Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions

<p>Abstract</p> <p>Background</p> <p>In 2005, a nationwide survey estimated that 6.5% of households in Ethiopia owned an insecticide-treated net (ITN), 17% of households had been sprayed with insecticide, and 4% of children under five years of age with a fever were taking an anti-malarial drug. Similar to other sub-Saharan African countries scaling-up malaria interventions, the Government of Ethiopia set an ambitious national goal in 2005 to (i) provide 100% ITN coverage in malarious areas, with a mean of two ITNs per household; (ii) to scale-up indoor residual spraying of households with insecticide (IRS) to cover 30% of households targeted for IRS; and (iii) scale-up the provision of case management with rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT), particularly at the peripheral level.</p> <p>Methods</p> <p>A nationally representative malaria indicator survey (MIS) was conducted in Ethiopia between September and December 2007 to determine parasite and anaemia prevalence in the population at risk and to assess coverage, use and access to scaled-up malaria prevention and control interventions. The survey used a two-stage random cluster sample of 7,621 households in 319 census enumeration areas. A total of 32,380 people participated in the survey. Data was collected using standardized Roll Back Malaria Monitoring and Evaluation Reference Group MIS household and women's questionnaires, which were adapted to the local context.</p> <p>Results</p> <p>Data presented is for households in malarious areas, which according to the Ethiopian Federal Ministry of Health are defined as being located <2,000 m altitude. Of 5,083 surveyed households, 3,282 (65.6%) owned at least one ITN. In ITN-owning households, 53.2% of all persons had slept under an ITN the prior night, including 1,564/2,496 (60.1%) children <5 years of age, 1,891/3,009 (60.9%) of women 15 - 49 years of age, and 166/266 (65.7%) of pregnant women. Overall, 906 (20.0%) households reported to have had IRS in the past 12 months. Of 747 children with reported fever in the two weeks preceding the survey, 131 (16.3%) sought medical attention within 24 hours. Of those with fever, 86 (11.9%) took an anti-malarial drug and 41 (4.7%) took it within 24 hours of fever onset. Among 7,167 surveyed individuals of all ages, parasitaemia as estimated by microscopy was 1.0% (95% CI 0.5 - 1.5), with 0.7% and 0.3% due to <it>Plasmodium falciparum </it>and <it>Plasmodium vivax</it>, respectively. Moderate-severe anaemia (haemoglobin <8 g/dl) was observed in 239/3,366 (6.6%, 95% CI 4.9-8.3) children <5 years of age.</p> <p>Conclusions</p> <p>Since mid-2005, the Ethiopian National Malaria Control Programme has considerably scaled-up its malaria prevention and control interventions, demonstrating the impact of strong political will and a committed partnership. The MIS showed, however, that besides sustaining and expanding malaria intervention coverage, efforts will have to be made to increase intervention access and use. With ongoing efforts to sustain and expand malaria intervention coverage, to increase intervention access and use, and with strong involvement of the community, Ethiopia expects to achieve its targets in terms of coverage and uptake of interventions in the coming years and move towards eliminating malaria.</p

To Act and Learn: A Bakhtinian Exploration of Action Learning

This paper considers the work of the Russian social philosopher and cultural theorist, Mikhail Mikhailovich Bakhtin as a source of understanding for those involved in action learning. Drawing upon data gathered over two years during the evaluation of 20 action learning sets in the north of England, we will seek to work with the ideas of Bakhtin to consider their value for those involved in action learning. We consider key Bakhtin features such as Making Meaning, Participative Thinking, Theoreticism and Presence, Others and Outsideness, Voices and Carnival to highlight how Bakhtin's can enhance our understanding of the nature of action and learning

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Ownership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use. Methods Generalized linear latent and mixed models (GLLAMM) were used to investigate net use using individual level data from people living in net-owning households from two surveys in Ethiopia: baseline 2006 included 12,678 individuals from 2,468 households and a sub-sample of the Malaria Indicator Survey (MIS) in 2007 included 14,663 individuals from 3,353 households. Individual factors (age, sex, pregnancy); net factors (condition, age, net density); household factors (number of rooms [2006] or sleeping spaces [2007], IRS, women's knowledge and school attendance [2007 only], wealth, altitude); and cluster level factors (rural or urban) were investigated in univariate and multi-variable models for each survey. Results In 2006, increased net use was associated with: age 25-49 years (adjusted (a) OR = 1.4, 95% confidence interval (CI) 1.2-1.7) compared to children U5; female gender (aOR = 1.4; 95% CI 1.2-1.5); fewer nets with holes (Ptrend = 0.002); and increasing net density (Ptrend < 0.001). Reduced net use was associated with: age 5-24 years (aOR = 0.2; 95% CI 0.2-0.3). In 2007, increased net use was associated with: female gender (aOR = 1.3; 95% CI 1.1-1.6); fewer nets with holes (aOR [all nets in HH good] = 1.6; 95% CI 1.2-2.1); increasing net density (Ptrend < 0.001); increased women's malaria knowledge (Ptrend < 0.001); and urban clusters (aOR = 2.5; 95% CI 1.5-4.1). Reduced net use was associated with: age 5-24 years (aOR = 0.3; 95% CI 0.2-0.4); number of sleeping spaces (aOR [per additional space] = 0.6, 95% CI 0.5-0.7); more old nets (aOR [all nets in HH older than 12 months] = 0.5; 95% CI 0.3-0.7); and increasing household altitude (Ptrend < 0.001). Conclusion In both surveys, net use was more likely by women, if nets had fewer holes and were at higher net per person density within households. School-age children and young adults were much less likely to use a net. Increasing availability of nets within households (i.e. increasing net density), and improving net condition while focusing on education and promotion of net use, especially in school-age children and young adults in rural areas, are crucial areas for intervention to ensure maximum net use and consequent reduction of malaria transmission.Peer Reviewe

Survivin (BIRC5) Peptide Vaccine in the 4T1 Murine Mammary Tumor Model: A Potential Neoadjuvant T Cell Immunotherapy for Triple Negative Breast Cancer: A Preliminary Study

A triple negative breast cancer model using the murine 4T1 tumor cell line was used to explore the efficacy of an adjuvanted survivin peptide microparticle vaccine using tumor growth as the outcome metric. We first performed tumor cell dose titration studies to determine a tumor cell dose that resulted in sufficient tumor takes but allowed multiple serial measurements of tumor volumes, yet with minimal morbidity/mortality within the study period. Later, in a second co-hort of mice, the survivin peptide microparticle vaccine was administered via intraperitoneal injection at the study start with a second dose given 14 days later. An orthotopic injection of 4T1 cells into the mammary tissue was performed on the same day as the administration of the sec-ond vaccine dose. The mice were followed for up to 41 days with subcutaneous measurements of tumor volume made every 3–4 days. Vaccination with survivin peptides was associated with a peptide antigen-specific gamma interferon enzyme-linked immunosorbent spot response in the murine splenocyte population but was absent from the control microparticle group. At the end of the study, we found that vaccination with adjuvanted survivin peptide microparticles resulted in statistically significant slower primary tumor growth rates in BALB/c mice challenged with 4T1 cells relative to the control peptideless vaccination group. These studies suggest that T cell immunotherapy specifically targeting survivin might be an applicable neoadjuvant immuno-therapy therapy for triple negative breast cancer. More preclinical studies and clinical trials are needed to explore this concept further

Rapid Increase in Ownership and Use of Long-Lasting Insecticidal Nets and Decrease in Prevalence of Malaria in Three Regional States of Ethiopia (2006-2007)

Following recent large scale-up of malaria control interventions in Ethiopia, this study aimed to compare ownership and use of long-lasting insecticidal nets (LLIN), and the change in malaria prevalence using two population-based household surveys in three regions of the country. Each survey used multistage cluster random sampling with 25 households per cluster. Household net ownership tripled from 19.6% in 2006 to 68.4% in 2007, with mean LLIN per household increasing from 0.3 to 1.2. Net use overall more than doubled from 15.3% to 34.5%, but in households owning LLIN, use declined from 71.7% to 48.3%. Parasitemia declined from 4.1% to 0.4%. Large scale-up of net ownership over a short period of time was possible. However, a large increase in net ownership was not necessarily mirrored directly by increased net use. Better targeting of nets to malaria-risk areas and sustained behavioural change communication are needed to increase and maintain net use

The VMC survey - XVII : The proper motions of the Small Magellanic Cloud and the Milky Way globular cluster 47 Tucanae

In this study we use multi-epoch near-infrared observations from the VISTA survey of the Magellanic Cloud system (VMC) to measure the proper motion of different stellar populations in a tile of 1.5 deg sq. in size in the direction of the Galactic globular cluster 47 Tuc. We obtain the proper motion of the cluster itself, of the Small Magellanic Cloud (SMC), and of the field Milky Way stars. Stars of the three main stellar components are selected from their spatial distribution and their distribution in colour-magnitude diagrams. Their average coordinate displacement is computed from the difference between multiple Ks-band observations for stars as faint as Ks=19 mag. Proper motions are derived from the slope of the best-fitting line among 10 VMC epochs over a time baseline of ~1 yr. Background galaxies are used to calibrate the absolute astrometric reference frame. The resulting absolute proper motion of 47 Tuc is (mu_alpha cos(delta), mu_delta)=(+7.26+/-0.03, -1.25+/-0.03) mas/yr. This measurement refers to about 35000 sources distributed between 10 and 60 arcmin from the cluster centre. For the SMC we obtain (mu_alpha cos(delta), mu_delta)=(+1.16+/-0.07, -0.81+/-0.07) mas/yr from about 5250 red clump and red giant branch stars. The absolute proper motion of the Milky Way population in the line-of-sight (l =305.9, b =-44.9) of this VISTA tile is (mu_alpha cos(delta), mu_delta)=(+10.22+/-0.14, -1.27+/-0.12) mas/yr and results from about 4000 sources. Systematic uncertainties associated to the astrometric reference system are 0.18 mas/yr. Thanks to the proper motion we detect 47 Tuc stars beyond its tidal radius.Peer reviewe

AMI-LA radio continuum observations of Spitzer c2d small clouds and cores: Perseus region

We present deep radio continuum observations of the cores identified as deeply embedded young stellar objects in the Perseus molecular cloud by the Spitzer c2d programme at a wavelength of 1.8 cm with the Arcminute Microkelvin Imager Large Array (AMI-LA). We detect 72% of Class 0 objects from this sample and 31% of Class I objects. No starless cores are detected. We use the flux densities measured from these data to improve constraints on the correlations between radio luminosity and bolometric luminosity, infrared luminosity and, where measured, outflow force. We discuss the differing behaviour of these objects as a function of protostellar class and investigate the differences in radio emission as a function of core mass. Two of four possible very low luminosity objects (VeLLOs) are detected at 1.8 cm.Comment: 18 pages, 9 figures, accepted MNRA

Statistical and machine learning methods evaluated for incorporating soil and weather into corn nitrogen recommendations

Nitrogen (N) fertilizer recommendation tools could be improved for estimating corn (Zea mays L.) N needs by incorporating site-specific soil and weather information. However, an evaluation of analytical methods is needed to determine the success of incorporating this information. The objectives of this research were to evaluate statistical and machine learning (ML) algorithms for utilizing soil and weather information for improving corn N recommendation tools. Eight algorithms [stepwise, ridge regression, least absolute shrinkage and selection operator (Lasso), elastic net regression, principal component regression (PCR), partial least squares regression (PLSR), decision tree, and random forest] were evaluated using a dataset containing measured soil and weather variables from a regional database. The performance was evaluated based on how well these algorithms predicted corn economically optimal N rates (EONR) from 49 sites in the U.S. Midwest. Multiple algorithm modeling scenarios were examined with and without adjustment for multicollinearity and inclusion of two-way interaction terms to identify the soil and weather variables that could improve three dissimilar N recommendation tools. Results showed the out-of-sample root-mean-square error (RMSE) for the decision tree and some random forest modeling scenarios were better than the stepwise or ridge regression, but not significantly different than any other algorithm. The best ML algorithm for adjusting N recommendation tools was the random forest approach (r2 increased between 0.72 and 0.84 and the RMSE decreased between 41 and 94 kg N ha−1). However, the ML algorithm that best adjusted tools while using a minimal amount of variables was the decision tree. This method was simple, needing only one or two variables (regardless of modeling scenario) and provided moderate improvement as r2 values increased between 0.15 and 0.51 and RMSE decreased between 16 and 66 kg N ha−1. Using ML algorithms to adjust N recommendation tools with soil and weather information shows promising results for better N management in the U.S. Midwest

Dissolution dominating calcification process in polar pteropods close to the point of aragonite undersaturation

Thecosome pteropods are abundant upper-ocean zooplankton that build aragonite shells. Ocean acidification results in the lowering of aragonite saturation levels in the surface layers, and several incubation studies have shown that rates of calcification in these organisms decrease as a result. This study provides a weight-specific net calcification rate function for thecosome pteropods that includes both rates of dissolution and calcification over a range of plausible future aragonite saturation states (Omega_Ar). We measured gross dissolution in the pteropod Limacina helicina antarctica in the Scotia Sea (Southern Ocean) by incubating living specimens across a range of aragonite saturation states for a maximum of 14 days. Specimens started dissolving almost immediately upon exposure to undersaturated conditions (Omega_Ar,0.8), losing 1.4% of shell mass per day. The observed rate of gross dissolution was different from that predicted by rate law kinetics of aragonite dissolution, in being higher at Var levels slightly above 1 and lower at Omega_Ar levels of between 1 and 0.8. This indicates that shell mass is affected by even transitional levels of saturation, but there is, nevertheless, some partial means of protection for shells when in undersaturated conditions. A function for gross dissolution against Var derived from the present observations was compared to a function for gross calcification derived by a different study, and showed that dissolution became the dominating process even at Omega_Ar levels close to 1, with net shell growth ceasing at an Omega_Ar of 1.03. Gross dissolution increasingly dominated net change in shell mass as saturation levels decreased below 1. As well as influencing their viability, such dissolution of pteropod shells in the surface layers will result in slower sinking velocities and decreased carbon and carbonate fluxes to the deep ocean

Soil sample timing, nitrogen fertilization, and incubation length influence anaerobic potentially mineralizable nitrogen

Understanding the variables that affect the anaerobic potentially mineralizable N (PMNan) test should lead to a standard procedure of sample collection and incubation length, improving PMNan as a tool in corn (Zea mays L.) N management. We evaluated the effect of soil sample timing (preplant and V5 corn development stage [V5]), N fertilization (0 and 180 kg ha−1) and incubation length (7, 14, and 28 d) on PMNan (0–30 cm) across a range of soil properties and weather conditions. Soil sample timing, N fertilization, and incubation length affected PMNan differently based on soil and weather conditions. Preplant vs. V5 PMNan tended to be greater at sites that received \u3c 183 mm of precipitation or \u3c 359 growing degree-days (GDD) between preplant and V5, or had soil C/N ratios \u3e 9.7:1; otherwise, V5 PMNan tended to be greater than preplant PMNan. The PMNan tended to be greater in unfertilized vs. fertilized soil in sites with clay content \u3e 9.5%, total C \u3c 24.2 g kg−1, soil organic matter (SOM) \u3c 3.9 g kg−1, or C to N ratios \u3c 11.0:1; otherwise, PMNan tended to be greater in fertilized vs. unfertilized soil. Longer incubation lengths increased PMNan at all sites regardless of sampling methods. Since PMNan is sensitive to many factors (sample timing, N fertilization, incubation length, soil properties, and weather conditions), it is important to follow a consistent protocol to compare PMNan among sites and potentially use PMNan to improve corn N management