Public Health Commons^™

Congenital Toxoplasmosis In Austria: Prenatal Screening For Prevention Is Cost-Saving, Andrea-Romana Prusa, David C. Kasper, Larry Sawers, Evelyn Walter, Michael Hayde, Eileen Stillwaggon

Economics Faculty Publications

Background:

Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario.

Methodology/Principal Findings:

We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric …

Religious Coping And Types And Sources Of Information Used In Making Prostate Cancer Treatment Decisions., Janice V Bowie, Caryn N Bell, Altovise Ewing, Ballington Kinlock, Ashley Ezema, Roland J Thorpe, Thomas A Laveist

Health Policy and Management Faculty Publications

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main …

Penile Anaerobic Dysbiosis As A Risk Factor For Hiv Infection, Cindy Liu, Jessica Prodger, Aaron Tobian, Alison Abraham, Godfrey Kigozi, Lance B. Price, +Several Additional Authors

Environmental and Occupational Health Faculty Publications

Sexual transmission of HIV requires exposure to the virus and infection of activated mucosal immune cells, specifically CD4⁺ T cells or dendritic cells. The foreskin is a major site of viral entry in heterosexual transmission of HIV. Although the probability of acquiring HIV from a sexual encounter is low, the risk varies even after adjusting for known HIV risk factors. The genital microbiome may account for some of the variability in risk by interacting with the host immune system to trigger inflammatory responses that mediate the infection of mucosal immune cells. We conducted a case-control study of uncircumcised participants …

Lung Ultrasound As A Diagnostic Tool For Radiographically-Confirmed Pneumonia In Low Resource Settings, L E. Ellington, R H. Gilman, M A. Chavez, F Pervaiz, J Marin-Concha, P Compen-Chang, S Riedel, S J. Rodriguez, C Gaydos, J Hardick, J M. Tielsch, M Steinhoff, J Benson, E A. May, D Figueroa-Quintanilla, W Checkley

Global Health Faculty Publications

Background

Pneumonia is a leading cause of morbidity and mortality in children worldwide; however, its diagnosis can be challenging, especially in settings where skilled clinicians or standard imaging are unavailable. We sought to determine the diagnostic accuracy of lung ultrasound when compared to radiographically-confirmed clinical pediatric pneumonia.

Methods

Between January 2012 and September 2013, we consecutively enrolled children aged 2–59 months with primary respiratory complaints at the outpatient clinics, emergency department, and inpatient wards of the Instituto Nacional de Salud del Niño in Lima, Peru. All participants underwent clinical evaluation by a pediatrician and lung ultrasonography by one of three …

Prevalence And Incidence Of Hypertension: Results From A Representative Cohort Of Over 16,000 Adults In Three Cities Of South Asia, Dorairaj Prabhakaran, Panniyammakal Jeemon, Shreeparna Ghosh, Roopa Shivashankar, Vamadevan S. Ajay, Dimple Kondal, Ruby Gupta, Mohammed K. Ali, Deepa Mohan, Viswanathan Mohan, Muhammad Masood Kadir, Nikhil Tandon, Kolli Srinath Reddy, K.M. Venkat Narayan

Community Health Sciences

Background: Despite high projected burden, hypertension incidence data are lacking in South Asian population. We measured hypertension prevalence and incidence in the Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) adult cohort.
Methods: The CARRS Study recruited representative samples of Chennai, Delhi, and Karachi in 2010/11, and socio-demographic and risk factor data were obtained using a standard common protocol. Blood pressure (BP) was measured in the sitting position using electronic sphygmomanometer both at baseline and two year follow-up. Hypertension and control were defined by JNC 7 criteria.
Results: In total, 16,287 participants were recruited (response rate=94.3%) and two …

Abnormal Dendritic Maturation Of Developing Cortical Neurons Exposed To Corticotropin Releasing Hormone (Crh): Insights Into Effects Of Prenatal Adversity?, Megan M. Curran, Curt A. Sandman, Elyssia Poggi Davis, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Corticotropin releasing hormone (CRH) produced by the hypothalamus initiates the hypothalamic- pituitary-adrenal (HPA) axis, which regulates the body's stress response. CRH levels typically are undetectable in human plasma, but during pregnancy the primate placenta synthesizes and releases large amounts of CRH into both maternal and fetal circulations. Notably, placental CRH synthesis increases in response to maternal stress signals. There is evidence that human fetal exposure to high concentrations of placental CRH is associated with behavioral consequences during infancy and into childhood, however the direct effects on of the peptide on the human brain are unknown. In this study, we used …

Point-Of-Care Testing For Toxoplasma Gondii Igg/Igm Using Toxoplasma Ict Igg-Igm Test With Sera From The United States And Implications For Developing Countries, Ian J. Begeman, Joseph Lykins, Ying Zhou, Bo Shiun Lai, Pauline Levinge, Kamal El Bissati, Kenneth Boyer, Shawn Withers, Fatima Clouser, A. Gwendolyn Noble, Peter Rabiah, Charles N. Swisher, Peter T. Heydemann, Depina G. Contopoulos-Ioannidis, Jose G. Montoya, Yvonne Maldonado, Raymund Ramirez, Cindy Press, Eileen Stillwaggon, François Peyron, Rima Mcleod

Economics Faculty Publications

Background

Congenital toxoplasmosis is a serious but preventable and treatable disease. Gestational screening facilitates early detection and treatment of primary acquisition. Thus, fetal infection can be promptly diagnosed and treated and outcomes can be improved.

Methods

We tested 180 sera with the Toxoplasma ICT IgG-IgM point-of-care (POC) test. Sera were from 116 chronically infected persons (48 serotype II; 14 serotype I-III; 25 serotype I-IIIa; 28 serotype Atypical, haplogroup 12; 1 not typed). These represent strains of parasites infecting mothers of congenitally infected children in the U.S. 51 seronegative samples and 13 samples from recently infected persons known to be IgG/IgM …

Colonization Density Of The Upper Respiratory Tract As A Predictor Of Pneumonia-Haemophilus Influenzae, Moraxella Catarrhalis, Staphylococcus Aureus, And Pneumocystis Jirovecii., Daniel E Park, Henry C Baggett, Stephen R C Howie, Qiyuan Shi, Nora L Watson, W Abdullah Brooks, Perch Study Group

Epidemiology Faculty Publications

Background.

There is limited information on the association between colonization density of upper respiratory tract colonizers and pathogen-specific pneumonia. We assessed this association for Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Pneumocystis jirovecii. Methods.

In 7 low- and middle-income countries, nasopharyngeal/oropharyngeal swabs from children with severe pneumonia and age-frequency matched community controls were tested using quantitative polymerase chain reaction (PCR). Differences in median colonization density were evaluated using the Wilcoxon rank-sum test. Density cutoffs were determined using receiver operating characteristic curves. Cases with a pathogen identified from lung aspirate culture or PCR, pleural fluid culture or …

Plasmonic Gold Nanoparticle For Detection Of Fungi And Human Cutaneous Fungal Infections, Tobiloba Sojinrin, Kangze Liu, Joao Conde, Hugh Byrne, James Curtin, Daxiang Cui, Furong Tian

Articles

Fungi, which are common in the environment, can cause a multitude of diseases. Warm, humid conditions allow fungi to grow and infect humans via the respiratory, digestive and reproductive tracts, genital area and other bodily interfaces. Fungi can be detected directly by microscopy, using the potassium hydroxide (KOH) test, which is the gold standard and most popular method for fungal screening. However, this test requires trained personnel operating specialist equipment, including a fluorescent microscope and culture facilities. As most acutely infected patients seek medical attention within the first few days of symptoms, the optimal diagnostic test would be rapid and …

Immune Checkpoint Inhibition And The Prevalence Of Autoimmune Disorders Among Patients With Lung And Renal Cancer, Sherif M. El-Refai

Pharmaceutical Sciences Faculty Publications

PURPOSE: Immune checkpoint inhibition reactivates the immune response against cancer cells in multiple tissue types and has been shown to induce durable responses. However, for patients with autoimmune disorders, their conditions can worsen with this reactivation. We sought to identify, among patients with lung and renal cancer, how many harbor a comorbid autoimmune condition and may be at risk of worsening their condition while on immune checkpoint inhibitors such as nivolumab and pembrolizumab.

METHODS: An administrative health care claims database, Truven MarketScan, was used to identify patients diagnosed with lung and renal cancer from 2010 to 2013. We assessed patients …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

Setting Health Research Priorities Using The Chnri Method: Vii. A Review Of The First 50 Applications Of The Chnri Method, Igor Rudan, Sachiyo Yoshida, Kit Yee Chan, Devi Sridhar, Kerri Wazny, Harish Nair, Aziz Sheikh, Mark Tomlinson, Joy E. Lawn, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Several recent reviews of the methods used to set research priorities have identified the CHNRI method (acronym derived from the "Child Health and Nutrition Research Initiative") as an approach that clearly became popular and widely used over the past decade. In this paper we review the first 50 examples of application of the CHNRI method, published between 2007 and 2016, and summarize the most important messages that emerged from those experiences.
Methods: We conducted a literature review to identify the first 50 examples of application of the CHNRI method in chronological order. We searched Google Scholar, PubMed and so-called …

Private Sector Role, Readiness And Performance For Malaria Case Management In Uganda, 2015., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Henry Kaula, Peter Buyungo, Jimmy Opigo

Collected Faculty Scholarship

BACKGROUND: Several interventions have been put in place to promote access to quality malaria case management services in Uganda's private sector, where most people seek treatment. This paper describes evidence using a mixed-method approach to examine the role, readiness and performance of private providers at a national level in Uganda. These data will be useful to inform strategies and policies for improving malaria case management in the private sector.

METHODS: The ACTwatch national anti-malarial outlet survey was conducted concurrently with a fever case management study. The ACTwatch nationally representative anti-malarial outlet survey was conducted in Uganda between May 18th 2015 …

Do Anti-Malarials In Africa Meet Quality Standards? The Market Penetration Of Non Quality-Assured Artemisinin Combination Therapy In Eight African Countries., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Paul N Newton, Kara Hanson, Catherine Goodman

Collected Faculty Scholarship

BACKGROUND: Quality of artemisinin-based combination therapy (ACT) is important for ensuring malaria parasite clearance and protecting the efficacy of artemisinin-based therapies. The extent to which non quality-assured ACT (non-QAACT), or those not granted global regulatory approval, are available and used to treat malaria in endemic countries is poorly documented. This paper uses national and sub-national medicine outlet surveys conducted in eight study countries (Benin, Kinshasa and Kantanga [Democratic Republic of the Congo, DRC], Kenya, Madagascar, Nigeria, Tanzania, Uganda and Zambia) between 2009 and 2015 to describe the non-QAACT market and to document trends in availability and distribution of non-QAACT in …

Analyzing Sexual Transmission In The Spread Of The Zika Virus In Colombia, Victoria M. Kelley

Biology and Medicine Through Mathematics Conference

No abstract provided.

Testing Times: Trends In Availability, Price, And Market Share Of Malaria Diagnostics In The Public And Private Healthcare Sector Across Eight Sub-Saharan African Countries From 2009 To 2015., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Kara Hanson, Catherine Goodman

Collected Faculty Scholarship

BACKGROUND: The World Health Organization guidelines have recommended that all cases of suspected malaria should receive a confirmatory test with microscopy or a malaria rapid diagnostic test (RDT), however evidence from sub-Saharan Africa (SSA) illustrates that only one-third of children under five with a recent fever received a test. The aim of this study was to evaluate availability, price and market share of microscopy and RDT from 2009/11 to 2014/15 in 8 SSA countries, to better understand barriers to improving access to malaria confirmatory testing in the public and private health sectors.

RESULTS: Repeated national cross-sectional quantitative surveys were conducted …

Control Policies And Sensitivity Analysis In A Cutaneous Leishmaniasis Model: A Case Study In Cusco Region, Peru., Rocio M. Caja-Rivera, Ignacio Barradas

Biology and Medicine Through Mathematics Conference

No abstract provided.

Detection Of Healthcare-Associated Infectious Disease Outbreaks With A Special Look At Clostridium Difficile Infection In Long-Term Care Facilities, Almea Matanock

Biomedical Sciences ETDs

Healthcare-associated infections (HAI) are a major cause of morbidity and mortality and a public health priority. However, standard procedures and comprehensive guidelines for HAI outbreak detection and response are still needed. This hybrid thesis describes what is known about HAI outbreaks in the introduction, reviews the HAI outbreaks reported to New Mexico Department of Health (NMDOH), in the first paper, and then in the second paper examines how established methods for detecting infectious disease outbreaks perform in identifying Clostridium difficile infection (CDI) outbreaks in long-term care facilities (LTCF) in Bernalillo County, New Mexico, and finally, it closes with our overall …

Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study., Anna M Gorczyca, Charles B Eaton, Michael J Lamonte, Joann E Manson, Jeanne D Johnston, Aurelian Bidulescu, Molly E Waring, Todd Manini, Lisa W Martin, Marcia L Stefanick, Ka He, Andrea K Chomistek

Medicine Faculty Publications

Background

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown.

Methods and Results

Participants included postmenopausal women in the Women's Health Initiative‐Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self‐reported at baseline, year 3, and year 6. Self‐reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as the …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

The Impact Of Freedson Bout Vs. Non-Freedson Bout Physical Activity On Metabolic Syndrome Risk In College Students, Valerie Olijar

Masters Theses, 2010-2019

Purpose The aim of this study is to examine moderate to vigorous physical activity in Freedson bouts compared to non-Freedson bouts and their association with Metabolic Syndrome risk factors in college students.

Methods 72 subjects aged 18-26 were recruited from James Madison University. Subjects height, weight, waist circumference, blood pressure, and body composition were assessed on visit 1. Blood pressure, fasted blood glucose, and lipid profile were assessed on visit 2. Subjects wore an Actigraph GT3X+ accelerometer, which measured physical activity and sleep for 7 days and nights. Univariate Pearson correlation analyses were performed to determine the relationship physical activity …

Cancer-Specific Mortality, Cure Fraction, And Noncancer Causes Of Death Among Diffuse Large B-Cell Lymphoma Patients In The Immunochemotherapy Era., Nadia Howlader, Angela B Mariotto, Caroline Besson, Gita Suneja, Kim Robien, Naji Younes, Eric A Engels

Epidemiology Faculty Publications

BACKGROUND

Survival after the diagnosis of diffuse large B-cell lymphoma (DLBCL) has been increasing since 2002 because of improved therapies; however, long-term outcomes for these patients in the modern treatment era are still unknown.

METHODS

Using Surveillance, Epidemiology, and End Results data, this study first assessed factors associated with DLBCL-specific mortality during 2002-2012. An epidemiologic risk profile, based on clinical and demographic characteristics, was used to stratify DLBCL cases into low-, medium-, and high-risk groups. The proportions of DLBCL cases that might be considered cured in these 3 risk groups was estimated. Risks of death due to various noncancer causes …

Private Sector Opportunities And Threats To Achieving Malaria Elimination In The Greater Mekong Subregion: Results From Malaria Outlet Surveys In Cambodia, The Lao Pdr, Myanmar, And Thailand., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sochea Phok, Saysana Phanalasy, Si Thu Thein, Asawin Likhitsup

Collected Faculty Scholarship

BACKGROUND: The aim of this paper is to review multi-country evidence of private sector adherence to national regulations, guidelines, and quality-assurance standards for malaria case management and to document current coverage of private sector engagement and support through ACTwatch outlet surveys implemented in 2015 and 2016.

RESULTS: Over 76,168 outlets were screened, and approximately 6500 interviews were conducted (Cambodia, N = 1303; the Lao People's Democratic Republic (PDR), N = 724; Myanmar, N = 4395; and Thailand, N = 74). There was diversity in the types of private sector outlets providing malaria treatment across countries, and the extent to which …

A Description Of The Methods Of The Aspirin Supplementation For Pregnancy Indicated Risk Reduction In Nulliparas (Aspirin) Study, Matthew K. Hoffman, Shivaprasad S. Goudar, Bhalachandra S. Kodkany, Norman Goco, Marion Koso-Thomas, Menachem Miodovnik, Elizabeth M. Mcclure, Dennis D. Wallace, Jennifer J. Emingway-Foday, Antoinette Tshefu, Adrien Lokangaka, Carl L. Bose, Elwyn Chomba, Musaku Mwenechanya, Waldemar A. Carlo, Ana Garces, Nancy F. Krebs, K. Michael Hambidge, Sarah Saleem, Robert L. Goldenberg, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Robert Silver, Richard J. Derman

Community Health Sciences

Background: Preterm birth (PTB) remains the leading cause of neonatal mortality and long term disability throughout the world. Though complex in its origins, a growing body of evidence suggests that first trimester administration of low dose aspirin (LDA) may substantially reduce the rate of PTB.
Methods: Hypothesis: LDA initiated in the first trimester reduces the risk of preterm birth. Study Design Type: Prospective randomized, placebo-controlled, double-blinded multi-national clinical trial conducted in seven low and middle income countries. Trial will be individually randomized with one-to-one ratio (intervention/control) Population: Nulliparous women between the ages of 14 and 40, with a …

Knowledge And Awareness Regarding Cervical Cancer And Uptake Of Pap Smear Among Women In Karachi, Pakistan, Shama Razzaq, Sayeeda Amber Sayed Amber Sayeeda Amber Sayed, Sumera Aziz Ali

Community Health Sciences

Objective: To determine the knowledge regarding cervical cancer, its symptoms and risk factors among women of 18 years and above attending the gynecology OPD in two public hospitals Karachi, Pakistan.
Methodology: A cross-sectional survey was held from February to June 2013 in Karachi, Pakistan. 384 females aged 18 years and above attending gynecology clinics in two public sector hospitals were taken through non-probability sampling method. The knowledge was assessed using a point scale method which had binary response i.e. correct and incorrect. A score of 50% (≥ 11 correct responses) was considered as optimum knowledge.
Results: Overall knowledge of cervical …

The Malaria Testing And Treatment Landscape In Benin., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Cyprien Zinsou, Adjibabi Bello Cherifath

Collected Faculty Scholarship

BACKGROUND: Since 2004, artemisinin-based combination therapy (ACT) has been the first-line treatment for uncomplicated malaria in Benin. In 2016, a medicine outlet survey was implemented to investigate the availability, price, and market share of anti-malarial treatment and malaria diagnostics. Results provide a timely and important benchmark to measure future interventions aimed at increasing access to quality malaria case management services.

METHODS: Between July 5th to August 6th 2016, a cross sectional, nationally-representative malaria outlet survey was conducted in Benin. A census of all public and private outlets with potential to distribute malaria testing and/or treatment was implemented among 30 clusters …

Anti-Malarial Landscape In Myanmar: Results From A Nationally Representative Survey Among Community Health Workers And The Private Sector Outlets In 2015/2016., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty Scholarship

BACKGROUND: In 2015/2016, an ACTwatch outlet survey was implemented to assess the anti-malarial and malaria testing landscape in Myanmar across four domains (Eastern, Central, Coastal, Western regions). Indicators provide an important benchmark to guide Myanmar's new National Strategic Plan to eliminate malaria by 2030.

METHODS: This was a cross-sectional survey, which employed stratified cluster-random sampling across four regions in Myanmar. A census of community health workers (CHWs) and private outlets with potential to distribute malaria testing and/or treatment was conducted. An audit was completed for all anti-malarials, malaria rapid diagnostic tests.

RESULTS: A total of 28,664 outlets were approached and …

Insights Into The Availability And Distribution Of Oral Artemisinin Monotherapy In Myanmar: Evidence From A Nationally Representative Outlet Survey., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Si Thu Thein, Hnin Su Su Khin, Aung Thi

Collected Faculty Scholarship

BACKGROUND: The containment of artemisinin resistance in Myanmar, historically an important probable origin and route of anti-malarial resistance to the India sub-continent and beyond, is crucial to global malaria control and elimination. This paper describes what is currently known about the sale and distribution of oral artemisinin monotherapy (AMT) across Myanmar, where this medicine is commonly found.

METHODS: A nationally representative 2015 outlet survey was conducted in the private sector, and among community health workers across four geographical domains. A national sample of outlets was screened for availability of malaria testing and treatment, and an audit was completed for all …

What Happened To Anti-Malarial Markets After The Affordable Medicines Facility-Malaria Pilot? Trends In Act Availability, Price And Market Share From Five African Countries Under Continuation Of The Private Sector Co-Payment Mechanism., Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sarah Tougher, Kara Hanson, Catherine Goodman

Collected Faculty Scholarship

BACKGROUND: The private sector supplies anti-malarial treatment for large proportions of patients in sub-Saharan Africa. Following the large-scale piloting of the Affordable Medicines Facility-malaria (AMFm) from 2010 to 2011, a private sector co-payment mechanism (CPM) provided continuation of private sector subsidies for quality-assured artemisinin combination therapies (QAACT). This article analyses for the first time the extent to which improvements in private sector QAACT supply and distribution observed during the AMFm were maintained or intensified during continuation of the CPM through 2015 in Kenya, Madagascar, Nigeria, Tanzania and Uganda using repeat cross-sectional outlet survey data.

RESULTS: QAACT market share in all …

Evidence On Anti-Malarial And Diagnostic Markets In Cambodia To Guide Malaria Elimination Strategies And Policies, Kathryn A. O'Connell, Vamsi Vasireddy, Megan Littrell, Andria Rusk, Actwatch Group, Sochea Phok, Dysoley Lek

Collected Faculty Scholarship

BACKGROUND: Understanding Cambodia's anti-malarial and diagnostic landscape in 2015 is critical for informing and monitoring strategies and policies as Cambodia moves forward with national efforts to eliminate malaria. The aim of this paper is to present timely and key findings on the public and private sector anti-malarial and diagnostic landscape in Cambodia. This evidence can serve as a baseline benchmark for guiding implementation of national strategies as well as other regional initiatives to address malaria elimination activities.

METHODS: From August 17th to October 1st, 2015, a cross sectional, nationally-representative malaria outlet survey was conducted in Cambodia. A census of all …