Using drivers and transmission pathways to identify SARS-like coronavirus spillover risk hotspots

Nature Communications, Год журнала: 2023, Номер 14(1)

Опубликована: Окт. 27, 2023

The emergence of SARS-like coronaviruses is a multi-stage process from wildlife reservoirs to people. Here we characterize multiple drivers-landscape change, host distribution, and human exposure-associated with the risk spillover zoonotic help inform surveillance mitigation activities. We consider direct indirect transmission pathways by modeling four scenarios livestock mammalian as potential known before examining how access healthcare varies within clusters scenarios. found 19 differing factor contributions single country (N = 9) or transboundary 10). High-risk areas were mainly closer (11-20%) rather than far ( < 1%) healthcare. Areas reveal inequalities, especially Scenario 3, which includes wild mammals not secondary hosts. China 2) Indonesia 1) had highest risk. Our findings can stakeholders in land use planning, integrating implementation One Health actions.

Язык: Английский

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Incorporating Community Case Management in Risk-Based Surveillance for Malaria Elimination in the Dominican Republic

American Journal of Tropical Medicine and Hygiene, Год журнала: 2025, Номер unknown

Опубликована: Янв. 21, 2025

As countries strive for malaria elimination, it is crucial to gather sufficient evidence confirm the absence of transmission. Routine surveillance data often lack sensitivity detect community transmission at low levels. In Dominican Republic, health workers (CHWs) have been deployed in foci perform active case detection. This study aimed assess added value CHWs enhancing system’s detection capabilities. Freedom from infection (FFI) a statistical framework designed demonstrate by using routinely collected data. We adapted this include CHW data, estimating their contribution ability. The model was applied facility and 33 facilities across nine provinces covering period January 2018 April 2022. likelihood that facility’s catchment population free ( P ) achieved 52% only routine sustained an average 13 months. With addition 88% reached , 37 Incorporating enhanced precision estimates over 500-fold. demonstrated near several populations. It highlighted importance management supplementing surveillance, thereby improving estimates. These findings support further application FFI accelerate progress toward elimination Republic.

Язык: Английский

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Mapping under-five child malaria risk that accounts for environmental and climatic factors to aid malaria preventive and control efforts in Ghana: Bayesian geospatial and interactive web-based mapping methods

Malaria Journal, Год журнала: 2022, Номер 21(1)

Опубликована: Дек. 15, 2022

Under-five child malaria is one of the leading causes morbidity and mortality globally, especially among sub-Saharan African countries like Ghana. In Ghana, responsible for about 20,000 deaths in children annually which 25% are those aged < 5 years. To provide opportunities efficient surveillance targeted control efforts amidst limited public health resources, study produced high resolution interactive web-based spatial maps that characterized geographical differences risk identified burden communities.This modelling mapping utilized data from 2019 Malaria Indicators Survey (MIS) Demographic Health Program. A novel advanced Bayesian geospatial approaches were to examine predictors under-five malaria. The model was validated via a cross-validation approach. an visualization map by predicted prevalence at both sampled unsampled locations.In 2019, 718 (25%) 2867 surveyed had Substantial observed. ITN coverage (log-odds 4.5643, 95% credible interval = 2.4086-6.8874), travel time 0.0057, 0.0017-0.0099) aridity 0.0600, 0.0079-0.1167) predictive model. overall national 16.3% (standard error (SE) 8.9%) with range 0.7% 51.4% covariates 28.0% (SE 13.9%) 2.4 67.2% without covariates. Residing parts Central Bono East regions associated highest after adjusting selected covariates.The high-resolution can be used as effective tool identification communities require urgent interventions programme managers implementers. This key part strategy reducing its country resources where universal intervention practically impossible.

Язык: Английский

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Health system effectiveness of symptomatic malaria case management in Papua New Guinea

BMJ Global Health, Год журнала: 2025, Номер 10(3), С. e016825 - e016825

Опубликована: Март 1, 2025

Effective case management is crucial for malaria control efforts and a cornerstone of programmes. Yet, although efficacious treatments exist, often faces challenges, such as poor access to treatment providers, supply-chain issues, non-compliance with guidelines or substandard medication. In Papua New Guinea (PNG), progress in has stagnated recent years. This study identifies barriers areas improvement PNG.A cascade care model was used estimate the health system effectiveness management. Data from nationwide surveys conducted between 2013 2021 were quantify steps along symptomatic pathway. Potential risk factors decay, including demographic, socioeconomic characteristics, investigated using mixed-effect logistic regression.The main bottleneck treatment-seeking, only 40% (95% CI: 37% 46%) cases attending formal facility. A further important confirmatory parasitological diagnosis, provided 77% 68% 80%) patients Younger those living high transmission regions more likely receive diagnostic test.Measures improve PNG should include increasing to, utilisation quality services. Further investigations elucidate local determinants treatment-seeking may support National Malaria Strategic Plan's emphasis optimise delivery proven interventions within existing system.

Язык: Английский

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Adherence to the Test, Treat and Track malaria policy among selected health facilities in Ghana: The clients’ perspective

Research Square (Research Square), Год журнала: 2025, Номер unknown

Опубликована: Май 7, 2025

Introduction The World Health Organization in 2012 introduced the test, treat and track (T3) policy to standardize process of malaria management endemic settings. All suspected conditions are expected be confirmed by test treatment initiated with recommended artemisinin-based combination therapy (ACTs) outcomes monitored over course illness. This study evaluated adherence T3 selected health facilities within three epidemiological zones Ghana. Methods crossectional was conducted November 2019 involving thirty comprising one district hospital, Centre 3 Community Planning Services (CHPS) randomly from six districts zones. In addition, Clients exit interviews were each facility. Frequency charts highlighted facility characteristics. Factors associated test, treat track defined assessed using chi square multivariable logistic regression models at 5% level significance 95% confidence interval. Data classified according clients’ perspectives. Results Overall, 590 patients 30 managers interviewed 6 across CHPS compounds formed 18 (60.0%) assessed. Twenty-nine out had Rapid Diagnostic Test (RDT) kits antimalarials. all, 31.9%, whiles 30% North Middle indicated inadequate training on policy. showed that 90% 98% tested treated respectively for malaria. However only 35% (range 22% − 44%) tracked all southern zone Ghana almost three-fold increased odds adhering compared middle [aOR = 2.87 (1.7, 4.8): p < 0.001]. Males more likely not return review 0.6 (0.3, 0.9): 0.018]. Conclusion Testing treating high among However, tracking very low Adherence perspective especially males, who default review, even though prescribers informed participants need review. hurdle adhere Recommendations National Maria Elimination Program (NMEP) should ensure periodic trainings staff those Northern strengthen monitoring supervision enhance NMEP could also intensify Client sensitization programs targeting male clients help understand line There is implementation research explore strategies improve component client levels framework.

Язык: Английский

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Impact of traffic congestion on spatial access to healthcare services in Nairobi

Frontiers in Health Services, Год журнала: 2022, Номер 2

Опубликована: Ноя. 16, 2022

Geographic accessibility is an important determinant of healthcare utilization and critical for achievement universal health coverage. Despite the high disease burden severe traffic congestion in many African cities, few studies have assessed how impacts geographical access to facilities professionals these settings. In this study, we impact on facilities, across facilities.Using data obtained from Ministry Health Kenya, mapped 944 primary, 94 secondary four tertiary Nairobi County. We then used probe identify areas within a 15-, 30- 45-min drive each facility during peak off-peak hours calculated proportion population with employed 2-step floating catchment area model calculate ratio times.During hours, <70% Nairobi's 4.1 million was 30-min facility. This increased >75% hours. 45 min, majority had index one accessible more than 100 people (<0.01) primary care 10,000 two per 100,000 facilities. Of sub-optimal <4.45 1,000 observed offering hours.Our study shows being negatively impacted by congestion, highlighting need multisectoral collaborations between urban planners, sector policymakers optimize city residents. Additionally, growing availability cities should enable similar analysis understanding residents other countries continent.

Язык: Английский

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Serological evaluation of risk factors for exposure to malaria in a pre-elimination setting in Malaysian Borneo

Scientific Reports, Год журнала: 2023, Номер 13(1)

Опубликована: Авг. 10, 2023

Abstract Malaysia has reported no indigenous cases of P. falciparum and vivax for over 3 years. When transmission reaches such low levels, it is important to understand the individuals locations where exposure risks are high, as they may be at greater risk in case a resurgence transmission. Serology useful tool settings, providing insight into longer durations than PCR or RDT. We ran blood samples from 2015 population-based survey northern Sabah, Malaysian Borneo on multiplex bead assay. Using supervised machine learning methods, we characterised recent historic Plasmodium found very low, with both species increasing age. performed risk-factor assessment environmental, behavioural, demographic household factors, identified forest activity travel times healthcare common risk-factors vivax. In addition, used remote-sensing derived data geostatistical models assess environmental spatial associations exposure. created predictive maps study area showed clear foci This provides factors period Borneo. The findings would valuable human malarias region.

Язык: Английский

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Improving access to care and community health in Haiti with optimized community health worker placement

PLOS Global Public Health, Год журнала: 2022, Номер 2(5), С. e0000167 - e0000167

Опубликована: Май 10, 2022

The national deployment of polyvalent community health workers (CHWs) is a constitutive part the strategy initiated by Ministry Health to accelerate efforts towards universal coverage in Haiti. Its implementation requires planning future recruitment and activities for which mathematical modelling tools can provide useful support exploring optimised placement scenarios based on access care population distribution. We combined existing gridded estimates travel times with optimisation methods derive theoretical CHW geographical including constraints walking time number people served per CHW. Four national-scale that align total numbers CHWs ensure each does not exceed predefined threshold are compared. first scenario accounts distribution rural urban areas only, while other three also incorporate different ways proximity centres. Comparing these current distribution, insufficient systematically identified several departments gaps within all departments. These results highlight suboptimal emphasize need consider an optimal (re-)allocation.

Язык: Английский

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Incorporating Community Case Management in Risk Based Surveillance for Malaria Elimination in the Dominican Republic

Опубликована: Янв. 1, 2024

Язык: Английский

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Mapping under-five child malaria risk that accounts for environmental and climatic factors to aid malaria preventive and control efforts in Ghana: Bayesian geospatial and interactive web- based mapping methods

Research Square (Research Square), Год журнала: 2022, Номер unknown

Опубликована: Окт. 3, 2022

Abstract Background: Under-five child malaria is one of the leading causes morbidity and mortality globally, especially among sub-Saharan African countries like Ghana. In Ghana, responsible for about 20000 deaths in children annually which 25% are those aged <5 years. To provide opportunities efficient surveillance targeted control efforts amidst limited public health resources, we produced high resolution interactive web-based spatial maps that characterized geographical differences risk identified burden communities. Methods: This modelling mapping studyutilised data from 2019 Malaria Indicators Survey (MIS) Demographic Health Program. A novel advanced Bayesian geospatial approaches were utilized to examine predictors under-five malaria. The model was validated via a cross-validation approach. We an visualization map by predicted prevalence at both sampled unsampled locations. Results: 2019, 718 (25%) 2867 surveyed had Substantial observed. ITN coverage (log-odds 4.5643, 95% credible interval = 2.4086 - 6.8874), travel time 0.0057, 0.0017 0.0099) aridity 0.0600, 0.0079 0.1167) predictive model. overall national 16.3% (standard error (SE) 8.9%) with range 0.7 % 51.4% covariates 28.0% (SE 13.9%) 2.4 67.2% without covariates. Residing parts Central Bono East regions associated highest after adjusting selected Conclusion: high-resolution can be used as effective tool identification communities require urgent interventions program managers implementers. key part strategy reducing its country resources where universal intervention practically impossible.

Язык: Английский

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