Travel risk, malaria importation and malaria transmission in Zanzibar

The prevalence of Plasmodium falciparum malaria in Zanzibar has reached historic lows. Improving control requires quantifying malaria importation rates, identifying high-risk travelers, and assessing onwards transmission

Bayesian hierarchical modelling approaches for combining information from multiple data sources to produce annual estimates of national immunization coverage

Estimates of national immunization coverage are crucial for guiding policy and decision-making in national immunization programs and setting the global immunization agenda. WHO and UNICEF estimates of national immunization coverage (WUENIC) are produced annually for various vaccine-dose combinations and all WHO Member States using information from multiple data sources and a deterministic computational logic approach. This approach, however, is incapable of characterizing the uncertainties inherent in coverage measurement and estimation. It also provides no statistically principled way of exploiting and accounting for the interdependence in immunization coverage data collected for multiple vaccines, countries and time points. Here, we develop Bayesian hierarchical modeling approaches for producing accurate estimates of national immunization coverage and their associated uncertainties. We propose and explore two candidate models: a balanced data single likelihood (BDSL) model and an irregular data multiple likelihood (IDML) model, both of which differ in their handling of missing data and characterization of the uncertainties associated with the multiple input data sources. We provide a simulation study that demonstrates a high degree of accuracy of the estimates produced by the proposed models, and which also shows that the IDML model is the better model. We apply the methodology to produce coverage estimates for select vaccine-dose combinations for the period 2000-2019. A contributed R package {\tt imcover} implementing the No-U-Turn Sampler (NUTS) in the Stan programming language enhances the utility and reproducibility of the methodology.Comment: 31 pages (main), 4 figure

Desarrollo, subjetividad y transgresiones identitarias en las costas del sur- austral chileno

This work is part of an investigation into the contemporary dynamics of development and modernization in the southern and far southern coastal areas of Chile, specifically the shoreline of the northern part of the Aysen Region. The objective is to propose a theoretical-conceptual reflection to enable ethnographic data to be framed as a problem and interpreted as a function of a political reading which - why not say so? - could transform the world of the southern and far southern coastal zone. The central argument of the text is hypothetical: the dilemmas of development, in the current circumstances of the coasts of the Aysen Region, are susceptible of resolution (at least up to a point) from a conscious, reflexive change of perspective on culture as the word is understood in anthropology. Este trabajo se enmarca en una investigación sobre las dinámicas contemporáneas del desarrollo y la modernización en las costas sur-australes de Chile, específicamente en el litoral norte de la región de Aisén. A partir de un conjunto de datos etnográficos se propone una reflexión teórico-conceptual que permita problematizar e interpretar esos datos en función de una lectura política y, por qué no decirlo, transformadora del mundo costero sur-austral. El argumento central del texto tiene carácter hipotético: las encrucijadas del desarrollo, en las actuales coyunturas de las costas aiseninas, son susceptibles de ser resueltas (al menos hasta cierto punto) a partir de un giro reflexivo y consciente sobre eso que en antropología llamamos cultura

Antarctic Surface Reflectivity Measurements from the ANITA-3 and HiCal-1 Experiments

The primary science goal of the NASA-sponsored ANITA project is measurement of ultra-high energy neutrinos and cosmic rays, observed via radio-frequency signals resulting from a neutrino- or cosmic ray- interaction with terrestrial matter (atmospheric or ice molecules, e.g.). Accurate inference of the energies of these cosmic rays requires understanding the transmission/reflection of radio wave signals across the ice-air boundary. Satellite-based measurements of Antarctic surface reflectivity, using a co-located transmitter and receiver, have been performed more-or-less continuously for the last few decades. Satellite-based reflectivity surveys, at frequencies ranging from 2--45 GHz and at near-normal incidence, yield generally consistent reflectivity maps across Antarctica. Using the Sun as an RF source, and the ANITA-3 balloon borne radio-frequency antenna array as the RF receiver, we have also measured the surface reflectivity over the interval 200-1000 MHz, at elevation angles of 12-30 degrees, finding agreement with the Fresnel equations within systematic errors. To probe low incidence angles, inaccessible to the Antarctic Solar technique and not probed by previous satellite surveys, a novel experimental approach ("HiCal-1") was devised. Unlike previous measurements, HiCal-ANITA constitute a bi-static transmitter-receiver pair separated by hundreds of kilometers. Data taken with HiCal, between 200--600 MHz shows a significant departure from the Fresnel equations, constant with frequency over that band, with the deficit increasing with obliquity of incidence, which we attribute to the combined effects of possible surface roughness, surface grain effects, radar clutter and/or shadowing of the reflection zone due to Earth curvature effects.Comment: updated to match publication versio

Mapping poverty using mobile phone and satellite data

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to comp- lement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evalu- ate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources providethebest predictive power (highest r 2 ¼ 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of datacollection

A framework for assessing the feasibility of malaria elimination

The recent scale-up of malaria interventions, the ensuing reductions in the malaria burden, and reinvigorated discussions about global eradication have led many countries to consider malaria elimination as an alternative to maintaining control measures indefinitely. Evidence-based guidance to help countries weigh their options is thus urgently needed. A quantitative feasibility assessment that balances the epidemiological situation in a region, the strength of the public health system, the resource constraints, and the status of malaria control in neighboring areas can serve as the basis for robust, long-term strategic planning. Such a malaria elimination feasibility assessment was recently prepared for the Minister of Health in Zanzibar. Based on the Zanzibar experience, a framework is proposed along three axes that assess the technical requirements to achieve and maintain elimination, the operational capacity of the malaria programme and the public health system to meet those requirements, and the feasibility of funding the necessary programmes over time. Key quantitative and qualitative metrics related to each component of the assessment are described here along with the process of collecting data and interpreting the results. Although further field testing, validation, and methodological improvements will be required to ensure applicability in different epidemiological settings, the result is a flexible, rational methodology for weighing different strategic options that can be applied in a variety of contexts to establish data-driven strategic plans