Amazonian malaria: Asymptomatic human reservoirs, diagnostic challenges, environmentally driven changes in mosquito vector populations, and the mandate for sustainable control strategies

Across the Americas and the Caribbean, nearly 561,000 slide-confirmed malaria infections were reported officially in 2008. The nine Amazonian countries accounted for 89% of these infections; Brazil and Peru alone contributed 56% and 7% of them, respectively. Local populations of the relatively neglected parasite Plasmodium vivax, which currently accounts for 77% of the regional malaria burden, are extremely diverse genetically and geographically structured. At a time when malaria elimination is placed on the public health agenda of several endemic countries, it remains unclear why malaria proved so difficult to control in areas of relatively low levels of transmission such as the Amazon Basin. We hypothesize that asymptomatic parasite carriage and massive environmental changes that affect vector abundance and behavior are major contributors to malaria transmission in epidemiologically diverse areas across the Amazon Basin. Here we review available data supporting this hypothesis and discuss their implications for current and future malaria intervention policies in the region. Given that locally generated scientific evidence is urgently required to support malaria control interventions in Amazonia, we briefly describe the aims of our current field-oriented malaria research in rural villages and gold-mining enclaves in Peru and a recently opened agricultural settlement in Brazil. (C) 2011 Elsevier B.V. All rights reserved.

De cada labrador un soldado y de cada agricultor un propietario : Economía, sociedad y política en el ejido de la Guardia de Luján (Mercedes), 1810-1870

En la siguiente investigación analizamos uno de los aspectos menos conocidos de la historia rural bonaerense: los ejidos de los pueblos de campaña. Estos espacios se conformaron a medida que la colonización avanzaba, primero de manera espontánea y luego por iniciativa estatal, con el objetivo de asentar a los pobladores alrededor de los centros poblados y fomentar el cultivo. Así, a diferencia de otros espacios de colonización española, los ejidos constituyeron las áreas donde se establecieron los solares, las quintas y las chacras. La historiografía tradicional reparó muy poco en ellos y cuando lo hizo, fue desde una óptica que contraponía la primera parte del siglo XIX con la expansión posterior a Pavón. Dentro de esta lógica, los pueblos rurales fueron descriptos como espacios rudimentarios y sus habitantes casi no fueron tenidos en cuenta puesto que la mirada centrada en la "estancia" opacó cualquier interés sobre los labradores y pastores que habitaban en estos espacios. En contrapartida, el período posterior fue caracterizado como de despegue de la economía exportadora y desarrollo de las instituciones. Desde ese momento los poblados habrían cobrado nueva vida convirtiéndose en importantes núcleos de población incentivados por la llegada de la inmigración. Para desandar estos supuestos, estudiamos específicamente la historia del ejido de la Guardia de Luján (Mercedes) desde el momento en que se creó el fuerte hasta 1870. Cada uno de los capítulos se estructuró en torno a núcleos problemáticos generales que fueron abordados desde lo local: la propiedad, los labradores, el mercado de tierras, la estructura productiva y la construcción del estado. El estudio demuestra la imposibilidad de definir la estructura productiva de un partido completamente sin tener en cuenta a los ejidos puesto que se puede incurrir en generalizaciones erróneas. Además, el período abarcado y los temas seleccionados permitieron reconocer los cambios y continuidades que se produjeron en estos espacios durante la transición a la Argentina Moderna.

De cada labrador un soldado y de cada agricultor un propietario : Economía, sociedad y política en el ejido de la Guardia de Luján (Mercedes), 1810-1870

En la siguiente investigación analizamos uno de los aspectos menos conocidos de la historia rural bonaerense: los ejidos de los pueblos de campaña. Estos espacios se conformaron a medida que la colonización avanzaba, primero de manera espontánea y luego por iniciativa estatal, con el objetivo de asentar a los pobladores alrededor de los centros poblados y fomentar el cultivo. Así, a diferencia de otros espacios de colonización española, los ejidos constituyeron las áreas donde se establecieron los solares, las quintas y las chacras. La historiografía tradicional reparó muy poco en ellos y cuando lo hizo, fue desde una óptica que contraponía la primera parte del siglo XIX con la expansión posterior a Pavón. Dentro de esta lógica, los pueblos rurales fueron descriptos como espacios rudimentarios y sus habitantes casi no fueron tenidos en cuenta puesto que la mirada centrada en la "estancia" opacó cualquier interés sobre los labradores y pastores que habitaban en estos espacios. En contrapartida, el período posterior fue caracterizado como de despegue de la economía exportadora y desarrollo de las instituciones. Desde ese momento los poblados habrían cobrado nueva vida convirtiéndose en importantes núcleos de población incentivados por la llegada de la inmigración. Para desandar estos supuestos, estudiamos específicamente la historia del ejido de la Guardia de Luján (Mercedes) desde el momento en que se creó el fuerte hasta 1870. Cada uno de los capítulos se estructuró en torno a núcleos problemáticos generales que fueron abordados desde lo local: la propiedad, los labradores, el mercado de tierras, la estructura productiva y la construcción del estado. El estudio demuestra la imposibilidad de definir la estructura productiva de un partido completamente sin tener en cuenta a los ejidos puesto que se puede incurrir en generalizaciones erróneas. Además, el período abarcado y los temas seleccionados permitieron reconocer los cambios y continuidades que se produjeron en estos espacios durante la transición a la Argentina Moderna.

The Iron Age landscape of Alcoi Valley, eastern Iberia: Agricultural intensification and sociopolitical dynamics

New archaeological survey data are combined with previous evidence to examine the rural landscape during the Iberian Iron Age in the Valencia region of eastern Spain. One goal was to understand the settlement pattern and agricultural intensification through manuring. The second objective was to address the socioeconomic aspects of changes in the landscape. It is possible to trace the emergence of a hierarchical settlement pattern in the Iberian Iron Age in which large fortified settlements carried out the most important functions of control and exploitation of the territory, extending their authority over small rural villages and farmsteads. This pattern is associated with the complex socioeconomic structures and political organization of early Iberian states.

Are marginalized women being left behind? A population-based study of institutional deliveries in Karnataka, India

Background While India has made significant progress in reducing maternal mortality, attaining further declines will require increased skilled birth attendance and institutional delivery among marginalized and difficult to reach populations. Methods A population-based survey was carried out among 16 randomly selected rural villages in rural Mysore District in Karnataka, India between August and September 2008. All households in selected villages were enumerated and women with children 6 years of age or younger underwent an interviewer-administered questionnaire on antenatal care and institutional delivery. Results Institutional deliveries in rural areas of Mysore District increased from 51% to 70% between 2002 and 2008. While increasing numbers of women were accessing antenatal care and delivering in hospitals, large disparities were found in uptake of these services among different castes. Mothers belonging to general castes were almost twice as likely to have an institutional birth as compared to scheduled castes and tribes. Mothers belonging to other backward caste or general castes had 1.8 times higher odds (95% CI: 1.21, 2.89) of having an institutional delivery as compared to scheduled castes and tribes. In multivariable analysis, which adjusted for inter- and intra-village variance, Below Poverty Line status, caste, and receiving antenatal care were all associated with institutional delivery. Conclusion The results of the study suggest that while the Indian Government has made significant progress in increasing antenatal care and institutional deliveries among rural populations, further success in lowering maternal mortality will likely hinge on the success of NRHM programs focused on serving marginalized groups. Health interventions which target SC/ST may also have to address both perceived and actual stigma and discrimination, in addition to providing needed services. Strategies for overcoming these barriers may include sensitization of healthcare workers, targeted health education and outreach, and culturally appropriate community-level interventions. Addressing the needs of these communities will be critical to achieving Millennium Development Goal Five by 2015.

Intervenção numa aldeia numa perspectiva de reconversão

Dissertação de Mestrado para obtenção do grau de Mestre em Arquitectura, apresentada na Universidade de Lisboa - Faculdade de Arquitectura.

Ensuring community and agricultural resiliency to climate change: Ceremonial practices as emic adaptive strategies

This paper is an analysis of emic versus etic approaches to climate change resiliency, taking as a case study the traditional ceremony performed by farmers in eastern Flores, Indonesia to rid their fields of rats. This paper begins by providing a theoretical framework discussion on the dominant etic and emic academic research on monsoons and climate change impacts on agriculture. The rat ceremony performed in villages throughout East Flores is a local custom used to rid agricultural fields of pests—often rats—that come from the surrounding forests to feed on the agricultural crops when the rains become erratic. This paper argues that analyzing the rat ceremony through an emic lens allows for better future resiliency to monsoon shifts due to climate change. It is argued that the rat ceremony demonstrates a way in which community resiliency is strengthened by an adaptive approach that supports an already existing community ceremony that emphasizes two essential tenets: community solidarity and coexistence with nature. Both tenets directly promote community resiliency. An explicit emphasis on emic approaches to climate change challenges could help re-define how resiliency is understood and supported within vulnerable communities such as rural villages.

Maternal health care utilization in rural Jordanian villages: Patterns and predictors

Background. Different individual (demographic) characteristic and health system related characteristics have been identified in the literature to contribute to different rates of maternal health care utilization in developing countries. This study is going to evaluate the individual and quality of health predictors of maternal health care utilization in rural Jordanian villages. ^ Methods. Data from a 2004 survey was used. Individual (predisposing and enabling) variables, quality of health care variables, and maternal care utilization variables were selected for 477 women who had a live birth during the last 5 years. The conceptual framework used in this study will be the Aday-Andersen model for health services utilization. ^ Results. 82.4% of women received at least one antenatal care visit. Individually, village of residence (p=0.036), parity (p=0.048), education (p=0.006), and health insurance (p=0.029) were found to be significant; in addition to respectful treatment (p=0.045) and clean facilities (p=0.001) were the only quality of health care factors found to be significant in predicting antenatal care use. Using logistic regression, living in southern villages (OR=4.7, p=0.01) and availability of transportation (sometimes OR=3.2, p=0.01 and never OR=2.4, p<0.05) were the only two factors to influence maternal care use. ^ Conclusions. Living in the South and transportation are major barriers to maternal care utilization in rural Jordan. Other important cultural factors of interest in some villages should be addressed in future research. Perceptions of women regarding quality of health services should be seriously taken into account. ^

Communication and culture : mobile telephony in PNG villages

This paper examines the recent introduction of mobile telephony into rural communities in Papua New Guinea (PNG). It presents the findings of substantial fieldwork conducted in 2009, and suggests ways in which the new technology is already changing people’s lives and relationships. The paper identifies the roles of mobile telephones in two communities, the changes taking place and how villagers are responding to them. Comparison of the two villages is strategic as it highlights similarities in perceptions of mobile phones in these two very different settings. An ethnographic approach is adopted, situated within an interpretative methodology. Data collection methods include semi-structured interviews, orally-administered surveys and participant observation. The village lifestyle or ‘culture’ provides an important lens for understanding this data and the assertions made by village respondents. This research is significant as it addresses changes currently occurring in the communication methods of whole communities.

Mobile phones in PNG villages : an island village experience

As a new communication technology expands in a disadvantaged, rural area of a developing country, changes take place in the lives of the people in the area. The paper examines the introduction of mobile telephony into a rural village in Papua New Guinea, and contains findings from field research conducted in February 2009. The analysis is undertaken through a social lens, providing an understanding of the roles of mobile phones in this community by foregrounding the feelings, thoughts and attitudes expressed by the village people. This in turn enables a deeper understanding of the sociological effects related to the uptake of mobile telephony.

Early experience of mobile telephony : a comparison of two villages in Papua New Guinea

This paper examines social change following the recent introduction of mobile telephony into rural communities in Papua New Guinea (PNG). It presents the findings of substantial fieldwork conducted in 2009, and suggests ways in which the new technology is already changing people’s lives and relationships. The paper identifies the roles of mobile telephones in two communities, the changes taking place, and how villagers are responding to them. Comparison of the two villages is strategic as it highlights similarities in perceptions of mobile phones in these two very different settings. An ethnographic approach is adopted, situated within an interpretative methodology. Data collection methods include semi-structured interviews, orally-administered surveys and participant observation. The theoretical lens is focused on the ‘communicative ecology’ concept, which stems from the communication research tradition. This research is significant as it addresses changes currently occurring in the communication methods of whole communities.

Life-course determinants of bone mass in young adults from a transitional rural community in India: The Andhra Pradesh Children and Parents Study (APCAPS)

Background: Undernutrition and physical inactivity are both associated with lower bone mass. Objective: This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development. Design: This was a prospective cohort study of participants of the Hyderabad Nutrition Trial (1987–1990), which offered balanced protein-calorie supplementation to pregnant women and preschool children younger than 6 y in the intervention villages. The 2009–2010 follow-up study collected data on current anthropometric measures, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, blood samples, diet, physical activity, and living standards of the trial participants (n = 1446, aged 18–23 y). Results: Participants were generally lean and had low BMD [mean hip BMD: 0.83 (women), 0.95 (men) g/cm2; lumbar spine: 0.86 (women), 0.93 (men) g/cm2]. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. On the other hand, current lean mass and weight-bearing physical activity were positively associated with BMD. No strong evidence of an association was found between BMD and current serum 25-hydroxyvitamin D or dietary intake of calcium, protein, or calories. Conclusions: Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population. In transitional rural communities from low-income countries, promotion of physical activity may help to mitigate any potential adverse effects of early nutritional disadvantage.

Rural energy consumption patterns - A field study

This paper is a condensed version of the final report of a detailed field study of rural energy consumption patterns in six villages located west of Bangalore in the dry belt of Karnataka State in India. The study was carried out in two phases; first, a pilot study of four villages and second, the detailed study of six villages, the populations of which varied from around 350 to about 950. The pilot survey ended in late 1976, and most of the data was collected for the main project in 1977. Processing of the collected data was completed in 1980. The aim was to carry out a census survey, rather than a sample study. Hence, considerable effort was expended in production of both a suitable questionnaire, ensuring that all respondents were contacted, and devising methods which would accurately reflect the actual energy use in various energy-utilising activities. In the end, 560 households out of 578 (97%) were surveyed. The following ranking was found for the various energy sources in order of average percentage contribution to the annual total energy requirement: firewood, 81·6%; human energy, 7·7%; animal energy, 2·7%; kerosene, 2·1%; electricity, 0·6% and all other sources (rice husks, agro-wastes, coal and diesel fuel), 5·3%. In other words commercial fuels made only a small contribution to the overall energy use. It should be noted that dung cakes are not burned in this region. The average energy use pattern, sector by sector, again on a percentage basis, was as follows: domestic, 88·3%; industry, 4·7%; agriculture, 4·3%; lighting, 2·2% and transport, 0·5%. The total annual per capita energy consumption was 12·6 ± 1·2 GJ, giving an average annual household consumption of around 78·6 GJ.