Simonsen P.E.,Copenhagen University |
Mwakitalu M.E.,National Institute for Medical Research
Parasitology Research | Year: 2013
Lymphatic filariasis (LF) is a disabling and disfiguring disease resulting from a mosquito-borne parasitic infection. It is a major public health problem in many countries with a warm climate. Research and control activities have mainly focused on LF in rural areas where it also has its major impact. However, with rapid and unplanned growth of cities in the developing world, there is a need also to consider LF transmission and control in urban settings. Here, we review currently available knowledge on urban LF and the environmental and socio-economic basis for its occurrence. Among the three parasite species causing LF in humans, only Wuchereria bancrofti has been documented to have a significant potential for urban transmission. This is primarily because one of its vectors, Culex quinquefasciatus, thrives and proliferates excessively in crowded city areas with poor sanitary, sewerage and drainage facilities. For this reason, urban LF also often shows a marked focality in distribution, with most cases clustered in areas inhabited by the less privileged city populations. More knowledge on urban LF is needed, in particular on its socio-economic and human behavioural context, on the potential for transmission in regions where other LF vector species predominate, and on rapid methods for identification and mapping of risk areas, to provide a strong evidence base for its control. © 2012 The Author(s). Source
Molyneux D.H.,Center for Neglected Tropical Diseases |
Malecela M.N.,National Institute for Medical Research
Parasites and Vectors | Year: 2011
Since 2004 there has been an increased recognition of the importance of Neglected Tropical Diseases (NTDs) as impediments to development. These diseases are caused by a variety of infectious agents - viruses, bacteria and parasites - which cause a diversity of clinical conditions throughout the tropics. The World Health Organisation (WHO) has defined seventeen of these conditions as core NTDs. The objectives for the control, elimination or eradication of these conditions have been defined in World Health Assembly resolutions whilst the strategies for the control or elimination of individual diseases have been defined in various WHO documents. Since 2005 there has been a drive for the expanded control of these diseases through an integrated approach of mass drug administration referred to as Preventive Chemotherapy via community-based distribution systems and through schools. This has been made possible by donations from major pharmaceutical companies of quality and efficacious drugs which have a proven track record of safety. As a result of the increased commitment of endemic countries, bilateral donors and non-governmental development organisations, there has been a considerable expansion of mass drug administration. In particular, programmes targeting lymphatic filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminth infections have expanded to treat 887. 8 million people in 2009. There has been significant progress towards guinea worm eradication, and the control of leprosy and human African trypanosomiasis. This paper responds to what the authors believe are inappropriate criticisms of these programmes and counters accusations of the motives of partners made in recently published papers. We provide a detailed response and update the information on the numbers of global treatments undertaken for NTDs and list the success stories to date. The paper acknowledges that in undertaking any health programme in environments such as post-conflict countries, there are always challenges. It is also recognised that NTD control must always be undertaken within the health system context. However, it is important to emphasise that the availability of donated drugs, the multiple impact of those drugs, the willingness of countries to undertake their distribution, thereby committing their own resources to the programmes, and the proven beneficial results outweigh the problems which are faced in environments where communities are often beyond the reach of health services. Given the availability of these interventions, their cost effectiveness and the broader development impact we believe it would be unethical not to continue programmes of such long term benefit to the "bottom billion". © 2011 Molyneux and Malecela; licensee BioMed Central Ltd. Source
Maswanya E.S.,National Institute for Medical Research
East African journal of public health | Year: 2011
In Tanzania female youth are increasingly becoming at greater risk of sexually transmitted HIV infection, whereby more than 80% cases occur through un-protected sex. The objective of this study was to examine related-factors which influence female students to have risky sexual contacts with casual partners including condom use and sex with sugar daddies. A cross section study involving face-to-face interview was conducted regarding sexual behavior among 219 sexually-debuted female students aged between 18 and 24 years who were attending high schools and colleges in Dar-es-salaam, Tanzania. Eighty-three percent had at least one boyfriend in the past 12 months, 57% had engaged in sex with a "sugar daddy", and 24% had engaged in sex with a casual partner other than a sugar daddy. Sixty-nine percent had ever used a condom, and 66% had used a condom during their most recent sexual encounter. Thirty-two percent reported always using a condom during sex with their boyfriends, whereas only 2% always used a condom with a sugar daddy. Decision-making about condom use during sex with boyfriends was made by couples together (48%) or by the girls alone (34%), whereas the decision during sex with a sugar daddy was predominantly made by the male partner (79%). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 9.5 for frequencies, cross-tabulations and chi-squired test and statistical significance set at p<0.05. The study highlighted risk factors for female students towards HIV infection. Receiving money and/or presents were the major motivations for having sex irrelevant with types of sex partners. Although most female's students disagreed in principle to have sex in exchange for money or presents, sex with sugar daddies was common among female students and was a major risk factor for HIV infection. Based on the findings, recommendations for improvement in prevention programs among female youth within Tanzanian context are discussed. Source
Agency: Cordis | Branch: H2020 | Program: RIA | Phase: PHC-09-2015 | Award Amount: 28.14M | Year: 2016
Many HIV vaccine concepts and several efficacy trials have been conducted in the prophylactic and therapeutic fields with limited success. There is an urgent need to develop better vaccines and tools predictive of immunogenicity and of correlates of protection at early stage of vaccine development to mitigate the risks of failure. To address these complex and challenging scientific issues, the European HIV Vaccine Alliance (EHVA) program will develop a Multidisciplinary Vaccine Platform (MVP) in the fields of prophylactic and therapeutic HIV vaccines. The Specific Objectives of the MVP are to build up: 1.Discovery Platform with the goal of generating novel vaccine candidates inducing potent neutralizing and non-neutralizing antibody responses and T-cell responses, 2. Immune Profiling Platform with the goal of ranking novel and existing (benchmark) vaccine candidates on the basis of the immune profile, 3. Data Management/Integration/Down-Selection Platform, with the goal of providing statistical tools for the analysis and interpretation of complex data and algorithms for the efficient selection of vaccines, and 4. Clinical Trials Platform with the goal of accelerating the clinical development of novel vaccines and the early prediction of vaccine failure. EHVA project has developed a global and innovative strategy which includes: a) the multidisciplinary expertise involving immunologists, virologists, structural biology experts, statisticians and computational scientists and clinicians; b) the most innovative technologies to profile immune response and virus reservoir; c) the access to large cohort studies bringing together top European clinical scientists/centres in the fields of prophylactic and therapeutic vaccines, d) the access to a panel of experimental HIV vaccines under clinical development that will be used as benchmark, and e) the liaison to a number of African leading scientists/programs which will foster the testing of future EHVA vaccines through EDCTP.
INTHEC - "Health Education and Community Integration: Evidence based Strategies to increase equity, integration and effectiveness of reproductive health services for poor communities in Sub Saharan Africa."
Agency: Cordis | Branch: FP7 | Program: CP-FP-SICA | Phase: HEALTH-2009-4.3.2-1 | Award Amount: 3.63M | Year: 2010
Objectives: The research aims to improve the delivery of reproductive health (RH) services in Tanzania and Niger by generating new evidence about effective ways to strengthen the provision, uptake, equity and effectiveness of adolescent reproductive health (ARH) programmes. Background: Poor adolescent reproductive health (ARH) continues to be a major cause of morbidity and worsening poverty for the poorest people in sub-Saharan Africa. The effectiveness of ARH programmes implemented within the health and education sectors is seriously hampered by adverse prevailing cultural norms and practices within those sectors and the wider community, and by poor programme integration. Methods: The proposed research will promote equitable reproductive health (RH) service provision and improve its uptake and effectiveness by : (i) conducting a situation analysis of current community and implementer experiences of existing ARH programmes in Tanzania and Niger, identifying priority areas of weakness in RH service provision and opportunities for strengthened service uptake and integration; (ii) addressing identified weaknesses and opportunities by developing an innovative package of interventions in 4 areas: (1) workplace ARH strategy in health units; (2) RH support to teachers in schools; (3) integrated school and community guardian support to pupils; (4) enhanced community referral to health services. We will evaluate the processes and impact of the interventions through a series of rigorous process evaluation studies, which will generate new knowledge, about intervention development, and indicators of intervention processes and effect. The overall impact of the interventions will be evaluated in a population-based cluster randomised trial. Involvement as project partners of the government ministries directly responsible for ARH policy in both Niger and Tanzania, will ensure the policy-relevance of this research, and its continued impact beyond the life of this project.