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2. Proceedings of the 2012 Annual Meeting of the Canadian Mathematics Education Study Group = Actes De La Rencontre Annuelle 2012 Du Groupe Canadien D'étude en Didactique Des Mathématiques (36th, Québec City, Québec, Canada, May 25-29, 2012)
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Canadian Mathematics Education Study Group (CMESG), Oesterle, Susan, Allan, Darien, and Liljedahl, Peter
- Abstract
This submission contains the Proceedings of the 2012 Annual Meeting of the Canadian Mathematics Education Study Group (CMESG), held at Laval University in Québec City, Québec. The CMESG is a group of mathematicians and mathematics educators who meet annually to discuss mathematics education issues at all levels of learning. The aims of the Study Group are: to advance education by organizing and coordinating national conferences and seminars to study and improve the theories of the study of mathematics or any other aspects of mathematics education in Canada at all levels; and to undertake research in mathematics education and to disseminate the results of this research. These proceedings include plenary lectures, a panel discussion, working group reports, topic session descriptions, new PhD reports, and summaries of ad hoc and poster sessions. Papers include: (1) Towards an Understanding of Ethical Practical Action in Mathematics Education: Insights from Contemporary Inquiries (Margaret Walshaw); (2) Old and New Mathematical Ideas from Africa: Challenges for Reflection (Paulus Gerdes); (3) Cooda, Wooda, Didda, Shooda: Time Series Reflections on CMESG/GCEDM (William Higginson); (4) Panel: What is Fundamental Mathematics for Learners? (Elaine Simmt, Darien Allan, Ralph Mason, Ruth Beatty, Peter Taylor, and Hélène Paradis); (5) Numeracy: Goals, Affordances, and Challenges (France Caron and Peter Liljedahl); (6) Diversities in Mathematics and their Relation to Equity (Beverly Caswell and David Wagner); (7) Technology and Mathematics Teachers (K-16) / La technologie et l'enseignant mathématique (K-16) (Chantal Buteau and Nathalie Sinclair); (8) La preuve en mathématiques et en classe / Proof in Mathematics and in Schools (David Reid and Denis Tanguay); (9) The Role of Text/books in the Mathematics Classroom / Le rôle des manuels scolaires dans la classe de mathématiques (Peter Appelbaum and Susan Gerofsky); (10) Preparing Teachers to Develop Algebraic Thinking in Primary and Secondary School / Préparer les enseignants au développement de la pensée algébrique au primaire et au secondaire (Hassane Squalli, Chris Suurtamm, and Viktor Freiman); (11) Collaboration Between Research in Mathematics Education and Teaching Mathematics: Case Study of Teaching Infinity in Calculus (Miroslav Lovric); (12) Dialogue sur la lecture de textes historiques dans la classe de mathématiques / Dialogue on Reading Original Texts in the Mathematics Classroom (Louis Charbonneau and David Guillemette) [Written in French]; (13) Teaching Toward Equity in Mathematics (Beverly Caswell); (14) Inequalities in the History of Mathematics: From Peculiarities to a Hard Discipline (Elena Halmaghi); (15) The Study of On-line Situations of Validation Experienced by 13- and 14-year-old Students With and Without the Aid of an Electronic Forum (Manon Leblanc); (16) Institutional Acculturation of the Researcher, Teacher, and Secondary 1 Students with Learning Difficulties in Problem Situations Involving Rational Numbers / Les effets d'une démarche d'acculturation sur l'action didactique conjointe de l'enseignant, des élèves et du chercheur, dans l'enseignement/apprentissage des nombres rationnels auprès d'élèves en difficultés d'apprentissage (Geneviève Lessard) [Written in French]; (17) Mathematics Education: An Aporetic of Epistemology, Language and Ethics (Jean-François Maheux); (18) Diverse Perspectives on Teaching "Math for Teachers": Living the Tensions (Susan Oesterle); (19) Conversations Held and Roles Played During Mathematics Teachers' Collaborative Design: Two Dimensions of Interaction (Armando Paulino Preciado Babb); (20) The Ordinary Yet Extraordinary Emotions and Motives of Preservice Mathematics Teachers (Oana Radu); (21) Élaboration et analyse d'une intervention didactique, co-construite entre chercheur et enseignant, visant le développement d'un contrôle sur l'activité mathématique chez les élèves du secondaire / Development and Analysis of a Didactic Intervention, Co-constructed Between Researcher and Teacher For the Development of a Control of the Mathematical Activity Among High School Students (Mireille Saboya) [Written in French]; (22) Publishing in the Journal of Mathematics Teacher Education (Olive Chapman and Margaret Walshaw); (23) Is It Possible to Measure the Effectiveness of a Specific Approach to Teaching Foundations Mathematics in a Post-Secondary Setting? / Est-il possible de mesurer l'efficacité d'une approche spécifique à l'enseignement mathématiques fondations dans un cadre de post-secondaire? (Taras Gula); (24) Challenges in Supporting Mathematics Teachers to Develop Their Teaching Practices (Lionel Lacroix); (25) Rapport sur le ad hoc éthique et éducation mathématique / Report on the Ethics and Mathematics Education Ad Hoc (Jean-François Maheux); (26) Reading Biographies and Autobiographies of Mathematicians: What Do They Tell Us About the Subject of Mathematics? (Veda Roodal Persad); (27) Online Environments for Mathematics Sharing and Collaboration (Geoffrey Roulet); (28) Ad Hoc Session on Planning for the Next Canadian Math Education Forum (CMEF) to be Held in May 2014 (Peter Taylor); (29) Preservice Elementary Teachers' Beliefs Toward Mathematics and Mathematics Teaching (Sean Beaudette, Alexandra Penn, and Geoffrey Roulet); (30) Gearing Up For Grade 9: A Learning Object (Laura Broley); (31) Students' Perceptions of the Role of Theory and Examples in College Level Mathematics (Dalia Challita and Nadia Hardy); (32) Une expérimentation de pratiques gagnantes en enseignement des mathématiques / An Experiment with Successful Practices in Mathematics Teaching (Lucie Deblois); (33) Blended Mathematical Collaboration Using a Wiki, Geogebra and Jing (Jill Lazarus and Geoffrey Roulet); (34) Some Things Technologies Can Tell Us About Technologies: An Instrumented Analysis of Two Successive Mathematics Curricula (Jean-François Maheux and Fabienne Venant); (35) Investigating the Teaching Practices of a Group of Mathematics Graduate Students (Tod L. Shockey and Sibylle Weck-Schwarz); (36) Mathematics For Young Children: Exploring What is Possible in Early Mathematics Education? (Diane Tepylo, Joan Moss, Catherine Bruce, Tara Flynn, Diana Chang, and Zachary Hawes); and (37) Mise à l'essai d'une situation d'enseignement-apprentissage en lien avec le métier du scénographe pour favoriser l'engagement mathématique des élèves du 1er cycle du secondaire (Josianne Trudel) [Written in French]. Appended are: (1) Working Groups at Each Annual Meeting; (2) Plenary Lectures at Each Annual Meeting; and (3) Proceedings of Annual Meetings. Individual papers contain references, tables, and figures. [For the 2011 proceedings, see ED547245.]
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- 2013
3. 'I Was Just Done with Calculations…. I Realized That I Like Working with People' Understanding Why Women Abandon Careers in Mathematics
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Ungadi, Benard Akala
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Contemporary research on women and the learning of science in higher educational institutions has persistently focused on equal representation and access. This study sets out to find out why women, after successfully completing their degrees in mathematics at undergraduate and/or masters, quit the field. This is despite the popular view that the anticipated value of a career in mathematics to one's social-economic status cannot be under-estimated. This happens at a time most governments worldwide are committing more resources in education to encourage women to study mathematics and science. This paper reports interviews conducted among three women (from different countries in Sub-Saharan Africa) who studied mathematics at undergraduate and have since abandoned it to take on new careers in humanities and social sciences. The findings reveal that as women engage with mathematics at higher levels, their expectations and value of mathematics starts weathering off. Some develop the feeling that mathematics limits one's ability to interact with people as compared to other fields of social science such as management. More surprising findings revealed that relatives still play an instrumental role in discouraging women to pursue mathematics to higher level
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- 2015
4. Reflections on Ethnomathematics.
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Gerdes, Paulus
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Discusses the ethnomathematics movement, the emergence of concepts related to ethnomathematics, ethnomathematics as a field of research that studies mathematics in its relationship to the whole of cultural and social life, and the beginning of ethnomathematical research in Mozambique. (41 references) (MKR)
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- 1994
5. The Hemispheric Roots of the Columbian Voyages.
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Shaffer, Lynda N.
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Urges that the search for origins of European exploration extend to Africa and East Asia and their international trade. Cites contributions of India and the Arabs, Chinese, and Malaysians. Emphasizes the importance of mathematics, navigation, and sailing technology. Argues that without these contributions the European voyages would not have been possible. (DK)
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- 1991
6. WASH activities at two Ebola treatment units in Sierra Leone.
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Mallow, Michaela, Gary, Lee, Jeng, Timmy, JrBongomin, Bob, Aschkenasy, Miriam Tamar, Wallis, Peter, Cranmer, Hilarie H., Debasu, Estifanos, and Levine, Adam C.
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EBOLA virus disease ,EPIDEMIOLOGY ,COHORT analysis ,CHLORINE ,PROTECTIVE clothing - Abstract
Purpose: The 2014 outbreak of Ebola virus disease (EVD) in West Africa was the largest in history. Starting in September 2014, International Medical Corps (IMC) operated five Ebola treatment units (ETUs) in Sierra Leone and Liberia. This paper explores how future infectious disease outbreak facilities in resource-limited settings can be planned, organized, and managed by analyzing data collected on water, sanitation, and hygiene (WASH) and infection prevention control (IPC) protocols. Design/Methodology/Approach: We conducted a retrospective cohort study by analyzing WASH/IPC activity data routinely recorded on paper forms or white boards at ETUs during the outbreak and later merged into a database from two IMC-run ETUs in Sierra Leone between December 2014 and December 2015. Findings: The IMC WASH/IPC database contains data from over 369 days. Our results highlight parameters key to designing and maintaining an ETU. High concentration chlorine solution usage was highly correlated with both daily patient occupancy and high-risk zone staff entries; low concentration chlorine usage was less well explained by these measures. There is high demand for laundering and disinfecting of personal protective equipment (PPE) on a daily basis and approximately 1 (0–4) piece of PPE is damaged each day. Research limitations/Implications: Lack of standardization in the type and format of data collected at ETUs made constructing the WASH/IPC database difficult. However, the data presented here may help inform humanitarian response operations in future epidemics. [ABSTRACT FROM AUTHOR]
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- 2018
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7. Components of information for multiple resolution comparison between maps that share a real variable.
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Pontius Jr., Robert, Thontteh, Olufunmilayo, and Hao Chen
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MATHEMATICAL variables ,LANDSCAPES ,REAL variables ,CONDITIONAL expectations ,FREE resolutions (Algebra) ,SPATIAL analysis (Statistics) ,GRIDS (Typographic design) ,MATHEMATICS - Abstract
This paper presents quantitative methods that allow scientists to compare the patterns in two maps that show a shared real variable. Specifically, this paper shows how to budget various components of agreement and disagreement between maps. The components are based on the separation of a map’s information of quantity from its information of location. The technique also examines how variation in resolution influences the measurement of the components of information. The manner in which the measurements change as a function of spatial resolution can be more important and interesting than the results at any single particular resolution, because the results at a single particular resolution may indicate more about the format of the data than about the overall pattern in the landscape. An example illustrates the mathematical concepts, and an application compares mapped vegetation indices in Africa to illustrate the usefulness of the proposed approach vis-à-vis a conventional approach. The results are presented visually in the form of stacked bar graphs that show separable components of information. The entire analysis is performed twice, each time with a different mathematical measurement of deviation: (1) root mean square error, and (2) mean absolute error. This paper compares these two approaches and discusses their relative advantages and disadvantages. Hopefully, this approach of budgeting components of information at multiple resolutions will become adopted as standard practice in the measurement of patterns. [ABSTRACT FROM AUTHOR]
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- 2008
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8. Predictive pollen-based biome modeling using machine learning.
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Sobol, Magdalena K. and Finkelstein, Sarah A.
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MACHINE learning ,FOSSIL pollen ,FISHER discriminant analysis ,BIOMES ,SUPPORT vector machines ,SUPERVISED learning ,VEGETATION dynamics - Abstract
This paper investigates suitability of supervised machine learning classification methods for classification of biomes using pollen datasets. We assign modern pollen samples from Africa and Arabia to five biome classes using a previously published African pollen dataset and a global ecosystem classification scheme. To test the applicability of traditional and machine-learning based classification models for the task of biome prediction from high dimensional modern pollen data, we train a total of eight classification models, including Linear Discriminant Analysis, Logistic Regression, Naïve Bayes, K-Nearest Neighbors, Classification Decision Tree, Random Forest, Neural Network, and Support Vector Machine. The ability of each model to predict biomes from pollen data is statistically tested on an independent test set. The Random Forest classifier outperforms other models in its ability correctly classify biomes given pollen data. Out of the eight models, the Random Forest classifier scores highest on all of the metrics used for model evaluations and is able to predict four out of five biome classes to high degree of accuracy, including arid, montane, tropical and subtropical closed and open systems, e.g. forests and savanna/grassland. The model has the potential for accurate reconstructions of past biomes and awaits application to fossil pollen sequences. The Random Forest model may be used to investigate vegetation changes on both long and short time scales, e.g. during glacial and interglacial cycles, or more recent and abrupt climatic anomalies like the African Humid Period. Such applications may contribute to a better understanding of past shifts in vegetation cover and ultimately provide valuable information on drivers of climate change. [ABSTRACT FROM AUTHOR]
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- 2018
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9. Perceptions of community safety and social activity participation among youth in South Africa.
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De Wet, Nicole, Somefun, Oluwaseyi, and Rambau, Ndivhuwo
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CRIME ,VIOLENCE ,SOCIAL advocacy ,YOUTH development ,COMMUNITY safety - Abstract
Background: Crime and violence causes massive disruptions to the health, survival and development of populations. In South Africa, incredibly high rates of crime and violence are noted. The country also has a very large youth population whose health, survival and development are key to economic growth. Among other efforts to encourage healthy youth development and the promotion of social activities such as sports, youth groups, choirs and so forth. This study examines the relationship between perceived community safety and the uptake of social activities among youth in South Africa. Data and methods: This paper uses data from the National Youth Lifestyle Survey (2008) with an unweighted sample of 4,391 youth (age12-22 years old). Using chi-square and logistic regression analysis the association between perceived community safety and social activity participation are tested. Findings: The results indicate that youth participation in social activities in South Africa is high (55% of males and 45% of females). Among males, the most prominent activity is sports (51.8%), while for females there is high participation in choir and singing groups (55.68%). More than 50% of males perceive their communities as risky while less than half of females feel the same. Male youth are more likely to participate in social activities if they perceive their communities as risky (OR = 1.04). Females (OR = 0.83), youth have a negative view of their future (OR = 0.43) are less likely to participate in social activities. Conclusions: There exists an association between youth’s perception of community safety and their participation in social activities. Whether sports and groups are protective or enabling environments for youth from unsafe communities is moot. More in-depth research is needed on why youth participate in these clubs and groups to truly understand the role of social activities in South African societies. [ABSTRACT FROM AUTHOR]
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- 2018
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10. Altruism and the pressure to share: Lab evidence from Tanzania.
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Di Falco, Salvatore, Lokina, Razack, Martinsson, Peter, and Pin, Paolo
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ALTRUISM ,PRESSURE ,SOCIAL networks ,SOCIAL psychology ,COGNITIVE science - Abstract
We propose a novel laboratory experiment to document the pressure to share income within social networks in Africa. We find that the redistributive pressure exerted via the possibility of receiving a claim increases altruism, while the possibility of hiding from such claim reduces it. Our results indicate that sharing norms are crucial drivers of giving to other members of the network. We also find that pressure to share has a detrimental effect on the undertaking of profitable but risky investments. [ABSTRACT FROM AUTHOR]
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- 2019
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11. Second-line HIV treatment failure in sub-Saharan Africa: A systematic review and meta-analysis.
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Edessa, Dumessa, Sisay, Mekonnen, and Asefa, Fekede
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THERAPEUTICS ,META-analysis ,HIV ,VIRAL load ,MULTIVARIABLE testing ,AIDS treatment - Abstract
Background: Increased second-line antiretroviral therapy (ART) failure rate narrows future options for HIV/AIDS treatment. It has critical implications in resource-limited settings; including sub-Saharan Africa (SSA) where the burden of HIV-infection is immense. Hence, pooled estimate for second-line HIV treatment failure is relevant to suggest valid recommendations that optimize ART outcomes in SSA. Methods: We retrieved literature systematically from PUBMED/MEDLINE, EMBASE, CINAHL, Google Scholar, and AJOL. The retrieved studies were screened and assessed for eligibility. We also assessed the eligible studies for their methodological quality using the Joanna Briggs Institute’s appraisal checklist. The pooled estimates for second-line HIV treatment failure and its associated factors were determined using STATA, version 15.0 and MEDCALC, version 18.11.3, respectively. We assessed publication bias using Comprehensive Meta-analysis software, version 3. Detailed study protocol for this review/meta-analysis is registered and found on PROSPERO (ID: CRD42018118959). Results: A total of 33 studies with the overall 18,550 participants and 19,988.45 person-years (PYs) of follow-up were included in the review. The pooled second-line HIV treatment failure rate was 15.0 per 100 PYs (95% CI: 13.0–18.0). It was slightly higher at 12–18 months of follow-up (19.0/100 PYs; 95% CI: 15.0–22.0), in children (19.0/100 PYs; 95% CI: 14.0–23.0) and in southern SSA (18.0/100 PYs; 95% CI: 14.0–23.0). Baseline values (high viral load (OR: 5.67; 95% CI: 13.40–9.45); advanced clinical stage (OR: 3.27; 95% CI: 2.07–5.19); and low CD4 counts (OR: 2.80; 95% CI: 1.83–4.29)) and suboptimal adherence to therapy (OR: 1.92; 95% CI: 1.28–2.86) were the factors associated with increased failure rates. Conclusion: Second-line HIV treatment failure has become highly prevalent in SSA with alarming rates during the 12–18 month period of treatment start; in children; and southern SSA. Therefore, the second-line HIV treatment approach in SSA should critically consider excellent adherence to therapy, aggressive viral load suppression, and rapid immune recovery. [ABSTRACT FROM AUTHOR]
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- 2019
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12. Blood lead level in infants and subsequent risk of malaria: A prospective cohort study in Benin, Sub-Saharan Africa.
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Garrison, Amanda, Khoshnood, Babak, Courtin, David, Milet, Jacqueline, Garcia, André, Massougbodji, Achille, Ayotte, Pierre, Cot, Michel, and Bodeau-Livinec, Florence
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LEAD toxicology ,MALARIA ,LONGITUDINAL method ,COHORT analysis ,INFANTS ,IRON deficiency ,REGRESSION analysis - Abstract
Lead and malaria both present significant health risks to children in Sub-Saharan Africa. Previous studies have shown that high blood lead levels in children act as a protective factor against subsequent malaria incidence. The main objective of this study was to investigate associations between blood lead level and malaria outcomes prospectively in Beninese children from 12 to 24 months of age. Two-hundred and four children were assessed for lead at 12 months and closely followed until 24 months for malaria; when symptoms and parasite density were also recorded. Univariate and multivariate negative binomial and linear regression models tested associations between blood lead level quartile and total episodes of malaria (total symptomatic and asymptomatic episodes) and parasite density, respectively. Median blood lead level among children measured at 12 months was 56.50 (4.81–578) μg/L. During the 12-month follow-up, 172 (84.31%) children had at least one malaria episode. Univariate and multivariate negative binomial and linear regressions did not reveal significant associations between blood lead level quartile and malaria outcomes. Iron deficiency was not found to be an effect modifier. Results from this prospective child-cohort study investigating associations between blood lead level and malaria did not confirm results from previous cross-sectional studies. Further research is needed to further explore this relationship and other co-morbidities due to malaria and lead. [ABSTRACT FROM AUTHOR]
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- 2019
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13. Trait-based plant ecology a flawed tool in climate studies? The leaf traits of wild olive that pattern with climate are not those routinely measured.
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Kassout, Jalal, Terral, Jean-Frederic, Hodgson, John G., and Ater, Mohammed
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PLANT ecology ,CLIMATE extremes ,CLIMATE change ,PRINCIPAL components analysis ,OLIVE ,CLIMATOLOGY - Abstract
Climate-related studies have generally focussed upon physiologically well-defined ‘mechanistic’ traits rather than ‘functional’ ones relating indirectly to resource capture. Nevertheless, field responses to climate are likely to typically include both ‘mechanistic’ specialization to climatic extremes and ‘functional’ strategies that optimize resource acquisition during less climatically-severe periods. Here, this hypothesis was tested. Seventeen traits (six ‘functional’, six ‘mechanistic’ and five ‘intermediate’) were measured from 19 populations of oleaster (wild olive) along a climatic gradient in Morocco. Principal components analysis of the trait dataset identified size and the ‘worldwide leaf economics spectrum’ as PCA axes 1 and 2. However, contrary to our prediction, these axes, and commonly-measured ‘functional’ traits, were little correlated with climate. Instead, PCA 3, perhaps relating to water-use and succulence, together stomatal density, specific leaf water content and leaf shape, patterned with altitude, aridity, rainfall and temperature. We concluded that, at least for slow-growing species, such as oleaster, ‘mechanistic’ traits are key to identifying mechanisms of climatic restriction. Meaningful collaboration between ‘mechanistic’ and ‘functional’ disciplines provides the best way of improving our understanding of the global impacts of climate change on species distribution and performance. [ABSTRACT FROM AUTHOR]
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- 2019
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14. Think: Theory for Africa.
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Currin, Christopher B., Khoza, Phumlani N., Antrobus, Alexander D., Latham, Peter E., Vogels, Tim P., and Raimondo, Joseph V.
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SCIENTIFIC knowledge ,SOCIAL sciences education ,TECHNOLOGY ,COMPUTATIONAL neuroscience ,SCIENCE & state - Abstract
The article offers information on the challenging scientific problems faced by humanity. Topics discussed include information on the efforts to empower Africans to join the global neuroscience community; discussions on the BRAIN initiative in the U.S. and the Human Brain Project in Europe; and the information on the limiting factor for computational neuroscience development in Africa.
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- 2019
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15. Exploring households’ resilience to climate change-induced shocks using Climate Resilience Index in Dinki watershed, central highlands of Ethiopia.
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Asmamaw, Mengistu, Mereta, Seid Tiku, and Ambelu, Argaw
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ECOLOGICAL resilience ,HOUSEHOLDS ,FOCUS groups ,MULTIPLE regression analysis ,PRINCIPAL components analysis ,UPLANDS - Abstract
This study assessed households’ resilience to climate change-induced shocks in Dinki watershed, northcentral highlands of Ethiopia. The data were collected through a cross-sectional survey conducted on 288 households, three focus group discussions, and 15 key informant interviews. The Climate Resilience Index (CRI) based on the three resilience capacities (absorptive, adaptive and transformative) frame was used to measure households’ resilience to climate change-induced shocks on an agro-ecological unit of analysis. A principal component analysis (PCA) and multiple regression analysis were used to identify determinant factors and indicators to households’ resilience, respectively. Findings indicate that the indexed scores of major components clearly differentiated the study communities in terms of their agro-ecological zones. Specifically, the absorptive capacity (0.495) was the leading contributing factor to resilience followed by adaptive (0.449) and transformative (0.387) capacities. Likewise, the Midland was relatively more resilient with a mean index value of 0.461. Both the PCA and multiple regression analysis indicated that access to and use of livelihood resources, such as farmlands and livestock holdings, diversity of income sources, infrastructure and social capital were determinants of households’ resilience. In general, it might be due to their exposure to recurrent shocks coupled with limited adaptive capacities including underdeveloped public services, poor livelihood diversification practices, among others, the study communities showed minimal resilience capacity with a mean score of 0.44. Thus, in addition to short-term buffering strategies, intervention priority focusing on both adaptive and transformative capacities, particularly focusing on most vulnerable localities and constrained livelihood strategies, would contribute to ensuring long-term resilience in the study communities. [ABSTRACT FROM AUTHOR]
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- 2019
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16. A systematic review of the effectiveness of strategies to improve health care provider performance in low- and middle-income countries: Methods and descriptive results.
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Rowe, Samantha Y., Peters, David H., Holloway, Kathleen A., Chalker, John, Ross-Degnan, Dennis, and Rowe, Alexander K.
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MIDDLE-income countries ,META-analysis ,MEDICAL care ,LOW-income countries ,TIME series analysis ,REGRESSION analysis - Abstract
Background: Health care provider (HCP) performance in low- and middle-income countries (LMICs) is often inadequate. The Health Care Provider Performance Review (HCPPR) is a comprehensive systematic review of the effectiveness and cost of strategies to improve HCP performance in LMICs. We present the HCPPR’s methods, describe methodological and contextual attributes of included studies, and examine time trends of study attributes. Methods: The HCPPR includes studies from LMICs that quantitatively evaluated any strategy to improve HCP performance for any health condition, with no language restrictions. Eligible study designs were controlled trials and interrupted time series. In 2006, we searched 15 databases for published studies; in 2008 and 2010, we completed searches of 30 document inventories for unpublished studies. Data from eligible reports were double-abstracted and entered into a database, which is publicly available. The primary outcome measure was the strategy’s effect size. We assessed time trends with logistic, Poisson, and negative binomial regression modeling. We were unable to register with PROSPERO (International Prospective Register of Systematic Reviews) because the protocol was developed prior to the PROSPERO launch. Results: We screened 105,299 citations and included 824 reports from 499 studies of 161 intervention strategies. Most strategies had multiple components and were tested by only one study each. Studies were from 79 countries and had diverse methodologies, geographic settings, HCP types, work environments, and health conditions. Training, supervision, and patient and community supports were the most commonly evaluated strategy components. Only 33.6% of studies had a low or moderate risk of bias. From 1958–2003, the number of studies per year and study quality increased significantly over time, as did the proportion of studies from low-income countries. Only 36.3% of studies reported information on strategy cost or cost-effectiveness. Conclusions: Studies have reported on the efficacy of many strategies to improve HCP performance in LMICs. However, most studies have important methodological limitations. The HCPPR is a publicly accessible resource for decision-makers, researchers, and others interested in improving HCP performance. [ABSTRACT FROM AUTHOR]
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- 2019
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17. Mapping access to domestic water supplies from incomplete data in developing countries: An illustrative assessment for Kenya.
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Yu, Weiyu, Wardrop, Nicola A., Bain, Robert E. S., Alegana, Victor, Graham, Laura J., and Wright, Jim A.
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WATER supply ,DEVELOPING countries ,LOW-income countries ,MIDDLE-income countries ,WATER ,WELL water - Abstract
Water point mapping databases, generated through surveys of water sources such as wells and boreholes, are now available in many low and middle income countries, but often suffer from incomplete coverage. To address the partial coverage in such databases and gain insights into spatial patterns of water resource use, this study investigated the use of a maximum entropy (MaxEnt) approach to predict the geospatial distribution of drinking-water sources, using two types of unimproved sources in Kenya as illustration. Geographic locations of unprotected dug wells and surface water sources derived from the Water Point Data Exchange (WPDx) database were used as inputs to the MaxEnt model alongside geological/hydrogeological and socio-economic covariates. Predictive performance of the MaxEnt models was high (all > 0.9) based on Area Under the Receiver Operator Curve (AUC), and the predicted spatial distribution of water point was broadly consistent with household use of these unimproved drinking-water sources reported in household survey and census data. In developing countries where geospatial datasets concerning drinking-water sources often have necessarily limited resolution or incomplete spatial coverage, the modelled surface can provide an initial indication of the geography of unimproved drinking-water sources to target unserved populations and assess water source vulnerability to contamination and hazards. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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18. Burden of fungal asthma in Africa: A systematic review and meta-analysis.
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Kwizera, Richard, Musaazi, Joseph, Meya, David B., Worodria, William, Bwanga, Freddie, Kajumbula, Henry, Fowler, Stephen J., Kirenga, Bruce J., Gore, Robin, and Denning, David W.
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MYCOSES ,META-analysis ,ASTHMA ,RANDOM effects model ,ASTHMA treatment ,DISEASE complications - Abstract
Background: Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of fungal asthma among adults and children in Africa using a systematic review. Methods: We first engaged the Institute for Health Metrics and Evaluation (IHME) to highlight the trend in morbidity and mortality attributed to asthma in Africa. We then searched PubMed, HINARI and Google Scholar for all studies of any design focusing on fungal asthma in any African country. Languages were restricted to English and French, but not year of publication. We estimated the weighted prevalence of allergic fungal infections among asthmatics with a 95% CI and pooled the results using a random effects model. This study is registered with PROSPERO, number CRD42019117319. Results: The IHME data showed that there has been a gradual increase in morbidity and mortality due to asthma in African adults with a prevalence of 4%. Our search retrieved 5233 citations. We retained 20 studies that met our selection criteria. These were from 13 African countries published between 1967 and 2018. There were eight cross-sectional studies and twelve review articles. The average asthma prevalence in Africa was 6% from these studies. The prevalence of fungal sensitisation was relatively high (3–52%) in the asthmatic population with an average of 28% and a pooled estimate of 23.3%, mostly due to Aspergillus species. Prevalence of Allergic bronchopulmonary apsergillosis was estimated at 1.6–21.2%. Diagnosis of fungal allergy was mostly made by skin prick tests. There was no data on the use of medication to manage fungal asthma. None of the studies evaluated the association between fungal allergy and asthma severity. Data were lacking in children. Conclusion: There is a high prevalence of fungal sensitization among Africans with asthma. Fungal asthma is a significant problem in Africa but there remains a paucity of data on the epidemiology and associated complications. There is urgent need for national epidemiological studies to estimate the actual burden of fungal asthma in Africa. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Can a standards-based approach improve access to and quality of primary health care? Findings from an end-of-project evaluation in Ghana.
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Maly, Christina, Okyere Boadu, Richard, Rosado, Carina, Lailari, Aliza, Vikpeh-Lartey, Bernard, and Allen, Chantelle
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MEDICAL quality control ,PRIMARY care ,PRAGMATICS ,FACILITY management ,BIVARIATE analysis ,HEALTH services administration - Abstract
Background: Jhpiego implemented a 5-year project to strengthen the Community-Based Health Planning and Services (CHPS) model in six coastal districts of Ghana’s Western Region. The project utilized a quality improvement approach (Standards-Based Management and Recognition [SBM-R]) to strengthen implementation fidelity of the CHPS model. This article presents findings from an end-of-project evaluation comparing quality, access to care, and experience of care in intervention and comparison CHPS zones. Methods: A non-equivalent, posttest–only, end-of-project evaluation compared 12 randomly selected intervention zones with 12 matched comparison zones. Data from standards-based assessments measured provision of care in three categories: community engagement, clinical services, and facility readiness and management. Access to and experience of care were assessed using a household survey of 426 randomly selected community members from the selected CHPS zones. Bivariate and multivariate analyses were conducted to compare performance on these measures between intervention and comparison CHPS zones. Results: Overall, intervention zones outperformed comparison zones on achievement of standards (83.6% vs 58.8%) across all three assessment categories, with strongest results in community engagement (85.7% vs. 41.4%). Respondents in intervention zones were more than twice as likely to have received a home visit from a community health officer, three times as likely to have a home visit from a community health volunteer, and more likely to have attended a health talk (41.9% vs. 27.0%). Client experiences of care were reported as positive in both study arms. Conclusions: The evaluation demonstrated improved access to quality care; however, there were very few differences in client experience of care between intervention and comparison zones. As Ghana and other countries are committed to scaling up universal health care, a pragmatic approach such as SBM-R could prove useful to engage both facility- and community-based service providers, as well as community members, to improve provision of care. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
20. Hypertension in older adults in Africa: A systematic review and meta-analysis.
- Author
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Bosu, William Kofi, Reilly, Siobhan Theresa, Aheto, Justice Moses Kwaku, and Zucchelli, Eugenio
- Subjects
META-analysis ,OLDER people ,RANDOM effects model ,RURAL population ,HYPERTENSION ,GREY literature - Abstract
Background: Hypertension is the leading driver of cardiovascular disease deaths in Africa. Its prevalence is highest in older populations. Yet, this group has received little attention in many African countries. We conducted a systematic review and meta-analysis (PROSPERO registration: CRD42017056474) to estimate the prevalence of hypertension in older adults living in Africa. Methods: We searched grey literature and major electronic databases including PubMed and Embase for population-based studies and published between 1 January 1980 to 28 May 2018 reporting the prevalence of hypertension for adults aged ≥50 years living in Africa. We employed a random effects model to estimate the pooled prevalence across included studies. Findings: We screened 10,719 articles and retrieved 103 full-text articles to evaluate for inclusion in the review. Thirty-four unique studies providing 37 data points on 43,025 individuals in 15 African countries were analyzed. The prevalence of hypertension ranged from 22.3% to 90.0% from the individual studies while the overall pooled prevalence was 57.0% (95% CI 52%-61%). The prevalence was not statistically significantly different by sex, residence, or African sub-region. In individual studies, older age and overweight/obesity were independently associated with hypertension. Twenty-nine (78%) data points were deemed to be of low- or moderate-risk of bias. Eliminating high-risk bias studies made little difference to the pooled estimate of hypertension. Sensitivity analyses, omitting one study at a time, identified three studies with significant but relatively small impact on the pooled estimate. We observed substantial heterogeneity (I
2 = 98.9%) across the studies which was further explored by meta-regression analyses. Overall, the GRADE assessment suggested moderate quality evidence in the results. Conclusion: The persistent high prevalence of hypertension among older adults in Africa, even in rural populations warrants more attention to the cardiovascular health of this group by public health authorities. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
21. Towards 90-90: Findings after two years of the HPTN 071 (PopART) cluster-randomized trial of a universal testing-and-treatment intervention in Zambia.
- Author
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null, null, Floyd, Sian, MacLeod, David, Hayes, Richard, Schaap, Albertus, Ayles, Helen, Shanaube, Kwame, Phiri, Mwelwa, Griffith, Sam, Bock, Peter, Beyers, Nulda, and Fidler, Sarah
- Subjects
RANDOMIZED controlled trials ,HIV prevention ,ZAMBIANS ,HEALTH surveys ,HEALTH - Abstract
Background: HPTN071(PopART) is a 3-arm community-randomised study in 21 peri-urban/urban communities in Zambia and the Western Cape of South Africa, with high HIV prevalence and high mobility especially among young adults. In Arm A communities, from November 2013 community HIV care providers (CHiPs) have delivered the “PopART” universal-test-and-treat (UTT) package in annual rounds, during which they visit all households and offer HIV testing. CHiPs refer HIV-positive (HIV+) individuals to routine HIV clinic services, where universal ART (irrespective of CD4 count) is offered, with re-visits to support linkage to care. The overall goal is to reduce population-level adult HIV incidence, through achieving high HIV testing and treatment coverage. Methods and findings: The second annual round was June 2015-October 2016. Included in analysis are all individuals aged ≥15 years who consented to participate, with extrapolation to the total population. Our three main outcomes are (1) knowledge of HIV+ status (2) ART coverage, by the end of Round 2 (R2) and compared with the start of R2, and (3) retention on ART on the day of consenting to participate in R2. We used “time-to-event” methods to estimate the median time to start ART after referral to care. CHiPs visited 45,631 households during R2, ~98% of the estimated total across the four communities, and for 94% (43,022/45,631) consent was given for all household members to be listed on the CHiPs’ electronic register; 120,272 individuals aged ≥15 years were listed, among whom 64% of men (37,265/57,901) and 86% (53,516/62,371) of women consented to participate in R2. We estimated there were 6,521 HIV+ men and 10,690 HIV+ women in the total population of visited households; and that ~80% and ~90% of HIV+ men and women respectively knew their HIV+ status by the end of R2, fairly similar across age groups but lower among those who did not participate in Round 1 (R1). Among those who knew their HIV+ status, ~80% of both men and women were on ART by the end of R2, close to 90% among men aged ≥45 and women aged ≥35 years, but lower among younger adults, those who were resident in R1 but did not participate in R1, and those who were newly resident in the area of the community in which they were living in R2. Overall ART coverage was ~65% among HIV+ men and ~75% among HIV+ women, compared with the cumulative 90–90 target of 81%. Among those who reported ever taking ART, 93% of men and 95% of women self-reported they were on ART and missed 0 pills in the last 3 days. The median time to start ART after referral to care was ~6 months in R2, similar across the age range 25–54 years, compared with ~9.5 months in R1. The two main limitations to our findings were that a comparison with control-arm communities cannot be made until the end of the study; and that to extrapolate to the total population, assumptions were required about individuals who were resident, but did not participate, in R2. Conclusions: Overall coverage against the 90–90 targets was high after two years of intervention, but was lower among men, individuals aged 18–34 years, and those who did not participate in R1. Our findings reflect the relative difficulties for CHiPs to contact men at home, compared with women, and that it is challenging to reach high levels of testing and treatment coverage in communities with substantial mobility and in-migration. The shortened time to start ART after referral to care in R2, compared with R1, was likely attributable to multiple factors including an increased focus of the CHiPs on linkage to care; increasing community acceptance and understanding of the CHiPs, and of ART and UTT, with time; increased coordination with the clinics to facilitate linkage; and clinic improvements. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
22. The South African Rea Phela Health Study: A randomized controlled trial of communication retention strategies.
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Rhyne, James M., Mumbauer, Alexandra, Rheeder, Paul, Hall, Megan N., Genkinger, Jeanine, and Medina-Marino, Andrew
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EPIDEMIOLOGICAL transition ,COHORT analysis ,PUBLIC health ,CHI-squared test ,NON-communicable diseases - Abstract
Epidemiological transitions are occurring throughout Africa. To inform public health programs and policies, longitudinal cohorts investigating non-communicable diseases are needed. However, loss-to-follow up is a major problem. In preparation for a longitudinal study, we conducted a randomized controlled trial to test communication-based retention strategies (message content and delivery methods) among a pilot cohort of South African healthcare workers (n = 1536; median age = 36; women = 1270). Two messaging formats across three delivery modes were tested. Response rates were analyzed by intervention, survey return date and method using chi-square tests and univariate logistic regression. Sixty-seven of 238 (17.4%) control group participants and 238 of 1152 (24.6%) intervention group participants were retained (OR 1.54: CI 1.15–2.07; P = 0.004). Odds of being retained were 1.68 times greater for participants who received regular contact and themed messages compared to control (CI 1.22–2.32; P = 0.001). Neither health status nor clinical condition affected response rates (P>0.05). Time-to-first contact did not impact response rates (P>0.05). Message content and delivery method influenced response rates compared to the control, however no difference was found between intervention groups. Although greater retention is required for valid cohort studies, these findings are the first to quantitatively assess retention factors in Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
23. Adaptive geostatistical sampling enables efficient identification of malaria hotspots in repeated cross-sectional surveys in rural Malawi.
- Author
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Kabaghe, Alinune N., Chipeta, Michael G., McCann, Robert S., Phiri, Kamija S., van Vugt, Michèle, Takken, Willem, Diggle, Peter, and Terlouw, Anja D.
- Subjects
MALARIA transmission ,MALARIA ,SPATIO-temporal variation ,ADAPTIVE sampling (Statistics) ,SOCIAL status - Abstract
Introduction: In the context of malaria elimination, interventions will need to target high burden areas to further reduce transmission. Current tools to monitor and report disease burden lack the capacity to continuously detect fine-scale spatial and temporal variations of disease distribution exhibited by malaria. These tools use random sampling techniques that are inefficient for capturing underlying heterogeneity while health facility data in resource-limited settings are inaccurate. Continuous community surveys of malaria burden provide real-time results of local spatio-temporal variation. Adaptive geostatistical design (AGD) improves prediction of outcome of interest compared to current random sampling techniques. We present findings of continuous malaria prevalence surveys using an adaptive sampling design. Methods: We conducted repeated cross sectional surveys guided by an adaptive sampling design to monitor the prevalence of malaria parasitaemia and anaemia in children below five years old in the communities living around Majete Wildlife Reserve in Chikwawa district, Southern Malawi. AGD sampling uses previously collected data to sample new locations of high prediction variance or, where prediction exceeds a set threshold. We fitted a geostatistical model to predict malaria prevalence in the area. Findings: We conducted five rounds of sampling, and tested 876 children aged 6–59 months from 1377 households over a 12-month period. Malaria prevalence prediction maps showed spatial heterogeneity and presence of hotspots—where predicted malaria prevalence was above 30%; predictors of malaria included age, socio-economic status and ownership of insecticide-treated mosquito nets. Conclusions: Continuous malaria prevalence surveys using adaptive sampling increased malaria prevalence prediction accuracy. Results from the surveys were readily available after data collection. The tool can assist local managers to target malaria control interventions in areas with the greatest health impact and is ready for assessment in other diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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24. New Experiments and a Model-Driven Approach for Interpreting Middle Stone Age Lithic Point Function Using the Edge Damage Distribution Method.
- Author
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Schoville, Benjamin J., Brown, Kyle S., Harris, Jacob A., and Wilkins, Jayne
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MESOLITHIC Period ,MATERIAL culture ,DECISION making ,TAPHONOMY ,ARCHAEOLOGICAL research ,TECHNOLOGICAL innovations - Abstract
The Middle Stone Age (MSA) is associated with early evidence for symbolic material culture and complex technological innovations. However, one of the most visible aspects of MSA technologies are unretouched triangular stone points that appear in the archaeological record as early as 500,000 years ago in Africa and persist throughout the MSA. How these tools were being used and discarded across a changing Pleistocene landscape can provide insight into how MSA populations prioritized technological and foraging decisions. Creating inferential links between experimental and archaeological tool use helps to establish prehistoric tool function, but is complicated by the overlaying of post-depositional damage onto behaviorally worn tools. Taphonomic damage patterning can provide insight into site formation history, but may preclude behavioral interpretations of tool function. Here, multiple experimental processes that form edge damage on unretouched lithic points from taphonomic and behavioral processes are presented. These provide experimental distributions of wear on tool edges from known processes that are then quantitatively compared to the archaeological patterning of stone point edge damage from three MSA lithic assemblages—Kathu Pan 1, Pinnacle Point Cave 13B, and Die Kelders Cave 1. By using a model-fitting approach, the results presented here provide evidence for variable MSA behavioral strategies of stone point utilization on the landscape consistent with armature tips at KP1, and cutting tools at PP13B and DK1, as well as damage contributions from post-depositional sources across assemblages. This study provides a method with which landscape-scale questions of early modern human tool-use and site-use can be addressed. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
25. Epidemiology of Histologically Proven Glomerulonephritis in Africa: A Systematic Review and Meta-Analysis.
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Okpechi, Ikechi G., Ameh, Oluwatoyin I., Bello, Aminu K., Ronco, Pierre, Swanepoel, Charles R., and Kengne, Andre P.
- Subjects
GLOMERULONEPHRITIS ,KIDNEY failure ,EPIDEMIOLOGY ,HISTOLOGY ,META-analysis ,HEALTH outcome assessment ,PATIENTS - Abstract
Background and aim: Glomerulonephritis (GN) is a leading cause of end-stage renal disease (ESRD) in Africa. Data on epidemiology and outcomes of glomerular diseases from Africa is still limited. We conducted a systematic review on the epidemiology of histologically proven glomerular diseases in Africa between 1980 and 2014. Materials and methods: We searched literature using PubMed, AfricaWide, the Cumulative Index to Nursing and Allied Health Literature on EBSCO Host, Scopus, African Journals online databases, and the African Index Medicus, for relevant studies. The review was conducted using standard methods and frameworks using only biopsy-confirmed data. Results: Twenty four (24) studies comprising 12,093 reported biopsies from 13 countries were included in this analysis. The median number of biopsies per study was 127.0 (50–4436), most of the studies (70.0%) originated from North Africa and the number of performed kidney biopsies varied from 5.2 to 617 biopsies/year. Nephrotic syndrome was the commonest indication of renal biopsy. The frequency of reported primary pathologic patterns included, minimal change disease (MCD); 16.5% (95%CI: 11.2–22.6), focal segmental glomerulosclerosis (FSGS); 15.9% (11.3–21.1), mesangiocapillary GN (MCGN); 11.8% (9.2–14.6), crescentic GN; 2.0% (0.9–3.5) and IgA nephropathy 2.8% (1.3–4.9). Glomerular diseases related to hepatitis B and systemic lupus erythematosus had the highest prevalence among assessed secondary diseases: 8.4% (2.0–18.4) and 7.7% (4.5–11.7) respectively. There was no evidence of publication bias and regional differences were seen mostly for secondary GNs. Conclusions: Glomerular diseases remain poorly characterized in sub-Saharan Africa due to declining renal biopsy rates and consequent paucity of data on pathologic patterns of key renal diseases. Development of renal biopsy registries in Africa is likely to enable adequate characterization of the prevalence and patterns of glomerular diseases; this could have a positive impact on chronic kidney disease evaluation and treatment in the African continent since most glomerulopathies are amenable to treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
26. Create Accessible Ethnic Math Games.
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Anderson, Cindy, Anderson, Kevin, and Lenzo, Sheri
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ELECTRONIC games ,MATHEMATICS ,MULTICULTURALISM ,STUDENTS ,SENET (Game) ,MANCALA (Game) - Abstract
The article presents several ethnic games that has been developed to allow all students to experience mathematics in a multicultural context. The first game is called Senet, an Egyptian game, which asks the students to use their number sense, together with their addition and subtraction skills, to advance on the gameboard. Roshambo, a game which originates in Japan and is known in English as Rock, Paper and Scissors, and is designed to use three different versions from different countries. The third game is the African game is called Mancala, which helps reinforce several standards of mathematics.
- Published
- 2006
27. Efficacy and Day 7 Plasma Piperaquine Concentrations in African Children Treated for Uncomplicated Malaria with Dihydroartemisinin-Piperaquine.
- Author
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Zongo, Issaka, Somé, Fabrice A., Somda, Serge A. M., Parikh, Sunil, Rouamba, Noel, Rosenthal, Philip J., Tarning, Joel, Lindegardh, Niklas, Nosten, François, and Ouédraogo, Jean Bosco
- Subjects
MALARIA treatment ,CHILDREN ,ARTEMISININ ,PHARMACOKINETICS ,DRUG efficacy ,CLINICAL trials ,DISEASE relapse ,THERAPEUTICS - Abstract
Background: One promising new Artemisinin-based combination therapies (ACTs) is dihydroartemisinin-piperaquine (DHA-PQ). However, the pharmacokinetics of piperaquine and the relationship between drug levels and clinical efficacy are incompletely characterized, particularly in children. Methods: We performed a single-arm open-label trial in Bobo-Dioulasso, Burkina Faso. A total of 379 participants aged 6 months or more with uncomplicated falciparum malaria were enrolled. Each participant received daily dose of DHA-PQ for three days and followed for 42 days. Parasitological efficacy was analyzed, considering rates of recrudescence and overall recurrence. PK was an exploratory endpoint and a priori, no sample size had been determined. Day 7 capillary and venous plasma concentrations of piperaquine were measured in children aged 2–10 years. Results: Of the 379 participants, 365 (96.3%) completed 42 days of follow-up. The median daily dose of PQ was 18.5 mg/kg [6.5–24]. Treatment with DHA-PQ was well tolerated with fever and parasitemia resolution within 48 hours in nearly all children. Recurrent malaria within 42 days of follow-up occurred in 31.3% (10/34) of children less than 2 years old, 16.0% (16/106) of those aged 2–5 years, 9.4% (15/160) of those aged 5–10 years, and none (0/68) of those over 10 years old. After genotyping, 3 of 41 recurrent episodes were recrudescence. An exploratory analysis shows that children with successful treatment outcomes had significantly higher median plasma concentrations of PQ compared to those with recurrent malaria within 42 days after therapy, considering either capillary samples (68 ng/ml [50–85] compared to 48 ng/ml [36–55], p<0.001) or venous samples (42 ng/ml [29–59] compared to 25 ng/ml [19–44], p<0.001). Conclusion: DHA-PQ was effective for uncomplicated P. falciparum malaria treatment and offers an alternative to other ACTs. Recurrent malaria was mainly due to new infections after treatment and was correlated with low day 7 PQ concentration in the youngest patients. Trial Registration: Controlled-Trials.com ISRCTN59761234 [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
28. Population-Level Impact of Same-Day Microscopy and Xpert MTB/RIF for Tuberculosis Diagnosis in Africa.
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Dowdy, David W., Davis, J. Lucian, den Boon, Saskia, Walter, Nicholas D., Katamba, Achilles, and Cattamanchi, Adithya
- Subjects
TUBERCULOSIS diagnosis ,TUBERCULOSIS mortality ,MICROSCOPY ,POPULATION dynamics ,MEDICAL statistics - Abstract
Objective: To compare the population-level impact of two World Health Organization-endorsed strategies for improving the diagnosis of tuberculosis (TB): same-day microscopy and Xpert MTB/RIF (Cepheid, USA). Methods: We created a compartmental transmission model of TB in a representative African community, fit to the regional incidence and mortality of TB and HIV. We compared the population-level reduction in TB burden over ten years achievable with implementation over two years of same-day microscopy, Xpert MTB/RIF testing, and the combination of both approaches. Findings: Same-day microscopy averted an estimated 11.0% of TB incidence over ten years (95% uncertainty range, UR: 3.3%–22.5%), and prevented 11.8% of all TB deaths (95% UR: 7.7%–27.1%). Scaling up Xpert MTB/RIF to all centralized laboratories to achieve 75% population coverage had similar impact on incidence (9.3% reduction, 95% UR: 1.9%–21.5%) and greater effect on mortality (23.8% reduction, 95% UR: 8.6%–33.4%). Combining the two strategies (i.e., same-day microscopy plus Xpert MTB/RIF) generated synergistic effects: an 18.7% reduction in incidence (95% UR: 5.6%–39.2%) and 33.1% reduction in TB mortality (95% UR: 18.1%–50.2%). By the end of year ten, combining same-day microscopy and Xpert MTB/RIF could reduce annual TB mortality by 44% relative to the current standard of care. Conclusion: Scaling up novel diagnostic tests for TB and optimizing existing ones are complementary strategies that, when combined, may have substantial impact on TB epidemics in Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
29. On the Politics of Traditional Rulership.
- Author
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Laleye, 0.M. and Ayeni, Victor
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MANIPULATIVE behavior ,COLONIES ,IMPERIALISM ,MATHEMATICS ,DEVELOPING countries - Abstract
The place of traditional rulers in contemporary society is a knotty one in practically all of the Third World. Supposedly caught between modernity and traditionalism, few of these societies have been able to provide more than make-shift solutions to the problem. There is clearly an insufficient understanding of both the dynamics of institutionalized traditional rulership and of the different factors, historical and environmental, which interact with it. The issue of the survival of the institution has often been reviewed without regard to its ideals, values and realities and with scant analysis of how these might be reconciled with the impact as well as the aftermath of colonialism and its concomitants. The place of traditional rulers in modern Africa is essentially a political issue. It is political because at stake are such basic questions as the survival of what has been an entrenched institution, and the calculus of benefits and liabilities that various interests derive from it. Traditional rulership brings various subtle techniques of manipulation and maneuver into the play of present-day post-colonial policies.
- Published
- 1993
- Full Text
- View/download PDF
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