Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030.... more Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region. Methods A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 ...
Thailand is classified by the World Health Organization as one of a few countries in the world wi... more Thailand is classified by the World Health Organization as one of a few countries in the world with the highest tuberculosis (TB) burden. The Thai Ministry of Public Health has implemented the 'Tuberculosis Case Management' (TBCM) as the main database for the national TB surveillance. TBCM is designed for case registration and management as well as case reporting and notification. This study thus aimed to evaluate TBCM for its surveillance function. A cross-sectional descriptive study was conducted to review the surveillance function of TBCM during 1 Jan to 30 Jun 2017 at Mae Sot Hospital, Thailand. The study team reviewed the protocols and guidelines of TBCM. The practice of health personnel at the TB clinic was observed to determine the data flow of TBCM. Qualitative and quantitative study methods were employed in accordance with the Center for Disease Control and Prevention's Guidelines for Evaluating Surveillance Systems. We found that TBCM reporting system at Mae Sot Hospital was acceptable, stable and useful in achieving the objectives of TB control program. Sensitivity and positive predictive value of TBCM accounted for 80.8% and 99.4% respectively. The most common reason of miss-reporting was a loss to follow-up after admission or after health exam, particularly amongst non-Thai patients. Timeliness and data quality were concerned attributes that required improvement. TBCM and the in-house medical recording system should be harmonized to mitigate the risk of erroneous coding.
In the Lao People’s Democratic Republic (Lao PDR), village health volunteers play an important ro... more In the Lao People’s Democratic Republic (Lao PDR), village health volunteers play an important role in providing health services including those to reduce the burden of malaria. Over the last two decades, the volunteer network has expanded to bring malaria services closer to communities and contributed to the reduction of malaria cases. However, as malaria test positivity rates decreased, many volunteers have lost motivation to continue providing routine malaria services, and other services they provide may not reflect growing healthcare demands for common diseases in the community. This study explored the perspectives, knowledge and inputs of key health stakeholders and community members in southern Lao PDR on community-delivered models in order to refine the volunteer model in the context of Lao PDR’s primary health care sector and malaria elimination goals. Semi-structured interviews with multi-level health stakeholders, participatory workshops with community leaders, and focus g...
The Help Systems information provided by search engines can facilitate or hinder its user’s infor... more The Help Systems information provided by search engines can facilitate or hinder its user’s information seeking process. This paper reports a study in how users would like to see search engines ’ Help Systems to be organized and presented. Six aspects of Help Systems, including navigation, design elements, technical help, conceptual help, terminological, and strategic aspects, were used as the framework to develop questionnaire for further study in stereotyping search engine users. Overall users do not expect animations, videos and speech as part of a search engine’s Help System, technical
Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot Distric... more Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot District, Tak Province, Thailand during 13-16 Aug 2019. The objectives of the evaluation were to describe the usefulness and to evaluate the performance of the system. A cross-sectional study was carried out to assess the reporting system of syphilis. Medical records were reviewed from all possible data sources. Semi-structured questionnaires were used for in-depth interviews with a policy maker, health care providers, laboratory technicians and information and technology personnel. The sensitivity of reporting syphilis cases into Thailand's national notifiable disease surveillance reporting system was about 67%, while the positive predictive value of reporting was reached 100%. The data quality of reporting reached almost 100%. The reported data represented the true cases in terms of sex and age. The majority of participants found the reporting system of syphilis cases to be useful, accept...
This paper examines the impact of foreign direct investment (FDI) in the industrial upgrading pro... more This paper examines the impact of foreign direct investment (FDI) in the industrial upgrading process of Vietnam based on the concept of the new structural economics. The most recent development of industries in Vietnam is analysed using the annual data published by the statistical office of Vietnam and the studies done by various academics on spillovers effects of FDI. The paper finds the an important role of spillovers effects such as technology transfer, linkages, exports and wage spillovers of FDI to the relatively more sustainable development of the industries. However, the government’s support and role is another crucial ingredient in reaping the benefit that FDI brings into the country. The interrelated and inextricable relation among FDI, the role of government and the development level of the economy, points out that a strategic and balance measure in terms of policies and infrastructure facilitation, is needed in going forward on the industrialisation process for Vietnam. ...
Background Strengthening surveillance systems to collect near-real-time case-based data plays a f... more Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis ...
Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it ... more Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown. Methods A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the...
Background The World Health Organization has yet to endorse deployment of topical repellents for ... more Background The World Health Organization has yet to endorse deployment of topical repellents for malaria prevention as part of public health campaigns. We aimed to quantify the effectiveness of repellent distributed by the village health volunteer (VHV) network in the Greater Mekong Subregion (GMS) in reducing malaria in order to advance regional malaria elimination. Methods and findings Between April 2015 and June 2016, a 15-month stepped-wedge cluster randomised trial was conducted in 116 villages in Myanmar (stepped monthly in blocks) to test the effectiveness of 12% N,N-diethylbenzamide w/w cream distributed by VHVs, on Plasmodium spp. infection. The median age of participants was 18 years, approximately half were female, and the majority were either village residents (46%) or forest dwellers (40%). No adverse events were reported during the study. Generalised linear mixed modelling estimated the effect of repellent on infection detected by rapid diagnostic test (RDT) (primary outcome) and polymerase chain reaction (PCR) (secondary outcome). Overall Plasmodium infection detected by RDT was low (0.16%; 50/32,194), but infection detected by PCR was higher
Journal of Epidemiology and Community Health, 2012
Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including mo... more Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. Method A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) or both (522, 24%) randomised to receive (1) NERS or (2) normal care and brief written information. Outcome measures at 12 months included the 7-day physical activity recall, the hospital anxiety and depression scale. Results Ordinal regression identified increased physical activity among those randomised to NERS compared with those receiving normal care in all participants (OR 1.19, 95% CI 0.99 to 1.43), and among those referred for CHD only (OR 1.29, 95% CI 1.04 to 1.60). For those referred for mental health reason alone, or in combination with CHD, there were significantly lower levels of anxiety (OR À1.56, 95% CI À2.75 to À0.38) and depression (OR À1.39, 95% CI À2.60 to À0.18), but no effect on physical activity. The base-case incremental cost-effectiveness ratio was £12 111 per quality adjusted life year, falling to £9741 if participants were to contribute £2 per session. Conclusions NERS was effective in increasing physical activity among those referred for CHD risk only. Among mental health referrals, NERS did not influence physical activity but was associated with reduced anxiety and depression. Effects were dependent on adherence. NERS is likely to be cost effective with respect to prevailing payer thresholds. Trial registration Current Controlled Trials ISRCTN47680448.
The Help Systems information provided by search engines can facilitate or hinder its user's infor... more The Help Systems information provided by search engines can facilitate or hinder its user's information seeking process. This paper reports a study in how users would like to see search engines' Help Systems to be organized and presented. Six aspects of Help Systems, including navigation, design elements, technical help, conceptual help, terminological, and strategic aspects, were used as the framework to develop questionnaire for further study in stereotyping search engine users. Overall users do not expect animations, videos and speech as part of a search engine's Help System, technical help is desirable, and the navigation to find Help page and relevant content is important.
Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030.... more Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region. Methods A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 ...
Thailand is classified by the World Health Organization as one of a few countries in the world wi... more Thailand is classified by the World Health Organization as one of a few countries in the world with the highest tuberculosis (TB) burden. The Thai Ministry of Public Health has implemented the 'Tuberculosis Case Management' (TBCM) as the main database for the national TB surveillance. TBCM is designed for case registration and management as well as case reporting and notification. This study thus aimed to evaluate TBCM for its surveillance function. A cross-sectional descriptive study was conducted to review the surveillance function of TBCM during 1 Jan to 30 Jun 2017 at Mae Sot Hospital, Thailand. The study team reviewed the protocols and guidelines of TBCM. The practice of health personnel at the TB clinic was observed to determine the data flow of TBCM. Qualitative and quantitative study methods were employed in accordance with the Center for Disease Control and Prevention's Guidelines for Evaluating Surveillance Systems. We found that TBCM reporting system at Mae Sot Hospital was acceptable, stable and useful in achieving the objectives of TB control program. Sensitivity and positive predictive value of TBCM accounted for 80.8% and 99.4% respectively. The most common reason of miss-reporting was a loss to follow-up after admission or after health exam, particularly amongst non-Thai patients. Timeliness and data quality were concerned attributes that required improvement. TBCM and the in-house medical recording system should be harmonized to mitigate the risk of erroneous coding.
In the Lao People’s Democratic Republic (Lao PDR), village health volunteers play an important ro... more In the Lao People’s Democratic Republic (Lao PDR), village health volunteers play an important role in providing health services including those to reduce the burden of malaria. Over the last two decades, the volunteer network has expanded to bring malaria services closer to communities and contributed to the reduction of malaria cases. However, as malaria test positivity rates decreased, many volunteers have lost motivation to continue providing routine malaria services, and other services they provide may not reflect growing healthcare demands for common diseases in the community. This study explored the perspectives, knowledge and inputs of key health stakeholders and community members in southern Lao PDR on community-delivered models in order to refine the volunteer model in the context of Lao PDR’s primary health care sector and malaria elimination goals. Semi-structured interviews with multi-level health stakeholders, participatory workshops with community leaders, and focus g...
The Help Systems information provided by search engines can facilitate or hinder its user’s infor... more The Help Systems information provided by search engines can facilitate or hinder its user’s information seeking process. This paper reports a study in how users would like to see search engines ’ Help Systems to be organized and presented. Six aspects of Help Systems, including navigation, design elements, technical help, conceptual help, terminological, and strategic aspects, were used as the framework to develop questionnaire for further study in stereotyping search engine users. Overall users do not expect animations, videos and speech as part of a search engine’s Help System, technical
Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot Distric... more Evaluation of the syphilis surveillance system was conducted at Mae Sot Hospital, Mae Sot District, Tak Province, Thailand during 13-16 Aug 2019. The objectives of the evaluation were to describe the usefulness and to evaluate the performance of the system. A cross-sectional study was carried out to assess the reporting system of syphilis. Medical records were reviewed from all possible data sources. Semi-structured questionnaires were used for in-depth interviews with a policy maker, health care providers, laboratory technicians and information and technology personnel. The sensitivity of reporting syphilis cases into Thailand's national notifiable disease surveillance reporting system was about 67%, while the positive predictive value of reporting was reached 100%. The data quality of reporting reached almost 100%. The reported data represented the true cases in terms of sex and age. The majority of participants found the reporting system of syphilis cases to be useful, accept...
This paper examines the impact of foreign direct investment (FDI) in the industrial upgrading pro... more This paper examines the impact of foreign direct investment (FDI) in the industrial upgrading process of Vietnam based on the concept of the new structural economics. The most recent development of industries in Vietnam is analysed using the annual data published by the statistical office of Vietnam and the studies done by various academics on spillovers effects of FDI. The paper finds the an important role of spillovers effects such as technology transfer, linkages, exports and wage spillovers of FDI to the relatively more sustainable development of the industries. However, the government’s support and role is another crucial ingredient in reaping the benefit that FDI brings into the country. The interrelated and inextricable relation among FDI, the role of government and the development level of the economy, points out that a strategic and balance measure in terms of policies and infrastructure facilitation, is needed in going forward on the industrialisation process for Vietnam. ...
Background Strengthening surveillance systems to collect near-real-time case-based data plays a f... more Background Strengthening surveillance systems to collect near-real-time case-based data plays a fundamental role in achieving malaria elimination in the Greater Mekong Subregion (GMS). With the advanced and widespread use of digital technology, mHealth is increasingly taking a prominent role in malaria surveillance systems in GMS countries, including Myanmar. In Myanmar’s malaria elimination program, an mHealth system called Malaria Case-based Reporting (MCBR) has been applied for case-based reporting of malaria data by integrated community malaria volunteers (ICMVs). However, the sustainability of such mHealth systems in the context of existing malaria elimination programs in Myanmar is unknown. Methods Focus group discussions were conducted with ICMVs and semi-structured in-depth interviews were conducted with malaria program stakeholders from Myanmar’s Ministry of Health and Sports and its malaria program implementing partners. Thematic (deductive followed by inductive) analysis ...
Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it ... more Background To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown. Methods A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the...
Background The World Health Organization has yet to endorse deployment of topical repellents for ... more Background The World Health Organization has yet to endorse deployment of topical repellents for malaria prevention as part of public health campaigns. We aimed to quantify the effectiveness of repellent distributed by the village health volunteer (VHV) network in the Greater Mekong Subregion (GMS) in reducing malaria in order to advance regional malaria elimination. Methods and findings Between April 2015 and June 2016, a 15-month stepped-wedge cluster randomised trial was conducted in 116 villages in Myanmar (stepped monthly in blocks) to test the effectiveness of 12% N,N-diethylbenzamide w/w cream distributed by VHVs, on Plasmodium spp. infection. The median age of participants was 18 years, approximately half were female, and the majority were either village residents (46%) or forest dwellers (40%). No adverse events were reported during the study. Generalised linear mixed modelling estimated the effect of repellent on infection detected by rapid diagnostic test (RDT) (primary outcome) and polymerase chain reaction (PCR) (secondary outcome). Overall Plasmodium infection detected by RDT was low (0.16%; 50/32,194), but infection detected by PCR was higher
Journal of Epidemiology and Community Health, 2012
Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including mo... more Background The Wales National Exercise Referral Scheme (NERS) is a 16-week programme including motivational interviewing, goal setting and relapse prevention. Method A pragmatic randomised controlled trial with nested economic evaluation of 2160 inactive participants with coronary heart disease risk (CHD, 1559, 72%), mild to moderate depression, anxiety or stress (79, 4%) or both (522, 24%) randomised to receive (1) NERS or (2) normal care and brief written information. Outcome measures at 12 months included the 7-day physical activity recall, the hospital anxiety and depression scale. Results Ordinal regression identified increased physical activity among those randomised to NERS compared with those receiving normal care in all participants (OR 1.19, 95% CI 0.99 to 1.43), and among those referred for CHD only (OR 1.29, 95% CI 1.04 to 1.60). For those referred for mental health reason alone, or in combination with CHD, there were significantly lower levels of anxiety (OR À1.56, 95% CI À2.75 to À0.38) and depression (OR À1.39, 95% CI À2.60 to À0.18), but no effect on physical activity. The base-case incremental cost-effectiveness ratio was £12 111 per quality adjusted life year, falling to £9741 if participants were to contribute £2 per session. Conclusions NERS was effective in increasing physical activity among those referred for CHD risk only. Among mental health referrals, NERS did not influence physical activity but was associated with reduced anxiety and depression. Effects were dependent on adherence. NERS is likely to be cost effective with respect to prevailing payer thresholds. Trial registration Current Controlled Trials ISRCTN47680448.
The Help Systems information provided by search engines can facilitate or hinder its user's infor... more The Help Systems information provided by search engines can facilitate or hinder its user's information seeking process. This paper reports a study in how users would like to see search engines' Help Systems to be organized and presented. Six aspects of Help Systems, including navigation, design elements, technical help, conceptual help, terminological, and strategic aspects, were used as the framework to develop questionnaire for further study in stereotyping search engine users. Overall users do not expect animations, videos and speech as part of a search engine's Help System, technical help is desirable, and the navigation to find Help page and relevant content is important.
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