Prototype Positive Control Wells for Malaria Rapid Diagnostic Tests: Prospective Evaluation of Implementation Among Health Workers in Lao People's Democratic Republic and Uganda.

Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis, but lack of quality control at point of care restricts trust in test results. Prototype positive control wells (PCW) containing recombinant malaria antigens have been developed to identify poor-quality RDT lots. This study assessed community and facility health workers' (HW) ability to use PCWs to detect degraded RDTs, the impact of PCW availability on RDT use and prescribing, and preferred strategies for implementation in Lao People's Democratic Republic (Laos) and Uganda. A total of 557 HWs participated in Laos (267) and Uganda (290). After training, most (88% to ≥ 99%) participants correctly performed the six key individual PCW steps; performance was generally maintained during the 6-month study period. Nearly all (97%) reported a correct action based on PCW use at routine work sites. In Uganda, where data for 127,775 individual patients were available, PCW introduction in health facilities was followed by a decrease in antimalarial prescribing for RDT-negative patients ≥ 5 years of age (4.7-1.9%); among community-based HWs, the decrease was 12.2% (P < 0.05) for all patients. Qualitative data revealed PCWs as a way to confirm RDT quality and restore confidence in RDT results. HWs in malaria-endemic areas are able to use prototype PCWs for quality control of malaria RDTs. PCW availability can improve HWs' confidence in RDT results, and benefit malaria diagnostic programs. Lessons learned from this study may be valuable for introduction of other point-of-care diagnostic and quality-control tools. Future work should evaluate longer term impacts of PCWs on patient management

»Give Work, not Aid«

Mit dem Schlagwort der „digitalen Kluft" (digital divide) wurden in den vergangenen Jahren soziale, politische und wirtschaftliche Effekte bezeichnet, die sich aus der Entkopplung oder nur partiellen Anbindung ganzer Regionen und Bevölkerungsgruppen an das Internet ergeben. Kritisch daran anknüpfend untersucht der Aufsatz, wie neue Formen der digitalen Arbeit in afrikanischen Kontexten diese Entkopplungen und darüber emergierende Ungleichheiten befördern und auch teilweise beschleunigen. Um dies ethnographisch untersuchen können, wird das Tätigkeitsfeld von Samasource beschrieben, einer Organisation, die sich über die Vermittlung digitaler Mikroarbeit an gering qualifizierte Bevölkerungsteile finanziert. Der Begriff Datenanreicherungspraktik bezeichnet im Fortgang sowohl die globale Verwertung kommerzialisierter Rohdaten für maschinelles Lernen, als auch auf eine spezifische Art der lokalen Breitband-Internetnutzung. Der Aufsatz zielt darauf ab, herauszufinden, wie sich diese Form neo-tayloristischer, nicht-innovativer Arbeit auf globale und lokale Diskurse zu Lohnarbeit und digitaler Bildung bezieht.In recent years, the term "digital divide" has been used to describe the social, political and economic effects that are felt when entire regions and populations are either only partially connected or completely decoupled from the internet. The paper examines how new forms of digital work in African contexts promote, and in some cases accelerate, this disconnect and the resulting inequalities. To examine this ethnographically, the paper focuses on Samasource, an organization that is financed through the mediation of digital microwork to low-skilled sectors of the population. From here the term ‘data enrichment practices‘ will be used to refer both to the global circulation of commercialized "raw data" for machine learning, and to a specific type of local broadband internet use. The paper aims to find out how this form of neo-Tayloristic, non-innovative work plays into global and local discourses on labour and digital education.Peer Reviewe

Stock-outs! Improvisations and processes of infrastructuring in Uganda’s HIV/Aids and malaria programmes

This paper examines the stock-outs of medicines and diagnostic devices in Uganda. Our aim is to trace and compare interruptions in the supply of antiretrovirals and Rapid Diagnostic Tests in order to provide an ethnographic account of the complex role that improvisations play within global health infrastructures. We will argue that the fragmented and mobile infrastructures of these key global health technologies require and necessitate improvisations by the different actors involved as well as on almost all levels of the Ugandan health-care system. The extent and abundance of improvisations in itself works to acquire infrastructural capacities, a process that we will call the infrastructuring of care and treatment. We will also show how this process of infrastructuring of care and treatment – here rendered visible through improvisations – produces new dilemmas and uncertainties. Our approach to infrastructure challenges technocratic overtones prevalent in current debates around the much-needed strengthening of health systems. Our study of stock-outs aims to show how the infrastructure of under-resourced health systems is maintained by a complex nexus of socio-material practices and improvisations

Analyse der Systemanforderungen

SIGLEDEGerman

Digitale Arbeitskulturen

Peer Reviewe

Evidence that Mono-ADP-Ribosylation of CtBP1/BARS Regulates Lipid Storage

Mono-ADP-ribosylation is emerging as an important posttranslational modification that modulates a variety of cell signaling pathways. Here, we present evidence that mono-ADP-ribosylation of the transcriptional corepressor C terminal binding protein, brefeldin A (BFA)-induced ADP-ribosylated substrate (CtBP1/BARS) regulates neutral lipid storage in droplets that are surrounded by a monolayer of phospholipid and associated proteins. CtBP1/BARS is an NAD-binding protein that becomes ribosylated when cells are exposed to BFA. Both endogenous lipid droplets and droplets enlarged by oleate treatment are lost after 12-h exposure to BFA. Lipid loss requires new protein synthesis, and it is blocked by multiple ribosylation inhibitors, but it is not stimulated by disruption of the Golgi apparatus or the endoplasmic reticulum unfolded protein response. Small interfering RNA knockdown of CtBP1/BARS mimics the effect of BFA, and mouse embryonic fibroblasts derived from embryos that are deficient in CtBP1/BARS seem to be defective in lipid accumulation. We conclude that mono-ADP-ribosylation of CtBP1/BARS inactivates its repressor function, which leads to the activation of genes that regulate neutral lipid storage