• Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008-2014

      Moakofhi, K; Edwards, JK; Motlaleng, M; Namboze, J; Butt, W; Obopile, M; Mosweunyane, T; Manzi, M; Takarinda, KC; Owiti, P (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Background: Malaria elimination requires infection detection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy. Methods: This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method. Results: During 2008-2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013. Conclusion: This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices.
    • Building operational research capacity in the Pacific

      Bissel, K; Viney, K; Brostrom, R; Gounder, S; Khogali, M; Kishore, K; Kool, B; Kumar, A M V; Manzi, M; Marais, B; et al. (The Union, 2014-06-21)
      Operational research (OR) in public health aims to investigate strategies, interventions, tools or knowledge that can enhance the quality, coverage, effectiveness or performance of health systems. Attention has recently been drawn to the lack of OR capacity in public health programmes throughout the Pacific Islands, despite considerable investment in implementation. This lack of ongoing and critical reflection may prevent health programme staff from understanding why programme objectives are not being fully achieved, and hinder long-term gains in public health. The International Union Against Tuberculosis and Lung Disease (The Union) has been collaborating with Pacific agencies to conduct OR courses based on the training model developed by The Union and Médecins Sans Frontières Brussels-Luxembourg in 2009. The first of these commenced in 2011 in collaboration with the Fiji National University, the Fiji Ministry of Health, the World Health Organization and other partners. The Union and the Secretariat of the Pacific Community organised a second course for participants from other Pacific Island countries and territories in 2012, and an additional course for Fijian participants commenced in 2013. Twelve participants enrolled in each of the three courses. Of the two courses completed by end 2013, 18 of 24 participants completed their OR and submitted papers by the course deadline, and 17 papers have been published to date. This article describes the context, process and outputs of the Pacific courses, as well as innovations, adaptations and challenges.
    • Compliance to follow up and adherence to medication in hypertensive patients in an urban informal settlement in Kenya: comparison of three models of care

      Kuria, N; Reid, A; Owiti, P; Tweya, H; Kibet, CK; Mbau, L; Manzi, M; Murunga, V; Namusonge, T; Kibachio, J (Wiley-Blackwell, 2018-05-19)
      To determine and compare, among three models of care, compliance to scheduled clinic appointments and adherence to anti-hypertensive medication of patients in an informal settlement of Kibera, Kenya.
    • Did microbial larviciding contribute to a reduction in malaria cases in eastern Botswana in 2012-2013?

      Obopile, M; Segoea, G; Waniwa, K; Ntebela, DS; Moakofhi, K; Motlaleng, M; Mosweunyane, T; Edwards, JK; Namboze, J; Butt, W; et al. (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Setting: Larviciding has potential as a component of integrated vector management for the reduction of malaria transmission in Botswana by complementing long-lasting insecticide nets and indoor residual sprays. Objective: To evaluate the susceptibility of local Anopheles to commonly used larvicides. Design: This field test of the efficacy of Bacillus thuringiensis subsp. israliensis vs. Anopheles was performed by measuring larval density before treatment and 24 h and 48 h after treatment in seven sites of Bobirwa district, eastern Botswana, in 2012 and 2013. Vector density and malaria cases were compared between Bobirwa and Ngami (northwestern Botswana), with no larviciding in the control arm. Results: Larviciding reduced larval density by 95% in Bobirwa in 2012, with two cases of malaria, while in 2013 larval density reduction was 81%, with 11 cases. Adult mosquito density was zero for both years in Robelela village (Bobirwa), compared to respectively four and 26 adult mosquitoes per room in Shorobe village (Ngami) in 2012 and 2013. There were no cases of malaria in Robelela in either year, but in Shorobe there were 20 and 70 cases, respectively, in 2012 and 2013. Conclusion: Larviciding can reduce the larval density of mosquitoes and reduce malaria transmission in Botswana. Large-scale, targeted implementation of larviciding in districts at high risk for malaria is recommended.
    • Driving towards malaria elimination in Botswana by 2018: progress on case-based surveillance, 2013-2014

      Motlaleng, M; Edwards, J; Namboze, J; Butt, W; Moakofhi, K; Obopile, M; Manzi, M; Takarinda, KC; Zachariah, R; Owiti, P; et al. (International Union Against Tuberculosis and Lung Disease, 2018-04-25)
      Background: Reliable information reporting systems ensure that all malaria cases are tested, treated and tracked to avoid further transmission. Botswana aimed to eliminate malaria by 2018, and surveillance is key. This study focused on assessing the uptake of the new malaria case-based surveillance (CBS) system introduced in 2012, which captures information on malaria cases reported in the Integrated Disease Surveillance and Response (IDSR) system. Methods: This was a retrospective descriptive study based on routine data focusing on Ngami, Chobe and Okavango, three high-risk districts in Botswana. Aggregated data variables were extracted from the IDSR and compared with data from the CBS. Results: The IDSR reported 456 malaria cases in 2013 and 1346 in 2014, of which respectively only 305 and 884 were reported by the CBS. The CBS reported 34% fewer cases than the IDSR system, indicating substantial differences between the two systems. The key malaria indicators with the greatest variability among the districts included in the study were case identification number and date of diagnosis. Conclusion: The IDSR and CBS systems are essential for malaria elimination, as shown by the significant gaps in reporting between the two systems. These findings highlight the need for further investigation into these discrepancies. Strengthening the CBS system will help to reach the objective of malaria elimination in Botswana.
    • Hidden dangers-prevalence of blood borne pathogens, hepatitis B, C, HIV and syphilis, among blood donors in Sierra Leone in 2016: opportunities for improvement: a retrospective, cross-sectional study.

      Yambasu, EE; Reid, A; Owiti, P; Manzi, M; Murray, MJS; Edwin, AK (African Field Epidemiology Network, 2018-05-18)
      INTRODUCTION: Transmissible blood-borne infections are a serious threat to blood transfusion safety in West African countries; and yet blood remains a key therapeutic product in the clinical management of patients. Sierra Leone screens blood donors for blood-borne infections but has not implemented prevention of mother-to-child transmission for hepatitis B. This study aimed to describe the overall prevalence of hepatitis B and C, HIV and syphilis among blood donors in Sierra Leone in 2016 and to compare the differences between volunteer versus family replacement donors, as well as urban versus rural donors. METHODS: Retrospective, cross-sectional study from January-December 2016 in five blood bank laboratories across the country. Routinely-collected programme data were analyzed; blood donors were tested with rapid diagnostic tests-HBsAg for HBV, anti-HCV antibody for HCV, antibodies HIV1&2 for HIV and TPHA for syphilis. RESULTS: There were 16807 blood samples analysed, with 80% from males; 2285 (13.6%) tested positive for at least one of the four pathogens. Overall prevalence was: 9.7% hepatitis B; 1.0% hepatitis C; 2.8% HIV; 0.8% syphilis. Prevalence was higher among samples from rural blood banks, the difference most marked for hepatitis C. The proportion of voluntary donors was 12%. Family replacement donors had a higher prevalence of hepatitis B, C and HIV than volunteers. CONCLUSION: A high prevalence of blood-borne pathogens, particularly hepatitis B, was revealed in Sierra Leone blood donors. The study suggests the country should implement the prevention of mother-to-child transmission of hepatitis B and push to recruit more volunteer, non-remunerated blood donors.
    • High Mortality in Tuberculosis Patients Despite HIV Interventions in Swaziland

      Mchunu, G; van Griensven, J; Hinderaker, S G; Kizito, W; Sikhondze, W; Manzi, M; Dlamini, T; Harries, A D (International Union Against TB and Lung Disease, 2016-06-21)
    • Management of multi- and extensively drug-resistant tuberculosis in Ukraine: how well are we doing?

      Lytvynenko, N; Cherenko, S; Feschenko, Y; Pogrebna, M; Senko, Y; Barbova, A; Manzi, M; Denisiuk, O; Ramsay, A; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2014-10-21)
    • Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality?

      Ngoy, B B; Zachariah, R; Hinderaker, S G; Khogali, M; Manzi, M; van Griensven, J; Ayada, L; Jemmy, J P; Maalim, A; Amin, H (International Union Against Tuberculosis and Lung Disease, 2014-03-25)
    • Pattern of primary tuberculosis drug resistance and associated treatment outcomes in Transnistria, Moldova

      Dolgusev, O; Obevzenco, N; Padalco, O; Pankrushev, S; Ramsay, A; Van den Bergh, R; Manzi, M; Denisiuk, O; Zachariah, R (International Union Against Tuberculosis and Lung Disease, 2014-10-21)
    • Performance of decentralised facilities in tuberculosis case notification and treatment success in Armenia

      Davtyan, K; Zachariah, R; Davtyan, H; Ramsay, A; Denisiuk, O; Manzi, M; Khogali, M; Van den Bergh, R; Hayrapetyan, A; Dara, M (International Union Against Tuberculosis and Lung Disease, 2014-10-21)
    • Public Health Action for public health action

      Harries, A D; Bianchi, L; Jensen, P M; Pantages, M; Bissell, K; Kumar, A M V; Hinderaker, S G; Tayler-Smith, K; Van den Bergh, R; van den Boogaard, W; et al. (International Union Against Tuberculosis and Lung Disease, 2014-09-21)
    • The Structured Operational Research and Training Initiative for public health programmes

      Ramsay, A; Harries, A D; Zachariah, R; Bissel, K; Hinderaker, S G; Edginton, M; Enarson, D A; Satyanarayana, S; Kumar, A M V; Hoa, N B; et al. (The Union, 2014-06-21)