This document is a dissertation submitted by Mudaheranwa Augustine King to Makerere University in partial fulfillment of the requirements for a Bachelor of Science degree in Quantitative Economics. The dissertation analyzes time series data on malaria cases from 2012-2018 from Rubavu Hospital in Rwanda. The objectives are to establish the time-series properties of malaria cases in Rwanda and provide a forecast. Secondary data on malaria cases by year and severity were collected from hospital records and analyzed using statistical software. Tests were performed to determine trends in malaria incidence and an ARIMA model was fitted to provide a reliable forecast.
This study summarizes the first outbreak of Chikungunya virus in Suriname in 2014-2015. It followed patients clinically suspected of Chikungunya infection and tested their blood to confirm cases. It found that 68% of symptomatic patients tested positive for Chikungunya virus. It described the symptoms in both adults and children over time. It also conducted household surveys to estimate a cumulative incidence of 249 Chikungunya cases per 1000 people in Paramaribo. A government campaign against mosquitos coincided with a sharp decline in reported cases.
There are several key reasons why infectious disease outbreaks have been increasing globally in recent decades. Increased travel, trade, and urbanization have made it easier for pathogens to spread to new areas. Climate change is also enabling some disease-carrying mosquitoes and other animals to thrive in new environments. However, public health organizations have gotten better at detecting and responding to outbreaks early, meaning fewer cases per outbreak overall. Still, underfunding of disease surveillance programs in some areas has allowed certain illnesses to resurge. Continued challenges include poverty, conflict, and environmental degradation. Proper isolation of infectious patients also remains important for control.
This document is a registration form and proposal for a study on avian influenza by Ashly Stephen, a nursing student at T. John College of Nursing in Bangalore, India. The proposed study aims to assess the effectiveness of a self-instructional module in improving knowledge about avian influenza prevention and control among workers at poultry centers. The literature review presented highlights gaps in current knowledge among poultry workers and the need for educational interventions to reduce infection risks.
The document discusses current epidemics and outbreaks globally and in Malaysia. It describes measles, typhoid, mass hysteria, rabies, and dengue outbreaks occurring in Malaysia between 2013-2016. Measles cases increased over 300% from 2013-2016. Typhoid cases in Kuala Lumpur rose from January to August 2015. Globally, it outlines recent Ebola, H7N9 avian flu, MERS, H1N1 flu, and influenza at the human-animal interface outbreaks. It provides details on symptoms, transmission, treatment and prevention for each disease.
This document summarizes a study on influenza-like illness (ILI) sentinel surveillance in Peru between 2006-2008. Over 6,800 patients with ILI were enrolled from clinics across Peru. Respiratory samples were tested and at least one virus was detected in 42.6% of samples. The most common viruses were influenza A (25.1%), influenza B (9.7%), and parainfluenza (3.2%). Genetic analysis found multiple lineages of influenza A and B circulating. This study characterized the viral causes of ILI in Peru and has implications for vaccine design and clinical treatment in South America.
This document analyzes mortality associated with influenza in the state of São Paulo, Brazil from 2002 to 2011. It finds that the pre-pandemic years showed a seasonal pattern of increased mortality during the winter linked to increased activity of influenza A(H3N2) viruses, especially in those over 60. The 2009 H1N1 pandemic was associated with higher than average mortality in those aged 5-19 and 20-59. Mortality in those over 60 was lower during the pandemic than previous influenza seasons. The pandemic wave occurred from July to November 2009. Overall mortality during the pandemic was higher than average but similar to severe H3N2 seasons.
Vector borne diseases recent concepts in management and elimination targets...Sruthi Meenaxshi
This document discusses vector-borne diseases and strategies for their management and elimination. It begins by stating that vector-borne diseases account for 17% of infectious diseases globally, with malaria being the main contributor. Vectors transmit diseases between humans or animals. Vector management aims to optimize control and reduce incidence. Mosquitoes transmit diseases like malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis. The National Vector Borne Disease Control Program integrates control of these diseases. Malaria elimination targets aim for transmission interruption in certain states by 2020 and nationwide by 2030. Integrated vector control includes insecticide spraying, bed nets, and source reduction.
Malaria remains a major global health problem, though incidence and mortality have decreased in recent years. In 2015, there were an estimated 214 million malaria cases and 438,000 deaths worldwide. India also has a significant malaria burden, with estimates of annual deaths ranging from 15,000 to over 200,000. Key malaria indices calculated to monitor disease burden and evaluate control programs include annual blood examination rate, annual parasite incidence, slide positivity rate, and percentage of malaria cases that are falciparum. These indices are calculated using population data and numbers of blood slides examined and positive results to measure aspects of local transmission and intervention effectiveness.
This study summarizes the first outbreak of Chikungunya virus in Suriname in 2014-2015. It followed patients clinically suspected of Chikungunya infection and tested their blood to confirm cases. It found that 68% of symptomatic patients tested positive for Chikungunya virus. It described the symptoms in both adults and children over time. It also conducted household surveys to estimate a cumulative incidence of 249 Chikungunya cases per 1000 people in Paramaribo. A government campaign against mosquitos coincided with a sharp decline in reported cases.
There are several key reasons why infectious disease outbreaks have been increasing globally in recent decades. Increased travel, trade, and urbanization have made it easier for pathogens to spread to new areas. Climate change is also enabling some disease-carrying mosquitoes and other animals to thrive in new environments. However, public health organizations have gotten better at detecting and responding to outbreaks early, meaning fewer cases per outbreak overall. Still, underfunding of disease surveillance programs in some areas has allowed certain illnesses to resurge. Continued challenges include poverty, conflict, and environmental degradation. Proper isolation of infectious patients also remains important for control.
This document is a registration form and proposal for a study on avian influenza by Ashly Stephen, a nursing student at T. John College of Nursing in Bangalore, India. The proposed study aims to assess the effectiveness of a self-instructional module in improving knowledge about avian influenza prevention and control among workers at poultry centers. The literature review presented highlights gaps in current knowledge among poultry workers and the need for educational interventions to reduce infection risks.
The document discusses current epidemics and outbreaks globally and in Malaysia. It describes measles, typhoid, mass hysteria, rabies, and dengue outbreaks occurring in Malaysia between 2013-2016. Measles cases increased over 300% from 2013-2016. Typhoid cases in Kuala Lumpur rose from January to August 2015. Globally, it outlines recent Ebola, H7N9 avian flu, MERS, H1N1 flu, and influenza at the human-animal interface outbreaks. It provides details on symptoms, transmission, treatment and prevention for each disease.
This document summarizes a study on influenza-like illness (ILI) sentinel surveillance in Peru between 2006-2008. Over 6,800 patients with ILI were enrolled from clinics across Peru. Respiratory samples were tested and at least one virus was detected in 42.6% of samples. The most common viruses were influenza A (25.1%), influenza B (9.7%), and parainfluenza (3.2%). Genetic analysis found multiple lineages of influenza A and B circulating. This study characterized the viral causes of ILI in Peru and has implications for vaccine design and clinical treatment in South America.
This document analyzes mortality associated with influenza in the state of São Paulo, Brazil from 2002 to 2011. It finds that the pre-pandemic years showed a seasonal pattern of increased mortality during the winter linked to increased activity of influenza A(H3N2) viruses, especially in those over 60. The 2009 H1N1 pandemic was associated with higher than average mortality in those aged 5-19 and 20-59. Mortality in those over 60 was lower during the pandemic than previous influenza seasons. The pandemic wave occurred from July to November 2009. Overall mortality during the pandemic was higher than average but similar to severe H3N2 seasons.
Vector borne diseases recent concepts in management and elimination targets...Sruthi Meenaxshi
This document discusses vector-borne diseases and strategies for their management and elimination. It begins by stating that vector-borne diseases account for 17% of infectious diseases globally, with malaria being the main contributor. Vectors transmit diseases between humans or animals. Vector management aims to optimize control and reduce incidence. Mosquitoes transmit diseases like malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis. The National Vector Borne Disease Control Program integrates control of these diseases. Malaria elimination targets aim for transmission interruption in certain states by 2020 and nationwide by 2030. Integrated vector control includes insecticide spraying, bed nets, and source reduction.
Malaria remains a major global health problem, though incidence and mortality have decreased in recent years. In 2015, there were an estimated 214 million malaria cases and 438,000 deaths worldwide. India also has a significant malaria burden, with estimates of annual deaths ranging from 15,000 to over 200,000. Key malaria indices calculated to monitor disease burden and evaluate control programs include annual blood examination rate, annual parasite incidence, slide positivity rate, and percentage of malaria cases that are falciparum. These indices are calculated using population data and numbers of blood slides examined and positive results to measure aspects of local transmission and intervention effectiveness.
- The document is a speech by the Secretary of Health and Human Services outlining preparations for an influenza pandemic.
- It discusses the history of past pandemics like the 1918 Spanish Flu that killed 50 million people worldwide.
- The emergence of H5N1 avian flu in 2005 prompted increased preparations, including developing domestic vaccine production capacity, stockpiling antiviral drugs and personal protective equipment, and improving state and local pandemic plans.
- The goal is to have enough pandemic vaccine available for every American within 6 months of a pandemic outbreak.
This study aimed to develop an early warning system to predict dengue outbreaks in Yogyakarta, Indonesia up to two months in advance. The researchers created prediction models using meteorological data, past disease surveillance data, and combinations of both. Generalized linear regression models were fitted to data from 2001-2010 and validated on data from 2011-2013. The best model combined meteorological variables with autoregressive terms of past dengue case counts up to several years, which helped indicate population cross-immunity levels. This model most accurately predicted dengue incidence and outbreak occurrence. While external validation results were poorer, the model still demonstrated skill in detecting outbreaks up to two months ahead.
The document discusses the threat of pandemic influenza and the need for healthcare systems to prepare for disease outbreaks. It notes that recent outbreaks of avian influenza A(H5N1) are a reminder that a human pandemic could occur at any time, causing major suffering and economic losses. Past pandemics like the 1918 Spanish flu prompted authorities to plan for preparedness, but structured planning is still lacking in many healthcare systems. The ability of influenza viruses to mutate and reassort means a new pandemic strain could emerge.
Forecasting the peak and fading out of novel coronavirus of 2019Islam Saeed
The document summarizes a statistical model that was developed to forecast the size, peak, and fading out of the 2019 novel coronavirus outbreak using confirmed case and death data. The model predicts that:
1) The outbreak will peak on February 20, 2020 with over 91,000 confirmed cases and 1,655 deaths worldwide.
2) The number of cases and deaths will then decline through the end of March 2020 as the outbreak fades out.
3) The outbreak will likely be completely died out by the first week of April 2020, according to the model.
This document discusses the use of subtractive genomics to identify potential drug targets for pathogenic organisms. Subtractive genomics involves subtracting the sequences between a host and pathogen's proteome to identify proteins essential to the pathogen but not present in the host. This approach has been applied to identify drug targets for multi-drug resistant pathogens like Salmonella typhi and Listeria monocytogenes, as well as pathogens with no existing effective drugs like Leishmania donovani and Clostridium botulinum. Identifying novel drug targets through subtractive genomics can help develop new defenses against antibiotic-resistant pathogens and treat diseases currently lacking effective treatments.
1) In late 2014, outbreaks of highly pathogenic avian influenza (HPAI) H5N8 virus from the Gs/GD lineage first emerged in poultry and wild birds in Europe, Asia, and North America. 2) The H5N8 virus spread from migratory waterfowl through the Pacific Flyway in North America, infecting commercial and backyard flocks across 21 U.S. states. 3) Factors associated with farm-to-farm spread included common disposal of dead birds and garbage pickup, while most early cases resulted from introduction through wild birds.
This document discusses epidemiology and various definitions of epidemiology from different sources. It discusses how epidemiology has evolved over time to include concerns about infectious diseases, non-infectious diseases, and the ecology of health and disease. Various organizations conducting epidemiological work in the Philippines are mentioned, along with some of their research studies and goals. Additional health-related information about the Philippines is also provided.
Human-to-Human transmission of H7H7 in Holland 2003Harm Kiezebrink
The outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. In this study, published in The Lancet in 2004, it is noted that an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, providing evidence for person-to-person transmission.
Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
453 people had health complaints—349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26·4%) people with conjunctivitis only, in five (9·4%) with influenza-like illness and conjunctivitis, in two (5·4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
Respiratory virus shedding in exhaled breath and efficacy of face masksValentina Corona
1) The study identified seasonal human coronaviruses, influenza viruses, and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness.
2) Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols. There was also a trend toward reduced detection of coronavirus RNA in respiratory droplets.
3) The results indicate that surgical face masks could help prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.
The document summarizes the 2009 H1N1 swine flu outbreak. It describes the virus as a hybrid containing genes from human, avian, and swine influenza viruses. Cases were initially reported in Mexico and the US. Symptoms are similar to seasonal flu. Treatment involves antiviral drugs. The virus can spread from pigs to humans and between humans. Precautions are recommended to control spread in healthcare settings.
AI transmission risks: Analysis of biosecurity measures and contact structureHarm Kiezebrink
Contacts between people, equipment and vehicles prior and during outbreak situations are critical to determine the possible source of infection of a farm. Hired laborers are known to play a big role in interconnecting farms. Once a farm is infected, culling entire flock is the only option to prevent further spreading with devastating consequences for the industry.
In this paper, based on the HPAI outbreak in Holland 2003, the researchers found that 32 farms hired external labor of which seven accessed other poultry on the same day.
However, they were not the only ‘connectors’ as some (twelve) farmers also reported themselves helping on other poultry farms.
Furthermore, 27 farms had family members visiting poultry or poultry-related businesses of which nine entered poultry houses during those visits. The other enhancing factor of farm interconnections was the reported ownership of multiple locations for ten of the interviewed farms and the reported on-premises sale of farm products on one pullet and eight layer farms.
Also worth mentioning is the practice of a multiple age system reported on eight of the interviewed farms as this may increase the risk of infecting remaining birds when off-premises poultry movements occur.
AI viruses may be introduced into poultry from reservoirs such as aquatic wild birds but the mechanisms of their subsequent spread are partially unclear. Transmission of the virus through movements of humans (visitors, servicemen and farm personnel), vectors (wild birds, rodents, insects), air- (and dust-) related routes and other fomites (e.g., delivery trucks, visitors’ clothes and farm equipment) have all been hypothesized.
It is therefore hypothesized that the risk of introducing the virus to a farm is determined by the farm’s neighborhood characteristics, contact structure and its biosecurity practices.
On the one hand, neighborhood characteristics include factors such as the presence of water bodies (accessed by wild birds), the density of poultry farms (together with the number and type of birds on these farms) and poultry-related businesses and the road network. The use of manure in the farm’s vicinity is also deemed to be risky.
On the other hand, contact structure risk factors include the nature and frequency of farm visits. Therefore, a detailed analysis of the contact structure, including neighborhood risks, and biosecurity practices across different types of poultry farms and poultry-related businesses helps the improvement of intervention strategies, biosecurity protocols and adherence to these, as well as contact tracing protocols.
Farmers’ perception of visitor- and neighborhood-associated risks of virus spread is also important due to its relevance to adherence with biosecurity protocols, to contact tracing and to communicating advice to them.
Per contact probability of infection by Highly Pathogenic Avian InfluenzaHarm Kiezebrink
Estimates of the per-contact probability of transmission between farms of Highly Pathogenic Avian Influenza virus of H7N7 subtype during the 2003 epidemic in the Netherlands are important for the design of better control and biosecurity strategies.
We used standardized data collected during the epidemic and a model to extract data for untraced contacts based on the daily number of infectious farms within a given distance of a susceptible farm.
With these data, the ‘maximum likelihood estimation’ approach was used to estimate the transmission probabilities by the individual contact types, both traced and untraced.
The outcomes were validated against literature data on virus genetic sequences for outbreak farms. The findings highlight the need to
1) Understand the routes underlying the infections without traced contacts and
2) To review whether the contact-tracing protocol is exhaustive in relation to all the farm’s day-to-day activities and practices.
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
This document discusses concepts related to disease transmission. It defines the epidemiologic triad as requiring an agent, reservoir, mode of transmission, portal of entry and susceptible host. Modes of transmission include direct contact or indirect transmission through vehicles or vectors. Disease levels range from sporadic to endemic to epidemic or pandemic. Herd immunity is achieved through vaccination above a threshold proportion of immune individuals. Types of epidemics include common source, propagated or mixed spread. Body surfaces and routes of exposure allow entry of infectious agents.
Avian influenza virus-infected poultry can release a large amount of virus-contaminated droppings that serve as sources of infection for susceptible birds. Much research so far has focused on virus spread within flocks. However, as fecal material or manure is a major constituent of airborne poultry dust, virus-contaminated particulate matter from infected flocks may be dispersed into the environment.
This study, demonstrates the presence of airborne influenza virus RNA downwind from buildings holding LPAI-infected birds, and the observed correlation between field data on airborne poultry and livestock associated microbial exposure and the OPS-ST model. These findings suggest that geographical estimates of areas at high risk for human and animal exposure to airborne influenza virus can be modeled during an outbreak, although additional field measurements are needed to validate this proposition. In addition, the outdoor detection of influenza virus contaminated airborne dust during outbreaks in poultry suggests that practical measures can assist in the control of future influenza outbreaks.
In general, exposure to airborne influenza virus on commercial poultry farms could be reduced both by minimizing the initial generation of airborne particles and implementing methods for abatement of particles once generated. As an example, emergency mass culling of poultry using a foam blanket over the birds instead of labor-intensive whole-house gassing followed by ventilation reduces both exposure of cullers and dispersion of contaminated dust into the environment, contributing to the control of influenza outbreaks.
The document discusses COVID-19, describing what it is, how it spreads, and who is most at risk. It then discusses factors in the environment that can affect the transmission of COVID-19, such as relative humidity, air temperature, and fecal contamination of water. Finally, it provides results of studies on how temperature, humidity, and wind speed can influence the spread and viability of the COVID-19 virus.
This study aimed to better understand the current epidemiology of malaria in western Thailand using more sensitive molecular detection methods. The study analyzed blood samples from 219 residents of a village and 61 patients at a malaria clinic. Quantitative PCR (qPCR) detected Plasmodium DNA in 25 village samples (11.4% prevalence), mostly asymptomatic and submicroscopic infections. qPCR also found 27 positive samples (44.3% prevalence) from the clinic, including submicroscopic infections. All samples showed antibody responses to malaria antigens, suggesting widespread exposure despite low detected parasite levels by microscopy. These findings suggest parasite prevalence is higher than estimated by local authorities and that asymptomatic and submicroscopic infections still contribute to transmission as malaria declines in Thailand.
Different environmental drivers of H5N1 outbreaks in poultry and wild birdsHarm Kiezebrink
Different environmental drivers operate on HPAI H5N1 outbreaks in poultry and wild birds in Europe. The probability of HPAI H5N1 outbreaks in poultry increases in areas with a higher human population density and a shorter distance to lakes or wetlands.
This reflects areas where the location of farms or trade areas and habitats for wild birds overlap. In wild birds, HPAI H5N1 outbreaks mostly occurred in areas with increased NDVI and lower elevations, which are typically areas where food and shelter for wild birds are available. The association with migratory flyways has also been found in the intra-continental spread of the low pathogenic avian influenza virus in North American wild birds. These different environmental drivers suggest that different spread mechanisms operate.
Disease might spread to poultry via both poultry and wild birds, through direct (via other birds) or indirect (e.g. via contaminated environment) infection. Outbreaks in wild birds are mainly caused by transmission via wild birds alone, through sharing foraging areas or shelters. These findings are in contrast with a previous study, which did not find environmental differences between disease outbreaks in poultry and wild birds in Europe.
Malaria Control Strategies among Rural Dwellers in a Typical Nigerian Settingasclepiuspdfs
Malaria is a major public health problem in sub-Saharan African, including Nigeria, causing 63% of total outpatient attendance in health facilities, 30% under-five mortality, and 11% of maternal mortality. Malaria control practices remain a major strategy in the combat of this menace. Therefore, the aim of this study is to determine the malaria control strategies utilized among rural dwellers in the Ezza North local government area (LGA) of Ebonyi state.
This document summarizes a study on acute adenolymphangitis (ADL) due to bancroftian filariasis in Rufiji district, Tanzania. The study monitored 3,000 individuals over 12 months and found an annual ADL incidence of 33 per 1,000 people. Incidence was higher in males and those over age 40. Individuals with lymphedema experienced more frequent ADL episodes than those with hydrocele or no symptoms. Most people experienced one ADL episode lasting an average of 8.6 days, during which 72.5% were incapacitated for 3.7 days on average.
1. The document discusses malaria, including its causes, transmission, clinical features, diagnosis and control. It is a lesson plan on malaria for community volunteers.
2. Key points covered include that malaria is transmitted by the bites of infected Anopheles mosquitoes and is caused by Plasmodium parasites. Symptoms include cold, hot and sweating stages that occur in intermittent cycles. Control relies on prevention of mosquito bites and rapid diagnosis and treatment of cases.
3. The role of community volunteers is discussed in the context of raising awareness of malaria and its prevention through activities like knowledge sharing and distribution of bed nets.
- The document is a speech by the Secretary of Health and Human Services outlining preparations for an influenza pandemic.
- It discusses the history of past pandemics like the 1918 Spanish Flu that killed 50 million people worldwide.
- The emergence of H5N1 avian flu in 2005 prompted increased preparations, including developing domestic vaccine production capacity, stockpiling antiviral drugs and personal protective equipment, and improving state and local pandemic plans.
- The goal is to have enough pandemic vaccine available for every American within 6 months of a pandemic outbreak.
This study aimed to develop an early warning system to predict dengue outbreaks in Yogyakarta, Indonesia up to two months in advance. The researchers created prediction models using meteorological data, past disease surveillance data, and combinations of both. Generalized linear regression models were fitted to data from 2001-2010 and validated on data from 2011-2013. The best model combined meteorological variables with autoregressive terms of past dengue case counts up to several years, which helped indicate population cross-immunity levels. This model most accurately predicted dengue incidence and outbreak occurrence. While external validation results were poorer, the model still demonstrated skill in detecting outbreaks up to two months ahead.
The document discusses the threat of pandemic influenza and the need for healthcare systems to prepare for disease outbreaks. It notes that recent outbreaks of avian influenza A(H5N1) are a reminder that a human pandemic could occur at any time, causing major suffering and economic losses. Past pandemics like the 1918 Spanish flu prompted authorities to plan for preparedness, but structured planning is still lacking in many healthcare systems. The ability of influenza viruses to mutate and reassort means a new pandemic strain could emerge.
Forecasting the peak and fading out of novel coronavirus of 2019Islam Saeed
The document summarizes a statistical model that was developed to forecast the size, peak, and fading out of the 2019 novel coronavirus outbreak using confirmed case and death data. The model predicts that:
1) The outbreak will peak on February 20, 2020 with over 91,000 confirmed cases and 1,655 deaths worldwide.
2) The number of cases and deaths will then decline through the end of March 2020 as the outbreak fades out.
3) The outbreak will likely be completely died out by the first week of April 2020, according to the model.
This document discusses the use of subtractive genomics to identify potential drug targets for pathogenic organisms. Subtractive genomics involves subtracting the sequences between a host and pathogen's proteome to identify proteins essential to the pathogen but not present in the host. This approach has been applied to identify drug targets for multi-drug resistant pathogens like Salmonella typhi and Listeria monocytogenes, as well as pathogens with no existing effective drugs like Leishmania donovani and Clostridium botulinum. Identifying novel drug targets through subtractive genomics can help develop new defenses against antibiotic-resistant pathogens and treat diseases currently lacking effective treatments.
1) In late 2014, outbreaks of highly pathogenic avian influenza (HPAI) H5N8 virus from the Gs/GD lineage first emerged in poultry and wild birds in Europe, Asia, and North America. 2) The H5N8 virus spread from migratory waterfowl through the Pacific Flyway in North America, infecting commercial and backyard flocks across 21 U.S. states. 3) Factors associated with farm-to-farm spread included common disposal of dead birds and garbage pickup, while most early cases resulted from introduction through wild birds.
This document discusses epidemiology and various definitions of epidemiology from different sources. It discusses how epidemiology has evolved over time to include concerns about infectious diseases, non-infectious diseases, and the ecology of health and disease. Various organizations conducting epidemiological work in the Philippines are mentioned, along with some of their research studies and goals. Additional health-related information about the Philippines is also provided.
Human-to-Human transmission of H7H7 in Holland 2003Harm Kiezebrink
The outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. In this study, published in The Lancet in 2004, it is noted that an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, providing evidence for person-to-person transmission.
Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
453 people had health complaints—349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26·4%) people with conjunctivitis only, in five (9·4%) with influenza-like illness and conjunctivitis, in two (5·4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
Respiratory virus shedding in exhaled breath and efficacy of face masksValentina Corona
1) The study identified seasonal human coronaviruses, influenza viruses, and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness.
2) Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols. There was also a trend toward reduced detection of coronavirus RNA in respiratory droplets.
3) The results indicate that surgical face masks could help prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.
The document summarizes the 2009 H1N1 swine flu outbreak. It describes the virus as a hybrid containing genes from human, avian, and swine influenza viruses. Cases were initially reported in Mexico and the US. Symptoms are similar to seasonal flu. Treatment involves antiviral drugs. The virus can spread from pigs to humans and between humans. Precautions are recommended to control spread in healthcare settings.
AI transmission risks: Analysis of biosecurity measures and contact structureHarm Kiezebrink
Contacts between people, equipment and vehicles prior and during outbreak situations are critical to determine the possible source of infection of a farm. Hired laborers are known to play a big role in interconnecting farms. Once a farm is infected, culling entire flock is the only option to prevent further spreading with devastating consequences for the industry.
In this paper, based on the HPAI outbreak in Holland 2003, the researchers found that 32 farms hired external labor of which seven accessed other poultry on the same day.
However, they were not the only ‘connectors’ as some (twelve) farmers also reported themselves helping on other poultry farms.
Furthermore, 27 farms had family members visiting poultry or poultry-related businesses of which nine entered poultry houses during those visits. The other enhancing factor of farm interconnections was the reported ownership of multiple locations for ten of the interviewed farms and the reported on-premises sale of farm products on one pullet and eight layer farms.
Also worth mentioning is the practice of a multiple age system reported on eight of the interviewed farms as this may increase the risk of infecting remaining birds when off-premises poultry movements occur.
AI viruses may be introduced into poultry from reservoirs such as aquatic wild birds but the mechanisms of their subsequent spread are partially unclear. Transmission of the virus through movements of humans (visitors, servicemen and farm personnel), vectors (wild birds, rodents, insects), air- (and dust-) related routes and other fomites (e.g., delivery trucks, visitors’ clothes and farm equipment) have all been hypothesized.
It is therefore hypothesized that the risk of introducing the virus to a farm is determined by the farm’s neighborhood characteristics, contact structure and its biosecurity practices.
On the one hand, neighborhood characteristics include factors such as the presence of water bodies (accessed by wild birds), the density of poultry farms (together with the number and type of birds on these farms) and poultry-related businesses and the road network. The use of manure in the farm’s vicinity is also deemed to be risky.
On the other hand, contact structure risk factors include the nature and frequency of farm visits. Therefore, a detailed analysis of the contact structure, including neighborhood risks, and biosecurity practices across different types of poultry farms and poultry-related businesses helps the improvement of intervention strategies, biosecurity protocols and adherence to these, as well as contact tracing protocols.
Farmers’ perception of visitor- and neighborhood-associated risks of virus spread is also important due to its relevance to adherence with biosecurity protocols, to contact tracing and to communicating advice to them.
Per contact probability of infection by Highly Pathogenic Avian InfluenzaHarm Kiezebrink
Estimates of the per-contact probability of transmission between farms of Highly Pathogenic Avian Influenza virus of H7N7 subtype during the 2003 epidemic in the Netherlands are important for the design of better control and biosecurity strategies.
We used standardized data collected during the epidemic and a model to extract data for untraced contacts based on the daily number of infectious farms within a given distance of a susceptible farm.
With these data, the ‘maximum likelihood estimation’ approach was used to estimate the transmission probabilities by the individual contact types, both traced and untraced.
The outcomes were validated against literature data on virus genetic sequences for outbreak farms. The findings highlight the need to
1) Understand the routes underlying the infections without traced contacts and
2) To review whether the contact-tracing protocol is exhaustive in relation to all the farm’s day-to-day activities and practices.
Introduction to Epidemiology
At the end of this session the participants will be able to:
Discuss the historical evolution of epidemiology
Explain the usage of epidemiology
List the core epidemiological functions
Explain types of epidemiological studies
This document discusses concepts related to disease transmission. It defines the epidemiologic triad as requiring an agent, reservoir, mode of transmission, portal of entry and susceptible host. Modes of transmission include direct contact or indirect transmission through vehicles or vectors. Disease levels range from sporadic to endemic to epidemic or pandemic. Herd immunity is achieved through vaccination above a threshold proportion of immune individuals. Types of epidemics include common source, propagated or mixed spread. Body surfaces and routes of exposure allow entry of infectious agents.
Avian influenza virus-infected poultry can release a large amount of virus-contaminated droppings that serve as sources of infection for susceptible birds. Much research so far has focused on virus spread within flocks. However, as fecal material or manure is a major constituent of airborne poultry dust, virus-contaminated particulate matter from infected flocks may be dispersed into the environment.
This study, demonstrates the presence of airborne influenza virus RNA downwind from buildings holding LPAI-infected birds, and the observed correlation between field data on airborne poultry and livestock associated microbial exposure and the OPS-ST model. These findings suggest that geographical estimates of areas at high risk for human and animal exposure to airborne influenza virus can be modeled during an outbreak, although additional field measurements are needed to validate this proposition. In addition, the outdoor detection of influenza virus contaminated airborne dust during outbreaks in poultry suggests that practical measures can assist in the control of future influenza outbreaks.
In general, exposure to airborne influenza virus on commercial poultry farms could be reduced both by minimizing the initial generation of airborne particles and implementing methods for abatement of particles once generated. As an example, emergency mass culling of poultry using a foam blanket over the birds instead of labor-intensive whole-house gassing followed by ventilation reduces both exposure of cullers and dispersion of contaminated dust into the environment, contributing to the control of influenza outbreaks.
The document discusses COVID-19, describing what it is, how it spreads, and who is most at risk. It then discusses factors in the environment that can affect the transmission of COVID-19, such as relative humidity, air temperature, and fecal contamination of water. Finally, it provides results of studies on how temperature, humidity, and wind speed can influence the spread and viability of the COVID-19 virus.
This study aimed to better understand the current epidemiology of malaria in western Thailand using more sensitive molecular detection methods. The study analyzed blood samples from 219 residents of a village and 61 patients at a malaria clinic. Quantitative PCR (qPCR) detected Plasmodium DNA in 25 village samples (11.4% prevalence), mostly asymptomatic and submicroscopic infections. qPCR also found 27 positive samples (44.3% prevalence) from the clinic, including submicroscopic infections. All samples showed antibody responses to malaria antigens, suggesting widespread exposure despite low detected parasite levels by microscopy. These findings suggest parasite prevalence is higher than estimated by local authorities and that asymptomatic and submicroscopic infections still contribute to transmission as malaria declines in Thailand.
Different environmental drivers of H5N1 outbreaks in poultry and wild birdsHarm Kiezebrink
Different environmental drivers operate on HPAI H5N1 outbreaks in poultry and wild birds in Europe. The probability of HPAI H5N1 outbreaks in poultry increases in areas with a higher human population density and a shorter distance to lakes or wetlands.
This reflects areas where the location of farms or trade areas and habitats for wild birds overlap. In wild birds, HPAI H5N1 outbreaks mostly occurred in areas with increased NDVI and lower elevations, which are typically areas where food and shelter for wild birds are available. The association with migratory flyways has also been found in the intra-continental spread of the low pathogenic avian influenza virus in North American wild birds. These different environmental drivers suggest that different spread mechanisms operate.
Disease might spread to poultry via both poultry and wild birds, through direct (via other birds) or indirect (e.g. via contaminated environment) infection. Outbreaks in wild birds are mainly caused by transmission via wild birds alone, through sharing foraging areas or shelters. These findings are in contrast with a previous study, which did not find environmental differences between disease outbreaks in poultry and wild birds in Europe.
Malaria Control Strategies among Rural Dwellers in a Typical Nigerian Settingasclepiuspdfs
Malaria is a major public health problem in sub-Saharan African, including Nigeria, causing 63% of total outpatient attendance in health facilities, 30% under-five mortality, and 11% of maternal mortality. Malaria control practices remain a major strategy in the combat of this menace. Therefore, the aim of this study is to determine the malaria control strategies utilized among rural dwellers in the Ezza North local government area (LGA) of Ebonyi state.
This document summarizes a study on acute adenolymphangitis (ADL) due to bancroftian filariasis in Rufiji district, Tanzania. The study monitored 3,000 individuals over 12 months and found an annual ADL incidence of 33 per 1,000 people. Incidence was higher in males and those over age 40. Individuals with lymphedema experienced more frequent ADL episodes than those with hydrocele or no symptoms. Most people experienced one ADL episode lasting an average of 8.6 days, during which 72.5% were incapacitated for 3.7 days on average.
1. The document discusses malaria, including its causes, transmission, clinical features, diagnosis and control. It is a lesson plan on malaria for community volunteers.
2. Key points covered include that malaria is transmitted by the bites of infected Anopheles mosquitoes and is caused by Plasmodium parasites. Symptoms include cold, hot and sweating stages that occur in intermittent cycles. Control relies on prevention of mosquito bites and rapid diagnosis and treatment of cases.
3. The role of community volunteers is discussed in the context of raising awareness of malaria and its prevention through activities like knowledge sharing and distribution of bed nets.
Epidemiology of Malaria & Dengue_Sagar Parajuli.pptxSagarParajuli9
This presentation is prepared as part of the Course assignment of “Epidemiology of Diseases and Health Problems” for the Master's Degree of Public Health (MPH), Pokhara University and can be used as reference materials. The content and facts included in the presentation are as of information available till December 2022 and no conflict of interest is associated with the presentation. The presentation is prepared by Sagar Parajuli.
National Vector Borne Disease Control Program.pptxDR.SUMIT SABLE
WELL THIS IS ABOUT VECTOR BORNE DISEASE CONTROL PROGRAMME AND MALERIA IN DEPTH . OVERALL OVERVIEW OF NVBDCP HAS GIVEN AND THEN DETAILS ABOUT MALERIA ARE DISCUSSED AND ALL OTHER DISEASES IN PROGRAMME ARE ALSO COVERED.
Malaria infection during pregnancy is a major public health problem- especially in tropical and sub-tropical regions; with substantial risks for the mother, her foetus and the new-born, Pregnant women are particularly susceptible to malaria, and in low transmission settings they have a greater risk of severe Plasmodium falciparum malaria. This study aimed at investigating the rate of parasitaemia amongst pregnant and none pregnant women was conducted among people attending clinics at the University of Calabar Teaching Hospital, Mambo hospital, Nosam medical laboratory services in Calabar Cross River state. They fall within the age group 18 to 60 years. They were pregnant women who came for Antenatal clinic, controls were sampled from patients who came to request for medical examination and blood donors. Thick and thin blood smears were made from finger prick samples of 400 candidates attending Antenatal clinics 200 of them were from established pregnant women and the other 200 were from non-pregnant women to serve as control. The blood films were dried and fixed in absolute methanol dried and stained with 2% Giemsa stain for 30 min. it was then rinse in clean water and allowed to dry in a draining rack. Dried slides were viewed using x100 oil immersion objective. Result revealed a parasitic rate of 132 (55.9 %) among pregnant women and104 (44.1%) parasitaemia among none pregnant women. The difference between pregnant women and none pegnant women were significantly different at p < 0.05. Similarly, the mean parasite density of the pregnant women was higher 28.9 against 14.2 of control none pregnant women. In conclusion there was a significant density of malaria parasitaemia amongst pregnant women in this study.
Malaria is still considered globally as a leading cause of morbidity with Nigeria carrying the highest burden of 19%. Coinfection of malaria and Human Immunodeficiency Virus (HIV) accelerate disease progression of HIV/AIDS subjects. This study investigated the prevalence and predictors of malaria among HIV infected subjects attending the antiretroviral therapy Clinic at Federal the Medical Centre, Keffi, Nigeria. After ethical clearance, 200 whole blood specimens were collected from patients who gave informed consent and completed a self-structured questionnaire. The specimens were examined for malarial parasite using rapid kits and microscopy. The overall prevalence of the infection was 78/200 (39.0%). The prevalence was higher in male (44.7%) than female (34.0%) subjects. Those subjects aged < 20 years (54.5), male gender (44.7%), non-formal education holders (61.5%), farmers (62.5%), stream water users (48.1%), those that lives in rural setting (43.6%), those that do not use Insecticides Treated Nets (ITNs) (39.4%) and swampy environment dwellers (41.7%) were identified predictors for malaria infection in the area. All the predictors studied did not show any statistically significant difference with the infection but some arithmetic difference exists (P > 0.05). The 39.0% prevalence of malaria in HIV infected subjects is a public health concern. Therefore, Public health surveillance and health education among HIV population should be advocated to help eradicate malaria comes 2030. Further study that will characterize the genes of the parasite should be carried out.
The document discusses the effect of climate change on malaria incidence in Gowa, South Sulawesi, Indonesia. It finds that malaria incidence peaks in March and June, during the rainy season. Changes in humidity and rainfall due to fluctuating rainy seasons impact mosquito breeding and malaria transmission. The highest number of cases occurred in the health center area near dams used for irrigation, which provide breeding sites for malaria-carrying mosquitoes. Rainy conditions allow mosquito populations to increase rapidly, leading to spikes in malaria cases even after the peak rainy season.
Abstracts Of The 20Th College Of Medicine Research Dissemination ConferenceAllison Thompson
This document contains abstracts from the 20th College of Medicine Research Dissemination Conference in Malawi. The summaries describe research on various topics related to malaria:
1. A study on the cost-effectiveness of a school-based malaria intervention program in Zomba district, finding it to be highly cost-effective.
2. A study assessing the spatial heterogeneity of malaria vectors in southern Malawi, finding clear spatial patterns in mosquito abundance.
3. A study of risk factors for Anopheles mosquitoes in rural and urban areas of Blantyre district, finding open eaves and altitude were associated with mosquito presence.
Statistical analysis on household factors influencing annual episodes of malariacimran15
Malaria is responsible for about 66 per cent of all clinic visits in Nigeria. It accounts for 25% of under-5 mortality, 30% childhood mortality and 11% maternal mortality. At least 50% of the population will have at least one episode of malaria annually. Moreover, environment dictates the incidence and prevalence of diseases all over the world and if timely action is not taken, it may lead to diseases. Three (3) out of six (6) major towns in Ido local government area are considered and accumulated one hundred and ninety one (191) individuals as respondents using haphazard non probability sampling technique for selection. The obtained data through questionnaire was presented on frequency table and charts while inferential statistics were analysed using dummy variables in regression. It was revealed that majority of the respondents suffered from one or more incidences of malaria in a year, where female had the higher percentage of the incidence and there was high incidence of malaria among the adult ages 30years and above. The qualitative predictor variable in regression analysis revealed significant relationship between annual episode of malaria and number of members of household, toilet type, absent ceiling, building type, disposable site and source of domestic water. The ANOVA, F – test was significant for all predicted factors. Conclusively, in the view of the discovery, it was therefore recommended that people need awareness on densely populated area / household are more prone to experience more episodes of malaria incidence than sparsely populated one, encouragement on utilization of closed domestic water system instead of open system to avoid reservoir for mosquito, enlightenment on type toilet used and avoid absence ceiling to prevent being a breeding site for mosquitoes, government to stage more campaign against malaria especially for adult not for children under 5year alone and create a task force officer/ sanitary inspectors to checkmate sanitation of our environment to avoid unkempt toilet habit which serves as breeding site for mosquitoes.
Am very excited to start the process of writing this research proposal because malaria is one of the most deadly diseases in Africa, especially in Ghana. so the reason behind this research proposal is that I want us to prevent this disease once and for all in our community. But am not done with this research I will continue it someday.
Epidemiological Perspective of Malaria_Sagar Parajuli.pptxSagarParajuli9
This presentation is prepared as part of the Course assignment of “Epidemiology of Diseases and Health Problems” for the Master's Degree of Public Health (MPH), Pokhara University and can be used as reference materials. The content and facts included in the presentation are as of information available till December 2022 and no conflict of interest is associated with the presentation. The presentation is prepared by Sagar Parajuli.
The document discusses World Malaria Day and the theme of harnessing innovation to reduce the malaria disease burden. It provides definitions and descriptions of malaria, including that it is caused by Plasmodium parasites and transmitted via infected Anopheles mosquitoes. It discusses the history of malaria, magnitude of the problem globally and in India, epidemiological determinants like parasite species, life cycle, host and environmental factors. It also summarizes diagnosis, treatment approaches, and the role of nurses in prevention and control of malaria through activities like health education, testing, and treatment adherence support.
This document provides an overview of malaria, including:
- Malaria is caused by Plasmodium parasites transmitted via mosquito bites and causes symptoms like fever and fatigue.
- It is most prevalent in tropical regions of Africa, Asia, and Latin America, infecting hundreds of millions annually and killing thousands.
- The life cycle involves sexual reproduction in mosquitoes and asexual reproduction in humans, starting with the liver and then infecting red blood cells.
- Recurrence of malaria symptoms can occur via recrudescence from incomplete treatment, relapse from dormant liver stages, or reinfection from new mosquito bites.
This document discusses malaria case management and treatment. It provides background on Dr. Ogunsinas qualifications and experience working on malaria in Nigeria. The document then covers: definitions and introduction to malaria; clinical diagnosis and parasitological diagnosis; treatment of uncomplicated and severe malaria; antimalarial combination therapy including ACTs; and recommended first and second line treatments.
Malaria is a life-threatening disease. It’s typically transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite. When this mosquito bites you, the parasite is released into your bloodstream.
Once the parasites are inside your body, they travel to the liver, where they mature. After several days, the mature parasites enter the bloodstream and begin to infect red blood cells. Within 48 to 72 hours, the parasites inside the red blood cells multiply, causing the infected cells to burst open.
The parasites continue to infect red blood cells, resulting in symptoms that occur in cycles that last 2 to 3 days at a time.
This document discusses the spatial patterns of malaria transmission globally and within Nigeria. It finds that malaria transmission is heaviest in sub-Saharan Africa, where nearly 300 million people lack access to preventative measures. Within Nigeria, malaria prevalence can be as high as 85% and is a major public health burden. The research analyzed malaria data from 1993 to 2007 and found seasonal variations influence transmission. States in Nigeria's north central and northeast regions had the highest infection rates, while states in the southwest and northwest had the lowest. Targeted interventions are needed in highly-affected states to reduce malaria's public health and economic impacts.
Knowledge of the Implementation of the Malaria Control Program in Four Health...YogeshIJTSRD
This document summarizes a study on healthcare providers' knowledge of malaria control programs in four health districts in Yaounde, Cameroon. The study involved surveying 42 healthcare providers who received training and 50 providers who did not, across the districts. It found that trained providers generally demonstrated good knowledge of malaria diagnosis, treatment and prevention, with higher percentages than untrained providers. However, not all practices followed national guidelines. The study concluded there was room for improvement in fully implementing recommended case management procedures.
Evaluation of factors that influence Reoccurrence of Cholera epidemics in Bwe...PUBLISHERJOURNAL
Cholera is an acute enteric infection characterised by sudden onset of profuse, painless watery diarrhoea and vomiting. Transmission of the disease is by faecal-oral route and from man to man via faecal contaminated water, ingestion of contaminated foods and drinks, and bottle feeding in infants. Globally, an estimated 1.4 to 4.3 million cholera cases and 28,000 to 142,000 cholera related deaths occur every year and the highest deaths rates occur in developing countries. The aim of this study was to explore the factors influencing reoccurrence of cholera outbreaks in Bwera hospital-Kasese district, Uganda. The study was a descriptive cross-sectional where quantitative strategy was applied on health workers and households within Bwera hospital. The study targeted 73 respondents; random sampling procedure was used. Three broad themes were based on to obtain results namely; sources of water for home use, environmental sanitation and the role of climate change. It emerged that water was mainly collected from unprotected sources using rudimentary methods and it was made safe by boiling. Hand washing was seen as a common practice done though occasionally. Generally solid wastes were poorly managed including human waste and reinforcing reforestation was seen as a remedy to avert effects of climate change. The commonest source of water for home consumption was from open water surfaces mainly rivers/streams. Boiling was seen as one of the commonest methods of making water safe for home consumption but the numbers of house hold that boils water are very few thereby making them prone to infection. Washing hands was the commonest practice especially before eating but still some children do ignore washing of their hands before eating if their caretakers are not around them; however, it was not consistently after visiting latrine. Poor waste disposal was seen present in the communities whereby bushes and river banks were seen as places where human waste is deposited.
Keywords: Cholera, Deaths, Households, Bwera hospital, contaminated Water.
National Vector Borne Disease Control ProgrammeDrAnup Kumar
The document summarizes the history and strategies of India's National Vector Borne Disease Control Programme (NVBDCP). It discusses the origins of the program in 1946 and outlines the various initiatives over time to control malaria, including the National Malaria Control Programme in 1953, National Malaria Eradication Programme in 1958, and the establishment of NVBDCP in 2004 to combat six vector-borne diseases. The current goals of NVBDCP through 2030 are outlined, including the phased elimination of malaria from across India and maintaining malaria-free status.
Codeless Generative AI Pipelines
(GenAI with Milvus)
https://ml.dssconf.pl/user.html#!/lecture/DSSML24-041a/rate
Discover the potential of real-time streaming in the context of GenAI as we delve into the intricacies of Apache NiFi and its capabilities. Learn how this tool can significantly simplify the data engineering workflow for GenAI applications, allowing you to focus on the creative aspects rather than the technical complexities. I will guide you through practical examples and use cases, showing the impact of automation on prompt building. From data ingestion to transformation and delivery, witness how Apache NiFi streamlines the entire pipeline, ensuring a smooth and hassle-free experience.
Timothy Spann
https://www.youtube.com/@FLaNK-Stack
https://medium.com/@tspann
https://www.datainmotion.dev/
milvus, unstructured data, vector database, zilliz, cloud, vectors, python, deep learning, generative ai, genai, nifi, kafka, flink, streaming, iot, edge
4th Modern Marketing Reckoner by MMA Global India & Group M: 60+ experts on W...Social Samosa
The Modern Marketing Reckoner (MMR) is a comprehensive resource packed with POVs from 60+ industry leaders on how AI is transforming the 4 key pillars of marketing – product, place, price and promotions.
06-04-2024 - NYC Tech Week - Discussion on Vector Databases, Unstructured Data and AI
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https://www.meetup.com/unstructured-data-meetup-new-york/
This meetup is for people working in unstructured data. Speakers will come present about related topics such as vector databases, LLMs, and managing data at scale. The intended audience of this group includes roles like machine learning engineers, data scientists, data engineers, software engineers, and PMs.This meetup was formerly Milvus Meetup, and is sponsored by Zilliz maintainers of Milvus.
The Ipsos - AI - Monitor 2024 Report.pdfSocial Samosa
According to Ipsos AI Monitor's 2024 report, 65% Indians said that products and services using AI have profoundly changed their daily life in the past 3-5 years.
End-to-end pipeline agility - Berlin Buzzwords 2024Lars Albertsson
We describe how we achieve high change agility in data engineering by eliminating the fear of breaking downstream data pipelines through end-to-end pipeline testing, and by using schema metaprogramming to safely eliminate boilerplate involved in changes that affect whole pipelines.
A quick poll on agility in changing pipelines from end to end indicated a huge span in capabilities. For the question "How long time does it take for all downstream pipelines to be adapted to an upstream change," the median response was 6 months, but some respondents could do it in less than a day. When quantitative data engineering differences between the best and worst are measured, the span is often 100x-1000x, sometimes even more.
A long time ago, we suffered at Spotify from fear of changing pipelines due to not knowing what the impact might be downstream. We made plans for a technical solution to test pipelines end-to-end to mitigate that fear, but the effort failed for cultural reasons. We eventually solved this challenge, but in a different context. In this presentation we will describe how we test full pipelines effectively by manipulating workflow orchestration, which enables us to make changes in pipelines without fear of breaking downstream.
Making schema changes that affect many jobs also involves a lot of toil and boilerplate. Using schema-on-read mitigates some of it, but has drawbacks since it makes it more difficult to detect errors early. We will describe how we have rejected this tradeoff by applying schema metaprogramming, eliminating boilerplate but keeping the protection of static typing, thereby further improving agility to quickly modify data pipelines without fear.
Global Situational Awareness of A.I. and where its headedvikram sood
You can see the future first in San Francisco.
Over the past year, the talk of the town has shifted from $10 billion compute clusters to $100 billion clusters to trillion-dollar clusters. Every six months another zero is added to the boardroom plans. Behind the scenes, there’s a fierce scramble to secure every power contract still available for the rest of the decade, every voltage transformer that can possibly be procured. American big business is gearing up to pour trillions of dollars into a long-unseen mobilization of American industrial might. By the end of the decade, American electricity production will have grown tens of percent; from the shale fields of Pennsylvania to the solar farms of Nevada, hundreds of millions of GPUs will hum.
The AGI race has begun. We are building machines that can think and reason. By 2025/26, these machines will outpace college graduates. By the end of the decade, they will be smarter than you or I; we will have superintelligence, in the true sense of the word. Along the way, national security forces not seen in half a century will be un-leashed, and before long, The Project will be on. If we’re lucky, we’ll be in an all-out race with the CCP; if we’re unlucky, an all-out war.
Everyone is now talking about AI, but few have the faintest glimmer of what is about to hit them. Nvidia analysts still think 2024 might be close to the peak. Mainstream pundits are stuck on the wilful blindness of “it’s just predicting the next word”. They see only hype and business-as-usual; at most they entertain another internet-scale technological change.
Before long, the world will wake up. But right now, there are perhaps a few hundred people, most of them in San Francisco and the AI labs, that have situational awareness. Through whatever peculiar forces of fate, I have found myself amongst them. A few years ago, these people were derided as crazy—but they trusted the trendlines, which allowed them to correctly predict the AI advances of the past few years. Whether these people are also right about the next few years remains to be seen. But these are very smart people—the smartest people I have ever met—and they are the ones building this technology. Perhaps they will be an odd footnote in history, or perhaps they will go down in history like Szilard and Oppenheimer and Teller. If they are seeing the future even close to correctly, we are in for a wild ride.
Let me tell you what we see.
1. MAKERERE UNIVERSITY
COLLEGE OF BUSINESS AND MANAGEMENT SCIENCES
SCHOOL OF STATISTICS AND PLANNING
TIME SERIES ANALYSIS OF MALARIA CASES IN RWANDA FOR THE PERIOD
2012-2018: A CASE STUDY OF RUBAVU HOSPITAL
BY
MUDAHERANWA AUGUSTINE KING
16/X/2336/EVE
A DISSERTATION SUBMITTED TO THE SCHOOL OF STATISTICS AND
PLANNING IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE
AWARD OF DEGREE OF BACHELOR OF SCIENCE IN QUANTITATIVE
ECONOMICS OF MAKERERE UNIVERSITY KAMPALA
AUGUST 2019
2. 2
DECLARATION
I, MUDAHERANWA AUGUSTIN KING, declare that this work is original and has never been
presented to any institution of higher learning or organization by any person for the award of any
qualification.
Signature …………………. Date …./…./……
MUDAHERANWA AUGUSTIN KING
Student
3. 3
APPROVAL
This dissertation of MUDAHERANWA AUGUSTIN KING has been approved as partial
fulfillment of the requirements for the award of the degree of Bachelor of Science in Quantitative
Economics of Makerere University.
Signature ………………………….
Date ……………………………….
James Wokadala, PhD
School of Statistics and Planning
5. 5
ACKNOWLEDGMENT
My Lord and God! You are worthy to be glorified and honored, for you created all things. Had it
not been for your grace, this report would not be a success. Boundless thanks to many who in one
way or the other assisted in the preparation of this report. First and foremost, to my family for the
encouragement, support and cheerleading.
Many thanks to my supervisor James Wokadala Ph.D. the Dean at the School of Statistics and
Planning. His tireless and selfless dedication of time since the beginning of this research to its
completion. My whole brain could function at its best because I was always challenged by his
questions. Had it not been his constructive criticisms, comments, and corrections, this research
would have been impossible.
In a special way, I am really grateful to Rubavu district hospital especially the director of the
Hospital Lt.Col. Kanyankore William who helped me get all the data I needed for this research
project. I highly believe that this research will be of help to the hospital. Finally, I want to thank
everyone who has been with me for this undergraduate course, directly or indirectly. I must say,
am humbled for having met you.
ABSTRACT
6. 6
The main objective of the study was to establish the time-series properties of malaria cases in
Rwanda. In this study, secondary data was collected from the hospital’s data records on malaria
cases with respect to year and severity. The data collected was thereafter entered, analysed using
Ms Excel and STATA. Tests of hypotheses using the Dickey-Fuller test at 95% confidence level
were done to determine whether there was a trend in malaria incidence. An ARIMA model was
then fitted in order to provide a more reliable forecast.
The results from the study revealed that malaria cases are highly affected by seasons. In Rwanda,
there are two seasons, dry seasons that occur from June to mid-September, then from December
to February that record a large number of malaria cases. The wet season starts from March to May,
then from October to November that records a slight decrease in malaria cases. It was also found
out that malaria incidence was estimated to be decreasing in the future though at a slow rate.
Arising from the study, two recommendations were proposed; First, preventive care should be a
priority. People should be sensitized on the importance of mosquito nets, indoor Residual
Spraying. Second, awareness of mosquito activity, factors that attract mosquitoes such as bushes
and swamps, the different seasons for mosquito activity should be provided through education and
media.
7. 7
LIST OF ABBREVIATIONS
DDT Dichlorodiphenyltrichloroethane
IPTP Intermittent Preventive Treatment of Pregnant women
IRS Indoor Residual Spraying
ITNs Insecticide-Treated mosquito Nets
MOH Ministry Of Health
PMI President’s Malaria Initiative
WHO World Health Organization
8. 8
TABLE OF CONTENTS
LIST OF TABLES viii
CHAPTER ONE: INTRODUCTION 1
1.1 14
1.2 Error! Bookmark not defined.
1.3 16
1.5 16
1.6 16
CHAPTER TWO: LITERATURE REVIEW 5
2.1 INTRODUCTION 5
2.2 DEFINITION AND FACTS ABOUT MALARIA 5
CHAPTER THREE: METHODOLOGY 11
3.1 Data collection procedure 11
3.3Data editing 11
3.4Data analysis 11
3.5.1.Univariate analysis 11
3.5.2.Time Series analysis 11
CHAPTER FOUR: PRESENTATION, ANALYSIS, AND INTERPRETATION OF FINDINGS 14
4.0 Introduction 14
4.1 Hypothesis testing 14
4.1.1 Research Hypothesis One 14
Time series plot of simple Malaria cases 15
4.1.2 Research Hypothesis Two 16
Time series plot for Severe Malaria cases 17
9. 9
4.1.3 Research Hypothesis Three 18
Time series plot for total malaria cases 20
Correlogram for simple malaria cases 21
Partial correlogram for simple malaria cases 22
4.2 Arima model for Simple Malaria cases 23
Correlogram for severe malaria cases 24
Partial correlogram for severe malaria cases 25
4.3 Arima model for Severe Malaria cases 26
Correlogram for total malaria cases 27
Partial correlogram for total malaria cases 28
CHAPTER FIVE: SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS 30
5.0 Introduction 30
5.1 SUMMARY AND CONCLUSIONS 30
5.1.1 Simple Malaria 30
5.1.2 Severe Malaria 30
5.1.3 Total Malaria 30
5.2 RECOMMENDATIONS 31
REFERENCES 35
11. 11
LIST OF FIGURES
Figure 1 Timeseries plot for simple malaria cases 18
Figure 2 Timeseries plot for severe malaria cases 20
Figure 3 Time series plot for total malaria cases Error! Bookmark not defined.
Figure 4 Correlogram for simple malaria cases 23
Figure 5 Partial correlogram for simple malaria cases 24
Figure 6 25
Figure 7 Correlogram for severe malaria cases 26
Figure 8 Partial correlogram for severe malaria cases 27
Figure 9 28
Figure 10 Correlogram for total malaria cases 29
Figure 11 Partial correlogram for total malaria cases 30
Figure 12 31
Figure 13 Cumulative Periodogram white-noise test for simple malaria cases 32
Figure 14 Cumulative Periodogram White-Noise test for severe malaria cases 33
Figure 15 Cumulative Periodogram white-noise test for total malaria cases 34
12. 12
LIST OF TABLES
Table 1 Dickey fuller test for simple malaria cases 17
Table 2 Dickey fuller test for severe malaria cases 19
Table 3 Dickey fuller test for total malaria cases 21
Table 4 White noise test output for normality of residual simple malaria cases 32
Table 5 White noise test output for normality of severe malaria cases 33
Table 6 White noise test output for normality of total malaria cases 33
Table 7 regression analysis for simple malaria cases 34
Table 8 regression analysis for severe malaria cases 35
Table 9 regression analysis for total malaria cases 36
Table 10 forecast for malaria cases 37
Table 11 DATA FROM RUBAVU DISTRICT HOSPITAL 39
14. 14
CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND TO THE STUDY
The history of malaria stretches from its prehistoric origin as a zoonotic disease in the primates of
Africa through to the 21st century. A widespread and potentially lethal human infectious disease,
at its peak malaria infested every continent, except Antarctica. Its prevention and treatment have
been targeted in science and medicine for hundreds of years. Since the discovery of the parasites
which cause it, research attention has focused on their biology, as well as that of the mosquitoes
which transmit the parasites. References to its unique, periodic fevers are found throughout
recorded history beginning in the first millennium BCE in Greece and China. (WIKIPEDIA, 2019)
For thousands of years, traditional herbal remedies have been used to treat malaria. The first
effective treatment for malaria came from the bark of the cinchona tree, which contains quinine.
After the link to mosquitoes and their parasites were identified in the early twentieth century,
mosquito control measures such as widespread use of the insecticide DDT, swamp drainage,
covering or oiling surface of open water sources, indoor residual spraying and use of insecticide-
treated nets was initiated (WIKIPEDIA, 2019).
Malaria researchers have won multiple noble prizes for their achievements, although the disease
continues to afflict some 200 million patients each year, killing more than 600,000. Malaria is
caused by Plasmodium parasites. The parasites are spread to people through the bites of infected
female Anopheles mosquitoes, called "malaria vectors." There are 5 parasite species that cause
malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat
(WIKIPEDIA, 2019).
● In 2017, P. falciparum accounted for 99.7% of estimated malaria cases in the WHO African
Region, as well as in the majority of cases in the WHO regions of South-East Asia (62.8%),
the Eastern Mediterranean (69%) and the Western Pacific (71.9%).
● P. vivax is the predominant parasite in the WHO Region of the Americas, representing
74.1% of malaria cases.
15. 15
Malaria is an acute febrile illness. In a non-immune individual, symptoms usually appear 10–15
days after the infective mosquito bite. The first symptoms – fever, headache, and chills – may be
mild and difficult to recognize as malaria. If not treated within 24 hours, P. falciparum malaria
can progress to severe illness, often leading to death.
1.2 PROBLEM STATEMENT
Since 2004 malaria interventions in Rwanda have resulted in a substantial decline in malaria
incidence. However, this achievement is fragile as potentials for local malaria transmissions
remain. The risk of getting malaria infection is partially explained by the social conditions of
vulnerable populations (Bizimana, 2015)
Vector control is the main way to prevent and reduce malaria transmission. If coverage of vector
control interventions within a specific area is high enough, then a measure of protection will be
conferred across the community.
Transmission also depends on climatic conditions that may affect the number and survival of
mosquitoes, such as rainfall patterns, temperature, and humidity. In many places, transmission is
seasonal, with the peak during and just after the rainy season. Malaria epidemics can occur when
climate and other conditions suddenly favor transmission in areas where people have little or no
immunity to malaria. They can also occur when people with low immunity move into areas with
intense malaria transmission, for instance to find work, or as refugees (WHO, 2002).
Human immunity is another important factor, especially among adults in areas of moderate or
intense transmission conditions. Partial immunity is developed over years of exposure, and while
it never provides complete protection, it does reduce the risk that malaria infection will cause
severe disease. For this reason, most malaria deaths in Africa occur in young children, whereas in
areas with less transmission and low immunity, all age groups are at risk.
Efforts have been made to reduce on the malaria incidence such as the PRESIDENT’S MALARIA
INITIATIVE (PMI) which was launched in 2005 and implementation as a PMI focus country in
2007. More details will be available in the literature review.
16. 16
despite all these efforts to intervene, no study has been conducted to address the problem of time
series modeling which will can help the government and other concerned parties to make the
necessary planning as far as malaria is concerned, which is the purpose of this study.
1.2 OBJECTIVES
Main Objective
● The main objective of the study is to conduct a time series analysis of MALARIA cases in
Rwanda.
Specific objectives
● To establish the time-series properties of malaria cases
● To estimate the ARIMA model of the malaria cases
● To fit trends and forecast the malaria cases in RUBAVU hospital.
1.3 HYPOTHESES
● The occurrence of simple malaria is trended.
● The occurrence of severe malaria is trended.
● The occurrence of total malaria is trended.
1.4 SCOPE AND COVERAGE OF THE STUDY
The study will cover simple and severe malaria cases that were registered in Gisenyi hospital for the
period of January 2012 to December 2018. The study will go beyond descriptive analysis to
a time series analysis of annual registration of malaria cases by type of malaria.
1.5 SIGNIFICANCE OF THE STUDY
The study is relevant to the Government and Medical society at large who will use this model
predictions to know how they can plan for the treatment, control and prevention of the
17. 17
disease and how much money the Government and its development partners will spend in
the future.
18. 18
CHAPTER TWO: LITERATURE REVIEW
2.1 INTRODUCTION
This chapter consists of previous interventions and research that was done related to the study.
Most literature presented here concentrates on the epidemiology of malaria and its control
measures.
2.2 DEFINITION AND FACTS ABOUT MALARIA
Malaria also known as plasmodium infection is a disease caused by a plasmodium parasite
transmitted by the bite of infected female anopheles mosquitoes. According to the World Health
Organization (WHO), most malaria cases and deaths occur in sub-Saharan Africa.
In Rwanda approximately 90% of Rwandans are at risk of malaria. Malaria is the leading cause of
morbidity(condition of being diseased) and mortality in Rwanda according to WHO. In 2005
Rwanda reported 991,612 malaria cases (WHO, 2003)
According to ministry of health (MOH), malaria cases in Rwanda rose at 68.6% in 2014 against
947,689 cases in 2013. The MOH attributed this increase in the number of malaria cases to poor
quality of mosquito nets.
According to the malaria operational plan financial year 2018, when the PMI was launched in
2005, the goal was to reduce malaria- related mortality by 50% across 15 high burden countries in
sub-Saharan Africa through a rapid scale up of four proven and highly effective malaria prevention
and treatment measures:
● Insecticide-treated mosquito nets(ITNs)
● Indoor residual spraying(IRS)
● Accurate diagnosis and prompt treatment with artemisinin-based combination therapies
and
Intermittent preventive treatment of pregnant women(IPTp)
19. 19
So far 81% of households have at least one ITN (National Institute of Statistics of Rwanda, 2016).
73 percent of pregnant women age 15 to 49 slept under any net the night before the survey.
(National Institute of Statistics of Rwanda, 2016)
A study that was done in Mozambique showed that the majority of respondents perceived the
effectiveness of the IRS as limited, a large proportion accepted the intervention to combat malaria
due to diverse motivations. The findings suggest that trusted community leaders and spray
mobilizers communicate with households that IRS kills the mosquitoes that cause malaria. (Sergio
Chicumbe, 2019)
Malaria is both curable and preventable with medication; however, a vaccine is not available.
According to WHO, in 2012, there were approximately 207 million cases of malaria resulting in
627,000 deaths (WHO, 2014). The overwhelming majority that is 90% of these cases occur in
Africa (Council, 2001). Most of the deaths occur in children. However, the rate of deaths in
children has been reduced by 54% since 2000 (WHO, 2014). The countries with most confirmed
cases are in sub-Saharan Africa and India (Time series analysis of Malaria in Kumasi using
ARIMA models to forecast future incidence ). Moreover, malaria contributed to 2.05% to the total
global death in 2000 and was responsible for 9% of all death in Africa (WHO, 2003). WHO also
estimated that the cost of malaria in Africa was US$ 1.08 billion in 1995 and US$ 2 billion in 1997
(WHO, 1997).
According to the WHO report, estimates of 3.3 billion people are at risk of malaria, of which 1.2
billion are at high risk. In a high-risk area, more than one malaria case occurs per 1000 population
(WHO, 2014). 2005 edition of the daily graphic, it was reported that 2000 pregnant women and
15000 children below the age of five died of malaria. The ministry of health reported that a quarter
of these cases of child mortality were attributed to malaria, which he said was responsible for 36%
of all admissions in the country hospital over ten years (Elvis Adam, 2017)
● Malaria is a life-threatening disease caused by parasites that are transmitted to people
through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
● In 2017, there were an estimated 219 million cases of malaria in 87 countries.
● The estimated number of malaria deaths stood at 435 000 in 2017.
20. 20
● The WHO African Region carries a disproportionately high share of the global malaria
burden. In 2017, the region was home to 92% of malaria cases and 93% of malaria deaths.
● Total funding for malaria control and elimination reached an estimated US$ 3.1 billion in
2017. Contributions from governments of endemic countries amounted to US$ 900 million,
representing 28% of total funding.
According to the latest World malaria report, released on November 2018, there were 219 million
cases of malaria in 2017, up from 217 million cases in 2016. The estimated number of malaria
deaths stood at 435 000 in 2017, a similar number to the previous year. The WHO African Region
continues to carry a disproportionately high share of the global malaria burden. In 2017, the region
was home to 92% of malaria cases and 93% of malaria deaths.In 2017, 5 countries accounted for
nearly half of all malaria cases worldwide: Nigeria (25%), the Democratic Republic of the Congo
(11%), Mozambique (5%), India (4%) and Uganda (4%) (world malaria report, 2018).
Children under 5 years of age are the most vulnerable group affected by malaria; in 2017, they
accounted for 61% (266 000) of all malaria deaths worldwide.In most cases, malaria is transmitted
through the bites of female Anopheles mosquitoes. There are more than 400 different species of
Anopheles mosquito; around 30 are malaria vectors of major importance. All of the important
vector species bite between dusk and dawn. The intensity of transmission depends on factors
related to the parasite, the vector, the human host, and the environment.
Anopheles mosquitoes lay their eggs in water, which hatch into larvae, eventually emerging as
adult mosquitoes. The female mosquitoes seek a blood meal to nurture their eggs. Each species of
Anopheles mosquito has its own preferred aquatic habitat; for example, some prefer small, shallow
collections of freshwater, such as puddles and hoof prints, which are abundant during the rainy
season in tropical countries.
Transmission is more intense in places where the mosquito lifespan is longer (so that the parasite
has time to complete its development inside the mosquito) and where it prefers to bite humans
rather than other animals. The long lifespan and strong human-biting habit of the African vector
species is the main reason why approximately 90% of the world's malaria cases are in Africa.
21. 21
WHO recommends protection for all people at risk of malaria with effective malaria vector control.
Two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying – are
effective in a wide range of circumstances.
Sleeping under an insecticide-treated net (ITN) can reduce contact between mosquitoes and
humans by providing both a physical barrier and an insecticidal effect. Population-wide protection
can result from the killing of mosquitoes on a large scale where there is high access and usage of
such nets within a community.
In 2017, about half of all people at risk of malaria in Africa were protected by an insecticide-
treated net, compared to 29% in 2010. However, ITN coverage increased only marginally in the
period 2015 to 2017.
Indoor residual spraying (IRS) with insecticides is another powerful way to rapidly reduce malaria
transmission. It involves spraying the inside of housing structures with an insecticide, typically
once or twice per year. To confer significant community protection, IRS should be implemented
at a high level of coverage (WIKIPEDIA, 2019).
Since 2012, WHO has recommended seasonal malaria chemoprevention as an additional malaria
prevention strategy for areas of the Sahel sub-region of Africa. The strategy involves the
administration of monthly courses of amodiaquine plus sulfadoxine-pyrimethamine to all children
under 5 years of age during the high transmission season.
Since 2000, progress in malaria control has resulted primarily from expanded access to vector
control interventions, particularly in sub-Saharan Africa. However, these gains are threatened by
emerging resistance to insecticides among Anopheles mosquitoes. According to the latest World
malaria report, 68 countries reported mosquito resistance to at least 1 of the 5 commonly-used
insecticide classes in the period 2010-2017; among these countries, 57 reported resistance to 2 or
more insecticide classes (world malaria report, 2017).
Despite the emergence and spread of mosquito resistance to pyrethroids (the only insecticide class
used in ITNs), insecticide-treated nets continue to provide a substantial level of protection in most
22. 22
settings. This was evidenced in a large 5 country study coordinated by WHO between 2011 and
2016.
While the findings of this study are encouraging, WHO continues to highlight the urgent need for
new and improved tools in the global response to malaria. To prevent an erosion of the impact of
core vector control tools, WHO also underscores the critical need for all countries with ongoing
malaria transmission to develop and apply effective insecticide resistance management strategies
(WHO, 2002).
Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes
to reducing malaria transmission. The best available treatment, particularly for P. falciparum
malaria, is artemisinin-based combination therapy (ACT).
WHO recommends that all cases of suspected malaria be confirmed using parasite-based
diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment.
Results of parasitological confirmation can be available in 30 minutes or less. Treatment, solely
on the basis of symptoms should only be considered when a parasitological diagnosis is not
possible. More detailed recommendations are available in the "WHO Guidelines for the treatment
of malaria", third edition, published on April 2015.
At the World Health Assembly in May 2015, WHO launched the Strategy for malaria elimination
in the Greater Mekong sub region (2015–2030), which was endorsed by all the countries in the
sub region. Urging immediate action, the strategy calls for the elimination of all species of human
malaria across the region by 2030, with priority action targeted to areas where multidrug-resistant
malaria has taken root. Surveillance entails tracking of the disease and programmatic responses
and taking action based on the data received. Currently, many countries with a high burden of
malaria have weak surveillance systems and are not in a position to assess disease distribution and
trends, making it difficult to optimize responses and respond to outbreaks.
Effective surveillance is required at all points on the path to malaria elimination. Stronger malaria
surveillance systems are urgently needed to enable a timely and effective malaria response in
endemic regions, to prevent outbreaks and resurgences, to track progress, and to hold governments
and the global malaria community accountable.Malaria elimination is defined as the interruption
23. 23
of local transmission of a specified malaria parasite species in a defined geographical area as a
result of deliberate activities. Malaria eradication is defined as the permanent reduction to zero of
the worldwide incidence of malaria infection caused by human malaria parasites as a result of
deliberate activities. Interventions are no longer required once eradication has been achieved
(WHO, 1997).
Countries that have achieved at least 3 consecutive years of 0 local cases of malaria are eligible to
apply for the WHO certification of malaria elimination. In recent years, 9 countries have been
certified by the WHO Director-General as having eliminated malaria: United Arab Emirates
(2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Maldives (2015), Sri Lanka
(2016), Kyrgyzstan (2016), Paraguay (2018) and Uzbekistan (2018). The WHO Framework for
Malaria Elimination (2017) provides a detailed set of tools and strategies for achieving and
maintaining elimination (framework for malaria elimination, 2017).
24. 24
CHAPTER THREE: METHODOLOGY
3.1 Data collection procedure
Quantitative data will be collected which will be purely secondary in nature. It will be collected
from the RUBAVU Hospital. The data will be collected on the following variables;
1. severity
2. Year
3.2 Data sources
Data was collected from the RUBAVU Hospital website and from the MALARIA registry of the
hospital. It consists of a number of MALARIA cases in the registry for the past five years.
3.3 Data editing
The data was entered into a Microsoft Excel spreadsheet, cross-checked for consistency,
correctness and reliability to ensure that it is perfect before analysis can be done.
3.4 Data analysis
The quantitative data were analyzed using STATA. The analysis will be done at uni-variate
level.
3.5.1.Univariate analysis
At the univariate level, data analysis was based on Box-Jenkins methodology for testing the
distribution and forecasting the time series and was done in four stages.
3.5.2.Time Series analysis
The time series analysis of Malaria cases will follow the Box -Jenkins Methodology.
25. 25
Diagrammatic Illustration of the Box-Jenkins Methodology
Stage 1: Identification
Stage 2: Estimation
Step 3: Diagnostic Check
Choose one or more
ARIMA models as
candidates
Estimate the parameters of
the Model chosen in Step 1
Check the candidate Model
for adequacy
Forecast
Is Model satisfactory? NoYes
26. 26
First, the time series was summarized using line plots to provide an insight into the nature of the
data. The data was then tested for stationarity as a requirement for Box-Jenkins criteria using the
Augmented Dickey Fuller (ADF) test. In case the series were not stationary, further differencing
was be done to achieve stationarity. Secondly, a series of ARIMA (Autoregressive Integrated
Moving Average) models were fitted and investigated for suitability. The appropriate model lags
were obtained by plotting the Autocorrelation Function (ACF) and Partial Autocorrelation
Function (PACF) on the correlogram plot. The selected lags were tested to assess the invertibility
condition for the AR and MA models and the white noise tests will be made to ascertain whether
the variables are independent. Furthermore, using an appropriate model, the principle of parsimony
was put into consideration thus the smallest number of coefficients were used to explain the data.
Thirdly, the estimated model was used to make a forecast of malaria cases by severity and
predicted series were plotted on a graph.
Identification
Identification process started with preliminary examinations of Malaria series to establish
their stationary properties by observing the behavior of series using graphical plots. Where
a trend was observed the series were differenced to make them stationary-oscillating about
the mean. In addition, Autocorrelation (ACF) and Partial Correlation Function (PACF)
plots for the series in level and in differenced from were examined. Identification of the
appropriate ARIMA (p, d, q) structure followed from Johnston & Dinardo summarized in
the table below;
Table 3.2: Model Identification parameters
Model Structure ACF PACF
27. 27
AR(p) Damps out towards zero Cuts-off after lag p
MA(q) Cuts-off after lag q Damps out towards zero
ARIMA Damps out towards zero Decays-off towards
The ARIMA Model Estimation
The study followed ARIMA (p,d,q) process proposed by the Box and Jenkins (1976). Where p is
the order of AR(p) process, q relates to the order of MA(q) process and d is the order of integration.
The appropriate ARIMA (p,d,q) model was selected based on suitable AR(q) and MA(q) process
obtained through an iterative process starting from maximum lag of 12 dictated data frequency
and the procedure adopted from Meyler et at. (1998) and Alnaa & Abdul-Mumuni (2005). The
standard ARIMA (p,d,q) model takes the form below:
Yt = φtYt-1+ φ2Yt-2 …+φpYt-p + ϵt - θ1 ϵt-1 - θ2ϵt-2 …- θqϵt-q
Where;
Yt = First difference of malaria cases
P = lag order of AR process component
q = lag order of MA process component
ϵt = error term at time t
Yt, Yt-1, …. Yt-p = lagged difference malaria cases
ϵt-1, ϵt-2, …, ϵt-q = lagged residuals
φp, φ2…, φp, θ1, θ2, …, θq are parameters to be estimated.
28. 28
Diagnostics Checking
The Bartlett’s white noise test ascertains whether the obtained residuals are independent. Bartlett’s
white noise test was performed to determine whether the model selected is good for the data.
Regression analysis was later carried out to test the suitability of the estimated models for
forecasting and fit the model.
3.5.3 Analytical Method
A simple linear regression model using Microsoft Excel for univariate analysis was fitted to predict
the malaria cases by severity in Rwanda as shown below;
Y=Bo + BiXi + ϵi
Where
Y = number malaria cases
Bo = constant term
Xi = previous year
ϵi = Error term at time i
3.5.4 Test ofSignificance
The study adopted a 95% confidence level to determine the statistical significance of the
independent variables in relation to the independent variables. The hypotheses were accepted if
the p-value was less than the 5% level of significance and rejected if the p-value is greater than
5%. The adjusted R-squared and coefficients of determination showed how the variation in malaria
cases is explained by malaria occurrence in the previous years .
3.6 Limitations
There was limited data on malaria cases below year 2012 making current assumptions based on
old data was difficult. Thus it would be better if there were more data in order to expand the years
and forecasting Horizon.
30. 30
CHAPTER FOUR: PRESENTATION, INTERPRETATION, AND DISCUSSION OF
THE FINDINGS
4.0 Introduction
In this chapter, data is presented, analysed and interpreted. Results are presented in various tables
and graphs for visual analysis and descriptive statistics. The Augmented Dickey-Fuller test statistic
was used to carry out hypothesis testing for the study hypotheses tested in chapter one, from which
interpretation is made.
4.1 Hypothesis testing
In testing hypotheses, The Augmented Dickey-Fuller test statistic was used to carry out hypothesis
testing, using STATA to test for Stationarity by focusing on only two values of the result; Z(t)
and Mackinnon p-value for Z(t) and For a time-series data to be stationary, the Z(t) should;
• have a large negative number.
• p-value should be significant at least on 5% level.
If neither conditions are met in this test, the null hypothesis i.e. time series data is non-stationary,
cannot be rejected.
4.1.1 Research Hypothesis One
H0: Simple Malaria cases are not trended
Ha: Simple Malaria cases are trended
Calculation:
Dickey fuller test for simple malaria cases
dfuller simple, lags(0)
Dickey-Fuller test for unit root Number of obs = 83
31. 31
Table 1 Dickey fuller test for simple malaria cases
---------- Interpolated Dickey-Fuller ---------
Test
Statistic
1%
Critical
Value
5%
Critical
Value
10% Critical
Value
Z(t
)
-
4.238
-3.534 -2.904 -2.587
Source: compiled by researcher from STATA
MacKinnon approximate p-value for Z(t) = 0.0006
The Zt value is a large negative value (-4.238) and the p-value is less than 0.05 (0.0006) , we fail
to reject the null hypothesis and we conclude that simple malaria occurrence is not trended.
Time series plot of simple Malaria cases
● The Y-axis represents the occurrence of simple Malaria cases.
● The X-axis represents time in months.
32. 32
Figure 1 Time series plot for simple malaria cases
Source: compiled by researcher from STATA
4.1.2 Research Hypothesis Two
H0: Occurrence of Severe Malaria cases is not trended.
Ha: Occurrence of Severe Malaria cases is trended.
Calculation :
Dickey fuller test for severe malaria cases
dfuller severe, lags(0)
Dickey-Fuller test for unit root Number of obs = 83
33. 33
Table 2 Dickey fuller test for severe malaria cases
---------- Interpolated Dickey-Fuller ---------
Test
Statisti
c
1%
Critical
Value
5% Critical
Value
10% Critical
Value
Z(t
)
-4.906 -3.534 2.587 -2.904 -
MacKinnon approximate p-value for Z(t) = 0.0000
Source: compiled by researcher from STATA
The Zt value is a large negative value (-4.906) and the p-value is less than 0.05 (0.000) , we fail to
reject the null hypothesis and we conclude that severe malaria occurrence is not trended.
Time series plot for Severe Malaria cases
● The Y-axis represents simple Malaria cases.
● The X-axis represents time in months.
34. 34
Figure 2 Time series plot for severe malaria cases
Source: compiled by researcher from STATA
4.1.3 Research Hypothesis Three
H0: The occurrence of malaria cases is not trended.
Ha: ccurrence of malaria cases is trended.
Calculation:
35. 35
Table 3 Dickey fuller test for total malaria cases
dfuller total , lags(0)
Dickey-Fuller test for unit root Number of observations = 83
---------- Interpolated Dickey-Fuller ---------
Test
Statisti
c
1%
Critical
Value
5%
Critical
Value
10% Critical
Value
Z(t
)
-4.282 -3.534 -2.587 -2.904
MacKinnon approximate p-value for Z(t) = 0.0005
Source: compiled by researcher from STATA
The Zt value is a large negative(-4.282) and the p-value is less than 0.05 (0.0005), we fail to reject
the null hypothesis and we conclude that malaria occurrence is not trended.
Figure SEQ Figure * ARABIC3 Time series plot for total malaria cases
36. 36
Source: compiled by researcher from STATA
From the diagram above, it was observed that malaria cases have fallen and hit their lowest in
june 2018 with cases less than 700. The effect of seasons also affected the cases as dry seasons
recorded a large number of cases and wet seasons recorded a small number of malaria cases.
7
0
8
0
9
0
1
0
1
1
1
2
to
ta
Jul
-12
Jan
-14
Jul
-15
Jan
-17
Jul
-18t
37. 37
Figure 4 Correlogram for simple malaria cases
Source: compiled by researcher from STATA
The above correlogram for malaria cases showed that only one lag is highly correlated and is
outside our confidence interval which determined our p to be one (p=1)
38. 38
Figure 5 Partial correlogram for simple malaria cases
Source: compiled by researcher from STATA
The above correlogram for malaria cases showed that only one lag is highly correlated and is
outside our confidence interval which determined our p to be one (q=0)
39. 39
4.2 Arima model for Simple Malaria cases
Figure 6
Source: compiled by researcher from STATA
From the ARIMA model above, there was significant high correlation in the series since the results
show that AR(1) coefficient is 0.614 and is highly significant since the first lag is significant since
the P value is less than the critical (P<0.05) .
41. 41
Figure 7 Correlogram for severe malaria cases
Source: compiled by researcher from STATA
The above correlogram for malaria cases showed that only one lag is highly correlated and is
outside our confidence interval which determined our p to be one (p=1)
42. 42
Figure 8 Partial correlogram for severe malaria cases
Source: compiled by researcher from STATA
The above partial correlogram for malaria cases showed that only two lags are highly correlated
and is outside our confidence interval which determined our p to be one (q=2).
43. 43
4.3 Arima model for Severe Malaria cases
Figure 9
Source: compiled by researcher from STATA
44. 44
From the ARIMA model above, there significant high correlation in the series since the results
show that AR(1) coefficient is -0.303, AR(2) coefficient is 0.377 and MA(1) coefficient is 1.00003
and all are highly significant the first lag is significant since the P value is less than the critical
(P<0.05) .
Figure 10 Correlogram for total malaria cases
Source: compiled by researcher from STATA
The above correlogram for malaria cases showed that only one lag is highly correlated and is
outside our confidence interval which determined our p to be one (p=1).
46. 46
Figure 11 Partial correlogram for total malaria cases
Source: compiled by researcher from STATA
The above partial correlogram for malaria cases showed that only three lags are highly correlated
and is outside our confidence interval which determined our q to be zero (q=3).
47. 47
4.4 Arima model for Total Malaria cases
Figure 12
Source: compiled by researcher from STATA
From the ARIMA model above, there significant high correlation in the series since the results
show that AR(1) coefficient is 0.616 and is highly significant the first lag is significant since the P
value is less than the critical (P<0.05) .
48. 48
4.5 Diagnostics Tests
The Bartlett’s white noise test ascertains whether the obtained residuals are independent. Bartlett’s
white noise test was performed to determine whether the model selected is good for the data.
Regression analysis was later carried out to test the suitability of the estimated models for
forecasting and fit the model.
4.5.1 White noise testfor malaria cases by severity and total
Using the portmanteau white noise test for normality of the residuals yields the following results.
Table 4 White noise test output for normality of residual simple malaria cases
Portmanteau (Q) Statistic 6.4317
Prob >chi2(1) 0.0394
Basing on table 4.5 results of portmanteau white noise, P=0.0394<0.05. It can thus be concluded
that the residuals of simple malaria series are not independent.
Figure 13 Cumulative Periodogram white-noise test for simple malaria cases
But the Figure 4.30 above has a plot of the cumulative periodogram that doesn’t appear outside
the confidence interval which implies the fitted model is appropriate for forecasting.
49. 49
Table 5 White noise test output for normality of severe malaria cases
Portmanteau (Q) Statistic 8.2645
Prob >chi2(1) 0.028
Basing on table 4.6 results of portmanteau white noise, P=0.028<0.05. It can thus be concluded
that the residuals of severe malaria series are independent.
Figure 14 Cumulative Periodogram White-Noise test for severe malaria cases
Figure 4.31 above has a plot of the cumulative periodogram that doesn’t appear outside the
confidence interval which implies that the fitted model is appropriate for forecasting.
Table 6 White noise test output for normality of total malaria cases
Portmanteau (Q) Statistic 7.6727
Prob >chi2(1) 0.0345
Basing on table 4.7 results of portmanteau white noise, P=0.0345<0.05. It can thus be concluded
that the residuals of total malaria cases series are not independent.
50. 50
Figure 15 Cumulative Periodogram white-noise test for total malaria cases
But the Figure 4.32 above has a plot of the cumulative periodogram that doesn’t appear outside
the confidence interval which implies the fitted model is appropriate for forecasting.
4.6 Regressionanalysis
Table 7 regression analysis for simple malaria cases
Regression Statistics
Multiple R 0.121469
9
R Square 0.614754
94
Adjusted R
Square
0.622739
75
Standard Error 70.06910
25
Observations 84
ANOVA
51. 51
df SS MS F Significan
ce F
Regression 1 6029.2048
24
6029.2
05
15.2280
24
0.0310314
61
Residual 82 402593.68
8
4909.6
79
Total 83 408622.89
29
Coefficie
nts
Standard
Error
t Stat P-value Lower
95%
Upper
95%
Lower
95.0%
Upper
95.0%
Intercept 484.8855
42
15.427878
7
31.429
18
1.68E-
47
454.19457
68
515.57
65
454.19
46
515.57
65
X Variable 1 -
0.349407
7
0.3153036
7
-
1.1081
6
0.27103
1
-
0.9766471
56
0.2778
32
-
0.9766
5
0.2778
32
Our model was simple malaria= 484.88 – 0.349t
From the table above it was observed that the coefficient of determination(R squared) is 61.4% which
meant that the model is a good fit and the probability value was 0.03 which is less than the critical 0.05
implying significance.
Table 8 regression analysis for severe malaria cases
Regression Statistics
Multiple R 0.011525
R Square 0.72133
Adjusted R
Square
0.73206
Standard Error 60.03489
Observations 84
ANOVA
52. 52
df SS MS F Significan
ce F
Regression 1 39.264
07
39.264
07
22.0108
94
0.017127
Residual 82 295543
.4
3604.1
88
Total 83 295582
.7
Coefficien
ts
Standar
d Error
t Stat P-value Lower
95%
Upper
95%
Lower
95.0%
Upper
95.0%
Intercept 469.7421 13.218
54
35.536
62
1.41E-
51
443.4462 496.03
8
443.44
62
496.03
8
X Variable 1 -0.12819 0.2701
51
0.1043
74
0.01712
7
-0.50922 0.5656
13
-
0.5092
2
0.5656
13
Our model was severe malaria= 469.74 – 0.128t
From the table above it was observed that the coefficient of determination(R squared) is 72.1% which
meant that the model is a good fit and the probability value was 0.017 which is less than the critical 0.05
implying significance.
Table 9 regression analysis for total malaria cases
Regression Statistics
Multiple R 0.065907
R Square 0.824344
AdjustedR
Square
0.837798
StandardError 119.3451
Observations 84
53. 53
ANOVA
df SS MS F Significan
ce F
Regression 1 5095.36
8
5095.36
8
0.35773
9
0.01413
Residual 82 116794
7
14243.2
5
Total 83 117304
2
Coefficien
ts
Standar
d Error
t Stat P-value Lower
95%
Upper
95%
Lower
95.0%
Upper
95.0%
Intercept 954.6277 26.2775
1
36.3286
9
2.56E-
52
902.3533 1006.90
2
902.353
3
1006.90
2
X Variable 1 -0.32121 0.53704 -
0.59811
0.04141
3
-1.38956 0.74713
4
-
1.38956
0.74713
4
Our model was severe malaria= 954.63 – 0.321t
From the table above it was observed that the coefficient of determination(R squared) is 82.4% which
meant that the model is a good fit and the probability value was 0.014 which is less than the critical 0.05
implying significance.
54. 54
4.6 forecasting malaria cases by severity and total
Table 10 forecast for malaria cases
year Simple malaria cases Severe malaria cases Total malaria cases
January 2019 455.2 458.9 927.3
January 2020 451 457.3 923.5
January 2021 446.8 455.8 919.6
January 2022 442.6 454.3 915.8
January 2023 438.5 452.7 911.9
55. 55
CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
5.0 Introduction
This chapter covers the summary, it further includes the conclusion based on the findings from the
study and presents the appropriate recommendations.
5.1 SUMMARY AND CONCLUSIONS
Findings from this research have highlighted a number of issues concerning malaria particularly
severe malaria and simple malaria.
5.1.1 Simple Malaria
It was found that simple malaria has been decreasing slightly over the past 7 years. Results show
that simple malaria occurrence is affected by seasonality. In Rwanda there are two seasons, dry
seasons that occur from June to mid September, then from December to February that record a
large number of malaria cases. The wet season starts from March to May, then from October to
November that records a slight decrease in malaria cases.
5.1.2 Severe Malaria
It was found that severe malaria has been decreasing slightly over the past 7 years. Results show
that simple malaria occurrence is affected by seasonality. In Rwanda there are two seasons, dry
seasons that occur from June to mid September, then from December to February that record a
56. 56
large number of malaria cases. The wet season starts from March to May, then from October to
November that records a slight decrease in malaria cases.
5.1.3 Total Malaria
It was found that severe malaria has been decreasing slightly over the past 7 years. Results show
that simple malaria occurrence is affected by seasonality. In Rwanda there are two seasons, dry
seasons that occur from June to mid September, then from December to February that record a
large number of malaria cases. The wet season starts from March to May, then from October to
November that records a slight decrease in malaria cases.
5.2 RECOMMENDATIONS
The Government of Rwanda should be given credit for giving Malaria the attention it deserves,
However, a lot has to be done as regards this disease.
The following suggestions have been recommended according to the findings;
1. Many government policies have put much emphasis on treatment of Malaria by providing
medicine such as Coartem to mention but a few. However, preventive care should be
number one priority. People should be sensitized on the importance of mosquito nets,
indoor Residual Spraying .
2. Awareness on mosquito activity, factors that attract mosquitoes suchs as bushes and
swamps, the different seasons for mosquito activity should be provided through Education
and the media.