A trial of intermittent preventive treatment and home-based management of malaria in a rural area of The Gambia

BACKGROUND: Individual malaria interventions provide only partial protection in most epidemiological situations. Thus, there is a need to investigate whether combining interventions provides added benefit in reducing mortality and morbidity from malaria. The potential benefits of combining IPT in children (IPTc) with home management of malaria (HMM) was investigated. METHODS: During the 2008 malaria transmission season, 1,277 children under five years of age resident in villages within the rural Farafenni demographic surveillance system (DSS) in North Bank Region, The Gambia were randomized to receive monthly IPTc with a single dose of sulphadoxine/pyrimethamine (SP) plus three doses of amodiaquine (AQ) or SP and AQ placebos given by village health workers (VHWs) on three occasions during the months of September, October and November, in a double-blind trial. Children in all study villages who developed an acute febrile illness suggestive of malaria were treated by VHWs who had been taught how to manage malaria with artemether-lumefantrine (Coartem™). The primary aims of the project were to determine whether IPTc added significant benefit to HMM and whether VHWs could effectively combine the delivery of both interventions. RESULTS: The incidence of clinical attacks of malaria was very low in both study groups. The incidence rate of malaria in children who received IPTc was 0.44 clinical attacks per 1,000 child months at risk while that for control children was 1.32 per 1,000 child months at risk, a protective efficacy of 66% (95% CI -23% to 96%; p = 0.35). The mean (standard deviation) haemoglobin concentration at the end of the malaria transmission season was similar in the two treatment groups: 10.2 (1.6) g/dL in the IPTc group compared to 10.3 (1.5) g/dL in the placebo group. Coverage with IPTc was high, with 94% of children receiving all three treatments during the study period. CONCLUSION: Due to the very low incidence of malaria, no firm conclusion can be drawn on the added benefit of IPTc in preventing clinical episodes of malaria among children who had access to HMM in The Gambia. However, the study showed that VHWs can successfully combine provision of HMM with provision of IPTc

Two Strategies for the Delivery of IPTc in an Area of Seasonal Malaria Transmission in The Gambia: A Randomised Controlled Trial

Bojang and colleagues report a randomized trial showing that delivery of intermittent preventive treatment for malaria in children by village health workers is more effective than delivery by reproductive and child health trekking clinics

Simulação numerica da separação de um escoamento bifasico gas-liquido em um te

Resumo: Este trabalho visa estudar o fenômeno da separação de fases que ocorre em um tê vertical, utilizando um programa de computador bidimensional baseado no modelo de dois fluidos, para representar o comportamento do escoamento bifásico, e no método dos volumes finitos, para discretizar as equações de conservação. Como partes essenciais deste estudo temos o desenvolvimento de um termo local de difusão viscosa para o modelo, assumindo escoamento laminar, como também o estudo de uma equação constitutiva para a transferência interfacial de quantidade de movimento, representativa para a simulação do fenômeno. A separação das fases foi simulada para valores 0.5 e 1 da razão entre os diâmetros do braço lateral e do ramo principal, de acordo com dados experimentais encontrados na literatura. Uma detalhada distribuição da fração de vazio, pressão e função de corrente é apresentada a partir dos resultados numéricos. Os valores preditos demonstram que o modelo utilizado consegue predizer razoavelmente a separação das fases, quando a taxa de extração é maior que 0.3, apresentando desvio médio de 10 % em relação aos dados experimentais. Para baixas extrações, um modelo tridimensional pode ser desejado para representar o fenômeno. Verificou-se, neste caso, uma tendência para subestimar a separação, com desvio médio de 25 %.Abstract: The main objective of this work is to study the phase separation phenomena in a vertical tee. A two-dimensional computer code was used to solve the two-fluid model equations, using the finite volume method. A fundamental part is the development of simple model to viscous diffusion term, assuming laminar flow. Special attention is directed to the modelling of the constitutive equation for the interfacial friction term. The phase separation was simulated considering two values of branch-to-inlet diameter ratio, 0.5 and 1, according to reported experimental results . Detailed distributions of void fraction, pressure and velocity of both phases are presented. A good agreement was obtained between the computer code results and the experimental data, when the extraction rate was greater than 0.3. The mean deviation for these data was about 10 %. For lower extraction rate, a three - dimensional model would be more suitable. ln this case, the mean deviation for alI data was about 25 %, with a tendency of the split ratio to be under predicted

Lack of Decline in Childhood Malaria, Malawi, 2001–2010

In some areas of Africa, health facility data have indicated declines in malaria that might have resulted from increasingly effective control programs. Most such reports have been from countries where malaria transmission is highly seasonal or of modest intensity. In Malawi, perennial malaria transmission is intense, and malaria control measures have been scaled up during the past decade. We examined health facility data for children seen as outpatients and parasitemia-positive children hospitalized with cerebral malaria in a large national hospital. The proportion of Plasmodium falciparum–positive slides among febrile children at the hospital declined early in the decade, but no further reductions were observed after 2005. The number of admissions for cerebral malaria did not differ significantly by year. Continued surveillance for malaria is needed to evaluate the effects of the increased malaria control efforts

Absolute prevalence difference in estimates of standard malaria indicators.

<p>ANC = Antenatal Clinic OPD = All OPD SC = School children WSC = Well or sick child BS = Blood slide PCR = Polymerase chain reaction RDT = Rapid diagnostic test.</p

Advantages and disadvantages of EAGs suitable for malaria surveillance.

<p>Advantages and disadvantages of EAGs suitable for malaria surveillance.</p