Community perception of school-based delivery of anthelmintics in Ghana and Tanzania.

This paper presents the results of an evaluation of community perception of two large-scale, government-run, school-based health programmes delivering anthelmintic drugs to primary school children, in Ghana (80 442 children in 577 schools) and Tanzania (110 000 children in 352 schools). Most teachers (96% in Ghana and 98% in Tanzania) were positive about their role in the programme, including administration of anthelmintic drugs, and parents and children fully accepted their taking on this role. The benefits of the programme were apparent to teachers, parents and children in terms of improved health and well-being of the children. Over 90% of parents in both Ghana and Tanzania indicated a willingness to pay for the continuation of drug treatment. The evaluation also highlighted areas that are critical to programme effectiveness, such as communication between schools and parents, the issue of collaboration between the health and education sectors, parents' perception of the importance of helminth infection as a serious and chronic health problem (compared with more acute and life threatening illnesses such as malaria), and who should pay for treatment of side-effects.     

Tracking of stem cells in vivo for cardiovascular applications

In the past ten years, the concept of injecting stem and progenitor cells to assist with rebuilding damaged blood vessels and myocardial tissue after injury in the heart and peripheral vasculature has moved from bench to bedside. Non-invasive imaging can not only provide a means to assess cardiac repair and, thereby, cellular therapy efficacy but also a means to confirm cell delivery and engraftment after administration. In this first of a two-part review, we will review the different types of cellular labeling techniques and the application of these techniques in cardiovascular magnetic resonance and ultrasound. In addition, we provide a synopsis of the cardiac cellular clinical trials that have been performed to-date.     

Hirschsprung's disease and imperforate anus in a new born: unusual assocation

The association of congenital aganglionic megacolon and imperforate anus is rare. Our patient was a male neonate who initially presented with intestinal obstruction due to imperforate anus without fistula. Intraoperative findings and colonic biopsy revealed the presence of concurrent Hirschsprung's disease (HD). A suspicision that these two disorders may coexist is mandatory for early correct diagnosis.     

Conjoined twins sharing major organs and with discordant congenital anomaly

Thoraco-omphalopagus conjoined twins born to a 25-year-old para one Ethiopian lady are presented. Prenatal diagnosis was not made until elective cesarean section delivery was done for severe preeclampsia and twin pregnancy with breech presentation. Detailed autopsy results and relevant literature reviews are described. To the best of our knowledge, these are the second-documented cases of conjoined twins in this country.     

Should governments subsidize the use of insecticide-impregnated mosquito nets in Africa? Implications of a cost-effectiveness analysis

Recent large-scale field trials show that mosquito nets impregnated with insecticide can substantially reduce all-cause mortality in children in malaria-endemic areas in Africa. This paper considers the cost-effectiveness of impregnated nets, initially from the perspective of a government programme which would distribute nets free of charge and organize and fund re-impregnation on an annual basis. The calculations show that with the reductions in all-cause mortality observed in the trials, complete government subsidy of nets through a vertical programme would represent an efficient use of scarce resources for most combinations of assumptions. However, alternative ways of financing and organizing the use of impregnated nets are also possible and may be more cost-effective than vertical delivery. Distribution of nets and insecticide might be less costly than required for a vertical programme by integrating delivery with other types of government health programmes, with private sector delivery systems for other types of products, or with government systems developed for other sectors such as agriculture. Further, not all the costs need to be met by governments, as costs could be shared with donors, NGOs and the beneficiaries. The major conclusion is that impregnated nets would save a large number of lives in malaria endemic areas, they are an efficient use of scare resources, and ways of encouraging their use need to be developed and tested.     

Wave Front–Obstacle Interactions in Cardiac Tissue: A Computational Study

An understanding of wave front–obstacle interactions will greatly enhance our knowledge of the mechanisms involved in cardiac arrhythmias and their therapy. The goal of this computational study is to examine the interactions between wave fronts and various obstacles in a two-dimensional sheet of myocardium. The myocardium is modeled as an isotropic sheet with Luo–Rudy I membrane kinetics. An examination is conducted of wave front interactions with nonconductive and passive-tissue obstacles. Simulations were performed either in environments of reduced myocardial excitability, or with rapid stimulation via a line electrode. The shape of the obstacles and their ability to withdraw current from the active tissue greatly influence wave front–obstacle interactions in each of these environments. The likelihood of wave front detachment from an obstacle corner increases as the curvature of the obstacle corner is increased. A passive-tissue obstacle promotes wave front–obstacle separation in regions of depressed excitability. Under rapid pacing, the presence of the passive obstacle results in wave fragmentation, while the insulator obstacle promotes wave front detachment. The results of this study reveal the importance of obstacle composition and geometry in wave front interactions with cardiac obstacles. © 2001 Biomedical Engineering Society. PAC01: 8719Hh, 8710+e, 8719Nn     

Evaluation of Determine HIV-1/2 rapid diagnostic test by 4th generation ELISA using blood donors' serum at Felege Hiwot Referral Hospital, northwest Ethiopia

OBJECTIVE: The study aims to evaluate the HIV-1/2 rapid diagnostic test kit is routinely used to screen HIV infection for safe blood transfusion and VCT services in many parts of Ethiopia. METHODS: A total of 324 sera were collected from consecutive blood donors from February to May 2006. All samples were screened for HIV infection using Determine HIV-1/2 (Abbott Japan) at hospital blood bank laboratory. Blindly, all serums were retested at Regional Health Research Laboratory using 4th generation ELISA (Vironostika HIV Uni-Form II AG/Ab) and Determine HIV-1/2 (Abbott lab). Discordant samples were repeatedly retested using the same ELISA and Determine HIV-1/2 to avoid technical errors. Finally, discordant results were resolved using Western Blot at the National HIV/AIDS Laboratory. RESULTS: Determine HIV-1/2 and ELISA showed 94.4% concordance in HIV antibody testing with fair Cohen's Kappa statistic value (0.68) among blood donors. The sensitivity, specificity, positive and negative predictive values of Determine HIV-1/2 were 60.5%, 98.9%, 88.5% and 94.9% respectively. CONCLUSION: As a rapid HIV screening test for blood donors, Determine HIV-1/2 showed poor sensitivity. Further evaluation at multiple centres is recommended to test its validity as a routine HIV screening test in blood donors. Use of a combination of rapid assays is also recommended for screening of HIV infection among the donor population.