionnaire and in the course of the sessions, as a snowball activity, were trained to survey 6 other crack smokers. Results: We obtained 56 questionnaires. The majority of participants were from non-European Community countries (62.69%), 70.2% of participants referred to sharing the smoking equipment. The most frequent symptoms reported during smoked cocaine were mydriasis (83.33%)), perspiration (72.92%) and compulsive object search (70.83%) During the group sessions, participants said that smoked cocaine is much more addictive than injected cocaine and causes more anxiety. Participants also reported the difficulty of changing from injected use to smoked use, due to the larger amount of cocaine needed to reach the same effects as when having injected. Conclusions We can conclude that the research, focused on achieving greater knowledge of the smoked cocaine user's profile, their usage of smoking crack, consumption patterns and acute effects, should be incorporated into substance misuse interventions

Biologia celular, saúde humana e sua relação com o aquecimento global e as mudanças climáticas. Um cenário para desenvolver habilidades de pensamento crítico em alunos iniciantes do curso de Medicina

Abstract The classroom innovation takes place in the Cell Biology course and aims to sensibilize medical students to climate change, environmental pollution, and its impact on human health.  It is based on situated cognition as a meaningful learning strategy. It addresses contents associated with cell communication, viruses, biomolecules, endocrine system, metabolism, and cell cycle.  The students implement strategies in their homes to address activities related to the following topics: vector-borne diseases (VTE), health risks associated with microplastics, effects of environmental pollutants such as endocrine disruptors and/or carcinogens, and solid waste management.  From this perspective, the recommended actions are aligned with the Sustainable Development Goals (SDGs).  At the same time, the development of critical thinking skills (CTS) in the face of these global challenges is enhanced.  HPCs are evaluated through a rubric and the effects on student learning through a pre-and post-test.  The results show that the students build learning communities that involve their families, peers, and teachers who are the guides of this experience. Likewise, progress was observed in the HPC, especially in the sub-skills of describing results, which increased by 97%, in categorization to 97%, conjecturing alternatives by 93%, and examining ideas by 85%.  Likewise, the pre-post comparison shows progress in the concepts related to the Cell Biology course.ommunities that link their families, peers, and teachers who are guides of this experience.La innovación de aula se desarrolla en la asignatura de Biología celular y busca sensibilizar a estudiantes de medicina frente al cambio climático, la contaminación ambiental y su impacto en la salud humana.  Se fundamente en la cognición situada como estrategia de aprendizaje significativo. Se abordan contenidos asociados a comunicación celular, virus, biomoléculas, sistema endocrino, metabolismo y ciclo celular.  A través del desarrollo de estrategias implementadas en los hogares de los estudiantes, se abordan actividades asociadas a los temas: enfermedades transmitidas por vectores (ETV), riesgos para la salud asociados a los microplásticos, efectos de contaminantes ambientales como disruptores endocrinos y/o carcinógenos, gestión de residuos sólidos.  Desde esta perspectiva, las acciones propuestas están alineadas con los Objetivos de desarrollo sostenible (ODS).  Paralelamente se potencia el desarrollo de habilidades de pensamiento crítico (HPC) frente a estos retos del planeta.  Las HPC son evaluadas a través de una rúbrica y los efectos en el aprendizaje de los estudiantes mediante un pre y post-test.  Los resultados muestran que el estudiantado construye comunidades de aprendizaje que vinculan a sus familiares, sus pares y profesores guías de esta experiencia. Así mismo se observó avance en la HPC, especialmente en las sub-habilidades describir resultados con un 97%, en categorización con 97%, en conjeturar alternativas 93% y en examinar ideas 85%.  Así mismo la comparación pre-post muestra avances en los conceptos asociados al curso de Biología celular.A inovação em sala de aula acontece no curso de Biologia Celular e visa sensibilizar os estudantes de medicina para as mudanças climáticas, a poluição ambiental e seu impacto na saúde humana.  Ele se baseia na cognição situada como uma estratégia de aprendizagem significativa. Ele aborda conteúdos associados à comunicação celular, vírus, biomoléculas, sistema endócrino, metabolismo e ciclo celular.  Os estudantes implementam estratégias em suas casas para abordar atividades relacionadas aos seguintes tópicos: doenças transmitidas por vetores (VTE), riscos à saúde associados a microplásticos, efeitos de poluentes ambientais, tais como disruptores endócrinos e/ou carcinogênicos, e gerenciamento de resíduos sólidos.  A partir desta perspectiva, as ações recomendadas estão alinhadas com os Objetivos de Desenvolvimento Sustentável (ODS).  Ao mesmo tempo, o desenvolvimento de habilidades de pensamento crítico (CTS) frente a estes desafios globais é aprimorado.  Os HPCs são avaliados através de uma rubrica e os efeitos no aprendizado dos estudantes através de um pré e pós-teste.  Os resultados mostram que os estudantes constroem comunidades de aprendizagem que envolvem suas famílias, colegas e professores que são os guias desta experiência. Da mesma forma, foram observados progressos no HPC, especialmente nas subqualificações de descrever resultados, que aumentaram em 97%, em categorização para 97%, conjecturando alternativas em 93%, e examinando idéias em 85%.  Da mesma forma, a comparação pré-post mostra progresso nos conceitos relacionados com o curso de Biologia Celular

Population and transmission dynamics model to determine WHO targets for eliminating Hepatitis C virus in Thailand

Background: Hepatitis C Virus is endemic to many areas of Thailand, whose population structure is tending towards older age groups as birth rate and mortality decrease. With around 790,000 cases in 2019, prevalence is still relatively high, but the World Health Organisation has called for elimination of HCV by 2030. Methods: An age structured compartmental transmission model was used to explore the effectiveness of screening strategies with respect to WHO elimination goals, as well as the effect of changing population structure on the success or failure of such strategies. Results: Population structure did not appear to affect the timeline of elimination targets and screening individuals over the age of 30 at a high (50% per year) coverage could bring forward achievement of the incidence elimination target by four years compared to baseline (approximately 6% per year). Achievement of mortality elimination targets was not reached until after the end of the simulation (2040), and intensive screening strategies did not appear to lead to incidence elimination by 2030. Conclusion: The model suggested that with age-targeted screening programmes incidence elimination could be brought forward by several years. However, WHO elimination goals may not be met by 2030

Infectivity of Chronic Malaria Infections and Its Consequences for Control and Elimination

Assessing the importance of targeting the chronic Plasmodium falciparum malaria reservoir is pivotal as the world moves toward malaria eradication. Through the lens of a mathematical model, we show how, for a given malaria prevalence, the relative infectivity of chronic individuals determines what intervention tools are predicted be the most effective. Crucially, in a large part of the parameter space where elimination is theoretically possible, it can be achieved solely through improved case management. However, there are a significant number of settings where malaria elimination requires not only good vector control but also a mass drug administration campaign. Quantifying the relative infectiousness of chronic malaria across a range of epidemiological settings would provide essential information for the design of effective malaria elimination strategies. Given the difficulties obtaining this information, we also provide a set of epidemiological metrics that can be used to guide policy in the absence of such data

High turnover drives prolonged persistence of influenza in managed pig herds.

Pigs have long been hypothesized to play a central role in the emergence of novel human influenza A virus (IAV) strains, by serving as mixing vessels for mammalian and avian variants. However, the key issue of viral persistence in swine populations at different scales is ill understood. We address this gap using epidemiological models calibrated against seroprevalence data from Dutch finishing pigs to estimate the 'critical herd size' (CHS) for IAV persistence. We then examine the viral phylogenetic evidence for persistence by comparing human and swine IAV. Models suggest a CHS of approximately 3000 pigs above which influenza was likely to persist, i.e. orders of magnitude lower than persistence thresholds for IAV and other acute viruses in humans. At national and regional scales, we found much stronger empirical signatures of prolonged persistence of IAV in swine compared with human populations. These striking levels of persistence in small populations are driven by the high recruitment rate of susceptible piglets, and have significant implications for management of swine and for overall patterns of genetic diversity of IAV.This work was supported by the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health (V.E.P., S.R., J.L.N.W. and B.T.G.) and the Bill & Melinda Gates Foundation (V.E.P. and B.T.G.). J.L.N.W. is also supported by the Alborada Trust, the European Union FP7 project ANTIGONE (contract no. 278976) and by Biotechnology and Biological Sciences Research Council sLOLA BB/L001330/1.This is the final version of the article. It first appeared from Royal Society Publishing via http://dx.doi.org/10.1098/rsif.2016.013

Costing malaria interventions from pilots to elimination programmes

Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of their epidemiological impacts and costs. There is a need to generalize these findings to different epidemiological and health systems contexts.; Drawing on experience of implementing partners, operational documents and costing studies from these pilots, reference scenarios were defined for rapid reporting (RR), reactive case detection (RACD), mass drug administration (MDA), and in-door residual spraying (IRS). These generalized interventions from their trial implementation to one typical of programmatic delivery. In doing so, resource use due to interventions was isolated from research activities and was related to the pilot setting. Costing models developed around this reference implementation, standardized the scope of resources costed, the valuation of resource use, and the setting in which interventions were evaluated. Sensitivity analyses were used to inform generalizability of the estimates and model assumptions.; Populated with local prices and resource use from the pilots, the models yielded an average annual economic cost per capita of $0.18 for RR,$0.75 for RACD, $4.28 for MDA (two rounds), and$1.79 for IRS (one round, 50% households). Intervention design and resource use at service delivery were key drivers of variation in costs of RR, MDA, and RACD. Scale was the most important parameter for IRS. Overall price level was a minor contributor, except for MDA where drugs accounted for 70% of the cost. The analyses showed that at implementation scales comparable to health facility catchment area, systematic correlations between model inputs characterizing implementation and setting produce large gradients in costs.; Prospective costing models are powerful tools to explore resource and cost implications of policy alternatives. By formalizing translation of operational data into an estimate of intervention cost, these models provide the methodological infrastructure to strengthen capacity gap for economic evaluation in endemic countries. The value of this approach for decision-making is enhanced when primary cost data collection is designed to enable analysis of the efficiency of operational inputs in relation to features of the trial or the setting, thus facilitating transferability

The last man standing is the most resistant: eliminating artemisinin-resistant malaria in Cambodia.

BACKGROUND: Artemisinin combination therapy (ACT) is now the recommended first-line treatment for falciparum malaria throughout the world. Initiatives to eliminate malaria are critically dependent on its efficacy. There is recent worrying evidence that artemisinin resistance has arisen on the Thai-Cambodian border. Urgent containment interventions are planned and about to be executed. Mathematical modeling approaches to intervention design are now integrated into the field of malaria epidemiology and control. The use of such an approach to investigate the likely effectiveness of different containment measures with the ultimate aim of eliminating artemisinin-resistant malaria is described. METHODS: A population dynamic mathematical modeling framework was developed to explore the relative effectiveness of a variety of containment interventions in eliminating artemisinin-resistant malaria in western Cambodia. RESULTS: The most effective intervention to eliminate artemisinin-resistant malaria was a switch of treatment from artemisinin monotherapy to ACT (mean time to elimination 3.42 years (95% CI 3.32-3.60 years). However, with this approach it is predicted that elimination of artemisinin-resistant malaria using ACT can be achieved only by elimination of all malaria. This is because the various forms of ACT are more effective against infections with artemisinin-sensitive parasites, leaving the more resistant infections as an increasing proportion of the dwindling parasite population. CONCLUSION: Containment of artemisinin-resistant malaria can be achieved by elimination of malaria from western Cambodia using ACT. The "last man standing" is the most resistant and thus this strategy must be sustained until elimination is truly achieved

Diseño de un producto lacteo tipo yogurt saborizado con berenjena (solanum melongena l.)

La berenjena (Solanum melongena L.) es una de las especies vegetales más importantes de la familia de las Solanáceas en el país específicamente en la región Caribe donde se encuentran agricultores dedicados al cultivo de la berenjena donde emplean pequeñas áreas y patios para el establecimiento de sus cultivos, situación por la cual la berenjena es considerada una hortaliza de patio y de economía campesina. En este territorio el sistema de producción utilizado es el cultivo a libre exposición, ya que se cuenta con una oferta ambiental favorable y una posición geográfica competitiva. (Coronado et al, 2015). El yogur es producto obtenido a partir de la leche higienizada o de una mezcla higienizada de ésta con derivados lácteos, fermentado por la acciónde Lactobacillus delbrueckii subsp. bulgaricus y Streptococcus salivarius subsp. Thermophilus. (INCONTEC, 2005). La berenjena es un producto hortofrutícola con amplia concentración sobre todo el caribe colombiano, por lo que puede estar al alcance de cualquier persona para su consumo; así mismo aprovechar el beneficio de muchas de sus propiedades para nuestra salud; dentro de estas propiedades de la berenjena son muy variadas, entre ellas podemos denotar: alto contenido en agua, alto contenido en hidratos de carbono, aporta mucha fibra y su baja cantidad de grasa y proteínas la hacen un alimento muy liviano, aportando beneficios al sistema nervioso, buena en la ayuda con el colesterol, cuida el hígado, Controla el azúcar en el cuerpo, etc. En los beneficios del yogur se destaca que es una de las mejores fuentes de calcio, un nutriente clave para mantener una buena salud en los huesos y los dientes, su gran contenido en proteínas, fortalece el sistema inmunológico, etc