Malaria rapid diagnostic test performance: results of WHO product testing of malaria RDTs: round 1 (2008)

1. Executive summary -- 2. Background -- 3. Objectives -- 4. Data management -- 5. Materials and methods -- 6. Quality assurance -- 7. Ethical considerations -- 8. Data analysis -- 9. Laboratory versus field-based malaria RDT evaluations -- 10. Results -- 11. Heat stability -- 12. Ease of use description -- 13. Discussion of key findings -- 14. Additional measures to ensure quality and utility of RDT testing -- 15. Conclusions -- 16. References -- -- Annex 1: Characteristics of rapid malaria malaria tests in the evaluation -- Annex 2: Malaria RDT guide to results interpretation -- Annex 3: Phase 1 results -- Annex 4: Phase 2 results -- Annex 5: Example algorithm for selecting a malaria RDT -- Annex 6: Introducing RDT-based malaria diagnosis into national programmesThis report, which presents the results of the first round of WHO product testing of malaria antigen-detecting RDTs, was completed in November 2008 in collaboration with FIND, the US Centers for Disease Control and Prevention (CDC) ...--P. 1.Also available online at: as an Acrobat .pdf file (2.77 MB, 110 p.

Malaria rapid diagnostic test performance: results of WHO product testing of malaria RDTs : round 3 (2010-2011)

This Summary presents an overview of the results of the first, second and third rounds of WHO Product Testing of malaria antigen-detecting RDTs completed in 2008, 2009 and 2011 respectively, and is published in conjunction with the release of the results of Round 3. The results of the three rounds of testing should be considered as a single data set. Concerning products re-submitted for evaluation, the results of earlier rounds are replaced by subsequent rounds and therefore only one set of results per product feature in this summary. Separate full reports of all rounds should be consulted for further detail on product performance, and on the interpretation and use of these results.Acknowledgements -- Abbreviations -- 1. Summary peformance of malaria RDTs: WHO product testing : Rounds 1-3 -- 2. WHO malaria RDT product testing: Round 3 executive summary -- 3. Background -- 4. Objective -- 5. Materials and methods -- 6. Data management -- 7. Quality assurance -- 8. Ethical considerations -- 9. Data analysis -- 10. Laboratory versus field-based malaria RDT evaluations -- 11. Results -- 12. Heat stability -- 13. Ease of use description -- 14. Discussion of key findings -- 15. Using these results to ensure quality of diagnosis in the field -- 16. Conclusions -- 17. References -- -- Annex 1: Characteristics of rapid malaria tests in Round 3-- Annex 2: Malaria RDT guide to results interpretation -- Annex 3: Phase 1 results -- Annex 4: Phase 2 results -- Annex 5a: Selection of an appropriae RDT -- Anneex 5b: RDT format review and ease of use assessment -- Annex 6: Introducing RDT-based malaria diagnosis into national programmesThe evaluation described in this report was a joint project of the Global Malaria Programme (GMP), the Foundation for Innovative New Diagnostics (FIND), TDR, Special Programme for Research and Training in Tropical Diseases sponsored by UNICEF, UNDP, World Bank and WHO and the US Centers for Disease Control and Prevention (CDC), under the WHO-FIND Malaria RDT Evaluation Programme. The project was financed by FIND, the Australian Agency for International Development (AusAID), the United States Agency for International Development (USAID), the UK Department for International Development (DFID) and TDR. The project would not have been possible without the cooperation and support of the specimen collection sites, and the specimen characterization laboratories mentioned herein, and acknowledges the technical advice from many malaria diagnostic manufacturers and developers in the development of the programme. This report on Round 3 of WHO Malaria RDT Product Testing was compiled by Jane Cunningham (Special Programme for Research and Training in Tropical Diseases (TDR), Switzerland) and David Bell (Foundation for Innovative New Diagnostics (FIND), Switzerland.Mode of access: World Wide Web as an Acrobat .pdf file (7.53 MB, 124 p.).Includes bibliographical references (p. 54)

PrEP as a feature in the optimal landscape of combination HIV prevention in sub-Saharan Africa

INTRODUCTION: The new WHO guidelines recommend offering pre-exposure prophylaxis (PrEP) to people who are at substantial risk of HIV infection. However, where PrEP should be prioritised, and for which population groups, remains an open question. The HIV landscape in sub-Saharan Africa features limited prevention resources, multiple options for achieving cost saving, and epidemic heterogeneity. This paper examines what role PrEP should play in optimal prevention in this complex and dynamic landscape. METHODS: We use a model that was previously developed to capture subnational HIV transmission in sub-Saharan Africa. With this model, we can consider how prevention funds could be distributed across and within countries throughout sub-Saharan Africa to enable optimal HIV prevention (that is, avert the greatest number of infections for the lowest cost). Here, we focus on PrEP to elucidate where, and to whom, it would optimally be offered in portfolios of interventions (alongside voluntary medical male circumcision, treatment as prevention, and behaviour change communication). Over a range of continental expenditure levels, we use our model to explore prevention patterns that incorporate PrEP, exclude PrEP, or implement PrEP according to a fixed incidence threshold. RESULTS: At low-to-moderate levels of total prevention expenditure, we find that the optimal intervention portfolios would include PrEP in only a few regions and primarily for female sex workers (FSW). Prioritisation of PrEP would expand with increasing total expenditure, such that the optimal prevention portfolios would offer PrEP in more subnational regions and increasingly for men who have sex with men (MSM) and the lower incidence general population. The marginal benefit of including PrEP among the available interventions increases with overall expenditure by up to 14% (relative to excluding PrEP). The minimum baseline incidence for the optimal offer of PrEP declines for all population groups as expenditure increases. We find that using a fixed incidence benchmark to guide PrEP decisions would incur considerable losses in impact (up to 7%) compared with an approach that uses PrEP more flexibly in light of prevailing budget conditions. CONCLUSIONS: Our findings suggest that, for an optimal distribution of prevention resources, choices of whether to implement PrEP in subnational regions should depend on the scope for impact of other possible interventions, local incidence in population groups, and total resources available. If prevention funding were to become restricted in the future, it may be suboptimal to use PrEP according to a fixed incidence benchmark, and other prevention modalities may be more cost-effective. In contrast, expansions in funding could permit PrEP to be used to its full potential in epidemiologically driven prevention portfolios and thereby enable a more cost-effective HIV response across Africa

Post abortion family planning counseling as a tool to increase contraception use

<p>Abstract</p> <p>Background</p> <p>To describe the impact of the post-abortion family planning counseling in bringing about the contraceptive usage in women who had induced abortion in a family planning clinic.</p> <p>Method</p> <p>The Diyarbakir Office of Turkish Family Planning Association (DTFPA) is a nonprofit and nongovernmental organization which runs a family planning clinic to serve the lower socio-economic populations, in Diyarbakir-Turkey. Post abortion counseling is introduced by using proper communication skills and with using appropriate methods to women. In this study we introduced contraceptive usage of women who had induced abortion one year ago and followed by DTFPA's clinic.</p> <p>Results</p> <p>55.3% of our clients were not using contraceptive methods before abortion. At the end of the one year, 75.9% of our followed-up clients revealed that they were using one of the modern contraceptive methods. There was no woman with IUD before induced abortion. At the end of one year 124 (52.3%) women had IUD. "A modern method was introduced immediately after abortion" was the most important factor increasing modern method usage.</p> <p>Conclusion</p> <p>Our results advocate that post-abortion counseling may be an effective tool to increase the usage of contraceptives. Improved and more qualified post-abortion family planning counseling should be an integral part of abortion services.</p