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Health and malarial issues

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  • Samwel Kongere
    Thanks Peter, As i am prepairing my community meetings in January to help me plan and budget afterwards, i will update you accordingly. This can help me
    Message 1 of 8 , Dec 25, 2008
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      Thanks Peter,
      As i am prepairing my community meetings in January to
      help me plan and budget afterwards, i will update you
      accordingly. This can help me unearth other Community
      demographics, which we call SITE (Standard Indicator
      Tool for Evaluation).
      Happy new year!
      Samwel.
      --- Peter Burgess <peterbNYC@...> wrote:

      > Dear Colleagues
      >
      > Adrius asked:
      > > Peter Burgess, please, what is a small $100
      > project that we could do in
      > > Kenya that would advance your Community
      > Accountancy ideas?
      >
      > Samwell also said:
      > I would wish Peter Ongele to answer, why mosquito
      > nets distributed
      > every year can not help reduce malarial cases around
      > the lake basin?
      > and is rearing mosquitoes able to help the locals
      > control malaria?.
      >
      > Please may I try to link these two.
      >
      > Community Accountancy is a SIMPLE system that helps
      > to put important
      > things at the top of the community's priority list.
      >
      > As I understand it, health is a problem ... and
      > specifically malaria.
      >
      > Various organizations have distributed bednets ...
      > and my guess is
      > that they are both the ordinary kind that need
      > retreatment with
      > insecticide several times a year (ITNs) , and
      > perhaps also the
      > longlasting sort (LLINs) that require no
      > retreatment. They help to
      > reduce the amount of malaria for the person who is
      > sleeping under the
      > bednet ... but do very little for the general
      > population unless more
      > than 80% of the population are sleeping under the
      > nets. This hardly
      > every happens in the real world ... and is made a
      > lot worse by the
      > donors who are controlling cost by giving nets only
      > for young children
      > (under 5) and pregnant women who are most at risk of
      > death from
      > malaria. Bednets ... on their own ... are going to
      > reduce the burden
      > of malaria by a rather small amount.
      >
      > Interior residual spraying (IRS) using DDT is a
      > better solution ...
      > (Is DDT permitted for public health use in Kenya ...
      > maybe not at the
      > moment ... but it is allowed by the international
      > health organizations
      > and the Stockholm Treaty on persistent pesticides
      > even if Kenya still
      > does nt allow it ... hopefully this will change
      > soon, if it has not
      > done so already. If DDT cannot be used, other
      > pesticides such as the
      > Pyrethroids can be used, but they only last about 4
      > months and
      > multiple treatments are usually required through the
      > year. IRS must be
      > done by people who have training and know the safety
      > rules. IRS has a
      > higher cost than bednets ... but works much better.
      > There is more
      > reduction in burden of malaria using money for IRS
      > than using money
      > for bednets.
      >
      > Better again is to stop the mosquito transmitting
      > malaria from person
      > to person by not having any mosquitoes to transmit
      > the malaria ... or
      > no malaria parasite to be transmitted. Is this
      > possible? Maybe!
      >
      > My colleague, Dr. Bob Novak (some of the ICIPE
      > people will know Dr.
      > Bob) tells me that surveillance and very specific
      > source control
      > interventions can make a big difference. I do the
      > cost analysis and I
      > see that if we have really detailed entomological
      > information there
      > can be a big change in the mosquito population and
      > its ability to
      > transmit malaria. When you know exactly where the
      > mosquitoes are
      > breeding (eggs ... larvae ... pupae) you can use
      > biological agents
      > like BTi to stop these from emerging as adult
      > mosquitoes.
      >
      > I believe you can make BTi locally ... but don't
      > have the details.
      >
      > As I understand it surveillance has (something like)
      > these major components:
      > A .....About breeding places
      > ....1..... location of breeding places
      > ....2 .... life cycle info about the specific place
      > ....3 .... treatment at this specific place
      > ....4 .... result at this specific place
      > B ..... About mosquitoes (from the traps)
      > ....1 .... location of the trap
      > ....2 .... catch (how many)
      > ....3 .... catch ... specie ... M/F ... parasite
      > prevalence
      >
      > How to manage the data and have it cost effective?
      > Ken Banks has
      > developed a system of doing data flow with a cell
      > phone and text
      > messages ... the free software is called
      > FrontlineSMS ... and with it
      > a small data message can be delivered to a local
      > cellphone attached to
      > a computer and a database. Periodically these data
      > can be sent to a
      > multi-location database where multivariate
      > scientific analysis may be
      > done .... ICIPE may want to do this ... or others
      > including Tr-Ac-Net
      > / IMMC.
      >
      > I would like to have the chance to experiment with
      > FrontlineSMS ... it
      > might be a very good solution to getting data from a
      > community worker
      > to a system of scientific analysis that is
      > interested in practical
      > implementation success beyond merely basic science.
      >
      > While $100 is modest compared to the HOPE ... it
      > might help to jump
      > start something. If we can do some of this ... it
      > might well set the
      > stage for some more substantial funding.
      >
      > At the moment I am being confronted by the general
      > malaria community
      > keeping their data secret ... and it is pretty clear
      > to me that the
      > reason is simply that these data do not support the
      > claims made up to
      > this point and they are not going to let the data
      > show the real
      > results.
      >
      > If this malaria work is too ambitious at this stage
      > ... I would like
      > to work quietly with Samwell and any others to build
      > a Phase 1 CA
      > dataset about Kisumu / Mbita and see where this
      > might take us.
      >
      > By the time you get this it may well be Christmas
      > Day in Africa. HAPPY
      > CHRISTMAS ... AND BEST WISHES FOR GOOD HEALTH AND
      > PROSPERITY IN THE
      > NEW YEAR to you, your families and friends.
      >
      > Peter
      > ____________
      > Peter Burgess
      > The Transparency and Accountability Network:
      > Tr-Ac-Net in New York
      > www.tr-ac-net.org
      > Community Accountancy (CA)
      > Integrated Malaria Management Consortium (IMMC)
      > 917 432 1191 or 212 772 6918 peterbnyc@...
      >


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