107 results on '"Drake, Lesley"'
Search Results
2. Contextual factors affecting integration of eye health into school health programme in Zanzibar: a qualitative health system research
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Chan, Ving Fai, Yard, Elodie, Mashayo, Eden, Mulewa, Damaris, Drake, Lesley, and Omar, Fatma
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- 2023
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3. The SABER School Feeding policy tool: a 10-year analysis of its use by countries in developing policies for their national school meals programs.
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Schultz, Linda, Renaud, Alice, Bundy, Donald A. P., Barry, Fatoumata B. M., Benveniste, Luis, de Lara, Carmen Burbano, Lo, Mouhamadou Moustapha, Neitzel, Jutta, O’Grady, Niamh, and Drake, Lesley
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- 2024
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4. The double burden of malnutrition in individuals: Identifying key challenges and re‐thinking research focus.
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Kiosia, Agklinta, Dagbasi, Aygul, Berkley, James A., Wilding, John P. H., Prendergast, Andrew J., Li, Jia V., Swann, Jon, Mathers, John C., Kerac, Marko, Morrison, Douglas, Drake, Lesley, Briend, Andre, Maitland, Kathryn, and Frost, Gary
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POLICY sciences ,MIDDLE-income countries ,MALNUTRITION ,SOCIAL determinants of health ,SOCIOECONOMIC factors ,GUT microbiome ,DIETARY fiber ,FOOD habits ,PUBLIC health ,FOOD supply ,METABOLOMICS ,OBESITY ,DIET ,LOW-income countries ,NUTRITION ,BIOMARKERS ,DIET therapy ,DISEASE risk factors - Abstract
The 'double burden of malnutrition' is a global health challenge that increasingly affects populations in both low‐ and middle‐income countries (LMICs). This phenomenon refers to the coexistence of undernutrition and overweight or obesity, as well as other diet‐related non‐communicable diseases, in the same population, household or even individual. While noteworthy progress has been made in reducing undernutrition in some parts of the world, in many of these areas, the prevalence of overweight and obesity is increasing, particularly in urban areas, resulting in greater numbers of people who were undernourished in childhood and have overweight or obesity in adulthood. This creates a complex and challenging situation for research experts and policymakers who must simultaneously address the public health burdens of undernutrition and overweight/obesity. This review identifies key challenges and limitations in the current research on the double burden of malnutrition in individuals, including the need for a more comprehensive and nuanced understanding of the drivers of malnutrition, the importance of context‐specific interventions and the need for greater attention to the food environment and food systems. We advocate for the re‐evaluation of research strategies and focus, with a greater emphasis on multidisciplinary and systems approaches and greater attention to the synergistic relationship between the biological, environmental, commercial and socio‐economic determinants of malnutrition. Addressing these key challenges can enable us to better comprehend and tackle the multifaceted and dynamic issues of the double burden of malnutrition, particularly in individuals and work towards more effective and sustainable solutions. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Does an integrated school eye health delivery model perform better than a vertical model in a real-world setting? A non-randomised interventional comparative implementation study in Zanzibar.
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Ving Fai Chan, Yard, Elodie, Mashayo, Eden, Mulewa, Damaris, Drake, Lesley, Price-Sanchez, Carlos, and Omar, Fatma
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Background Few studies on school eye health programmes have shown they were cost-effective. We compared the performance (Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)) between an integrated model (IM) and a vertical model (VM) of school eye health delivery in Zanzibar. Methods The set of RE-AIM performance indicators of the IM (n=9) and VM (n=10) cohorts was compared. The VM implemented only the eye health interventions, while the IM had the eye health interventions conducted within the school feeding programme. Semistructured interviews were conducted with 36 stakeholders to understand the challenges and outcomes experienced when implementing both models. Results The IM achieved higher screening coverage, voluntary follow-up rate, screening validity and spectacle compliance than VM. This was due to effective coordination between implementers, motivated teachers to prevent vision problems and related negative impacts in children, and activities implemented timeously post-training. Both models recorded low wearing compliance. All schools in the IM cohort completed screening activities, but two schools in the VM cohort did not. Both models ceased activities after the funding stopped. Local stakeholders emphasised that evidence from this study can be used to advocate for more resources for children's eye health. Conclusions The IM cohort achieved better reach, effectiveness, adoption rate and implementation performance than the VM cohort. The poor maintenance performance indicators in both arms postfunding call for improvement to the implementation strategy to ensure the sustainability of school eye health. In the optics of scaling up, an integrated approach is recommended. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Investment in child and adolescent health and development: key messages from Disease Control Priorities, 3rd Edition
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Abubakara, Amina, Ahuja, Amrita, Alderman, Harold, Allen, Nicolas, Appleby, Laura, Aurino, Elisabetta, Azzopardi, Peter, Baird, Sarah, Banham, Louise, Behrman, Jere, Benzian, Habib, Bhalotra, Sonia, Bhutta, Zulfiqar, Black, Maureen, Bloem, Paul, Bonell, Chris, Bradley, Mark, Brinkman, Sally, Brooker, Simon, Burbano, Carmen, Burnett, Nicolas, Cernuschi, Tania, Clarke, Sian, Coffey, Carolyn, Colenso, Peter, Croke, Kevin, Daniels, Amy, De la Cruz, Elia, de Walque, Damien, Deolaikar, Anil, Drake, Lesley, Fernald, Lia, Fernandes, Meena, Fernando, Deepika, Fink, Günther, Galloway, Rae, Gelli, Aulo, Georgiadis, Andreas, Gitonga, Caroline, Giyosa, Boitshepo, Glewwe, Paul, Gona Nzovu, Joseph, Gove, Amber, Graham, Natasha, Greenwood, Brian, Grigorenko, Elena, Heath, Cai, Hicks, Joan Hamory, Hidrobo, Melissa, Hill, Kenneth, Hill, Tara, Hollingsworth, T. Deirdre, Kennedy, Elissa, Khan, Imran, Kiamba, Josephine, Kim, Jane, Kremer, Michael, LaMontagne, D. Scott, Lassi, Zohra, Laxminarayan, Ramanan, Mahon, Jacqueline, Mai, Lu, Martínez, Sebastián, Meresman, Sergio, Merseth, Katherine A., Miguel, Edward, Mitchell, Arlene, Mitra, Sophie, Moin, Anoosh, Mokdad, Ali, Mont, Daniel, Nandi, Arindam, Nankabirwa, Joaniter, Plaut, Daniel, Pradhan, Elina, Pullan, Rachel, Reavley, Nicola, Santelli, Joan, Sarr, Bachir, Sawyer, Susan M, Bundy, Donald A P, de Silva, Nilanthi, Horton, Susan, Patton, George C, Schultz, Linda, and Jamison, Dean T
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- 2018
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7. National mapping of soil-transmitted helminth and schistosome infections in Ethiopia
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Leta, Gemechu Tadesse, Mekete, Kalkidan, Wuletaw, Yonas, Gebretsadik, Abeba, Sime, Heven, Mekasha, Sindew, Woyessa, Adugna, Shafi, Oumer, Vercruysse, Jozef, Grimes, Jack E. T., Gardiner, Iain, French, Michael, Levecke, Bruno, Drake, Lesley, Harrison, Wendy, and Fenwick, Alan
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- 2020
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8. A positive consequence of the COVID-19 pandemic: how the counterfactual experience of school closures is accelerating a multisectoral response to the treatment of neglected tropical diseases.
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Bundy, Donald A. P., Schultz, Linda, Antoninis, Manos, Barry, Fatoumata B. M., Burbano, Carmen, Croke, Kevin, Drake, Lesley, Gyapong, John, Karutu, Carol, Kihara, Jimmy, Lo, Mouhamadou Moustapha, Makkar, Prerna, Mwandawiro, Charles, Ossipow, Suzy J., Bento, Ana Ramos, Rollinson, David, Shah, Hemang, and Turner, Hugo C.
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NEGLECTED diseases ,COVID-19 pandemic ,SCHOOL closings ,COUNTERFACTUALS (Logic) ,TWENTY-first century ,COVID-19 - Abstract
Global access to deworming treatment is one of the public health success stories of low-income countries in the twenty-first century. Parasitic worm infections are among the most ubiquitous chronic infections of humans, and early success with mass treatment programmes for these infections was the key catalyst for the neglected tropical disease (NTD) agenda. Since the launch of the 'London Declaration' in 2012, school-based deworming programmes have become the world's largest public health interventions. WHO estimates that by 2020, some 3.3 billion school-based drug treatments had been delivered. The success of this approach was brought to a dramatic halt in April 2020 when schools were closed worldwide in response to the COVID-19 pandemic. These closures immediately excluded 1.5 billion children not only from access to education but also from all school-based health services, including deworming. WHO Pulse surveys in 2021 identified NTD treatment as among the most negatively affected health interventions worldwide, second only to mental health interventions. In reaction, governments created a global Coalition with the twin aims of reopening schools and of rebuilding more resilient school-based health systems. Today, some 86 countries, comprising more than half the world's population, are delivering on this response, and school-based coverage of some key school-based programmes exceeds those from January 2020. This paper explores how science, and a combination of new policy and epidemiological perspectives that began in the 1980s, led to the exceptional growth in school-based NTD programmes after 2012, and are again driving new momentum in response to the COVID-19 pandemic. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Characterization of execretory/secretory proteins of Trichuris
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Drake, Lesley Jayne
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572 ,Worms ,Peptidases - Published
- 1993
10. Agriculture, nutrition and education: On the status and determinants of primary schooling in rural Mali before the crises of 2012
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Gelli, Aulo, Masset, Edoardo, Diallo, Amadou Sekou, Assima, Amidou, Hombrados, Jorge, Watkins, Kristie, and Drake, Lesley
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- 2014
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11. Clinical Informatics: A Workforce Priority for 21st Century Healthcare
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Smith, Susan E, Drake, Lesley E, Harris, Julie-Gai B, Watson, Kay, and Pohlner, Peter G
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- 2011
12. Schools for health, education and development: a call for action
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TANG, KWOK-CHO, NUTBEAM, DON, ALDINGER, CARMEN, ST LEGER, LAWRENCE, BUNDY, DONALD, HOFFMANN, ANNA MARIA, YANKAH, EKUA, MCCALL, DOUG, BUIJS, GOOF, ARNAOUT, SAID, MORALES, SOFIALETICIA, ROBINSON, FAYE, TORRANIN, CHARUAYPON, DRAKE, LESLEY, ABOLFOTOUH, MOSTAFA, WHITMAN, CHERYL VINCE, MERESMAN, SERGIO, ODETE, COSSA, JOUKHADAR, ABDUL-HALIM, AVISON, CLAIRE, WRIGHT, CREAM, HUERTA, FRANSCICO, MUNODAWAFA, DAVISON, NYAMWAYA, DAVID, and HECKERT, KAREN
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- 2009
13. The Major Secreted Product of the Whipworm, Trichuris, is a Pore-Forming Protein
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Drake, Lesley, Korchev, Yuri, Bashford, Lindsay, Djamgoz, Mustafa, Wakelin, Derek, Ashall, Frank, and Bundy, Donald
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- 1994
14. Cluster-randomised trial of the impact of school-based deworming and iron supplementation on the cognitive abilities of schoolchildren in Sri Lankaʼs plantation sector
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Ebenezer, Roshini, Gunawardena, Kithsiri, Kumarendran, Balachandran, Pathmeswaran, Arunasalam, Jukes, Matthew C. H., Drake, Lesley J., and de Silva, Nilanthi
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- 2013
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15. Influence of timing of intraaortic balloon placement in cardiac surgical patients
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Lavana, Jayshree D., Fraser, John F., Smith, Susan E., Drake, Lesley, Tesar, Peter, and Mullany, Daniel V.
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- 2010
16. Epidemiology of soil-transmitted nematode infections in Ha Nam Province, Vietnam
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Needham, Cathy, Kim, Hoang Thi, Hoa, Nguyen Viet, Cong, Le Dinh, Michael, Edwin, Drake, Lesley, Hall, Andrew, and Bundy, Donald A. P.
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- 1998
17. The Role of Health in Education and Human Capital: Why an Integrated Approach to School Health Could Make a Difference in the Futures of Schoolchildren in Low-Income Countries.
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Cohee, Lauren M., Halliday, Katherine E., Gelli, Aulo, Mwenyango, Irene, Lavadenz, Fernando, Burbano, Carmen, Drake, Lesley, and Bundy, Donald A. P.
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- 2021
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18. A School Meals Program Implemented at Scale in Ghana Increases Height-for-Age during Midchildhood in Girls and in Children from Poor Households: A Cluster Randomized Trial.
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Gelli, Aulo, Aurino, Elisabetta, Folson, Gloria, Arhinful, Daniel, Adamba, Clement, Osei-Akoto, Isaac, Masset, Edoardo, Watkins, Kristie, Fernandes, Meena, Drake, Lesley, and Alderman, Harold
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CLUSTER randomized controlled trials ,SCHOOL food ,POOR children ,ADOLESCENCE ,READY meals ,HOUSEHOLDS ,GROWTH - Abstract
Background: Attention to nutrition during all phases of child and adolescent development is necessary to ensure healthy physical growth and to protect investments made earlier in life. Leveraging school meals programs as platforms to scale-up nutrition interventions is relevant as programs function in nearly every country in the world.Objective: The aim of this study was to evaluate the impact of a large-scale school meals program in Ghana on school-age children's anthropometry indicators.Methods: A longitudinal cluster randomized control trial was implemented across the 10 regions of Ghana, covering 2869 school-age children (aged 5-15 y). Communities were randomly assigned to 1) control group without intervention or 2) treatment group providing the reformed national school feeding program, providing 1 hot meal/d in public primary schools. Primary outcomes included height-for-age (HAZ) and BMI-for-age (BAZ) z scores. The analysis followed an intention-to-treat approach as per the published protocol for the study population and subgroup analysis by age (i.e., midchildhood for children 5-8 y and early adolescence for children 9-15 y), gender, poverty, and region of residence. We used single-difference ANCOVA with mixed-effect regression models to assess program impacts.Results: School meals had no effect on HAZ and BAZ in children aged 5-15 y. However, in per-protocol subgroup analysis, the school feeding intervention improved HAZ in 5- to 8-y-old children (effect size: 0.12 SDs), in girls (effect size: 0.12 SDs)-particularly girls aged 5-8 y living in the northern regions, and in children aged 5-8 y in households living below the poverty line (effect size: 0.22 SDs). There was also evidence that the intervention influenced food allocation and sharing at the household level.Conclusion: School meals can provide a platform to scale-up nutrition interventions in the early primary school years, with important benefits accruing for more disadvantaged children. This trial was registered at www.isrctn.com as ISRCTN66918874. [ABSTRACT FROM AUTHOR]- Published
- 2019
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19. Integrated delivery of school health interventions through the school platform: Investing for the future.
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Appleby, Laura J., Tadesse, Gemechu, Wuletawu, Yonas, Dejene, Nigussie G., Grimes, Jack E. T., French, Michael D., Teklu, Askale, Moreda, Berhanu, Negussu, Nebiyu, Kebede, Biruck, Yard, Elodie, Gardiner, Iain, and Drake, Lesley J.
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SCHOOL integration ,EDUCATION ,HEALTH education ,HEALTH ,LOW-income countries - Abstract
School health and nutrition (SHN) programmes are recognized as a significant contributor to both health and education sector goals. The school system offers an ideal platform from which to deliver basic health interventions that target the most common health conditions affecting school-age children (SAC) in low-income countries, leading to improved participation and learning outcomes. However, governments require evidence to cost, design, and implement these programmes. In Ethiopia, prevalent health conditions affecting SAC's education participation and learning outcomes include infection with soil-transmitted helminths (STHs), hunger, and malnutrition. In recognition of the multiple issues affecting the health and education of SAC, the government has taken a proactive approach, coordinating an integrated SHN programme designed to be implemented in partnership and monitored and financed through a single, integrated mechanism. The programme, known as the Enhanced School Health Initiative (ESHI), integrates three complimentary health interventions: deworming; school feeding; and provision of a water, sanitation, and hygiene (WASH) package in schools, which in delivery aim to maximize the benefits of each of the individual components. Operational research surrounding the ESHI programme includes both qualitative and quantitative analyses. Here, we present an overview of the ESHI programme and its genesis. We also introduce three additional supporting papers that provide in-depth analyses of key findings, including the baseline situational analysis, the costs, and community perceptions of the programme. The findings from ESHI provide initial evidence to develop an understanding of the related costs and synergies of integrating multiple health interventions onto a single platform. The work has translated into strengthened institutional capacity and improved cross-sectoral coordination. The government is now committed to supporting 25 million school children in Ethiopia through SHN. The ESHI model serves as a reference point for other countries looking to scale up targeted SHN interventions. [ABSTRACT FROM AUTHOR]
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- 2019
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20. Reopening schools during the COVID-19 pandemic: governments must balance the uncertainty and risks of reopening schools against the clear harms associated with prolonged closure.
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Viner, Russell M., Bonell, Christopher, Drake, Lesley, Jourdan, Didier, Davies, Nicolette, Baltag, Valentina, Jerrim, John, Proimos, Jenny, and Darzi, Ara
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COVID-19 pandemic ,PUBLIC health education ,SCHOOLS - Published
- 2021
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21. A commentary on the interagency symposium: 'Building a Healthier Future: A Human Capital Perspective on Health and Education', presented at the European Congress of Tropical Medicine and International Health, Liverpool, UK, October 2019.
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Bundy, Donald, Burbano, Carmen, Lloyd-Evans, Edward, Sorgho, Gaston, Lavadenz, Fernando, Adam, Zeinab, Drake, Lesley, Rowland-Jones, Sarah, and Piot, Peter
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- 2020
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22. Sanitation, hookworm, anemia, stunting, and wasting in primary school children in southern Ethiopia: Baseline results from a study in 30 schools.
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Grimes, Jack E. T., Tadesse, Gemechu, Gardiner, Iain A., Yard, Elodie, Wuletaw, Yonas, Templeton, Michael R., Harrison, Wendy E., and Drake, Lesley J.
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SCHISTOSOMA mansoni ,CHILDREN'S health ,ANEMIA ,PRIMARY schools ,HEMOGLOBINS - Abstract
Background: Inadequate nutrition; neglected topical diseases; and insufficient water, sanitation, and hygiene (WASH) are interrelated problems in schools in low-income countries, but are not routinely tackled together. A recent three-year longitudinal study investigated integrated school health and nutrition approaches in 30 government primary schools in southern Ethiopia. Here, we report on baseline associations between sanitation, hookworm infection, anemia, stunting, and wasting. Methods: In each school, the Schistosoma mansoni, S. haematobium, and soil-transmitted helminth infection intensities; blood hemoglobin concentrations; heights; and weights of approximately 125 students were assessed. Of these 125 students, approximately 20 were randomly selected for student WASH surveys. Of these 20, approximately 15 were randomly selected for household sanitation observations. School WASH was also assessed through a combination of observations and questions to the headteacher. Mixed-effects logistic regression was used to compare household sanitation with hookworm infection (the other parasites being much less prevalent); and hookworm infection with anemia, stunting, and wasting. Findings: Blood, stool, and urine samples were provided by 3,729 children, and student WASH and household WASH surveys were conducted with 596 and 448 of these students, respectively. Hookworm, Ascaris lumbricoides, Trichuris trichiura, and S. mansoni infections had prevalences of 18%, 4.8%, 0.6%, and 0.3%, respectively, and no S. haematobium infections were found. Anemia, stunting, and wasting had prevalences of 23%, 28%, and 14%, respectively. No statistically significant associations were found between latrine absence or evidence of open defecation at home, and hookworm infection (adjusted odds ratio, OR = 1.28, 95% confidence interval, CI: 0.476–3.44; and adjusted OR = 1.21, 95% CI: 0.468–3.12; respectively); or between hookworm infection and anemia, stunting, or wasting (adjusted OR = 1.24, 95% CI: 0.988–1.57; adjusted OR = 0.992, 95% CI: 0.789–1.25; and adjusted OR = 0.969, 95% CI: 0.722–1.30; respectively). Conclusions: In this setting, no statistically significant associations were found between sanitation and hookworm; or between hookworm and anemia, stunting, or wasting. More evidence on best practices for integrated school health interventions will be gathered from the follow-up surveys in this study. [ABSTRACT FROM AUTHOR]
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- 2017
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23. HIV as Part of the Lives of Children and Youth as Life Expectancy Increases : Implications for Education
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Cooper, Edward S., Risley, Claire L., Drake, Lesley J., and Bundy, Donald A. P.
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The education sector is crucial to any national response to the world epidemic of HIV and AIDS. The school age years, about 5 to 15 years, make up the cross section of any population with the lowest prevalence of HIV infection. This is the “Window of Hope", and education is the social vaccine against HIV infection. Now, with effective anti-viral treatment increasingly available, the number of infected children of school age is rising through increased survival. Schools must adapt to having more such children in class. Furthermore, there will be many infected and affected children, orphans and vulnerable children, who will not access formal education, or not fully, and the path to education must be made easier for them. We are able to predict a rise and then a fall of the school age numbers, but new preparations must be made for these young people to adapt to their adult lives, living with HIV. All such school and educational responses must take the developmental stages of children and their emotional needs into account.
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- 2007
24. Enhancing Linkages Between Healthy Diets, Local Agriculture, and Sustainable Food Systems: The School Meals Planner Package in Ghana.
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Fernandes, Meenakshi, Hamdani, Salha, Kiamba, Josephine, Aurino, Elisabetta, Peel, Francis, Drake, Lesley, Gelli, Aulo, Mumuni, Daniel, Galloway, Rae, Quarshie, Kate, and Bhatia, Rita
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Background: Interventions that enhance linkages between healthy diets and local agriculture can promote sustainable food systems. Home-grown school feeding programs present a promising entry point for such interventions, through the delivery of nutritious menus and meals.Objective: To describe the adaptation of the School Meals Planner Package to the programmatic and environmental reality in Ghana during the 2014 to 2015 school year.Methods: Guided by a conceptual framework highlighting key considerations and trade-offs in menu design, an open-source software was developed that could be easily understood by program implementers. Readily available containers from markets were calibrated into "handy measures" to support the provision of adequate quantities of food indicated by menus. Schools and communities were sensitized to the benefits of locally sourced, nutrient-rich diets. A behavior change communication campaign including posters and songs promoting healthy diets was designed and disseminated in schools and communities.Results: The School Meals Planner Package was introduced in 42 districts in Ghana, reaching more than 320 000 children. Monitoring reports and feedback on its use were positive, demonstrating how the tool can be used by planners and implementers alike to deliver nutritious, locally-sourced meals to schoolchildren. The value of the tool has been recognized at the highest levels by Ghana's government who have adopted it as official policy.Conclusions: The School Meals Planner Package supported the design of nutritious, locally sourced menus for the school feeding program in Ghana. The tool can be similarly adapted for other countries to meet context-specific needs. [ABSTRACT FROM AUTHOR]- Published
- 2016
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25. Courage and Hope: Stories from Teachers Living with HIV in Sub-Saharan Africa
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Bundy, Donald, Aduda, David, Woolnough, Alice, Drake, Lesley, Manda, Stella, Bundy, Donald, Aduda, David, Woolnough, Alice, Drake, Lesley, and Manda, Stella
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- Teachers--Health and hygiene--Africa, Sub-Saharan, Prejudices, HIV-positive persons--Africa, Sub-Saharan--Social conditions, Teachers--Africa, Sub-Saharan--Social conditions
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Courage and Hope gives voice to the real life experiences of 12 HIV-positive teachers, five of whom are women, from Burkina Faso, Cameroon, Ghana, Kenya, Mozambique, Rwanda, Senegal, Tanzania (both Mainland and Zanzibar) and Zambia. The teachers recount their experiences of discovering their HIV-positive status and how this has affected them in their families, their communities, and their professional lives. Their stories are documented by journalists, emphasizing the human dimension. The voices of these teachers suggest that a number of obstacles are commonly faced by teachers living with HIV. Paramount among them are stigma and discrimination, both within their families and communities as well as their workplaces and in society more generally. The difficulties of overcoming stigma and discrimination are further exacerbated by a failure to ensure confidentiality in the workplace.
- Published
- 2009
26. School Water, Sanitation, and Hygiene, Soil-Transmitted Helminths, and Schistosomes: National Mapping in Ethiopia.
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Grimes, Jack E. T., Tadesse, Gemechu, Mekete, Kalkidan, Wuletaw, Yonas, Gebretsadik, Abeba, French, Michael D., Harrison, Wendy E., Drake, Lesley J., Gardiner, Iain A., Yard, Elodie, and Templeton, Michael R.
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SCHOOL hygiene ,HELMINTHS ,SCHISTOSOMA ,ASCARIS lumbricoides ,HOOKWORM disease - Abstract
Background: It is thought that improving water, sanitation, and hygiene (WASH) might reduce the transmission of schistosomes and soil-transmitted helminths, owing to their life cycles. However, few large-scale studies have yet assessed the real extent of associations between WASH and these parasites. Methodology/Principal Findings: In the 2013–2014 Ethiopian national mapping of infections with these parasites, school WASH was assessed alongside infection intensity in children, mostly between 10 and 15 years of age. Scores were constructed reflecting exposure to schistosomes arising from water collection for schools, from freshwater sources, and the adequacy of school sanitation and hygiene facilities. Kendall’s τ
b was used to test the WASH scores against the school-level arithmetic mean intensity of infection with each parasite, in schools with at least one child positive for the parasite in question. WASH and parasitology data were available for 1,645 schools. More frequent collection of water for schools, from open freshwater sources was associated with statistically significantly higher Schistosoma mansoni infection intensity (Kendall’s τb = 0.097, 95% confidence interval, CI: 0.011 to 0.18), better sanitation was associated with significantly lower Ascaris lumbricoides intensity (Kendall’s τb = -0.067, 95% CI: -0.11 to -0.023) and borderline significant lower hookworm intensity (Kendall’s τb = -0.039, 95% CI: -0.090 to 0.012, P = 0.067), and better hygiene was associated with significantly lower hookworm intensity (Kendall’s τb = -0.076, 95% CI: -0.13 to -0.020). However, no significant differences were observed when comparing sanitation and infection with S. mansoni or Trichuris trichiura, or hygiene and infection with A. lumbricoides or T. trichiura. Conclusions/Significance: Improving school WASH may reduce transmission of these parasites. However, different forms of WASH appear to have different effects on infection with the various parasites, with our analysis finding the strongest associations between water and S. mansoni, sanitation and A. lumbricoides, and hygiene and hookworm. [ABSTRACT FROM AUTHOR]- Published
- 2016
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27. Evaluation of alternative school feeding models on nutrition, education, agriculture and other social outcomes in Ghana: rationale, randomised design and baseline data.
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Gelli, Aulo, Masset, Edoardo, Folson, Gloria, Kusi, Anthoni, Arhinful, Daniel K., Asante, Felix, Ayi, Irene, Bosompem, Kwabena M., Watkins, Kristie, Abdul-Rahman, Lutuf, Agble, Rosanna, Ananse-Baden, Getrude, Mumuni, Daniel, Aurino, Elisabetta, Fernandes, Meena, and Drake, Lesley
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SCHOOL lunchrooms, cafeterias, etc. ,NUTRITION ,EDUCATION ,AGRICULTURE ,STAKEHOLDERS ,SMALL farms ,CLUSTER randomized controlled trials ,SCHOOL attendance ,CHILD nutrition ,COMPARATIVE studies ,COST effectiveness ,EXPERIMENTAL design ,FOOD service ,RESEARCH methodology ,MEDICAL cooperation ,NUTRITIONAL requirements ,RESEARCH ,SCHOOLS ,TEENAGERS ,MICRONUTRIENTS ,SAMPLE size (Statistics) ,EVALUATION research ,RANDOMIZED controlled trials ,ACQUISITION of data ,EVALUATION of human services programs ,NUTRITIONAL status - Abstract
Background: 'Home-grown' school feeding programmes are complex interventions with the potential to link the increased demand for school feeding goods and services to community-based stakeholders, including smallholder farmers and women's groups. There is limited rigorous evidence, however, that this is the case in practice. This evaluation will examine explicitly, and from a holistic perspective, the simultaneous impact of a national school meals programme on micronutrient status, alongside outcomes in nutrition, education and agriculture domains. The 3-year study involves a cluster-randomised control trial designed around the scale-up of the national school feeding programme, including 116 primary schools in 58 districts in Ghana. The randomly assigned interventions are: 1) a school feeding programme group, including schools and communities where the standard government programme is implemented; 2) 'home-grown' school feeding, including schools and communities where the standard programme is implemented alongside an innovative pilot project aimed at enhancing nutrition and agriculture; and 3) a control group, including schools and households from communities where the intervention will be delayed by at least 3 years, preferably without informing schools and households. Primary outcomes include child health and nutritional status, school participation and learning, and smallholder farmer income. Intermediate outcomes along the agriculture and nutrition pathways will also be measured. The evaluation will follow a mixed-method approach, including child-, household-, school- and community-level surveys as well as focus group discussions with project stakeholders. The baseline survey was completed in August 2013 and the endline survey is planned for November 2015.Results: The tests of balance show significant differences in the means of a number of outcome and control variables across the intervention groups. Important differences across groups include marketed surplus, livestock income, per capita food consumption and intake, school attendance, and anthropometric status in the 2-5 and 5-15 years age groups. In addition, approximately 19 % of children in the target age group received some form of free school meals at baseline.Conclusion: Designing and implementing the evaluation of complex interventions is in itself a complex undertaking, involving a multi-disciplinary research team working in close collaboration with programme- and policy-level stakeholders. Managing the complexity from an analytical and operational perspective is an important challenge. The analysis of the baseline data indicates that the random allocation process did not achieve statistically comparable treatment groups. Differences in outcomes and control variables across groups will be controlled for when estimating treatment effects.Trial Registration Number: ISRCTN66918874 (registered on 5 March 2015). [ABSTRACT FROM AUTHOR]- Published
- 2016
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28. Bihar's Pioneering School-Based Deworming Programme: Lessons Learned in Deworming over 17 Million Indian School-Age Children in One Sustainable Campaign.
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Drake, Lesley J., Singh, Sarman, Mishra, C. K., Sinha, Amarjeet, Kumar, Sanjay, Bhushan, Rajesh, Hollingsworth, T. Deirdre, Appleby, Laura J., Kumar, Rakesh, Sharma, Kriti, Kumar, Yogita, Raman, Sri, Chakrabarty, Stalin, Kihara, Jimmy H., Gunawardena, N. K., Hollister, Grace, Kumar, Vandana, Ankur, Anish, Prasad, Babul, and Ramachandran, Sushma
- Subjects
- *
SCHOOL children , *HELMINTHS , *HEALTH of school children , *ANTHELMINTICS , *DRUG administration , *PREVENTION , *THERAPEUTICS , *JUVENILE diseases - Abstract
The article informs on the Bihar, India's "Pioneering School-Based Deworming Programme." Topics discussed include prevention of school age children with the risks of infection with soil-transmitted helminths; regulations to administration of antihelminthics as provided by the World Health Organization; and recommendation for mass drug administration.
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- 2015
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29. The Epidemiology of Soil-Transmitted Helminths in Bihar State, India.
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Greenland, Katie, Dixon, Ruth, Khan, Shabbir Ali, Gunawardena, Kithsiri, Kihara, Jimmy H., Smith, Jennifer L., Drake, Lesley, Makkar, Prerna, Raman, Sri, Singh, Sarman, and Kumar, Sanjay
- Subjects
SCHOOL children ,HELMINTHS ,WATER supply - Abstract
Background: Soil-transmitted helminths (STHs) infect over a billion individuals worldwide. In India, 241 million children are estimated to need deworming to avert the negative consequences STH infections can have on child health and development. In February-April 2011, 17 million children in Bihar State were dewormed during a government-led school-based deworming campaign. Prior to programme implementation, a study was conducted to assess STH prevalence in the school-age population to direct the programme. The study also investigated risk factors for STH infections, including caste, literacy, and defecation and hygiene practices, in order to inform the development of complementary interventions. Methods: A cross-sectional survey was conducted among children in 20 schools in Bihar. In addition to providing stool samples for identification of STH infections, children completed a short questionnaire detailing their usual defecation and hand-hygiene practices. Risk factors for STH infections were explored. Results: In January-February 2011, 1279 school children aged four to seventeen provided stool samples and 1157 children also completed the questionnaire. Overall, 68% of children (10-86% across schools) were infected with one or more soil-transmitted helminth species. The prevalence of ascariasis, hookworm and trichuriasis was 52%, 42% and 5% respectively. The majority of children (95%) practiced open defecation and reported most frequently cleansing hands with soil (61%). Increasing age, lack of maternal literacy and certain castes were independently associated with hookworm infection. Absence of a hand-washing station at the schools was also independently associated with A. lumbricoides infection. Conclusions: STH prevalence in Bihar is high, and justifies mass deworming in school-aged children. Open defecation is common-place and hands are often cleansed using soil. The findings reported here can be used to help direct messaging appropriate to mothers with low levels of literacy and emphasise the importance of water and sanitation in the control of helminths and other diseases. Author Summary: Deworming is recognised as a cost-effective way to increase the educational attainment and health of school-age children who experience high prevalence and intensity of soil-transmitted helminth (STH) infections and bear the majority of the disease burden. STH transmission is driven by a number of factors including the environment, water availability and lack of sanitation. Previous government surveys in India revealed small geographic areas have extremely heterogeneous prevalence, generating interest in exploring what explains this heterogeneity. Having recently implemented a large deworming progamme, the government of Bihar State was keen to utilise the deworming campaign to undertake complementary activities to reduce transmission and establish an integrated approach to STH control. This paper presents the results of the prevalence and intensity cross-sectional survey and takes an exploratory look at the contribution of key risk factors to transmission. Maternal literacy, caste, open defecation (a common practice) and absence of handwashing stations at schools were associated with increased risk of hookworm or ascariasis. Using this information it is possible to hypothesise about potential key areas of focus during the deworming campaign and interventions that could complement deworming programmes, as well as to develop some key messages to accompany the next deworming programme in Bihar. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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30. School food, politics and child health.
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Bundy, Donald AP, Drake, Lesley J, and Burbano, Carmen
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- *
SCHOOL lunchrooms, cafeterias, etc. , *POLITICAL science , *HEALTH of school children , *BUSINESS partnerships , *CHILD development , *FOOD safety - Abstract
ObjectiveAn analysis undertaken jointly in 2009 by the UN World Food Programme, The Partnership for Child Development and the World Bank was published as Rethinking School Feeding to provide guidance on how to develop and implement effective school feeding programmes as a productive safety net and as part of the efforts to achieve Education for All. The present paper reflects on how understanding of school feeding has changed since that analysis.DesignData on school feeding programme outcomes were collected through a literature review. Regression models were used to analyse relationships between school feeding costs (from data that were collected), the per capita costs of primary education and Gross Domestic Product per capita. Data on the transition to national ownership, supply chains and country examples were collected through country case studies.ResultsSchool feeding programmes increase school attendance, cognition and educational achievement, as well as provide a transfer of resources to households with possible benefits to local agricultural production and local market development. Low-income countries exhibit large variations in school feeding costs, with concomitant opportunities for cost containment. Countries are increasingly looking to transition from externally supported projects to national programmes.ConclusionsSchool feeding is now clearly evident as a major social programme in most countries with a global turnover in excess of $US 100 billion. This argues for a continuing focus on the evidence base with a view to helping countries ensure that their programmes are as cost-effective as possible. Clear policy advice has never been more important. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
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31. Economic Impact of HIV and Antiretroviral Therapy on Education Supply in High Prevalence Regions.
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Risley, Claire L., Drake, Lesley J., and Bundy, Donald A. P.
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- *
HIV infections , *HUMAN capital , *ECONOMIC impact analysis , *ECONOMIC impact , *EDUCATION , *ANTIRETROVIRAL agents - Abstract
Background: We set out to estimate, for the three geographical regions with the highest HIV prevalence, (sub-Saharan Africa [SSA], the Caribbean and the Greater Mekong sub-region of East Asia), the human resource and economic impact of HIV on the supply of education from 2008 to 2015, the target date for the achievement of Education For All (EFA), contrasting the continuation of access to care, support and Antiretroviral therapy (ART) to the scenario of universal access. Methodology/Principal Findings: A costed mathematical model of the impact of HIV and ART on teacher recruitment, mortality and absenteeism (Ed-SIDA) was run using best available data for 58 countries, and results aggregated by region. It was estimated that (1) The impact of HIV on teacher supply is sufficient to derail efforts to achieve EFA in several countries and universal access can mitigate this. (2) In SSA, the 2008 costs to education of HIV were about half of those estimated in 2002. Providing universal access for teachers in SSA is cost-effective on education returns alone and provides a return of $3.99 on the dollar. (3) The impacts on education in the hyperendemic countries in Southern Africa will continue to increase to 2015 from its 2008 level, already the highest in the world. (4) If treatment roll-out is successful, numbers of HIV positive teachers are set to increase in all the regions studied. Conclusions/Significance: The return on investing in care and support is also greater in those areas with highest impact. SSA requires increased investment in teacher support, testing and particularly ART if it is to achieve EFA. The situation for teachers in the Caribbean and East Asia is similar but on a smaller scale proportionate to the lower levels of infection and greater existing access to care and support. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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32. Assays to Detect β-Tubulin Codon 200 Polymorphism in Trichuris trichiura and Ascaris lumbricoides.
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Diawara, Aissatou, Drake, Lesley J., Suswillo, Richard R., Kihara, Jimmy, Bundy, Donald A. P., Scott, Marilyn E., Halpenny, Carli, Stothard, J. Russell, and Prichard, Roger K.
- Published
- 2009
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33. Schools for health, education and development: a call for action.
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Kwok-Cho Tang, Nutbeam, Don, Aldinger, Carmen, St. Leger, Lawrence, Bundy, Donald, Hoffmann, Anna Maria, Yankah, Ekua, McCall, Doug, Buijs, Goof, Arnaout, Said, Morales, Sofialeticia, Robinson, Faye, Torranin, Charuaypon, Drake, Lesley, Abolfotouh, Mostafa, Whitman, Cheryl Vince, Meresman, Sergio, Odete, Cossa, Joukhadar, Abdul-Halim, and Avison, Claire
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HEALTH promotion ,SCHOOL health services ,SCHOOLS & society ,SCHOOL-linked human services ,HEALTH education ,PREVENTIVE health services ,PUBLIC health - Abstract
In 2007, the World Health Organization, together with United Nations and international organization as well as experts, met to draw upon existing evidence and practical experience from regions, countries and individual schools in promoting health through schools. The goal of the meeting was to identify current and emerging global factors affecting schools, and to help them respond more effectively to health, education and development opportunities. At the meeting, a Statement was developed describing effective approaches and strategies that can be adopted by schools to promote health, education and development. Five key challenges were identified. These described the need to continue building evidence and capturing practical experience in school health; the importance of improving implementation processes to ensure optimal transfer of evidence into practice; the need to alleviating social and economic disadvantage in access to and successful completion of school education; the opportunity to harness media influences for positive benefit, and the continuing challenge to improve partnerships among different sectors and organizations. The participants also identified a range of actions needed to respond to these challenges, highlighting the need for action by local school communities, governments and international organizations to invest in quality education, and to increase participation of children and young people in school education. This paper describes the rationale for and process of the meeting and the development of the Statement and outlines some of the most immediate efforts made to implement the actions identified in the Statement. It also suggests further joint actions required for the implementation of the Statement. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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34. Long-Term Impact of Malaria Chemoprophylaxis on Cognitive Abilities and Educational Attainment: Follow-Up of a Controlled Trial.
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Jukes, Matthew C. H., Pinder, Margaret, Grigorenko, Elena L., Smith, Helen Baños, Walraven, Gijs, Bariau, Elisa Meier, Sternberg, Robert J., Drake, Lesley J., Milligan, Paul, Cheung, Yin Bun, Greenwood, Brian M., and Bundy, Donald A. P.
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MALARIA prevention ,CHEMOPREVENTION ,PLACEBOS ,SCHOOL enrollment ,COGNITIVE ability ,EDUCATIONAL attainment - Abstract
Objectives: We investigated the long-term impact of early childhood malaria prophylaxis on cognitive and educational outcomes. Design: This was a household-based cluster-controlled intervention trial. Setting: The study was conducted in 15 villages situated between 32 km to the east and 22 km to the west of the town of Farafenni, the Gambia, on the north bank of the River Gambia. Participants: A total of 1,190 children aged 3-59 mo took part in the trial. We traced 579 trial participants (291 in the prophylaxis group and 288 in the placebo group) in 2001, when their median age was 17 y 1 mo (range 14 y 9 mo to 19 y 6 mo). Interventions: Participants received malaria chemoprophylaxis (dapsone/pyrimethamine) or placebo for between one and three malaria transmission seasons from 1985 to 1987 during the controlled trial. At the end of the trial, prophylaxis was provided for all children under 5 y of age living in the study villages. Outcome Measures: The outcome measures were cognitive abilities, school enrolment, and educational attainment (highest grade reached at school). Results: There was no significant overall intervention effect on cognitive abilities, but there was a significant interaction between intervention group and the duration of post-trial prophylaxis (p = 0.034), with cognitive ability somewhat higher in the intervention group among children who received no post-trial prophylaxis (treatment effect = 0.2 standard deviations [SD], 95% confidence interval [CI] -0.03 to 0.5) and among children who received less than 1 y of post-trial prophylaxis (treatment effect = 0.4 SD, 95% CI 0.1 to 0.8). The intervention group had higher educational attainment by 0.52 grades (95% CI = -0.041 to 1.089; p = 0.069). School enrolment was similar in the two groups. Conclusions: The results are suggestive of a long-term effect of malaria prophylaxis on cognitive function and educational attainment, but confirmatory studies are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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35. Understanding and enabling nutrition and agriculture linkages : development and implementation of home-grown school feeding in Nepal
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Singh, Samrat, Conway, Gordon, and Drake, Lesley
- Abstract
Providing nutritionally balanced diets through ecologically sustainable and equitable food systems is the most profound challenge facing us today. The current state of food and nutrition security is in many ways is a legacy of the green revolution and neoliberal market based political economy. Technocratic and market- based approaches have contributed to creating a highly homogenised food system at the expense of diversity, ecological sustainability and nutrition quality. The origin of agriculture around 10000 years ago and the processes of domestication provide useful insights on the key drivers of food production that influence policy and programmes even today. More importantly there is compelling evidence which shows how the transition to agriculture adversely impacted human health in a wide range of contexts. The study is an action research project primarily based on design, implementation and evaluation of 'Home Grown School Feeding' in eight districts across the three main agroecological zones of Nepal. It provides important policy and programmatic evidence on enabling decentralized food systems which are nutritionally and ecologically sensitive, as part of a government led universal food-based safety net project. Based on action research inquiry process, the thesis develops concepts and theories through the different chapters to contribute to our understanding of food systems and programme design. The intervention creates an effective platform for food system mediation through different pathways. Evidence on intervention governance through 'food sovereignty' lens demonstrates how HSGF interventions can also promote equity in food systems in terms of policies, funding and knowledge. COVID-19 pandemic control measures have contributed to undermining food and nutrition security, with the poorest being hit the hardest and young children potentially facing life-long consequences. Overall evidence from the thesis including the recent Covid crisis highlights the importance of resilient and context sensitive food production and it is an emphatic reminder of the need to have integrated public health-nutrition-ecology approach to food systems.
- Published
- 2022
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36. Local food for local children : the relationships between household agriculture and the health and nutrition of school-age children
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Watkins, Kristie Lynn and Drake, Lesley
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614 - Abstract
The target groups for many nutrition interventions are mothers and children under the age of two, as evidence has shown significant and substantial benefit for these age groups. Less is known about the potential for school-age children to benefit nutritionally from interventions through a complementary, life-cycle approach. The central hypothesis tested here is that nutrition-sensitive interventions can improve growth at school-age and that schools are an effective platform for children to be able to access these interventions. I address this hypothesis by examining three key research questions: 1) whether and to what extent catch-up growth can occur at school age; 2) how household characteristics (agriculture and dietary quantity and quality in particular) are related to nutrition at school age and what entry points may exist for holistic intervention; and 3) how school feeding programs are related to education participation (and thus access to nutritional inputs through programming) and how programs may be strengthened to improve links with local agriculture. Examining the first question, in a review of the potential for catch-up growth at school age, a range of intervention studies counter claims of the irreversibility of pre-school growth faltering with evidence that early deficits can, at least to some extent, be made up in childhood and adolescence. For the second question, in analysis of relationships between school-age nutritional status and household agriculture in Mali, associations were observed between household agricultural production variety and measures of dietary diversity and food variety, but no associations between these measures and school-age child nutrition outcomes were found. In making the link to programming through the third question, no significant associations were found between school feeding and the education participation outcomes measured at the school level in Kenya. I conclude that opportunities for improving the nutrition of school-age children do exist and that understanding the potential for agriculture-nutrition disconnects and the dynamic nature of school feeding programs could help improve the design of multi-sectoral, nutrition-sensitive interventions at school age, including Home Grown School Feeding (HGSF).
- Published
- 2015
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37. Hunger and learning : evidence on the costs and effectiveness of providing food through schools in food-insecure areas
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Gelli, Aulo, Donnelly, Christl, and Drake, Lesley
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614 - Abstract
Globally, over the last decade primary school access has improved significantly. Yet challenges remain: 67 million primary school-aged children are not in school. Poor nutrition and health among schoolchildren are important barriers in achieving education-for-all goals. School feeding is a popular intervention supporting the education, health and nutrition of children in food-insecure settings. However, school feeding programmes are complex, involving a broad range of stakeholders across different sectors and implementation levels. This thesis is aimed at providing evidence to support policy-makers in managing trade-offs among alternative targeting approaches, feeding modalities, and costs. This work is also aimed at building an evidence-based framework to guide Governments in managing the inherent complexity of school feeding interventions. The thesis includes an analysis of a natural experiment involving survey data from 32 countries across sub-Saharan Africa that suggested that school feeding increased enrolment by 10 percent. Enrolment changes varied by modality and gender, with onsite meals having stronger effects in the first year of treatment in lower grades, and onsite combined with take-home rations being effective post-year 1, particularly for girls. Expenditures across 62 countries indicated considerable differences in costs across modalities, ranging from $23 USD for fortified biscuits to $75 USD for take-home rations. This raises important questions of cost-effectiveness and sustainability, also in terms of school-level costs not normally captured in programme expenditures. Findings also suggest that school level costs are substantive, and are a considerable overhead, considering that these costs are generally borne by food-insecure communities. The thesis also highlights that scaling-up school feeding requires significant financing, on average equal to 40 percent of primary education costs. Despite these opportunity costs there is strong buy-in on school feeding from governments in sub-Saharan Africa. The implications of this thesis also suggest that the complexity of school feeding as an intervention has perhaps been underestimated by policymakers. Strengthening the evidence linking outcomes to the design of school feeding and to the quality of the service delivery, including the trade-offs between implementation modalities, remains a critical area of future research. This thesis provides both a foundation and a step towards answering these complex questions in a comparable and meaningful way.
- Published
- 2013
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38. Global School Feeding Sourcebook : Lessons from 14 Countries
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Carmen Burbano, Alice Woolnough, Donald A. P. Bundy, Lesley Drake, Drake, Lesley, Woolnough, Alice, Burbano, Carmen, and Bundy, Donald
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Economic growth ,school feeding ,Free education ,Universal Primary Education ,Safety net ,Primary education ,child nutrition ,food security ,School meal ,school meals ,Cape verde ,Social protection ,accountability ,Political science ,Pedagogy ,Curriculum - Abstract
School feeding programs are gaining increasing recognition for their twin roles as a long-term social protection investment as well as acting as a productive safety net for children and their families in the short-term. This was the conclusion of an analysis undertaken by the World Bank and the United Nations World Food Program (WFP), in collaboration with the Partnership for Child Development (PCD), with the aim of understanding why so many poor countries were using school feeding programs as a key part of their response to the emerging food, fuel, and financial crises of 2008. The analysis, published as Rethinking School Feeding (Bundy et al., 2009), showed that governments viewed school feeding programs as providing multiple benefits to education, to health, and to local agriculture, and as being important and readily expandable mechanisms to reach the most vulnerable. Whether called ‘school food’, ‘school meals’ or ‘school feeding’, these programs met most of the important criteria for a productive safety net. This Sourcebook is the third analysis of school feeding by the same three partners, and was produced in response to demand from governments and development agencies for operational guidance on the operational experiences of national programs. This analysis uses a standardized approach to provide a more in-depth understanding of individual programs from 14 different countries, and then to compare their case studies to see what lessons can be learned. The following 14 countries were selected to provide diversity in geography, approach, and development: Botswana, Brazil, Cape Verde, Chile, Cote d’Ivoire, Ecuador, Ghana, India, Kenya, Mali, Mexico, Namibia, Nigeria, and South Africa.
- Published
- 2016
39. Association between post-sternotomy tracheostomy and deep sternal wound infection.
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Tsai, Yi-Chin, Phan, Kevin, Stroebel, Andrie, Williams, Livia, Nicotra, Lisa, Drake, Lesley, Ryan, Elizabeth, McGree, James, Tesar, Peter, and Shekar, Kiran
- Subjects
- *
TRACHEOTOMY , *STERNAL gland , *SURGICAL site infections , *CARDIAC intensive care , *ARTIFICIAL respiration - Published
- 2015
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40. Does an integrated school eye health delivery model perform better than a vertical model in a real-world setting? A non-randomised interventional comparative implementation study in Zanzibar.
- Author
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Chan VF, Yard E, Mashayo E, Mulewa D, Drake L, Price-Sanchez C, and Omar F
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- Child, Humans, Program Evaluation, Schools, Tanzania, Research Design, School Health Services
- Abstract
Background: Few studies on school eye health programmes have shown they were cost-effective. We compared the performance (Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)) between an integrated model (IM) and a vertical model (VM) of school eye health delivery in Zanzibar., Methods: The set of RE-AIM performance indicators of the IM (n=9) and VM (n=10) cohorts was compared. The VM implemented only the eye health interventions, while the IM had the eye health interventions conducted within the school feeding programme. Semistructured interviews were conducted with 36 stakeholders to understand the challenges and outcomes experienced when implementing both models., Results: The IM achieved higher screening coverage, voluntary follow-up rate, screening validity and spectacle compliance than VM. This was due to effective coordination between implementers, motivated teachers to prevent vision problems and related negative impacts in children, and activities implemented timeously post-training. Both models recorded low wearing compliance. All schools in the IM cohort completed screening activities, but two schools in the VM cohort did not. Both models ceased activities after the funding stopped. Local stakeholders emphasised that evidence from this study can be used to advocate for more resources for children's eye health., Conclusions: The IM cohort achieved better reach, effectiveness, adoption rate and implementation performance than the VM cohort. The poor maintenance performance indicators in both arms postfunding call for improvement to the implementation strategy to ensure the sustainability of school eye health. In the optics of scaling up, an integrated approach is recommended., Competing Interests: Competing interests: The study was a collaborative project between the Ministry of Health, Zanzibar, Brien Holden Vision Institute Foundation Africa Trust and Partnership for Child Development. FO and VFC were the principal investigator and coprincipal investigator of the study. VFC and EM were employees at the Brien Holden Vision Institute Foundation Africa Trust throughout the study’s conception, implementation and completion., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
- Published
- 2023
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41. Editorial: COVID-19: School and community feeding programs for children and young people.
- Author
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Defeyter MA, Drake L, and Bundy DAP
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- Humans, Child, Adolescent, Schools, Poverty, COVID-19 epidemiology
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Published
- 2022
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42. Is an integrated model of school eye health delivery more cost-effective than a vertical model? An implementation research in Zanzibar.
- Author
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Chan VF, Omar F, Yard E, Mashayo E, Mulewa D, Drake L, Wepo M, and Minto H
- Abstract
Objective: To review and compare the cost-effectiveness of the integrated model (IM) and vertical model (VM) of school eye health programme in Zanzibar., Methods and Analysis: This 6-month implementation research was conducted in four districts in Zanzibar. Nine and ten schools were recruited into the IM and VM, respectively. In the VM, teachers conducted eye health screening and education only while these eye health components were added to the existing school feeding programme (IM). The number of children aged 6-13 years old screened and identified was collected monthly. A review of project account records was conducted with 19 key informants. The actual costs were calculated for each cost categories, and costs per child screened and cost per child identified were compared between the two models., Results: Screening coverage was 96% and 90% in the IM and VM with 297 children (69.5%) from the IM and 130 children (30.5%) from VM failed eye health screening. The 6-month eye health screening cost for VM and IM was US$6 728 and US$7 355. The cost per child screened for IM and VM was US$1.23 and US$1.31, and the cost per child identified was US$24.76 and US$51.75, respectively., Conclusion: Both models achieved high coverage of eye health screening with the IM being a more cost-effective school eye health delivery screening compared with VM with great opportunities for cost savings., Competing Interests: Competing interests: The study was a collaborative project between the Ministry of Health, Zanzibar, Brien Holden Vision Institute Foundation Africa Trust and Partnership for Child Development. FO and VFC were the principal investigator and coprincipal investigator of the study. VFC, EM and MW were employees at the Brien Holden Vision Institute Foundation Africa Trust; and HM was an employee at Brien Holden Vision Institute, Sydney throughout the conception, implementation and completion of the study., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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43. The Broader Economic Value of School Feeding Programs in Low- and Middle-Income Countries: Estimating the Multi-Sectoral Returns to Public Health, Human Capital, Social Protection, and the Local Economy.
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Verguet S, Limasalle P, Chakrabarti A, Husain A, Burbano C, Drake L, and Bundy DAP
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- Botswana, Brazil, Cabo Verde, Child, Chile, Cote d'Ivoire, Ecuador, Ghana, Humans, India epidemiology, Kenya, Mali, Mexico, Namibia, Nigeria, Public Policy, Schools, South Africa, Developing Countries, Public Health
- Abstract
Introduction: Globally, there are 370 million children receiving school meals every day. Coverage is least in low-income countries, where the need is greatest and where program costs are viewed as high in comparison with the benefits to public health alone. Here we explore the policy implications of including the returns of school feeding to other sectors in an economic analysis. Methods: We develop an economic evaluation methodology to estimate the costs and benefits of school feeding programs across four sectors: health and nutrition; education; social protection; and the local agricultural economy. We then apply this multi-sectoral benefit-cost analytical framework to school feeding programs in 14 countries (Botswana, Brazil, Cape Verde, Chile, Côte d'Ivoire, Ecuador, Ghana, India, Kenya, Mali, Mexico, Namibia, Nigeria, and South Africa) for which input data are readily available. Results: Across the 14 countries, we estimate that 190 million schoolchildren benefit from school feeding programs, with total program budgets reaching USD11 billion per year. Estimated annual human capital returns are USD180 billion: USD24 billion from health and nutrition gains, and USD156 billion from education. In addition, school feeding programs offer annual social protection benefits of USD7 billion and gains to local agricultural economies worth USD23 billion. Conclusions: This multi-sectoral analysis suggests that the overall benefits of school feeding are several times greater than the returns to public health alone, and that the overall benefit-cost ratio of school feeding programs could vary between 7 and 35, with particular sensitivity to the value of local wages. The scale of the findings suggests that school feeding programs are potentially much more cost-beneficial when viewed from the perspective of their multi-sectoral returns, and that it would be worthwhile following up with more detailed analyses at the national level to enhance the precision of these estimates., Competing Interests: CB and AH were employed by the United Nations World Food Programme while contributing to the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Verguet, Limasalle, Chakrabarti, Husain, Burbano, Drake and Bundy.)
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- 2020
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44. Establishing Global School Feeding Program Targets: How Many Poor Children Globally Should Be Prioritized, and What Would Be the Cost of Implementation?
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Drake LJ, Lazrak N, Fernandes M, Chu K, Singh S, Ryckembusch D, Nourozi S, Bundy DAP, and Burbano C
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- Adolescent, Africa, Child, Growth Disorders, Humans, Income, Poverty, Schools
- Abstract
The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and nutrition after the first 1,000 days. Working with governments and partners, the UN World Food Program is leading a global scale up of investment in school health, and has undertaken a strategic analysis to explore the scale and cost of meeting the needs of the most disadvantaged school age children and adolescents in low and middle-income countries globally. Of the 663 million school children enrolled in school, 328 million live where the current coverage of school meals is inadequate (<80%), of these, 251 million live in countries where there are significant nutrition deficits (>20% anemia and stunting), and of these an estimated 73 million children in 60 countries are also living in extreme poverty (
- Published
- 2020
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45. The Role of Health in Education and Human Capital: Why an Integrated Approach to School Health Could Make a Difference in the Futures of Schoolchildren in Low-Income Countries.
- Author
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Cohee LM, Halliday KE, Gelli A, Mwenyango I, Lavadenz F, Burbano C, Drake L, and Bundy DAP
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- Child, Humans, Educational Status, Health, Poverty statistics & numerical data, Schools, Students
- Abstract
Healthy students learn better, yet most current investments in schoolchildren focus on education and learning while largely neglecting the health of the learner. Some school-based interventions, such as school feeding and deworming, are already successfully targeted at this age-group, but the efficiency and cost-effectiveness of such programs could be greatly enhanced by better integrated delivery alongside other priority health interventions. A symposium at the society's 68th annual meeting launched a process to explore how integrated delivery of school-based interventions can address prevalent health conditions in school-age children.
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- 2020
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46. Editorial: The Impact of School Food Consumption on Children's Cognition, Educational Attainment and Social Development.
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Drake L, Russo R, and Defeyter MGA
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- 2017
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47. The Evolution of School Health and Nutrition in the Education Sector 2000-2015 in sub-Saharan Africa.
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Sarr B, Fernandes M, Banham L, Bundy D, Gillespie A, McMahon B, Peel F, Tang KC, Tembon A, and Drake L
- Abstract
Study Objectives: To document the progression of school health and nutrition and its integration within the education sector in sub-Saharan Africa between 2000 and 2015., Background: School health and nutrition programs have contributed to "Education for All" objectives by helping ensure that children benefit from quality education and reach their educational potential., Methods: Analysis of education sector plans (ESPs) in terms of the Focusing Resources on Effective School Health (FRESH) framework and the World Bank Systems Approach for Better Education Results (SABER) School Health survey from a set of countries in sub-Saharan Africa., Results: Between 2000 and 2015, the presence and scope of school health and nutrition as reflected in the four FRESH pillars grew substantially in ESPs. Three of these pillars have large, upfront costs. The fourth pillar requires recurring annual budgetary allotments., Conclusion: Governments clearly recognize that evidence-based, contextually designed school health and nutrition programs can contribute to education sector goals. Moving into the post-2015 era, these programs can also help draw the last 10% of children into school and enhance their readiness to learn.
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- 2017
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48. Association between post-sternotomy tracheostomy and deep sternal wound infection: a retrospective analysis.
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Tsai YC, Phan K, Stroebel A, Williams L, Nicotra L, Drake L, Ryan E, McGree J, Tesar P, and Shekar K
- Abstract
Background: Tracheostomy has traditionally been used as a means of facilitated mechanical ventilation in patients requiring respiratory management following cardiac surgery. However in the clinical setting, the advantages of tracheostomy has been questioned by concerns surrounding evidence of its association with increased risk of deep sternal wound infections (DSWI). The present study sought to evaluate retrospectively our experience with post-sternotomy tracheostomy among cardiac surgery patients and association with DSWI., Methods: Between July 2003 and June 2013, 11,795 patients underwent open cardiac surgery via sternotomy in our department. Among these, 225 underwent post-sternotomy tracheostomy. Data were obtained by reviewing and analyzing the Cardiac Surgical and Cardiac Intensive Care Unit (ICU) databases for adult cardiac patients., Results: Out of the 11,795 sternotomy patients analyzed, 225 (1.9%) underwent tracheostomy. The overall mortality rate for post-sternotomy tracheostomy patients was 21.3%. DSWI developed in 23 patients (10.2%) of the tracheostomy group. Seven of these 23 patients had DSWI after insertion of tracheostomy. DSWI was significantly higher in tracheostomy versus no-tracheostomy patients (10.2% vs . 0.48%; P<0.001). DSWI was also associated with higher mortality rates compared to non-DSWI patients (11.4% vs . 2.3%; P<0.001)., Conclusions: The present study demonstrated that tracheostomy was an independent risk factor for post-sternotomy DSWI, and that DSWI was a predictor of mortality. For tracheostomy patients, coronary artery bypass grafting (CABG) procedures and longer durations of tracheostomy were strong predictors of DSWI. Across all sternotomy patients, tracheostomy, diabetes, urgency status and blood transfusions were significant risk factors for DSWI. As such, the decision for tracheostomy post-sternotomy should be carefully considered on a case by case basis., Competing Interests: This article was presented in Royal Australasian College of Surgeons, 2014 Annual Scientific Congress, Singapore, May 7, 2014.
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- 2016
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49. Are School Feeding Programs Prepared to Be Inclusive of Children with Disabilities?
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Meresman S and Drake L
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- 2016
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50. Assays to detect beta-tubulin codon 200 polymorphism in Trichuris trichiura and Ascaris lumbricoides.
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Diawara A, Drake LJ, Suswillo RR, Kihara J, Bundy DA, Scott ME, Halpenny C, Stothard JR, and Prichard RK
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- Amino Acid Sequence, Animals, Anthelmintics pharmacology, Ascariasis parasitology, Ascaris lumbricoides drug effects, Benzimidazoles pharmacology, Child, Codon genetics, Drug Resistance genetics, Humans, Kenya, Molecular Sequence Data, Panama, Polymorphism, Single Nucleotide, Sequence Alignment, Trichuriasis parasitology, Trichuris drug effects, Ascaris lumbricoides genetics, Helminth Proteins genetics, Sequence Analysis, DNA methods, Trichuris genetics, Tubulin genetics
- Abstract
Background: The soil-transmitted helminths (STH) Ascaris lumbricoides and Trichuris trichiura are gastrointestinal parasites causing many disabilities to humans, particularly children. The benzimidazole (BZ) drugs, albendazole (ALB) and mebendazole (MBZ), are commonly used for mass treatment for STH. Unfortunately, there is concern that increased use of anthelmintics could select for resistant populations of these human parasites. In veterinary parasites, and lately in filarial nematodes, a single amino acid substitution from phenylalanine to tyrosine, known to be associated with benzimidazole resistance, has been found in parasite beta-tubulin at position 200. We have developed pyrosequencer assays for codon 200 (TTC or TAC) in A. lumbricoides and T. trichiura to screen for this single nucleotide polymorphism (SNP)., Method and Findings: Pyrosequencing assays were developed and evaluated for detecting the TTC or TAC SNP at codon 200 in beta-tubulin in A. lumbricoides and T. trichiura. Genomic DNA from individual worms, eggs isolated from individual adult worms or from fecal samples with known treatment history and origin, were sequenced at beta-tubulin by pyrosequencing, and genotypes were confirmed by conventional sequencing. The assays were applied to adult worms from a benzimidazole-naïve population in Kenya. Following this, these assays were applied to individual worms and pooled eggs from people in East Africa (Uganda and Zanzibar) and Central America (Panama) where mass anthelmintic drug programs had been implemented. All A. lumbricoides samples were TTC. However, we found 0.4% homozygous TAC/TAC in T. trichiura worms from non-treated people in Kenya, and 63% of T. trichiura egg pools from treated people in Panama contained only TAC., Conclusion: Although the codon 200 TAC SNP was not found in any of the A. lumbricoides samples analyzed, a rapid genotyping assay has been developed that can be used to examine larger populations of this parasite and to monitor for possible benzimidazole resistance development. The TAC SNP at codon 200, associated with benzimidazole resistance in other nematodes, does occur in T. trichiura, and a rapid assay has been developed to allow populations of this parasite to be monitored for the frequency of this SNP. Sample sizes were small, anthelmintic efficacy was not assessed, and treated and non-treated samples were from different locations, so these frequencies cannot be extrapolated to other populations of T. trichiura or to a conclusion about resistance to treatment. The occurrence of the TAC SNP at codon 200 of beta-tubulin in T. trichiura may explain why benzimidazole anthelmintics are not always highly effective against this species of STH. These assays will be useful in assessing appropriate treatment in areas of high T. trichiura prevalence and in monitoring for possible resistance development in these STH.
- Published
- 2009
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