The population structure of Plasmodium falciparum and Plasmodium vivax during an epidemic of malaria in the eastern highlands of Papua New Guinea

Although most of the Papua New Guinea highlands are too high for stable malaria transmission, local epidemics are a regular feature of the region. Few detailed descriptions of such epidemics are available, however. We describe the investigation of a malaria epidemic in the Obura Valley, Eastern Highlands Province, Papua New Guinea. Of the 244 samples examined by microscopy, 6.6% were positive for Plasmodium falciparum only, 9.4% were positive for Plasmodium vivax only, and 1.2% were mixed infections. MSP2 and MSP3alpha genotyping and AMA1 sequencing were used to determine the genetic variation present in a sample of P. falciparum and P. vivax infections. The P. vivax infections were found to be genetically highly diverse. In contrast, all P. falciparum samples were of a single genotype. This striking difference in genetic diversity suggests endemic, low-level local transmission for P. vivax but an outside introduction of P. falciparum as the most likely source of the epidemic.

Does terrestrial epidemiology apply to marine systems?

Most of epidemiological theory has been developed for terrestrial systems, but the significance of disease in the ocean is now being recognized. However, the extent to which terrestrial epidemiology can be directly transferred to marine systems is uncertain. Many broad types of disease-causing organism occur both on land and in the sea, and it is clear that some emergent disease problems in marine environments are caused by pathogens moving from terrestrial to marine systems. However, marine systems are qualitatively different from terrestrial environments, and these differences affect the application of modelling and management approaches that have been developed for terrestrial systems. Phyla and body plans are more diverse in marine environments and marine organisms have different life histories and probably different disease transmission modes than many of their terrestrial counterparts. Marine populations are typically more open than terrestrial ones, with the potential for long-distance dispersal of larvae. Potentially, this might enable unusually rapid propagation of epidemics in marine systems, and there are several examples of this. Taken together, these differences will require the development of new approaches to modelling and control of infectious disease in the ocean.

Exposing extinction risk analysis to pathogens: Is disease just another form of density dependence?

In the United States and several other countries., the development of population viability analyses (PVA) is a legal requirement of any species survival plan developed for threatened and endangered species. Despite the importance of pathogens in natural populations, little attention has been given to host-pathogen dynamics in PVA. To study the effect of infectious pathogens on extinction risk estimates generated from PVA, we review and synthesize the relevance of host-pathogen dynamics in analyses of extinction risk. We then develop a stochastic, density-dependent host-parasite model to investigate the effects of disease on the persistence of endangered populations. We show that this model converges on a Ricker model of density dependence under a suite of limiting assumptions, including. a high probability that epidemics will arrive and occur. Using this modeling framework, we then quantify: (1) dynamic differences between time series generated by disease and Ricker processes with the same parameters; (2) observed probabilities of quasi-extinction for populations exposed to disease or self-limitation; and (3) bias in probabilities of quasi-extinction estimated by density-independent PVAs when populations experience either form of density dependence. Our results suggest two generalities about the relationships among disease, PVA, and the management of endangered species. First, disease more strongly increases variability in host abundance and, thus, the probability of quasi-extinction, than does self-limitation. This result stems from the fact that the effects and the probability of occurrence of disease are both density dependent. Second, estimates of quasi-extinction are more often overly optimistic for populations experiencing disease than for those subject to self-limitation. Thus, although the results of density-independent PVAs may be relatively robust to some particular assumptions about density dependence, they are less robust when endangered populations are known to be susceptible to disease. If potential management actions involve manipulating pathogens, then it may be useful to. model disease explicitly.

The impact of a reduction in drug supply on demand for and compliance with treatment for drug dependence

Background: In early 2001, Australia experienced a sudden, dramatic and;sustained decrease in heroin availability that was accompanied by sharp increases in price and decreases in street level purity-the so-called heroin shortage. These unprecedented changes occurred in a context of widespread treatment availability, which made it possible for the first time to examine the impact of a sharp reduction in heroin supply in New South Wales (NSW) on entry to and adherence with treatment for heroin dependence. Given the evidence of drug substitution by some users. the current paper also examines the effects of the shortage on entry to treatment for other forms of drug dependence. Methods: Interrupted time-series analysis of the number of persons entering opioid pharmacotherapy and other treatment modalities in NSW for heroin dependence and for the treatment for other types of drug dependence. Findings: The heroin shortage was associated with a reduction in the number of younger persons entering opioid pharmacotherapy. There was a dramatic decrease in the number of persons entering heroin withdrawal or assessment only treatment episodes. There appear to have been small improvements in adherence to and retention in heroin treatment after the reduction in heroin supply. Relatively small increases were observed in numbers being treated for cocaine dependence. Conclusions: In the context of good treatment provision, a reduction in heroin supply appeared to produce modest improvements in intermediate outcomes. Supply and demand reduction measures, when both are implemented successfully, may be complementary. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Documenting the heroin shortage in New South Wales

Australian heroin markets have recently undergone dramatic change, sparking debate about the nature of such markets. This study aimed to determine the onset, peak and decline of the heroin shortage in New South Wales (NSW), using the most appropriate available methods to detect market level changes. The parameters of the heroin shortage were determined by reviewing: reports of heroin users about availability and price (derived from the existing literature and the Illicit Drug Reporting System); qualitative interviews with injecting drug users, and health and law enforcement professionals working in the illicit drug field; and examining data on heroin seizures over the past decade. There was a marked reduction in heroin supply in NSW in early 2001. An increase in the price of heroin occurred in 2001, whereas it had decreased steadily since 1996. A reduction in purity also occurred, as reported by drug users and heroin seizures. The peak period of the shortage appears to have been January to April 2001. The market appears to have stabilised since that time, although it has not returned to pre- 2001 levels: heroin prices have decreased in NSW for street grams, but not to former levels, and the price of `caps' (street deals) remain elevated. Heroin purity in NSW has remained low, with perhaps a 10% increase above the lowest recorded levels. These data support the notion that the heroin market in NSW underwent significant changes, which appear to have involved a lasting shift in the nature of the market.

Treatment of falciparum malaria in the age of drug-resistance

The growing problem of drug resistance has greatly complicated the treatment for falciparum malaria. Whereaschloroquine and sulfadoxine/ pyrimethamine could once cure most infections, this is no longer true and requiresexamination of alternative regimens. Not all treatment failures are drug resistant and other issues such asexpired antimalarials and patient compliance need to be considered. Continuation of a failing treatment policyafter drug resistance is established suppresses infections rather than curing them, leading to increasedtransmission of malaria, promotion of epidemics and loss of public confidence in malaria control programs.Antifolate drug resistance (i.e. pyrimethamine) means that new combinations are urgently needed particularlybecause addition of a single drug to an already failing regimen is rarely effective for very long. Atovaquone/proguanil and mefloquine have been used against multiple drug resistant falciparum malaria with resistance toeach having been documented soon after drug introduction. Drug combinations delay further transmission ofresistant parasites by increasing cure rates and inhibiting formation of gametocytes. Most currentlyrecommended drug combinations for falciparum malaria are variants of artemisinin combination therapy wherea rapidly acting artemisinin compound is combined with a longer half-life drug of a different class. Artemisininsused include dihydroartemisinin, artesunate, artemether and companion drugs include mefloquine, amodiaquine,sulfadoxine/ pyrimethamine, lumefantrine, piperaquine, pyronaridine, chlorproguanil/dapsone. The standard ofcare must be to cure malaria by killing the last parasite. Combination antimalarial treatment is vital not only tothe successful treatment of individual patients but also for public health control of malaria.

Temporal dynamics of rabbit haemorrhagic disease virus infection in a low-density population of wild rabbits (Oryctolagus cuniculus) in New Zealand

A longitudinal capture-mark-recapture study was conducted to determine the temporal dynamics of rabbit haemorrhagic disease (RHD) in a European rabbit (Oryctolagus cuniculus) population of low to moderate density on sand-hill country in the lower North Island of New Zealand. A combination of sampling ( trapping and radio-tracking) and diagnostic (cELISA, PCR and isotype ELISA) methods was employed to obtain data weekly from May 1998 until June 2001. Although rabbit haemorrhagic disease virus ( RHDV) infection was detected in the study population in all 3 years, disease epidemics were evident only in the late summer or autumn months in 1999 and 2001. Overall, 20% of 385 samples obtained from adult animals older than 11 weeks were seropositive. An RHD outbreak in 1999 contributed to an estimated population decline of 26%. A second RHD epidemic in February 2001 was associated with a population decline of 52% over the subsequent month. Following the outbreaks, the seroprevalence in adult survivors was between 40% and 50%. During 2000, no deaths from RHDV were confirmed and mortalities were predominantly attributed to predation. Influx of seronegative immigrants was greatest in the 1999 and 2001 breeding seasons, and preceded the RHD epidemics in those years. Our data suggest that RHD epidemics require the population immunity level to fall below a threshold where propagation of infection can be maintained through the population.

The onset and effectiveness of Adult Plant Resistance (APR) in Tallon barley

Field observations of net blotch epidemics indicated that Tallon barley was quite resistant to infection during later stages of growth despite being susceptible as a seedling. A glasshouse experiment was conducted to determine the effectiveness of this resistance and when it became operative. Three cultivars – Gilbert (very susceptible), Patty (resistant) and Tallon – were inoculated at various stages of growth with conidia of Pyrenophora teres f. teres and the infection response and leaf area diseased, recorded 13 days later. The response of Tallon clearly changed from susceptible to moderately susceptible at growth stage 33. Plants sown two weeks earlier were susceptible and plants sown two weeks later were moderately resistant. The response of the other two cultivars at similar growth stages paralleled their seedling responses. The resistance of Tallon appeared to increase with maturity so that, at its most resistant growth stage, the leaf area diseased was just 10% that of the susceptible, Gilbert. While this resistance appears pathotype specific, this experiment demonstrated very effective APR to net blotch. As most losses to this disease occur during the later stages of plant development, APR offers a valuable source of resistance.

Iraqi Birth Defects and the WHO Report

Since the U.S.-led invasion of Iraq in 2003, epidemics of birth defects and cancers are rising in many Iraqi cities. In 2012, the World Health Organization (WHO) and the Iraqi Ministry of Health (MoH) undertook a large-scale epidemiological study to determine the prevalence of birth defects in the Iraqi population. A report which appeared on the WHO website in September 2013, claims that "The rates for spontaneous abortion, stillbirths and congenital birth defects found in the [Iraq] study are consistent with or even lower than international estimates." This article discusses the severe shortcomings of this report and questions its reliability .

Sonho e cura: o culto de Asclépio em Epidauro entre os séculos IV e II a. C.

Profound changes have marked Greek society from the fourth century B.C.. Conquests, wars and epidemics altered drastically the Greek’s posture regarding his public life, his conception of gods and hence the construction of their spaces, whether sacred or profane. Through the fonts, we perceived that the cult of god Asklepeios turned very popular, in this context, for the peculiar way that the god relates to his devotees, through the dreams. We know that the dream was held, for the Greeks, as a space of real existence, it was sacred, and could be accessed in the healing rituals of Asklepios. Our work intends, thereby, to understand the curious and peculiar oniric space, mainly through the inscriptions, architectural structures of the sanctuary and the ancient texts that refer to the context of the period, because we understand that this space was the essential condition for the popularization of the cult, it placed the individual in direct contact with the divinity, a rare closeness between men and gods accepted by the greek imagery until then.

A atuação do enfermeiro no combate à dengue e a febre chikungunya: estudo comparativo nos municípios de Parnamirim e Santa Cruz/RN

The research aimed to analyze the role of nurses in the Family Health Strategy (FHS) in the control of Dengue and Chikungunya fever in the cities of Parnamirim and Santa Cruz. It is exploratory and descriptive nature of research, with a qualitative approach, which was developed with nurses of the Family Health Strategy in the municipalities of Parnamirim and Santa Cruz. All research process followed the ethical standards laid out research in Resolution No. 466/2012 of the National Health Council about research involving human beings. Data collection was performed using a semi-structured questionnaire with open and closed questions, organized into three parts: the profile of respondents, knowledge of the disease (transmission, prevention, control) and description of practices. The actions performed by nurses are punctual performed when there is growing disease of the number of cases in order to try to reduce the number of cases. The principal methodology used for them is to talk and guidelines resulting from campaigns and home visits, using leaflets and social networks. Regarding knowledge of nurses in the city of Santa Cruz on Dengue Fever and Chikungunya, is clearly some gaps. Nursing professionals know recognize a suspected case of dengue, but get confused when trying to explain to the Chikungunya fever, exhibiting the same symptoms of dengue. Although everybody had participated in a training on Chikungunya Fever and Dengue, a very limited knowledge of nurses regarding the clinical management. It is suggested that further studies are developed on the ground a few nurses have accepted to participate in the study, so that we can identify strategies, interventions, activities and nursing actions that are consistent with the reality of working in favor of coping Aedes epidemics aegypti that have positive impact on reducing the infestation rates and may be suitable and applied in other regions.

A atuação do enfermeiro no combate à dengue e a febre chikungunya: estudo comparativo nos municípios de Parnamirim e Santa Cruz/RN

The research aimed to analyze the role of nurses in the Family Health Strategy (FHS) in the control of Dengue and Chikungunya fever in the cities of Parnamirim and Santa Cruz. It is exploratory and descriptive nature of research, with a qualitative approach, which was developed with nurses of the Family Health Strategy in the municipalities of Parnamirim and Santa Cruz. All research process followed the ethical standards laid out research in Resolution No. 466/2012 of the National Health Council about research involving human beings. Data collection was performed using a semi-structured questionnaire with open and closed questions, organized into three parts: the profile of respondents, knowledge of the disease (transmission, prevention, control) and description of practices. The actions performed by nurses are punctual performed when there is growing disease of the number of cases in order to try to reduce the number of cases. The principal methodology used for them is to talk and guidelines resulting from campaigns and home visits, using leaflets and social networks. Regarding knowledge of nurses in the city of Santa Cruz on Dengue Fever and Chikungunya, is clearly some gaps. Nursing professionals know recognize a suspected case of dengue, but get confused when trying to explain to the Chikungunya fever, exhibiting the same symptoms of dengue. Although everybody had participated in a training on Chikungunya Fever and Dengue, a very limited knowledge of nurses regarding the clinical management. It is suggested that further studies are developed on the ground a few nurses have accepted to participate in the study, so that we can identify strategies, interventions, activities and nursing actions that are consistent with the reality of working in favor of coping Aedes epidemics aegypti that have positive impact on reducing the infestation rates and may be suitable and applied in other regions.

La protection de la vie privée au temps de la biosécurité

Cette thèse s’intéresse à la protection de la vie privée informationnelle dans le contexte de la biosécurité. La biosécurité se définit comme le processus qui vise à prendre en charge, dans une optique de sécurité nationale, les menaces et dangers que représentent les épidémies de maladies infectieuses pour la santé des populations humaines et la sécurité de l’État. Notre projet remet en question l’idée selon laquelle la conduite des activités de surveillance de la santé publique implique nécessairement une diminution de la protection offerte aux renseignements personnels sur la santé. Nos recherches tendent à démontrer que la conciliation de la surveillance de la santé et la protection de la vie privée est non seulement possible, mais qu’elle est surtout nécessaire. Nous portons plus précisément notre attention sur le cas de la collecte et de l’utilisation de renseignements dépersonnalisés sur la santé par les systèmes de surveillance syndromique. Bien calibrée et soigneusement réglementée, cette forme novatrice et particulière de surveillance offrirait le double avantage de réduire les risques d’atteintes à la vie privée des individus et d’augmenter de manière considérable l’efficacité des capacités étatiques en matière de détection des épidémies.

‘Black Settlers’: Hybridity, Neoliberalism and Ecosystemic Change Among Tonga Farmers of Southern Zambia, 1964-2008

This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.

Uses of agent-based modeling for health communication: the TELL ME case study

Government communication is an important management tool during a public health crisis, but understanding its impact is difficult. Strategies may be adjusted in reaction to developments on the ground and it is challenging to evaluate the impact of communication separately from other crisis management activities. Agent-based modeling is a well-established research tool in social science to respond to similar challenges. However, there have been few such models in public health. We use the example of the TELL ME agent-based model to consider ways in which a non-predictive policy model can assist policy makers. This model concerns individuals’ protective behaviors in response to an epidemic, and the communication that influences such behavior. Drawing on findings from stakeholder workshops and the results of the model itself, we suggest such a model can be useful: (i) as a teaching tool, (ii) to test theory, and (iii) to inform data collection. We also plot a path for development of similar models that could assist with communication planning for epidemics.