Mortality and morbidity : the Matlab experience

Presents examples of how mortality and morbidity can be studied within a "small area". The possibility of grafting small studies at relatively little cost into a longitudinal system is described

Mortalité et morbidité : l'expérience de Matlab

Version anglaise disponible dans la Bibliothèque numérique du CRDI sous le titre: Mortality and morbidity : the Matlab experienc

Wildlife Trade and Human Health in Lao PDR: An Assessment of the Zoonotic Disease Risk in Markets.

Although the majority of emerging infectious diseases can be linked to wildlife sources, most pathogen spillover events to people could likely be avoided if transmission was better understood and practices adjusted to mitigate risk. Wildlife trade can facilitate zoonotic disease transmission and represents a threat to human health and economies in Asia, highlighted by the 2003 SARS coronavirus outbreak, where a Chinese wildlife market facilitated pathogen transmission. Additionally, wildlife trade poses a serious threat to biodiversity. Therefore, the combined impacts of Asian wildlife trade, sometimes termed bush meat trade, on public health and biodiversity need assessing. From 2010 to 2013, observational data were collected in Lao PDR from markets selling wildlife, including information on volume, form, species and price of wildlife; market biosafety and visitor origin. The potential for traded wildlife to host zoonotic diseases that pose a serious threat to human health was then evaluated at seven markets identified as having high volumes of trade. At the seven markets, during 21 observational surveys, 1,937 alive or fresh dead mammals (approximately 1,009 kg) were observed for sale, including mammals from 12 taxonomic families previously documented to be capable of hosting 36 zoonotic pathogens. In these seven markets, the combination of high wildlife volumes, high risk taxa for zoonoses and poor biosafety increases the potential for pathogen presence and transmission. To examine the potential conservation impact of trade in markets, we assessed the status of 33,752 animals observed during 375 visits to 93 markets, under the Lao PDR Wildlife and Aquatic Law. We observed 6,452 animals listed by Lao PDR as near extinct or threatened with extinction. The combined risks of wildlife trade in Lao PDR to human health and biodiversity highlight the need for a multi-sector approach to effectively protect public health, economic interests and biodiversity

Electricity Demand Forecast For the Bristol Bay Regional Power Plan

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St. George Basin and North Aleutian Basin Economic and Demographic Systems Impacts Analysis

In this report, we present descriptions and "base case" projections of population and employment for the communities of Unalaska and Cold Bay. We also present projections of the impacts on population and employment in these communities which might result from the proposed St. George Basin and North Aleutian Shelf OCS Lease offerings. The future development of Unalaska is highly uncertain. Our projections suggest that the population of Unalaska in the year 2000 could range from as low as 900-only a little larger than the 1980 resident population- to as high as 4,600. Future development of the crab and bottomfish industries will be the key factor affecting the future size of the community. Unalaska is envisioned primarily as a marine support base for future OCS development. Our projections suggest that the relative impacts of development resulting from the proposed lease sales would be relatively small. Development of both sale areas might increase population and employment by approximately 15 percent during the peak year of 1993. These projections are based on the assumption that only workers associated with the shore base would become residents of Unalaska. Cold Bay is primarily a transient community based around aviation and communication facilities. In the "base case," the resident population may fall by about one-third due to future cutbacks in employment by the FAA, the U.S. Air Force, and RCA. However, OCS development in the Navarin Basin might reverse this decline, bringing population back to approximately current levels. Additional development from development of the St. George Basin or North ALeutian Shelf OC sale areas could further increase population by as much as 40 percent, Cold Bay would still remain a small community of approximately the same size as it was during the Vietnam war years. In addition to our descriptions and projections for Unalaska and Cold Bay, we have provided descriptions for Sand Point, St. Paul, St. George, and Nelson Lagoon. However, we don not expect these communities to be directly affected by future OCS development in the St. George or North Aleutian Shelf lease sale areas.Ye

Gulf of Alaska Economic and Demographic Systems Analysis

This report examines possible impacts of the Gulf of Alaska lease offering, scheduled for October of 1984, upon the population and economics of five communities in southcentral Alaska: Homer, Kenai, Kodiak, Seward, and Yakutat. For each community we provide descriptions of current populations and employment. We then use the Rural Alaska Model ("RAM" model) to project a number of economic and demographic variables for these five communities with and without development of the proposed lease sale area. These projections are sensitive to the numerous assumptions required by the model. In the base case, we project relatively low rates of growth in resident population for Kenai and Kodiak (less than 1.2 percent annually over the period 1981-2010); we project a moderate growth rate for Yakutat (1.9 percent annually over the period , with most growth occurring before 1990); and we project high rates of growth for Homer and Seward (2.3 percent and 3.6 percent) due to increased tourism, fish processing, and shipbuilding. We project relativity minor impacts from development in the lease sale area upon population and employment in Homer, Kenai, Kodiak, and Seward (generally less than 10 percent at maximum). In contrast, we project more substantial relative impacts upon population and employment in Yakutat (up to 46 percent and 82 percent, respectively). Although absolute impacts are similar in Yakutat to those in the other communities, relative impacts are greater because Yakutat is much smaller.Prepared for Minerals management service Alaska OCS officeYe

Reaching Hard-to-Reach Individuals: Nonselective Versus Targeted Outbreak Response Vaccination for Measles

Current mass vaccination campaigns in measles outbreak response are nonselective with respect to the immune status of individuals. However, the heterogeneity in immunity, due to previous vaccination coverage or infection, may lead to potential bias of such campaigns toward those with previous high access to vaccination and may result in a lower-than-expected effective impact. During the 2010 measles outbreak in Malawi, only 3 of the 8 districts where vaccination occurred achieved a measureable effective campaign impact (i.e., a reduction in measles cases in the targeted age groups greater than that observed in nonvaccinated districts). Simulation models suggest that selective campaigns targeting hard-to-reach individuals are of greater benefit, particularly in highly vaccinated populations, even for low target coverage and with late implementation. However, the choice between targeted and nonselective campaigns should be context specific, achieving a reasonable balance of feasibility, cost, and expected impact. In addition, it is critical to develop operational strategies to identify and target hard-to-reach individuals

Too little but not too late: Results of a literature review to improve routine immunization programs in developing countries

<p>Abstract</p> <p>Background</p> <p>Globally, immunization services have been the center of renewed interest with increased funding to improve services, acceleration of the introduction of new vaccines, and the development of a health systems approach to improve vaccine delivery. Much of the credit for the increased attention is due to the work of the GAVI Alliance and to new funding streams. If routine immunization programs are to take full advantage of the newly available resources, managers need to understand the range of proven strategies and approaches to deliver vaccines to reduce the incidence of diseases. In this paper, we present strategies that may be used at the sub-national level to improve routine immunization programs.</p> <p>Methods</p> <p>We conducted a systematic review of studies and projects reported in the published and gray literature. Each paper that met our inclusion criteria was rated based on methodological rigor and data were systematically abstracted. Routine-immunization – specific papers with a methodological rigor rating of greater than 60% and with conclusive results were reported.</p> <p>Results</p> <p>Greater than 11,000 papers were identified, of which 60 met our inclusion criteria and 25 papers were reported. Papers were grouped into four strategy approaches: bringing immunizations closer to communities (n = 11), using information dissemination to increase demand for vaccination (n = 3), changing practices in fixed sites (n = 4), and using innovative management practices (n = 7).</p> <p>Conclusion</p> <p>Immunization programs are at a historical crossroads in terms of developing new funding streams, introducing new vaccines, and responding to the global interest in the health systems approach to improving immunization delivery. However, to complement this, actual service delivery needs to be strengthened and program managers must be aware of proven strategies. Much was learned from the 25 papers, such as the use of non-health workers to provide numerous services at the community level. However it was startling to see how few papers were identified and in particular how few were of strong scientific quality. Further well-designed and well-conducted scientific research is warranted. Proposed areas of additional research include integration of additional services with immunization delivery, collaboration of immunization programs with new partners, best approaches to new vaccine introduction, and how to improve service delivery.</p

Distribution Systems of Insecticide-Treated Bed Nets for Malaria Control in Rural Burkina Faso: Cluster-Randomized Controlled Trial

BACKGROUND: Insecticide-impregnated bed nets (ITNs) have been shown to be a highly effective tool against malaria in the endemic regions of sub-Saharan Africa (SSA). There are however different opinions about the role of ITN social marketing and ITN free distribution in the roll-out of ITN programmes. The objective of this study was to evaluate the effects of free ITN distribution through antenatal care services in addition to an ITN social marketing programme in an area typical for rural SSA. METHODS: A cluster-randomised controlled ITN trial took place in the whole Kossi Province in north-western Burkina Faso, an area highly endemic for malaria. Twelve clusters were assigned to long-term ITN (Serena brand) social marketing plus free ITN (Serena brand) distribution to all pregnant women attending governmental antenatal care services (group A), and 13 clusters to ITN social marketing only (group B). The intervention took place during the rainy season of 2006 and thereafter. The trial was evaluated through a representative household survey at baseline and after one year. Serena ITN household ownership was the primary outcome measure. FINDINGS: A total of 1052 households were visited at baseline in February 2006 and 1050 at follow-up in February 2007. Overall Serena ITN household ownership increased from 16% to 28% over the study period, with a significantly higher increase in group A (13% to 35%) than in group B (18% to 23%) (p<0.001). INTERPRETATION: The free distribution of ITNs to pregnant women through governmental antenatal care services in addition to ITN social marketing substantially improved ITN household ownership in rural Burkina Faso. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN07985309