Connectivity sustains disease transmission in environments with low potential for endemicity: modelling schistosomiasis with hydrologic and social connectivities

Social interaction and physical interconnections between populations can influence the spread of parasites. The role that these pathways play in sustaining the transmission of parasitic diseases is unclear, although increasingly realistic metapopulation models are being used to study how diseases persist in connected environments. We use a mathematical model of schistosomiasis transmission for a distributed set of heterogeneous villages to show that the transport of parasites via social (host movement) and environmental (parasite larvae movement) pathways has consequences for parasite control, spread and persistence. We find that transmission can be sustained regionally throughout a group of connected villages even when individual village conditions appear not to support endemicity. Optimum transmission is determined by an interplay between different transport pathways, and not necessarily by those that are the most dispersive (e.g. disperse social contacts may not be optimal for transmission). We show that the traditional targeting of villages with high infection, without regard to village interconnections, may not lead to optimum control. These findings have major implications for effective disease control, which needs to go beyond considering local variations in disease intensity, to also consider the degree to which populations are interconnected

Impact of annual praziquantel treatment on urogenital schistosomiasis in a seasonal transmission focus in central Senegal

In Sub-Saharan Africa, urogenital schistosomiasis remains a significant public health problem, causing 150.000 deaths/year with approximately 112 million cases diagnosed. The Niakhar district is a disease hotspot in central Senegal where transmission occurs seasonally with high prevalences. The aim of this study was to determine the effect of annual treatment over 3 years on the seasonal transmission dynamics of S. haematobium in 9 villages in the Niakhar district. Adults and children aged between 5 and 60 years were surveyed from 2011 to 2014. Urine samples were collected door-to-door and examined for S. haematobium eggs at baseline in June 2011, and all participants were treated in August 2011 with PZQ (40 mg/kg). After this initial examination, evaluations were conducted at 3 successive time points from September 2011 to March 2014, to measure the efficacy of the annual treatments and the rates of reinfection. Each year, during the transmission period, from July to November-December, malacological surveys were also carried out in the fresh water bodies of each village to evaluate the infestation of the snail intermediate hosts. At baseline, the overall prevalence of S. haematobium infection was 57.7%, and the proportion of heavy infection was 45.3%, but one month after the first treatment high cure rates (92.9%) were obtained. The overall infection prevalence and proportion of heavy infection intensities were drastically reduced to 4.2% and 2.3%, respectively. The level of the first reinfection in February-March 2012 was 9.5%. At follow-up time points, prevalence levels varied slightly between reinfection and treatment from 9.5% in June 2012 to 0.3% in March 2013, 11.2 in June 2013, and 10.1% April 2014. At the end of the study, overall prevalence was significantly reduced from 57.7% to 10.1%. The overall rate of infested Bulinid snails was reduced after repeated treatment from 0.8% in 2012 to 0.5% in 2013. Repeated annual treatments are suggested to have a considerable impact on the transmission dynamics of S. haematobium in Niakhar, due to the nature of the epidemiological system with seasonal transmission. Thus, to maintain this benefit and continue to reduce the morbidity of urogenital schistosomiasis, other approaches should be integrated into the strategy plans of the National program to achieve the goal of urogenital schistosomiasis elimination in seasonal foci in Senegal

Percentage, bacterial etiology and antibiotic susceptibility of acute respiratory infection and pneumonia among children in rural Senegal

Acute respiratory infections (ARI) are still a major health problem in most developing countries. So far no study has evaluated the importance of childhood ARI in rural Senegal. We prospectively studied ARI, the percentage of pneumonia and related mortality, as well as the bacterial composition of nasopharyngeal flora using nasopharyngeal aspirates in 114 children, aged 2-59 months, presenting at Ndioum's pediatric ward. Excluded from the trial were those children that had had antimicrobial therapy in the previous 2 weeks. The Kirby-Bauer method was used to determine antibiotic resistance throughout the study. The percentage of ARI and pneumonia among the population tested was 24 per cent and 11 per cent respectively. Streptococcus pneumonia was often resistant to cotrimoxazole (31 per cent) but only 9 per cent were resistant to chloramphenicol and 14 per cent to penicillin. Haemophilus influenzae (HI) was uniformly sensitive to ampicillin, and only 4 per cent were resistant to chloramphenicol and 11 per cent to cotrimoxazole. We conclude that SP and HI resistance to cotrimoxazole is important and warrants larger clinical trials using chloramphenicol. Information campaigns and intense management of comorbidities are desirable in this type of population. Comorbidities (tuberculosis, malaria, HIV-AIDS, severe malnutrition) are determinant variables in many ARI cases and carry a high negative prognosis value

Delegation of Authority to the Performance of the Medical Staff and Its Relationship to Improving the Quality of Health Care in Palestine

The study aimed to identify the delegation of authority for the performance of the medical staff and its relationship to improving the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. Administrators, and technicians) with a total of 2150 employees, and the questionnaire was distributed to a stratified random sample of 330 employees, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence of a statistically significant relationship between delegation of authority and the quality of health care. One of the most important recommendations of the study was to strengthen the direction of senior management towards excellence in patient service, because the patient represents a fundamental focus in health services

Training For the Performance of the Medical Staff and Its Role in Developing the Quality of Health Care in Palestine

The study aimed to identify training for the performance of the medical staff and its role in developing the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. , and technicians) of 2150 employees, a stratified random sample of 330 employees was selected, the questionnaire was distributed to them, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was the existence of a statistically significant effect of training on the development of health care quality. One of the most important recommendations of the study was to provide more suitable opportunities to create a climate for the professional growth of employees, and pay more attention to the expansion of programs and training courses that are in line with the requirements of administrative empowerment

Sharing Information on the Performance of the Medical Staff and Its Impact on Improving the Quality of Health Care in Palestine

The study aimed to identify the sharing of information and its impact on the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. The study adopted the descriptive analytical approach. The number is 2150 employees, and the questionnaire was distributed to a stratified random sample of 330 employees, and 302 questionnaires were retrieved, with a rate of 91.5%. One of the most important results of the study was that there is a statistically significant effect at the level (α≤0.05) of information sharing for the performance of the medical staff in the quality of health care in Al-Shifa Medical Complex in the southern Palestinian governorates. The axis of participation in information came with a relative weight (69.6%) and a high degree. The level of health care quality was high with a relative weight of (69.0%). One of the most important recommendations of the study was the need to pay attention to measuring patients' satisfaction levels, and to set up a box for complaints and suggestions for patients, and what are their suggestions and point of view for the service provided to them

The level of Mediation Outcomes of Disputes Resolution in Workplace at UNRWA, Gaza

Abstract: The research also aims at identifying the differences between respondents as attributed to their professional and personal traits of age, gender, educational level, distribution of department, dispute resolution experience and representation party. Researchers adopted mixed data collection methods; quantitative and qualitative. For qualitative, a semi-structured interview was conducted with (9) officials including management, staff unions and expert external mediators. (63) Questionnaires were distributed to a systematic random sample population; (56) were received, with a response rate 88.9%. The results proved that there are no significant differences among respondents attributed to personal and professional traits of age, academic background, gender, department, years’ of experience, educational degree and representation party. The research has presented some recommendations concerning the factors affecting the mediation outcomes of workplace disputes resolution. The recommendations include: Selecting expert mediators to deal with multi-culture groups. Ensuring equal gender representation in working groups, teamwork and committees and encouraging female participation in mediation processes to resolve dispute at work place. Developing the mediation schema in a way that empowers the mediator to increase her/his ability to lead and establish compromise solutions for workplace disputes

Factors Affecting Of Disputes Resolution in Workplace: UNRWA at Gaza as a Case Study

UNRWA’s Mediation Process is a key element in the organization’s efforts to strengthen its internal justice system. The research aims to study the reality of mediator competencies, emotional intelligence and case characteristics variables, (UNRWA) Gaza. The research also aims at identifying the differences between respondents as attributed to their professional and personal traits of age, gender, educational level, distribution of department, dispute resolution experience and representation party. The researchers adopted mixed data collection methods; quantitative and qualitative. For qualitative, a semi-structured interview was conducted with (9) officials including management, staff unions and expert external mediators. (63) Questionnaires were distributed to a systematic random sample population; (56) were received, with a response rate 88.9%. The results proved that there are no significant differences among respondents attributed to personal and professional traits of age, academic background, gender, department, years’ of experience, educational degree and representation party. The research has presented some recommendations concerning the factors affecting the mediation outcomes of workplace disputes resolution. The recommendations include: UNRWA should adopt mediation as a method to resolve disputes at workplace instead of following litigation before the courts, as many organizations today increasingly started to adopt mediation as a method to resolve disputes at workplace. This will help decreasing the high cost, non-flexibility, and threatening features of disputes and conflicts resolution before courts, as well as enhance the relationship between disputant parties. Mediators are essentially recommended to attend regular training such as guiding negotiation processes, employing group sessions properly, overcoming obstacles, summarizing & analytical skills and selecting emotional words and phrases, it is also important to encourage the mediation experts' training workshops and meetings. Regular training sessions will not only improve skills and abilities, but will also imply variety and flexibility. This leads to having competent qualified mediators who are able to resolve organization’s workplace disputes in a way, which satisfies the need of disputants