Predicting malaria epidemics in Burkina Faso with machine learning

Accurately forecasting the case rate of malaria would enable key decision makers to intervene months before the onset of any outbreak, potentially saving lives. Until now, methods that forecast malaria have involved complicated numerical simulations that model transmission through a community. Here we present the first data-driven malaria epidemic early warning system that can predict the 13-week case rate in a primary health facility in Burkina Faso. Using the extraordinarily high-fidelity data of infant consultations taken from the Integrated e-Diagnostic Approach (IeDA) system that has been rolled out throughout Burkina Faso, we train a combination of Gaussian Processes and Random Forest Regressors to estimate the weekly number of malaria cases over a 13 week period. We test our algorithm on historical epidemics and find that for our lowest threshold for an epidemic alert, our algorithm has 30% precision with > 99% recall at raising an alert. This rises to > 99% precision and 5% recall for the high alert threshold. Our two-tailed predictions have an average 1σ and 2σ precision of 5 cases and 30 cases respectively.

HCV Seroprevalence among HIV Patients and Associated Comorbidities at One Primary Health Facility in Rwanda

Hepatitis C virus (HCV) and HIV have emerged as major viral infections within the past two decades, and their coinfection poses a big challenge with a significant impact in terms of morbidity and mortality associated with liver disease and renal failure. The current study aimed at assessing the prevalence of HCV infection and associated comorbidities among HIV patients at one primary health facility in Rwanda. In total, 417 HIV-positive patients were recruited and included in the study from January 1, 2019 up to June 30, 2019. All participants were screened for HCV infection by using the SD Bioline HCV antibody rapid test. In addition, underlying medical conditions were also recorded as comorbidities. Among 417 participants, 52 exhibited HCV-positive results (12.5%). The group of 41- to 50- and 51- to 60-year-olds had higher prevalence of HIV/HCV coinfection than other age-groups with 3.6% and 4.6%, respectively. Furthermore, five underlying medical conditions were found as comorbidities among the study participants. Those with HIV/HCV coinfection showed higher comorbidities than those with mono-infection including liver toxicity, P value 0.005; tuberculosis, P value 0.005; renal failure, P value 0.003; hypertension, P value 0.001; and diabetes mellitus, P value 0.001. The relative risk ratio of having comorbidities in those groups was 4.09. To conclude, the prevalence of HCV/HIV coinfection is high, and there was a statistical significant association of having comorbidities in HIV/HCV-coinfected group compared with the group of HIV mono-infection, which suggests more intervention in this vulnerable group of patients.

Modeling schistosomiasis spatial risk dynamics over time in Rwanda using zero-inflated Poisson regression

The recorded clinical cases of S. mansoni at primary health facility level contain an excessive number of zero records. This could mean that no S. mansoni infection occurred (a true zero) in the health facility service area but it could also that at least one infection occurred but none were reported or diagnosed (a false zero). Standard statistical analysis, using exploratory or confirmatory spatial regression, fail to account for this type of data insufficiency. This study developed a zero-inflated Poisson model to explore the spatiotemporal variation in schistosomiasis risk at a fine spatial scale. We used environmental data generated at primary health facility service area level as explanatory variables affecting transmission risk. Identified risk factors were subsequently used to project the spatial variability of S. mansoni infection risk for 2050. The zero-inflated Poisson model shows a considerable increase of relative risk of the schistosomiasis over one decade. Furthermore, the changes between the risk in 2009 and forecasted risk by 2050 indicated both persistent and emerging areas with high relative risk of schistosomiasis infection. The risk of schistosomiasis transmission is 69%, 29%, and 50% higher in areas with rice cultivation, proximity to rice farms, and proximity to a water body respectively. The prediction and forecasting maps provide a valuable tool for monitoring schistosomiasis risk in Rwanda and planning future disease control initiatives in wetland ecosystem development context.

“What Will I Be Doing There Among So Many Women?”: Perceptions on Male Support in Prevention of Mother to Child Services in Lilongwe, Malawi

Participation of males in the prevention of mother-to-child transmission (PMTCT) programs remains a challenge despite the implementation of guidelines. The study aimed at exploring male involvement in the PMTCT program at a primary health facility in Lilongwe, Malawi. Focus group discussions and in-depth individual interviews were used to collect data from health care workers, men, and women who were attending PMTCT services. Snowball sampling was used to recruit participants who were purposively identified. Alcohol consumption, pressure from work places, stigma, role conflict, denial or nondisclosure of HIV status among women, and lack of awareness were among factors found to hinder male participation in PMTCT services. Therefore, to have an effective PMTCT program, male involvement is needed as this could positively influence the delivery of interventions including antiretroviral treatment among HIV-infected pregnant women. As such, health education awareness campaigns emphasizing the value of men in PMTCT services should be reinforced.

The Implementation of Acute Respiratory Infection (ARI) Controlling Programme and the Coverage of Pneumonia among Under-Five Children

Pneumonia is an acute infection of lung tissue (alveoli). Pneumonia is one of the main focus ARI preventing and controlling program. One of the ARI preventing and controlling program indicators was pneumonia coverage among under five years old. The coverage of pneumonia finding among under five years old in Banyuwangi Regency since 2014-2016 years have not reached the national target. Pneumonia toddler coverage in 2014 and 2015 shows 33,7% and 71,1%, while in 2016 shows 41,99%. This research aims to analyze the association between officer characteristics, logistics availability and ARI control activities with pneumonia toddler coverage in Banyuwangi Regency. The research uses cross sectional analytic desain with 31 respondents. The result of this research has significant relationship is age, work length and capacity buailding. Nevertheless, gender, education, knowladge, availability of diagnostic tools, guideline, KIE media, recording and reporting media, advocation and socialisation, pneumonia find and management, supervision, recording and reporting, partnership and network, monitoring and evaluation has not significant relationship. Banyuwangi Health Office is hoped to do conduct periodic training every year to ARI program officer on ARI control management, management of pneumonia toddler and promotion of pneumonia control in under fives to increase human resources capacity in primary health facility. Abstrak Pneumonia merupakan salah satu fokus utama Program Pencegahan dan Pengendalian ISPA. Salah satu indikator program P2 ISPA adalah cakupan penemuan pneumonia balita. Cakupan pneumonia pada balita di Kabupaten Banyuwangi dari tahun 2014-2016 belum mencapai target nasional. Pada tahun 2014 dan 2015 cakupan pneumonia pada balita sebesar 33,7% dan 71,1% sedangkan tahun 2016 sebesar 41,99%. Penelitian ini bertujuan menganalisis hubungan antara karakteristik petugas, ketersediaan logistik dan kegiatan pengendalian ISPA dengan cakupan penemuan pneumonia pada balita di Kabupaten Banyuwangi. Desain penelitian yang digunakan adalah analitik cross sectional dengan jumlah sampel 31 responden. Hasil penelitian ini yang memiliki hubungan signifikan dengan cakupan penemuan pneumonia pada balita adalah usia, lama kerja dan peningkatan kapasitas SDM dengan cakupan penemuan pneumonia pada balita. Sedangkan jenis kelamin, pendidikan, pengetahuan, ketersediaan alat diagnostik, buku pedoman, media KIE, media pencatatan dan pelaporan, advokasi dan sosialisasi, penemuan dan tata laksana pneumonia, supervisi, pencatatan dan pelaporan, kemitraan dan jejaring serta monitoring dan evaluasi tidak memiliki hubungan. Dinas Kesehatan Kabupaten banyuwangi diharapkan dapat melaksanakan pelatihan secara berkala setiap tahun kepada pemegang program P2 ISPA mengenai manajemen pengendalian ISPA, tatalaksana pneumonia pada balita serta promosi pengendalian pneumonia pada balita untuk meningkatkan kapasitas sumber daya manusia yang telah tersedia di puskesmas.

Design of Android Application for Telemedicine System to Improve Public Health Services

One of the services provided by health facilities in Indonesia is the heart condition’s examination using Electrocardiogram machine. This service is important to provide because heart disease is one of the 10 most common causes of death in Indonesia. The electrocardiogram machine produces a print out that contains a graph of patient’s heart condition status. A cardiologist reads an ECG Scan to diagnose whether the patient’s heart condition is normal or abnormal. Health facilities that has a cardiologist is a secondary health facility located in the city but in the primary health facility in the village, although the examination by electrocardiogram machine can be done, the patient still have to wait for the diagnosis result because the print out result is sent first to the secondary health facility which has a cardiologist. Therefore it is necessary to design an Android Application for supporting telemedicine system as an effort to accelerate diagnostic service so that patient in primary health facility can also get immediate medical treatment.