A5088693820- Malaria Research and Control
- Mosquito-borne diseases and control
- Global Maternal and Child Health
- Parasites and Host Interactions
- Reproductive tract infections research
- Complement system in diseases
- Cervical Cancer and HPV Research
- Amoebic Infections and Treatments
- Parasitic Diseases Research and Treatment
- HIV, Drug Use, Sexual Risk
- Parasitic infections in humans and animals
- COVID-19 epidemiological studies
- Census and Population Estimation
- Parasite Biology and Host Interactions
- Reproductive System and Pregnancy
- Zoonotic diseases and public health
University of California, San Francisco
2023
Tulane University
2014-2020
Catholic University of South Sudan
2012
Mass drug administration (MDA) using dihydroartemisinin plus piperaquine (DHAp) represents a potential strategy to clear Plasmodium falciparum infections and reduce the human parasite reservoir. A cluster-randomized controlled trial in Southern Province, Zambia, was used assess short-term impact of 2 rounds community-wide MDA household-level (focal) with DHAp compared no mass treatment. Study end points included prevalence children, infection incidence, confirmed malaria case incidence. All...
Over the past decade, Zambia has made substantial progress against malaria and recently set ambitious goal of eliminating by 2021. In context very high vector control improved access to diagnosis treatment in Southern Province, we implemented a community-randomized controlled trial assess impact four rounds community-wide mass drug administration (MDA) household-level MDA (focal MDA) with dihydroartemisinin-piperaquine (DHAP) between December 2014 February 2016. The campaigns achieved...
Summary Objective To evaluate the diagnostic accuracy of a circulating cathodic antigen (CCA) urine dipstick test for detecting Schistosoma mansoni and S. haematobium alongside an integrated rapid mapping survey in Southern Sudan. Methods Results A total 373 children aged 5–16 years were included study. Of these 26.0% infected with 24.5% , as identified by filtration or single Kato–Katz thick smear, respectively. The CCA performed moderately sensitivity 89.1% specificity 74.2%, poorly...
Background Large parts of South Sudan are thought to be trachoma-endemic but baseline data limited. This study aimed estimate prevalence for planning trachoma interventions in Unity State, identify risk factors and investigate the effect different sampling approaches on conclusions. Methods Findings The survey area was defined as one domain eight counties State. Across area, 40 clusters (villages) were randomly selected proportional county population size a population-based survey....
Mass drug administration (MDA) and focal MDA (fMDA) using dihydroartemisinin plus piperaquine (DHAp), represent two strategies to maximize the use of existing information achieve greater clearance human infection reduce parasite reservoir, provide longer chemoprophylactic protection against new infections. The primary aim this study is quantify relative effectiveness fMDA with DHAp no mass treatment (standard care) for reducing Plasmodium falciparum prevalence incidence.The will be conducted...
Insecticide-treated nets (ITNs) are one of the most cost-effective measures for preventing malaria. The World Health Organization recommends both large-scale mass distribution campaigns and continuous distributions (CD) as part a multifaceted strategy to achieve sustain universal access ITNs. A combination these strategies has been effective scaling up ITN access. For policy makers make informed decisions on how efficiently implement CD or combined strategies, information costs...
In areas where malaria transmission has been suppressed by vector control interventions many and elimination programmes are actively seeking new to further reduce prevalence, incidence transmission. Malaria infection prevalence shown cluster geographically, especially at lower levels, as such a reactive strategy is frequently used, which index cases presenting passive surveillance system used target small for testing treatment, case detection (RCD), or focal drug administration (fDA). This...
Background Mass drug administration (MDA) of antibiotics is a key component the so-called "SAFE" strategy for trachoma control, while MDA anthelminthics provides cornerstone control number other neglected tropical diseases (NTDs). Simultaneous delivery two or more these drugs, renowned as "integrated NTD control," being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an campaign in remote endemic area, inform budgeting South Sudan. Methods...
A mass test and treat campaign (MTAT) using rapid diagnostic tests (RDTs) artemether-lumefantrine (AL) was conducted in Southern Zambia 2012 2013 to reduce the parasite reservoir progress towards malaria elimination. Through this intervention, community health workers (CHWs) tested all household members with provided treatment those that positive.A qualitative study undertaken understand CHW perceptions regarding MTAT campaign. total of eight focus groups 33 in-depth key informant interviews...
Rigorous evidence of effectiveness is needed to determine where and when apply mass drug administration (MDA) or focal MDA (fMDA) as part a malaria elimination strategy. The Zambia National Malaria Elimination Centre recently completed community-randomized controlled trial in Southern Province evaluate fMDA for transmission reduction. To assess the role on infection incidence, we enrolled longitudinal cohort an 18-month period data collection including monthly parasite detection based...
Community-wide administration of antimalarial drugs in therapeutic doses is a potential tool to prevent malaria infection and reduce the parasite reservoir. To measure effectiveness cost using drug combination dihydroartemisinin-piperaquine (DHAp) through different community-wide distribution strategies, Zambia's National Malaria Control Centre conducted three-armed community-randomized controlled trial. The trial arms were as follows: 1) standard care (SoC) interventions, 2) SoC plus focal...
Mass drug administration (MDA) is currently being considered as an intervention in low-transmission areas to complement existing malaria control and elimination efforts. The effectiveness of any MDA strategy dependent on achieving high epidemiologic coverage participant adherence rates. A community-randomized controlled trial was conducted from November 2014 March 2016 evaluate the impact four rounds or focal (fMDA)—where treatment given all eligible household members if anyone had a...
Background Integrated rapid mapping to target interventions for schistosomiasis, soil-transmitted helminthiasis (STH) and lymphatic filariasis (LF) is ongoing in South Sudan. From May September 2010, three states – Unity, Eastern Equatoria Central were surveyed with the aim of identifying which administrative areas are eligible mass drug administration (MDA) preventive chemotherapy (PCT). Methods Principal Findings Payams (third tier) Schistosoma mansoni, S. haematobium STH infections while...
Mass drug administration (MDA) with artemisinin combination therapy is a potentially useful tool for malaria elimination programs, but its success depends partly on effectiveness and treatment coverage in the targeted population. As part of cluster-randomized controlled trial Southern Province, Zambia evaluating impact MDA household focal (fMDA) dihydroartemisinin-piperaquine (DHAp), sub-studies were conducted investigating population adherence rates DHAp as administered clearing Plasmodium...
Many neglected tropical diseases, including the zoonotic disease cystic echinococcosis (hydatidosis), are endemic to East Africa. However, their geographical distribution is heterogenous and incompletely characterized. The aim of this study was determine if Mundari pastoralists harbor human hydatidosis. survey conducted in cattle camps randomly selected from accessible sites provided by officials Terekeka, South Sudan. Following informed consent, a questionnaire collected demographic data...
In malaria-endemic countries, the absence of parasitological confirmation malaria infection potentially results in overtreatment non-malaria febrile illness with antimalarial drugs; this may lead to healthcare workers (HCW) missing other treatable or wastage resources. This paper presents from nationally representative assessments diagnostic accuracy, quality and capacity Ghana Republic Benin.Cross-sectional surveys were conducted December 2012 among a sample health facilities (n=30 per...
From 2014 to 2016, a community-randomized controlled trial in Southern Province, Zambia, compared mass drug administration (MDA) and focal MDA (fMDA) with the standard of care. Acceptability intervention was assessed quantitatively using closed-ended Likert scale-based questions posed during three household surveys conducted from April May 2014, 2015, 2016 40 health catchments that implemented fMDA 20 served as controls. In 47 households per catchment were selected, targeting 1,880 arms; 55...
Abstract Background Reactive case detection (RACD) or testing and treatment of close contacts recent malaria cases, is commonly practiced in settings approaching elimination, but standard diagnostics have limited sensitivity to detect low level infections. drug administration (RDA), presumptive without testing, an alternative approach, better understanding regarding community acceptability operational feasibility are needed. Methods A qualitative study was conducted as part a two-arm cluster...
As Zambia continues to reduce its malaria incidence and target elimination in Southern Province, there is a need identify factors that can reintroduce parasites sustain transmission. To examine the relative contributions of types human mobility on prevalence, this analysis quantifies proportion population having recently traveled during both peak nonpeak transmission seasons over course 2 years assesses relationship between short-term travel infection status. Among all residents targeted by...