Assessing Surveillance Elements of the Zanzibar Malaria Elimination Program to Support Malaria Elimination in Zanzibar

Though significant progress has been made through control efforts in recent years, malaria remains a leading cause of morbidity and mortality throughout the world, with 3.2 billion people at risk of developing the disease. Zanzibar is currently pursuing malaria elimination through the Zanzibar Malaria Elimination Program (ZAMEP), and is working toward a goal of no locally acquired malaria cases by 2018. A comprehensive and well functioning malaria surveillance program is central to achieving this goal. Under ZAMEP’s current surveillance strategy, District Malaria Surveillance Officers (DMSOs) respond to malaria case notifications through the reactive case detection (RACD) system. Three malaria screening and treatment strategies are undertaken in response to this system, including household-level (HSaT), focal-level (FSaT), and mass-level (MSaT). Each strategy is triggered by a different case threshold and tests different-sized populations. The aims of this study were to (1) assess the cost effectiveness of three malaria screening and treatment strategies; (2) assess the timeliness and completeness of ZAMEP’s RACD system; (3) and qualitatively explore the roles of DMSOs.

Screening disposition and budget information for 2014 screening and treatment strategies was analyzed to determine prevalence rates in screened populations and the cost effectiveness of each strategy. Prevalence rates within the screened population varied by strategy: 6.1 percent in HSaT, 1.2 percent in FSaT, and 0.9 percent in MSaT. Of the various costing scenarios considering cost per person screened, MSaT was the most cost-effective, with costs ranging from $9.57 to $12.57 per person screened. Of the various costing scenarios considering cost per case detected, HSaT was the most cost-effective, at $385.51 per case detected.

Case data from 2013 through mid-2015 was used to assess the timeliness and completeness of the RACD system. The average number of RACD activities occurring within 48 hours of notification improved slightly between 2013 and the first half of 2015, from 90.7 percent to 93.1 percent. The average percentage of household members screened during RACD also increased over the same time period, from 84 percent in 2013 to 89.9 percent in the first half of 2015.

Interviews with twenty DMSOs were conducted to gain insights into the challenges to malaria elimination both from the health system and the community perspectives. Major themes discussed in the interviews include the need for additional training, inadequate information capture at health facility, resistance to household testing, transportation difficulties, inadequate personnel during the high transmission season, and community misinformation.

Zanzibar is now considered a low transmission setting, making elimination feasible, but also posing new challenges to achieving this goal. The findings of this study provide insight into how surveillance activities can be improved to support the goal of malaria elimination in Zanzibar. Key changes include reevaluating the use of MSaT activities, improving information capture at health facilities, hiring additional DMSOs during the high transmission season, and improving community communication.

Metabarcoding approach for non-indigenous species surveillance in marine coastal waters

In this study, high-throughput sequencing (HTS) metabarcoding was applied for the surveillance of plankton communities within the southeastern (SE) Baltic Sea coastal zone. These results were compared with those from routine monitoring survey and morphological analyses. Four of five nonindigenous species found in the samples were identified exclusively by metabarcoding. All of them are considered as invasive in the Baltic Sea with reported impact on the ecosystem and biodiversity. This study indicates that, despite some current limitations, HTS metabarcoding can provide information on the presence of exotic species and advantageously complement conventional approaches, only requiring the same monitoring effort as before. Even in the currently immature status of HTS, this combination of HTS metabarcoding and observational records is recommended in the early detection of marine pests and delivery of the environmental status metrics of nonindigenous species.

Internet Surveillance after Snowden: A Critical Empirical Study of Computer Experts' Attitudes on Commercial and State Surveillance of the Internet and Social Media post-Edward Snowden

Acknowledgement: The research presented in this paper was conducted as part of the EU FP7 research project PACT (http://www.projectpact.eu), grant agreement number 285635.

Organic Surveillance: Security and Myth in the Rural

This project looks at the ways Northeastern Ontario citizens in rural communities regulate their private property through traditional and contemporary surveillance means. Through art and objects, this project allows viewers the opportunity to experience surveillance in rural areas through visual and creative ways that encourage interaction and critique. This project defines organic surveillance by looking at the ways ruralists in Markstay Ontario practice surveillance and deterrence which is influenced by characteristics of land, risks and other determining factors such as psychology, resourcefulness, sustainability, technology and private property. Organic surveillance argues that surveillance and deterrence is prevalent far beyond datamining, GPS tracking and social media. Surveillance and deterrence as methods of survival are found everywhere, even in the farthest, most “wild” and forested areas.

Image usefulness of compressed surveillance footage with different scene contents

The police use both subjective (i.e. police staff) and automated (e.g. face recognition systems) methods for the completion of visual tasks (e.g person identification). Image quality for police tasks has been defined as the image usefulness, or image suitability of the visual material to satisfy a visual task. It is not necessarily affected by any artefact that may affect the visual image quality (i.e. decrease fidelity), as long as these artefacts do not affect the relevant useful information for the task. The capture of useful information will be affected by the unconstrained conditions commonly encountered by CCTV systems such as variations in illumination and high compression levels. The main aim of this thesis is to investigate aspects of image quality and video compression that may affect the completion of police visual tasks/applications with respect to CCTV imagery. This is accomplished by investigating 3 specific police areas/tasks utilising: 1) the human visual system (HVS) for a face recognition task, 2) automated face recognition systems, and 3) automated human detection systems. These systems (HVS and automated) were assessed with defined scene content properties, and video compression, i.e. H.264/MPEG-4 AVC. The performance of imaging systems/processes (e.g. subjective investigations, performance of compression algorithms) are affected by scene content properties. No other investigation has been identified that takes into consideration scene content properties to the same extend. Results have shown that the HVS is more sensitive to compression effects in comparison to the automated systems. In automated face recognition systems, `mixed lightness' scenes were the most affected and `low lightness' scenes were the least affected by compression. In contrast the HVS for the face recognition task, `low lightness' scenes were the most affected and `medium lightness' scenes the least affected. For the automated human detection systems, `close distance' and `run approach' are some of the most commonly affected scenes. Findings have the potential to broaden the methods used for testing imaging systems for security applications.

Information ethics in the age of digital labour and the surveillance-industrial complex

Thee rise of computing and the internet have brought about an ethical eld of studies that some term information ethics, computer ethics, digital media ethics, or internet ethics e aim of this contribution is to discuss information ethics’ foundations in the context of the internet’s political economy e chapter rst looks to ground the analysis in a comparison of two information ethics approaches, namely those outlined by Rafael Capurro and Luciano Floridi It then develops, based on these foundations, analyses of the information ethical dimensions of two important areas of social media: one concerns the framing of social media by a surveillance-industrial complex in the context of Edward Snowden’s revelations and the other deals with issues of digital labour processes and issues of class that arises in this context e contribution asks ethical questions about these two phenomena that bring up issues of power, exploitation, and control in the information age It asks if, and if so, how, the approaches of Capurro and Floridi can help us to understand ethico-political aspects of the surveillance-industrial complex and digital labour

Contextual anomaly detection in crowded surveillance scenes

This work addresses the problem of detecting human behavioural anomalies in crowded surveillance environments. We focus in particular on the problem of detecting subtle anomalies in a behaviourally heterogeneous surveillance scene. To reach this goal we implement a novel unsupervised context-aware process. We propose and evaluate a method of utilising social context and scene context to improve behaviour analysis. We find that in a crowded scene the application of Mutual Information based social context permits the ability to prevent self-justifying groups and propagate anomalies in a social network, granting a greater anomaly detection capability. Scene context uniformly improves the detection of anomalies in both datasets. The strength of our contextual features is demonstrated by the detection of subtly abnormal behaviours, which otherwise remain indistinguishable from normal behaviour.

Real-time PCR demonstrates high prevalence of Schistosoma japonicum in the Philippines:implications for surveillance and control

BACKGROUND: The Philippines has a population of approximately 103 million people, of which 6.7 million live in schistosomiasis-endemic areas with 1.8 million people being at risk of infection with Schistosoma japonicum. Although the country-wide prevalence of schistosomiasis japonica in the Philippines is relatively low, the prevalence of schistosomiasis can be high, approaching 65% in some endemic areas. Of the currently available microscopy-based diagnostic techniques for detecting schistosome infections in the Philippines and elsewhere, most exhibit varying diagnostic performances, with the Kato-Katz (KK) method having particularly poor sensitivity for detecting low intensity infections. This suggests that the actual prevalence of schistosomiasis japonica may be much higher than previous reports have indicated.

METHODOLOGY/PRINCIPAL FINDINGS: Six barangay (villages) were selected to determine the prevalence of S. japonicum in humans in the municipality of Palapag, Northern Samar. Fecal samples were collected from 560 humans and examined by the KK method and a validated real-time PCR (qPCR) assay. A high S. japonicum prevalence (90.2%) was revealed using qPCR whereas the KK method indicated a lower prevalence (22.9%). The geometric mean eggs per gram (GMEPG) determined by the qPCR was 36.5 and 11.5 by the KK. These results, particularly those obtained by the qPCR, indicate that the prevalence of schistosomiasis in this region of the Philippines is much higher than historically reported.

CONCLUSIONS/SIGNIFICANCE: Despite being more expensive, qPCR can complement the KK procedure, particularly for surveillance and monitoring of areas where extensive schistosomiasis control has led to low prevalence and intensity infections and where schistosomiasis elimination is on the horizon, as for example in southern China.

Systematic Review Protocol to Evaluate the Effectiveness and Cost Effectiveness of Personalised Surveillance after Colorectal Adenomatous Polypectomy

Lifetime risk of developing colorectal cancer (CRC) is 5% and five-year survival at early-stage is 92%. CRC risk following index colonoscopy should establish post-screening surveillance benefit, which may be greater in high-risk patients. This review evaluated published cost-effectiveness estimates of post-polypectomy surveillance to assess the potential for personalised recommendations by risk sub-group. Current data suggested colonoscopy identifies those at low-risk of CRC, who may not benefit from intensive surveillance, which risks unnecessary harms and inefficient use of colonoscopy resources. Meta-analyses of incidence of advanced-neoplasia post-polypectomy for low-risk was comparable to those without adenoma; both rates were under the lifetime risk of 5%. Therefore, greater personalisation through de-intensified strategies for low-risk individuals could be beneficial and could employ non-invasive testing such as faecal immunochemical tests (FIT) combined with primary prevention or chemoprevention, thereby reserving colonoscopy for targeted use in personalised risk-stratified surveillance.
This systematic review aims to:
1. Assess if there is evidence supporting a program of personalised surveillance in patients with colorectal adenoma according to risk sub-group.
2. Compare the effectiveness of surveillance colonoscopy with alternative prevention strategies.
3. Assess trade-off between costs, benefits and adverse effects which must be considered in a decision to adopt or reject personalised surveillance.

An exploration of men’s experiences of undergoing active surveillance for favourable-risk prostate cancer: A mixed methods study protocol

Background
Prostate cancer is one of the most common male cancers worldwide. Active Surveillance (AS) has been developed to allow men with lower risk disease to postpone or avoid the adverse side effects associated with curative treatments until the disease progresses. Despite the medical benefits of AS, it is reported that living with untreated cancer can create a significant emotional burden for patients.

Methods/design
The aim of this study is to gain insight into the experiences of men eligible to undergo AS for favourable-risk PCa.

This study has a mixed-methods sequential explanatory design consisting of two phases: quantitative followed by qualitative. Phase 1 has a multiple point, prospective, longitudinal exploratory design. Ninety men diagnosed with favourable-risk prostate cancer will be assessed immediately post-diagnosis (baseline) and followed over a period of 12 months, in intervals of 3 month. Ninety age-matched men with no cancer diagnosis will also be recruited using peer nomination and followed up in the same 3 month intervals. Following completion of Phase 1, 10–15 AS participants who have reported both the best and worst psychological functioning will be invited to participate in semi-structured qualitative interviews. Phase 2 will facilitate further exploration of the quantitative results and obtain a richer understanding of participants’ personal interpretations of their illness and psychological wellbeing.

Discussion
To our knowledge, this is the first study to utilise early baseline measures; include a healthy comparison group; calculate sample size through power calculations; and use a mixed methods approach to gain a deeper more holistic insight into the experiences of men diagnosed with favourable-risk prostate cancer.