Effectiveness of artemether-lumefantrine provided by community health workers in under-five children with uncomplicated malaria in rural Tanzania : an open label prospective study

Background: Home-management of malaria (HMM) strategy improves early access of anti-malarial medicines to high-risk groups in remote areas of sub-Saharan Africa. However, limited data are available on the effectiveness of using artemisinin-based combination therapy (ACT) within the HMM strategy. The aim of this study was to assess the effectiveness of artemether-lumefantrine (AL), presently the most favoured ACT in Africa, in under-five children with uncomplicated Plasmodium falciparum malaria in Tanzania, when provided by community health workers (CHWs) and administered unsupervised by parents or guardians at home. Methods: An open label, single arm prospective study was conducted in two rural villages with high malaria transmission in Kibaha District, Tanzania. Children presenting to CHWs with uncomplicated fever and a positive rapid malaria diagnostic test (RDT) were provisionally enrolled and provided AL for unsupervised treatment at home. Patients with microscopy confirmed P. falciparum parasitaemia were definitely enrolled and reviewed weekly by the CHWs during 42 days. Primary outcome measure was PCR corrected parasitological cure rate by day 42, as estimated by Kaplan-Meier survival analysis. This trial is registered with ClinicalTrials.gov, number NCT00454961. Results: A total of 244 febrile children were enrolled between March-August 2007. Two patients were lost to follow up on day 14, and one patient withdrew consent on day 21. Some 141/241 (58.5%) patients had recurrent infection during follow-up, of whom 14 had recrudescence. The PCR corrected cure rate by day 42 was 93.0% (95% CI 88.3%-95.9%). The median lumefantrine concentration was statistically significantly lower in patients with recrudescence (97 ng/mL [IQR 0-234]; n = 10) compared with reinfections (205 ng/mL [114-390]; n = 92), or no parasite reappearance (217 [121-374] ng/mL; n = 70; p <= 0.046). Conclusions: Provision of AL by CHWs for unsupervised malaria treatment at home was highly effective, which provides evidence base for scaling-up implementation of HMM with AL in Tanzania.

Un mundo rural en transición : La campaña bonaerense según el Primer Censo Nacional de Población de la República Argentina (1869)

La campaña de Buenos Aires había recibido desde fines del siglo XVIII importantes corrientes migratorias interprovinciales que fueron progresivamente desplazadas por las provenientes de Europa. Si bien existen trabajos ;basados en los resultados generales, se ha abordado muy poco el ;estudio de la población a partir de las cédulas censales en sí mismas. Nos proponemos aquí observar la estructura de la población de la campaña bonaerense durante estos primeros tiempos de la inmigración masiva, aplicando una perspectiva comparada entre tres pueblos: San Antonio de Areco en la zona norte, Mercedes en el centro y San Vicente en el sur. Se prestará particular atención a la composición de la población, su origen, las actividades productivas y el proceso de urbanización. Se analizan igualmente las pautas de destino y localización geográfica de los extranjeros en los pueblos rurales, las ocupaciones preferidas y la eventual diversificación de actividades en función de las nacionalidades

Un mundo rural en transición : La campaña bonaerense según el Primer Censo Nacional de Población de la República Argentina (1869)

La campaña de Buenos Aires había recibido desde fines del siglo XVIII importantes corrientes migratorias interprovinciales que fueron progresivamente desplazadas por las provenientes de Europa. Si bien existen trabajos ;basados en los resultados generales, se ha abordado muy poco el ;estudio de la población a partir de las cédulas censales en sí mismas. Nos proponemos aquí observar la estructura de la población de la campaña bonaerense durante estos primeros tiempos de la inmigración masiva, aplicando una perspectiva comparada entre tres pueblos: San Antonio de Areco en la zona norte, Mercedes en el centro y San Vicente en el sur. Se prestará particular atención a la composición de la población, su origen, las actividades productivas y el proceso de urbanización. Se analizan igualmente las pautas de destino y localización geográfica de los extranjeros en los pueblos rurales, las ocupaciones preferidas y la eventual diversificación de actividades en función de las nacionalidades

Infrastructure (Rural Road) Development and Poverty Alleviation in Lao PDR

Rural road in Lao PDR defined as connecting road from village to main road, where it will lead them to market and access to other economic and social service facilities. However, due to mostly rural people accustom with subsistence farming, connecting road seems less important for rural people as their main farming produce is for own consumption rather than markets. After the introduction and implementation of New Economic Mechanism (NEM) since 1986, many rural villages have gradually developed and integrated into market system where people have significantly changed their livelihood with a better system. This progress has significantly contributed in improving income earning of people, better living standard and reduce poverty. The paper aims to illustrate the significant of rural road as connecting road from village to markets or a market access approach of farm produces. It also demonstrates through which approach, rural farmers/people could improve their income earning, develop their farming system, living standard and reduce poverty.

Un mundo rural en transición : La campaña bonaerense según el Primer Censo Nacional de Población de la República Argentina (1869)

La campaña de Buenos Aires había recibido desde fines del siglo XVIII importantes corrientes migratorias interprovinciales que fueron progresivamente desplazadas por las provenientes de Europa. Si bien existen trabajos ;basados en los resultados generales, se ha abordado muy poco el ;estudio de la población a partir de las cédulas censales en sí mismas. Nos proponemos aquí observar la estructura de la población de la campaña bonaerense durante estos primeros tiempos de la inmigración masiva, aplicando una perspectiva comparada entre tres pueblos: San Antonio de Areco en la zona norte, Mercedes en el centro y San Vicente en el sur. Se prestará particular atención a la composición de la población, su origen, las actividades productivas y el proceso de urbanización. Se analizan igualmente las pautas de destino y localización geográfica de los extranjeros en los pueblos rurales, las ocupaciones preferidas y la eventual diversificación de actividades en función de las nacionalidades

Food customs of rural and urban Inupiaq elders and their relationships to select nutrition parameters, food insecurity, health, and physical and mental functioning

The Inupiaq Tribe resides north of the Arctic Circle in northwestern Alaska. The people are characterized by their continued dependence on harvested fish, game and plants, known as a subsistence lifestyle (Lee 2000:35-45). Many are suggesting that they leave their historical home and move to urban communities, places believed to be more comfortable as they age. Tribal Elders disagree and have stated, "Elders need to be near the river where they were raised" (Branch 2005:1). The research questions focused on differences that location had on four groups of variables: nutrition parameters, community support, physical functioning and health. A total of 101 Inupiaq Elders ≥ 50 years were surveyed: 52 from two rural villages, and 49 in Anchorage. Location did not influence energy intake or intake of protein; levels of nutrition risk and food insecurity; all had similar rates between the two groups. Both rural and urban Elders reported few limitations of ADLs and IADLs. Self-reported general health scores (SF-12.v2 GH) were also similar by location. Differences were found with rural Elders reporting higher physical functioning summary scores (SF-12.v2 PCS), higher mental health scores (SF-12.v2 MH), higher vitality and less pain even though the rural mean ages were five years older than the urban Elders. Traditional food customs appear to support the overall health and well being of the rural Inupiaq Elders as demonstrated by higher intakes of Native foods, stronger food sharing networks and higher family activity scores than did urban Elders. The rural community appeared to foster continued physical activity. It has been said that when Elders are in the rural setting they are near "people they know" and it is a place "where they can get their Native food" (NRC 2005). These factors appear to be important as Inupiaq Elders age, as rural Inupiaq Elders fared as well or better than Inupiaq Elders in terms of diet, mental and physical health.

Built heritage-making and socioeconomic renewal in declining rural areas : evidence from Portugal

This article focuses on the connections between built heritage-making and socioeconomic renewal in declining rural areas. Drawing on fieldwork in twelve rural villages in eastern Portugal, it sheds light on the outcomes of a State-led programme, the objectives of which were to renovate the historic built fabric and generate tourism revenue for a region with declining population levels. Overall, the programme was successful in terms of preservation / conservation of monuments and the built fabric, but failed to stimulate the anticipated social and economic development. The conclusion is that the making of heritage spaces is not the remedy for the economic and demographic ills of rural areas, notwithstanding the positive effect that such measures may have in certain cases.

Variations between post- and pre-harvest seasons in stunting, wasting, and Infant and Young Child Feeding (IYCF) practices among children 6-23 months of age in lowland and midland agro-ecological zones of rural Ethiopia

Introduction: Food availability and access are strongly affected by seasonality in Ethiopia. However, there are little data on seasonal variation in Infant and Young Child Feeding (IYCF) practices and malnutrition among 6-23 months old children in different agro-ecological zones of rural Ethiopia. Methods: Socio-demographic, anthropometry and IYCF indicators were assessed in post- and pre-harvest seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 39.8% and 26.9% in post-harvest to 46.0% and 31.8% in pre-harvest seasons, respectively. The biggest increase in prevalence of stunting and underweight between post- and pre-harvest seasons was noted in the midland zone. Wasting decreased from 11.6% post-harvest to 8.5% pre-harvest, with the biggest decline recorded in the lowland zone. Minimum meal frequency, minimum acceptable diet and poor dietary diversity increased considerably in pre-harvest compared to post-harvest season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women’s dietary diversity and children age was predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in malnutrition and IYCF practices among children 6-23 months of age with more pronounced effect in midland agro-ecological zone. A major contributing factor for child malnutrition may be poor feeding practices. Health information strategies focused on both IYCF practices and dietary diversity of mothers could be a sensible approach to reduce the burden of child malnutrition in rural Ethiopia.

Frozen Chicken for Wild Fish: Nutritional Transition in the Brazilian Amazon Region Determined by Carbon and Nitrogen Stable Isotope Ratios in Fingernails

Objectives: Amazonian populations are experiencing dietary changes characteristic of the nutrition transition. However, the degree of change appears to vary between urban and rural settings. To investigate this process, we determined carbon and nitrogen stable isotope ratios in fingernails and dietary intake of Amazonian populations living along a rural to urban continuum along the Solimoes River in Brazil. Methods: Carbon and nitrogen stable isotope ratios were analyzed from the fingernails of 431 volunteer subjects living in different settings ranging from rural villages, small towns to urban centers along the Solimoes River. Data from 200 dietary intake surveys were also collected using food frequency questionnaires and 24-h recall interviews in an effort to determine qualitative aspects of diet composition. Results: Fingernail delta(13)C values (mean standard deviation) were -23.2 +/- 1.3, 20.2 +/- 1.5, and 17.4 +/- 1.3 parts per thousand and delta(15)N values were 11.8 +/- 0.6, 10.4 +/- 0.8, and 10.8 +/- 0.7 parts per thousand for those living in rural villages, small towns, and major cities, respectively. We found a gradual increase in the number of food items derived from C(4) plant types (meat and sugar) and the replacement of food items derived from C(3) plant types (fish and manioc flour) with increasing size of urban centers. Conclusion: Increasing urbanization in the Brazilian Amazon is associated with a significant change in food habits with processed and industrialized products playing an increasingly important role in the diet and contributing to the nutrition transition in the region. Am. J. Hum. Biol. 23:642-650, 2011. (C) 2011 Wiley-Liss, Inc.

Lead, hemoglobin, zinc protoporphyrin and ferritin concentrations in children

OBJECTIVE: To assess the relationship of blood lead and hemoglobin, zinc protoporphyrin, and ferritin concentrations in children. METHODS: A cross-sectional study was carried out in 136 anemic and non-anemic children from two rural villages near a lead smelter in Adrianópolis, Southern Brazil, from July to September 2001. Hemoglobin electrophoresis was performed to exclude children with hemoglobin variants and thalassemia syndromes associated with anemia. Lead was determined by atomic absorption spectrophotometry; hemoglobin by automated cell counting; zinc protoporphyrin by hematofluorometry; ferritin by chemiluminescence. Student's t-test, Mann-Whitney test, and the c² test were used to assess the significance of the differences between the variables investigated in anemic and non-anemic children. Stepwise multivariate linear regression analysis was performed using two models for anemic and non-anemic children respectively. RESULTS: Lead was negatively associated to hemoglobin (p<0.017) in the first model, and in the second model lead was positively associated to zinc protoporphyrin (p<0.004) after controlling for ferritin, age, sex, and per capita income. There was an inverse association between hemoglobin and blood lead in anemic children. It was not possible to confirm if anemic children had iron deficiency anemia or subclinical infection, considering that the majority (90.4%) had normal ferritin. CONCLUSIONS: The study detected a relationship between anemia and elevated blood lead concentrations. Further epidemiological studies are necessary to investigate the impact of iron nutritional interventions as an attempt to decrease blood lead in children.

A multi-purpose grammar generating a multi-scale integrated analysis of Laos

In this study we propose an application of the MuSIASEM approach which is used to provide an integrated analysis of Laos across different scales. With the term “integrated analysis across scales” we mean the generation of a series of packages of quantitative indicators, characterizing the performance of the socioeconomic activities performed in Laos when considering: (i) different hierarchical levels of organization (farming systems described at the level of household, rural villages, regions of Laos, the whole country level); and (ii) different dimensions of analysis (economic dimension, social dimension, ecological dimension, technical dimension). What is relevant in this application is that the information carried out by these different packages of indicators is integrated in a system of accounting which establishes interlinkages across these indicators. This is a essential feature to study sustainability trade-offs and to build more robust scenarios of possible changes. The multi-scale integrated representation presented in this study is based on secondary data (gathered in a three year EU project – SEAtrans and integrated by other available statistical sources) and it is integrated in GIS, when dealing with the spatial representation of Laos. However, even if we use data referring to Laos, the goal of this study is not that of providing useful information about a practical policy issue of Laos, but rather, to illustrate the possibility of using a multipurpose grammar to produce an integrated set of sustainability indicators at three different levels: (i) local; (ii) meso; (iii) macro level. The technical issue addressed is the simultaneous adoption of two multi-level matrices – one referring to a characterization of human activity over a set of different categories, and another referring to a characterization of land uses over the same set of categories. In this way, it becomes possible to explain the characteristics of Laos (an integrated set of indicators defining the performance of the whole country) in relation to the characteristics of the rural Laos and urban Laos. The characteristics of rural Laos, can be explained using the characteristics of three regions defined within Laos (Northern Laos, Central Laos and Southern Laos), which in turn can be defined (using an analogous package of indicators), starting from the characteristics of three main typologies of farming systems found in the regions.

Immunodiagnosis of Trypanosoma cruzi (Chagas' Disease) Infection in Naturally Infected Dogs

This study reports on the standardization of an enzyme-linked immunosorbent assay (ELISA) for detecting specific antibodies anti-Trypanosoma cruzi in naturally infected dogs. Sera from 182 mongrel dogs of all ages residing in four rural villages in Santiago del Estero, Argentina, were collected in November 1994 and preserved in buffered neutral glycerin. All sera were tested by indirect hemagglutination test (IHAT), indirect immunofluorescence test (IFAT), and ELISA using the flagellar fraction of T. cruzi as antigen. Dog sera from an area without vectorial transmission were used to calculate ELISA specificity and cut-off value. Eighty-six percent of sera had concordant results for all tests. All sera reactive for IHAT and IFAT were also reactive for ELISA, except in one case. Sera tested by ELISA when diluted 1:200 allowed a clearer division between non-reactive and reactive sera than when 1:100 with greater agreement among serologic techniques. The specificity of ELISA was 96.2%. Among 34 adult dogs with a positive xenodiagnosis, sensitivity was 94% both for ELISA and IFAT. ELISA is the first choice for screening purposes and one of the pair of techniques recommended for diagnostic studies in dog populations

Chagas Disease in Dogs from Endemic Areas of Costa Rica

Dogs with the presumptive diagnosis of Chagas disease are commonly sent to our School of Veterinary Medicine by independent veterinarians. This prompted us to evaluate the prevalence of canine trypanosomiasis in some villages of the Central Valley of Costa Rica. A total of 54 dogs (21 males and 33 females) from five rural villages, with ages between 3 months and 10 years old, were bled and submitted to three serological tests: indirect immunofluorescence, indirect hemagglutination and ELISA. Among all animals, 15 (27.7%) revealed antibodies (6 pure bred and 9 mongrels) and in 3 of them the parasite was also demonstrated by xenodiagnosis. All positive animals except 1, and 9 negative animals (control group) were examined by X-rays and electrocardiography, revealing different degrees of cardiomegaly and ECG alteration, consistent with Chagas disease pathology in one dog (SA-11) of the infected ones. Examination of 50 inhabitants living in the houses where dogs and Triatoma dimidiata were found, yielded negative serological reactions. This was assumed to support the hypothesis that dogs are commonly infected by the oral route, a more effective means of infection compared with the vector transmission mechanism that occurs in humans.

Genetic polymorphisms in the glutamate-rich protein of Plasmodium falciparum field isolates from a malaria-endemic area of Brazil

The genetic diversity displayed by Plasmodium falciparum, the most deadly Plasmodium species, is a significant obstacle for effective malaria vaccine development. In this study, we identified genetic polymorphisms in P. falciparum glutamate-rich protein (GLURP), which is currently being tested in clinical trials as a malaria vaccine candidate, from isolates found circulating in the Brazilian Amazon at variable transmission levels. The study was performed using samples collected in 1993 and 2008 from rural villages situated near Porto Velho, in the state of Rondônia. DNA was extracted from 126 P. falciparum-positive thick blood smears using the phenol-chloroform method and subjected to a nested polymerase chain reaction protocol with specific primers against two immunodominant regions of GLURP, R0 and R2. Only one R0 fragment and four variants of the R2 fragment were detected. No differences were observed between the two time points with regard to the frequencies of the fragment variants. Mixed infections were uncommon. Our results demonstrate conservation of GLURP-R0 and limited polymorphic variation of GLURP-R2 in P. falciparum isolates from individuals living in Porto Velho. This is an important finding, as genetic polymorphisms in B and T-cell epitopes could have implications for the immunological properties of the antigen.

Carcass composition of Venda indigenous scavenging chickens under village management

Four Venda indigenous scavenging (VIS) chickens (one young male and one young female of 10-16 weeks of age, a mature cockerel and a mature hen) were randomly purchased from each of six adjacent rural villages during three different seasons (autumn, winter and spring) to determine the meat yield and carcass chemical composition. A total of 72 chickens were slaughtered and feathers, head, neck, viscera, feet and lungs were removed. The live body weight, dressed carcass weight and also the mass of the breast without wings, thighs and drumsticks were recorded with bones and skin. The muscle tissues of the breast and both legs without tendons and fat were sampled for chemical analysis and were analysed for dry matter, ether extract, crude protein and ash. The carcass weight, dressing %, mass of the breast, mass of the thighs, mass of the drumsticks, breast yield, thighs yield and drumsticks yield of both grower and adult VIS chickens were not influenced by season. The crude protein of the grower chickens breast muscles and fat content of the adult chicken leg muscles differed with season. The meat from VIS chickens provided a constant nutrient (crude protein) supply throughout the year to the rural communities.