BMC Public Health
http://www.biomedcentral.com/bmcpublichealth/content
(Accessed 4 July 2015)

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Research article
Implementation of couples’ voluntary HIV counseling and testing services in Durban, South Africa
William Kilembe, Kristin Wall, Mammekwa Mokgoro, Annie Mwaanga, Elisabeth Dissen, Miriam Kamusoko, Hilda Phiri, Jean Sakulanda, Jonathan Davitte, Tarylee Reddy, Mark Brockman, Thumbi Ndung’u, Susan Allen
BMC Public Health 2015, 15:601 (2 July 2015)

Bulletin of the World Health Organization
Volume 93, Number 7, July 2015, 437-512
http://www.who.int/bulletin/volumes/93/7/en/

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Editorials
Technology, innovation and health equity
Hildy Fong a & Eva Harris a
a. Center for Global Public Health and Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, CA, United States of America.
Bulletin of the World Health Organization 2015;93:438-438A. doi:
[Initial text]
Innovative technologies have enormous potential to improve human well-being. However, technological progress does not guarantee equitable health outcomes. As advances in technology redefine the ways people, systems and information interact, resource-poor communities are often excluded. Where technological fixes have been imposed on communities, the results have included abandoned equipment, incompatible computer programs and ineffective policies….

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Research
A comparative analysis of national HIV policies in six African countries with generalized epidemics
Kathryn Church, Francis Kiweewa, Aisha Dasgupta, Mary Mwangome, Edith Mpandaguta, Francesc Xavier Gómez-Olivé, Samuel Oti, Jim Todd, Alison Wringe, Eveline Geubbels, Amelia Crampin, Jessica Nakiyingi-Miiro, Chika Hayashi, Muthoni Njage, Ryan G Wagner, Alex Riolexus Ario, Simon D Makombe, Owen Mugurungi & Basia Zaba
Abstract
Objective
To compare national human immunodeficiency virus (HIV) policies influencing access to HIV testing and treatment services in six sub-Saharan African countries.
Methods
We reviewed HIV policies as part of a multi-country study on adult mortality in sub-Saharan Africa. A policy extraction tool was developed and used to review national HIV policy documents and guidelines published in Kenya, Malawi, South Africa, Uganda, the United Republic of Tanzania and Zimbabwe between 2003 and 2013. Key informant interviews helped to fill gaps in findings. National policies were categorized according to whether they explicitly or implicitly adhered to 54 policy indicators, identified through literature and expert reviews. We also compared the national policies with World Health Organization (WHO) guidance.
Findings
There was wide variation in policies between countries; each country was progressive in some areas and not in others. Malawi was particularly advanced in promoting rapid initiation of antiretroviral therapy. However, no country had a consistently enabling policy context expected to increase access to care and prevent attrition. Countries went beyond WHO guidance in certain areas and key informants reported that practice often surpassed policy.
Conclusion
Evaluating the impact of policy differences on access to care and health outcomes among people living with HIV is challenging. Certain policies will exert more influence than others and official policies are not always implemented. Future research should assess the extent of policy implementation and link these findings with HIV outcomes.

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Policy & Practice
The need to accelerate access to new drugs for multidrug-resistant tuberculosis
Helen S Cox, Jennifer J Furin, Carole D Mitnick, Colleen Daniels, Vivian Cox & Eric Goemaere
Abstract
Approximately half a million people are thought to develop multidrug-resistant tuberculosis annually. Barely 20% of these people currently receive recommended treatment and only about 10% are successfully treated. Poor access to treatment is probably driving the current epidemic, via ongoing transmission. Treatment scale-up is hampered by current treatment regimens, which are lengthy, expensive, poorly tolerated and difficult to administer in the settings where most patients reside. Although new drugs provide an opportunity to improve treatment regimens, current and planned clinical trials hold little promise for developing regimens that will facilitate prompt treatment scale-up. In this article we argue that clinical trials, while necessary, should be complemented by timely, large-scale, operational research that will provide programmatic data on the use of new drugs and regimens while simultaneously improving access to life-saving treatment. Perceived risks – such as the rapid development of resistance to new drugs – need to be balanced against the high levels of mortality and transmission that will otherwise persist. Doubling access to treatment and increasing treatment success could save approximately a million lives over the next decade.

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Perspectives
Redefining shared sanitation
Thilde Rheinländer a, Flemming Konradsen a, Bernard Keraita a, Patrick Apoya b & Margaret Gyapong c
a. Department of Public Health, University of Copenhagen, Øster Farigmagsgade 5, 1014 Copenhagen, Denmark.
b. Africa Sanitation Think Tank, 03 BP 7112, Ouagadougou 03, Burkina Faso.
c. Dodowa Health Research Center and School of Public Health, University of Ghana, Accra, Ghana.
(Submitted: 20 August 2014 – Revised version received: 09 February 2015 – Accepted: 16 February 2015 – Published online: 28 April 2015.)
Bulletin of the World Health Organization 2015;93:509-510. doi:
[Excerpt]
As the Millennium Development Goals reach their deadline, it is clear that the world is not on track to achieve global sanitation targets. With sanitation trends, global developments and local contexts in mind, it is time to adopt a more flexible approach to achieving universal functional sanitation. By functional sanitation, we mean toilet facilities that protect human health by preventing contamination of the environment with human faecal waste….
…Key sanitation stakeholders and donors should recognize the potential of household shared sanitation as an important driver behind sanitation progress in African and Asian high-density areas and low-income populations. Accepting household shared sanitation as a suitable toilet type could have major implications. This would legitimize innovative funding mechanisms, shared maintenance schemes and upgrading of large numbers of existing shared toilets to acceptable standards.
We argue that the focus for future sanitation programmes should be on improving the hygienic standards of shared facilities to a level that satisfies and protects sanitation users – irrespective of the toilet design. If well managed, household shared sanitation can be a feasible, economical, practical and socially acceptable choice for millions of sanitation users.

Development in Practice
Volume 25, Issue 5, 2015
http://www.tandfonline.com/toc/cdip20/current

Can top-down community enterprise development reduce poverty and out-migration? Evidence from Thailand
DOI:10.1080/09614524.2015.1047739
Vipavee Valeepitakdej* & Winai Wongsurawat
pages 737-746
Abstract
This article examines the performance of a poverty alleviation policy in Thailand known as the Small and Micro Community Enterprises (SMCEs) programme. It investigates provincial determinants affecting the establishments of the SMCEs and assesses the effects of the programme on household income and out-migration by using panel data analysis and propensity score matching model. The research findings indicated that such enterprises have spread widely. Average household expenditure, the rate of poverty, and agricultural output were significant predictors of SMCE establishments. However, the research did not find any concrete evidence to support the claim that this policy helped reduce poverty or out-migration

Development in Practice
Volume 25, Issue 5, 2015
http://www.tandfonline.com/toc/cdip20/current

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.Development-induced displacement in Asia: conflicts, risks, and resilience
DOI: 10.1080/09614524.2015.1052374
Andreas Neef* & Jane Singer
pages 601-611
Abstract
This introduction to the themed special feature on development-induced displacement in Asia discusses the scope and major drivers of development-induced displacement and resettlement (DIDR) in Asia, and recent policy developments at the national and international level. It describes some of the existing conceptual frameworks in the field of DIDR and presents a new set of questions and concerns that are addressed by the five articles that make up this special feature.

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A no-displacement option? Rights, risks and negotiated settlement in development displacement
DOI:10.1080/09614524.2015.1051514
Susanna Price*
pages 673-685
Abstract
“Voluntary” land transfer agreements, negotiated directly between “willing buyers and willing sellers”, present a seemingly empowering alternative to the use of legal instruments for land acquisition or transfer which entail forced displacement. Yet asymmetrical bargaining power between the negotiating parties can undermine the fairness of negotiated outcomes and the right of the sellers to a “no-displacement” option. Viewed against a complex background of bourgeoning land transfers in multiple sites, this article examines rights-based and risks-based approaches to negotiated settlements, concluding that measures to address asymmetries in bargaining power must look beyond enhanced negotiation procedures to address underlying social and political dimensions.

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Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 4 July 2015]

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Research
A study of mobile phone use among patients with noncommunicable diseases in La Paz, Bolivia: implications for mHealth research and development
Kamis K, Janevic MR, Marinec N, Jantz R, Valverde H and Piette JD Globalization and Health 2015, 11:30 (4 July 2015)
Abstract
Background
While global momentum supporting mobile health (mHealth) research and development is increasing, it is imperative to assess the potential fit of mHealth programs in local settings. We describe the penetration of mobile technologies among Bolivian patients with noncommunicable diseases (NCDs) to inform research on mHealth interventions for the Andean region as well as low- and middle-income countries more generally.
Methods
Five-hundred and fifty-nine NCD patients were identified from outpatient clinics affiliated with four hospitals in the cities of La Paz and El Alto. Respondents completed surveys about their use of standard mobile phones and smartphones. Respondents also provided information about their sociodemographic characteristics, health status, and access to care. We used descriptive statistics and logistic regression to understand the variation in mobile phone use across groups defined by patient characteristics associated with health service access and socioeconomic vulnerability.
Results
Respondents were on average 52 years of age, 33 % had at most a sixth grade education, and 30 % spoke an indigenous language in their home. Eighty-six percent owned a mobile phone and 13 % owned a smartphone. Fifty-eight percent of mobile phone users sent or received a text message at least once a week. Some mobile phone owners reported connectivity problems, such as lacking mobile signal (9 %) or credit to make a call (17 %). Younger age, male gender, high health literacy, more years of education, and having fewer previously diagnosed NCDs were positively related to mobile phone ownership. Among mobile phone users, respondents with lower education and other indicators of vulnerability were less likely than their counterparts to report frequent usage of texting services.
Conclusions
Mobile phones have high penetration among NCD patients in La Paz, Bolivia, including among those who are older, less educated, and who have other socioeconomic risk factors. Smartphone use is still relatively uncommon, even among patients who are younger and more educated. While certain patient characteristics such as age or education impact patients’ use of text messaging, mobile phone-based mHealth interventions are feasible strategies for increasing NCD patients’ access to self-management support between face-to-face clinical encounters.

Health and Human Rights
Volume 17, Issue 1 June 2015
http://www.hhrjournal.org/

Special Section on Bioethics and the Right to Health
in collaboration with the Dalla Lana School of Public Health, University of Toronto

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Editorial
Bioethics and the Right to Health: Advancing a Complementary Agenda
Jennifer L. Gibson, PhD, Lisa Forman, SJD, Stephanie A. Nixon, PT, PhD
Guest Editors
[Initial text]
This special section in Health and Human Rights Journal explores the relationship between bioethics and the right to health. Although bioethics scholars may argue for a right to health, particularly in the domains of universal health coverage and global health governance, and human rights scholars may advance ethical norms in their work, there has been little scholarly attention to the intersections, synergies, and contrasts between these two areas of study. At first glance, this is surprising given that bioethics and human rights share conceptual and normative terrain in articulating guidance for action on health-related issues and international policy and practice is explicitly interrelating human rights and ethics…

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The Foundations of a Human Right to Health: Human Rights and Bioethics in Dialogue
Audrey Chapman

A Sensitive Period: Bioethics, Human Rights, and Child Development
Avram Denburg

Setting a Minimum Standard of Care in Clinical Trials: Human Rights and Bioethics as Complementary Frameworks
Fatma E. Marouf and Bryn S. Esplin

Commentaries
Limiting Rights and Freedoms in the Context of Ebola and Other Public Health Emergencies: How the Principle of Reciprocity Can Enrich the Application of the Siracusa Principles
Diego S. Silva, Maxwell J. Smith
PDF

The Lancet
Jul 04, 2015 Volume 386 Number 9988 p1-102
http://www.thelancet.com/journals/lancet/issue/current

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Articles
Breakdown of simple female genital fistula repair after 7 day versus 14 day postoperative bladder catheterisation: a randomised, controlled, open-label, non-inferiority trial
Dr Mark A Barone, DVM, Mariana Widmer, MSc, Steven Arrowsmith, MD, Joseph Ruminjo, MMed, Armando Seuc, PhD, Evelyn Landry, MPH, Thierno Hamidou Barry, MD, Dantani Danladi, MBBS, Lucien Djangnikpo, MD, Tagie Gbawuru-Mansaray, MBChB, Issoufa Harou, MD, Alyona Lewis, MD, Mulu Muleta, MD, Dolorès Nembunzu, MD, Robert Olupot, MMed, Prof Ileogben Sunday-Adeoye, MBBS, Weston Khisa Wakasiaka, MMed, Sihem Landoulsi, MSc, Alexandre Delamou, MD, Lilian Were, MPH, Vera Frajzyngier, PhD, Karen Beattie, MA, A Metin Gülmezoglu, MD
Published Online: 21 April 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(14)62337-0
Summary
Background
Duration of bladder catheterisation after female genital fistula repair varies widely. We aimed to establish whether 7 day bladder catheterisation was non-inferior to 14 days in terms of incidence of fistula repair breakdown in women with simple fistula.
Methods
In this randomised, controlled, open-label, non-inferiority trial, we enrolled patients at eight hospitals in the Democratic Republic of the Congo, Ethiopia, Guinea, Kenya, Niger, Nigeria, Sierra Leone, and Uganda. Consenting patients were eligible if they had a simple fistula that was closed after surgery and remained closed 7 days after surgery, understood study procedures and requirements, and agreed to return for follow-up 3 months after surgery. We excluded women if their fistula was not simple or was radiation-induced, associated with cancer, or due to lymphogranuloma venereum; if they were pregnant; or if they had multiple fistula. A research assistant at each site randomly allocated participants 1:1 (randomly varying block sizes of 4–6; stratified by country) to 7 day or 14 day bladder catheterisation (via a random allocation sequence computer generated centrally by WHO). Outcome assessors were not masked to treatment assignment. The primary outcome was fistula repair breakdown, on the basis of dye test results, any time between 8 days after catheter removal and 3 months after surgery. The non-inferiority margin was 10%, assessed in the per-protocol population. This trial is registered with ClinicalTrials.gov, number NCT01428830.
Findings
We randomly allocated 524 participants between March 7, 2012, and May 6, 2013; 261 in the 7 day group and 263 in the 14 day group. In the per-protocol analysis, ten (4%) of 250 patients had repair breakdown in the 7 day group (95% CI 2–8) compared with eight (3%) of 251 (2–6) in the 14 day group (risk difference 0·8% [95% CI −2·8 to 4·5]), meeting the criteria for non-inferiority.
Interpretation
7 day bladder catheterisation after repair of simple fistula is non-inferior to 14 day catheterisation and could be used for management of women after repair of simple fistula with no evidence of a significantly increased risk of repair breakdown, urinary retention, or residual incontinence up to 3 months after surgery.
Funding
US Agency for International Development.

The Lancet
Jul 04, 2015 Volume 386 Number 9988 p1-102
http://www.thelancet.com/journals/lancet/issue/current

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Comment
Keeping score: fostering accountability for children’s lives
Christopher Murray, Ray Chambers
DOI: http://dx.doi.org/10.1016/S0140-6736(15)61171-0
Preview
We live in a remarkable era of accelerated progress in reducing child deaths in the poorest countries.1 The death rate in children younger than 5 years in low-income countries has dropped by 28·1% since 2000. The Millennium Declaration set an ambitious goal of reducing the death rate in this age group by two-thirds in each country.2 Progress has not been even, but since the year 2000 reductions were recorded in 136 of 138 low-income and middle-income countries. In the few months remaining until the end of the Millennium Development Goal period, even more can be achieved.

The Lancet
Jul 04, 2015 Volume 386 Number 9988 p1-102
http://www.thelancet.com/journals/lancet/issue/current

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Comment
Final results from a pivotal phase 3 malaria vaccine trial
Vasee S Moorthy, Jean-Marie Okwo-Bele
Published Online: 23 April 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60767-X
Preview
In The Lancet, the RTS,S Clinical Trials Partnership1 report the most recent results from the pivotal phase 3 trial of RTS,S/AS01 malaria vaccine, the fourth major publication from this randomised controlled trial.2–4 The trial enrolled 15 459 infants and young children at 11 centres in seven sub-Saharan African countries: Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique, and Tanzania. Two age groups were included: 6–12 weeks and 5–17 months at first dose. The schedule involved a primary series of three monthly doses, with a booster dose given 18 months later in one of the three trial groups.

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Articles
Efficacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: final results of a phase 3, individually randomised, controlled trial
RTS,S Clinical Trials Partnership – Members listed at end of paper
Published Online: 23 April 2015
DOI: http://dx.doi.org/10.1016/S0140-6736(15)60721-8
Summary
Background
The efficacy and safety of the RTS,S/AS01 candidate malaria vaccine during 18 months of follow-up have been published previously. Herein, we report the final results from the same trial, including the efficacy of a booster dose.
Methods
From March 27, 2009, until Jan 31, 2011, children (age 5–17 months) and young infants (age 6–12 weeks) were enrolled at 11 centres in seven countries in sub-Saharan Africa. Participants were randomly assigned (1:1:1) at first vaccination by block randomisation with minimisation by centre to receive three doses of RTS,S/AS01 at months 0, 1, and 2 and a booster dose at month 20 (R3R group); three doses of RTS,S/AS01 and a dose of comparator vaccine at month 20 (R3C group); or a comparator vaccine at months 0, 1, 2, and 20 (C3C [control group]). Participants were followed up until Jan 31, 2014. Cases of clinical and severe malaria were captured through passive case detection. Serious adverse events (SAEs) were recorded. Analyses were by modified intention to treat and per protocol. The coprimary endpoints were the occurrence of malaria over 12 months after dose 3 in each age category. In this final analysis, we present data for the efficacy of the booster on the occurrence of malaria. Vaccine efficacy (VE) against clinical malaria was analysed by negative binomial regression and against severe malaria by relative risk reduction. This trial is registered with ClinicalTrials.gov, number NCT00866619.
Findings
8922 children and 6537 young infants were included in the modified intention-to-treat analyses. Children were followed up for a median of 48 months (IQR 39–50) and young infants for 38 months (34–41) after dose 1. From month 0 until study end, compared with 9585 episodes of clinical malaria that met the primary case definition in children in the C3C group, 6616 episodes occurred in the R3R group (VE 36·3%, 95% CI 31·8–40·5) and 7396 occurred in the R3C group (28·3%, 23·3–32·9); compared with 171 children who experienced at least one episode of severe malaria in the C3C group, 116 children experienced at least one episode of severe malaria in the R3R group (32·2%, 13·7 to 46·9) and 169 in the R3C group (1·1%, −23·0 to 20·5). In young infants, compared with 6170 episodes of clinical malaria that met the primary case definition in the C3C group, 4993 episodes occurred in the R3R group (VE 25·9%, 95% CI 19·9–31·5) and 5444 occurred in the R3C group (18·3%, 11·7–24·4); and compared with 116 infants who experienced at least one episode of severe malaria in the C3C group, 96 infants experienced at least one episode of severe malaria in the R3R group (17·3%, 95% CI −9·4 to 37·5) and 104 in the R3C group (10·3%, −17·9 to 31·8). In children, 1774 cases of clinical malaria were averted per 1000 children (95% CI 1387–2186) in the R3R group and 1363 per 1000 children (995–1797) in the R3C group. The numbers of cases averted per 1000 young infants were 983 (95% CI 592–1337) in the R3R group and 558 (158–926) in the R3C group. The frequency of SAEs overall was balanced between groups. However, meningitis was reported as a SAE in 22 children: 11 in the R3R group, ten in the R3C group, and one in the C3C group. The incidence of generalised convulsive seizures within 7 days of RTS,S/AS01 booster was 2·2 per 1000 doses in young infants and 2·5 per 1000 doses in children.
Interpretation
RTS,S/AS01 prevented a substantial number of cases of clinical malaria over a 3–4 year period in young infants and children when administered with or without a booster dose. Efficacy was enhanced by the administration of a booster dose in both age categories. Thus, the vaccine has the potential to make a substantial contribution to malaria control when used in combination with other effective control measures, especially in areas of high transmission.
Funding
GlaxoSmithKline Biologicals SA and the PATH Malaria Vaccine Initiative.

The Lancet Global Health
Jul 2015 Volume 3 Number 7 e341-e422
http://www.thelancet.com/journals/langlo/issue/current

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Editorial
African children in the spotlight
Zoë Mullan
Open Access
DOI: http://dx.doi.org/10.1016/S2214-109X(15)00058-3
Summary
June 16 is the Day of the African Child—an African Union initiative to commemorate the hundreds who died during the 1976 protests by black schoolchildren against racially biased educational practices in Soweto, South Africa. Today the anniversary is an opportunity to highlight the rights of all African children to a quality education, and to a healthy childhood

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Articles
Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration)
Caroline H D Fall, Harshpal Singh Sachdev, Clive Osmond, Maria Clara Restrepo-Mendez, Cesar Victora, Reynaldo Martorell, Aryeh D Stein, Shikha Sinha, Nikhil Tandon, Linda Adair, Isabelita Bas, Shane Norris, Linda M Richter, COHORTS investigators
e366

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Maternal mortality and distance to facility-based obstetric care in rural southern Tanzania: a secondary analysis of cross-sectional census data in 226 000 households
Claudia Hanson, Jonathan Cox, Godfrey Mbaruku, Fatuma Manzi, Sabine Gabrysch, David Schellenberg, Marcel Tanner, Carine Ronsmans, Joanna Schellenberg

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Tanzania’s Countdown to 2015: an analysis of two decades of progress and gaps for reproductive, maternal, newborn, and child health, to inform priorities for post-2015
Hoviyeh Afnan-Holmes, Moke Magoma, Theopista John, Francis Levira, Georgina Msemo, Corinne E Armstrong, Melisa Martínez-Álvarez, Kate Kerber, Clement Kihinga, Ahmad Makuwani, Neema Rusibamayila, Asia Hussein, Joy E Lawn, Tanzanian Countdown Country Case Study Group

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Countdown to 2015: changes in official development assistance to reproductive, maternal, newborn, and child health, and assessment of progress between 2003 and 2012
Leonardo Arregoces, Felicity Daly, Catherine Pitt, Justine Hsu, Melisa Martinez-Alvarez, Giulia Greco, Anne Mills, Peter Berman, Josephine Borghi

The Lancet Infectious Diseases
Jul 2015 Volume 15 Number 7 p747-866
http://www.thelancet.com/journals/laninf/issue/current

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Comment
Ebola: the hidden toll
Mary J Hamel, Laurence Slutsker
Published Online: 23 April 2015
Open Access
DOI: http://dx.doi.org/10.1016/S1473-3099(15)70167-2
Summary
The first anniversary of the west African Ebola epidemic has just passed. In Guinea, Liberia, and Sierra Leone, Ebola virus disease has resulted in more than 10 000 reported deaths while the virtual collapse of the countries’ health-care systems has contributed to countless more. In The Lancet Infectious Diseases, Patrick Walker and colleagues1 describe a mathematical model to estimate the effect of the ongoing Ebola disease epidemic on a less exotic and more familiar killer—malaria. The estimates are sobering, if not surprising: up to 10 900 additional malaria deaths in these three countries in 2014 can be attributed to the disruption of health-care services, with another 3900 attributed to lapses in the delivery of insecticide-treated bednets.

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Articles
Malaria morbidity and mortality in Ebola-affected countries caused by decreased health-care capacity, and the potential effect of mitigation strategies: a modelling analysis
Patrick G T Walker, PhD, Michael T White, PhD, Jamie T Griffin, PhD, Alison Reynolds, MA, Prof Neil M Ferguson, PhD, Prof Azra C Ghani, PhD
Published Online: 23 April 2015
Open Access
DOI: http://dx.doi.org/10.1016/S1473-3099(15)70124-6
Summary
Background
The ongoing Ebola epidemic in parts of west Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved over the past decade. We quantified this additional indirect burden of Ebola virus disease.
Methods
We estimated the number of cases and deaths from malaria in Guinea, Liberia, and Sierra Leone from Demographic and Health Surveys data for malaria prevalence and coverage of malaria interventions before the Ebola outbreak. We then removed the effect of treatment and hospital care to estimate additional cases and deaths from malaria caused by reduced health-care capacity and potential disruption of delivery of insecticide-treated bednets. We modelled the potential effect of emergency mass drug administration in affected areas on malaria cases and health-care demand.
Findings
If malaria care ceased as a result of the Ebola epidemic, untreated cases of malaria would have increased by 45% (95% credible interval 43–49) in Guinea, 88% (83–93) in Sierra Leone, and 140% (135–147) in Liberia in 2014. This increase is equivalent to 3·5 million (95% credible interval 2·6 million to 4·9 million) additional untreated cases, with 10 900 (5700–21 400) additional malaria-attributable deaths. Mass drug administration and distribution of insecticide-treated bednets timed to coincide with the 2015 malaria transmission season could largely mitigate the effect of Ebola virus disease on malaria.
Interpretation
These findings suggest that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems.
Funding
UK Medical Research Council, UK Department for International Development, Bill & Melinda Gates Foundation.

The Lancet Infectious Diseases
Jul 2015 Volume 15 Number 7 p747-866
http://www.thelancet.com/journals/laninf/issue/current

Review
The HIV care continuum in Latin America: challenges and opportunities
Alicia Piñeirúa, MD, Juan Sierra-Madero, MD, Pedro Cahn, MD, Rafael Napoleón Guevara Palmero, MD, Ernesto Martínez Buitrago, MD, Dr Benjamin Young, MD, Prof Carlos Del Rio, MD
DOI: http://dx.doi.org/10.1016/S1473-3099(15)00108-5
Summary
Combination antiretroviral therapy (ART), also known as highly active antiretroviral therapy, provides clinical and immunological benefits for people living with HIV and is an effective strategy to prevent HIV transmission at the individual level. Early initiation of ART as part of a test and treat approach might decrease HIV transmission at the population level, but to do so the HIV continuum of care, from diagnosis to viral suppression, should be optimised. Access to ART has improved greatly in Latin America, and about 600 000 people are on treatment. However, health-care systems are deficient in different stages of the HIV continuum of care, and in some cases only a small proportion of individuals achieve the desired outcome of virological suppression. At present, data for most Latin American countries are not sufficient to build reliable metrics. Available data and estimates show that many people living with HIV in Latin America are unaware of their status, are diagnosed late, and enter into care late. Stigma, administrative barriers, and economic limitations seem to be important determinants of late diagnosis and failure to be linked to and retained in care. Policy makers need reliable data to optimise the HIV care continuum and improve individual-based and population-based outcomes of ART in Latin America.

New England Journal of Medicine
July 2, 2015 Vol. 373 No. 1
http://www.nejm.org/toc/nejm/medical-journal

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Perspective
International Health Care Systems: India’s Aspirations for Universal Health Coverage
K.S. Reddy

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 4 July 2015]

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Application of Behavioral Theories to Disaster and Emergency Health Preparedness: A Systematic Review
July 1, 2015 · Research article
Background: Preparedness for disasters and emergencies at individual, community and organizational levels could be more effective tools in mitigating (the growing incidence) of disaster risk and ameliorating their impacts. That is, to play more significant roles in disaster risk reduction (DRR). Preparedness efforts focus on changing human behaviors in ways that reduce people’s risk and increase their ability to cope with hazard consequences. While preparedness initiatives have used behavioral theories to facilitate DRR, many theories have been used and little is known about which behavioral theories are more commonly used, where they have been used, and why they have been preferred over alternative behavioral theories. Given that theories differ with respect to the variables used and the relationship between them, a systematic analysis is an essential first step to answering questions about the relative utility of theories and providing a more robust evidence base for preparedness components of DRR strategies. The goal of this systematic review was to search and summarize evidence by assessing the application of behavioral theories to disaster and emergency health preparedness across the world.
Methods: The protocol was prepared in which the study objectives, questions, inclusion and exclusion criteria, and sensitive search strategies were developed and pilot-tested at the beginning of the study. Using selected keywords, articles were searched mainly in PubMed, Scopus, Mosby’s Index (Nursing Index) and Safetylit databases. Articles were assessed based on their titles, abstracts, and their full texts. The data were extracted from selected articles and results were presented using qualitative and quantitative methods.
Results: In total, 2040 titles, 450 abstracts and 62 full texts of articles were assessed for eligibility criteria, whilst five articles were archived from other sources, and then finally, 33 articles were selected. The Health Belief Model (HBM), Extended Parallel Process Model (EPPM), Theory of Planned Behavior (TPB) and Social Cognitive Theories were most commonly applied to influenza (H1N1 and H5N1), floods, and earthquake hazards. Studies were predominantly conducted in USA (13 studies). In Asia, where the annual number of disasters and victims exceeds those in other continents, only three studies were identified. Overall, the main constructs of HBM (perceived susceptibility, severity, benefits, and barriers), EPPM (higher threat and higher efficacy), TPB (attitude and subjective norm), and the majority of the constructs utilized in Social Cognitive Theories were associated with preparedness for diverse hazards. However, while all the theories described above describe the relationships between constituent variables, with the exception of research on Social Cognitive Theories, few studies of other theories and models used path analysis to identify the interdependence relationships between the constructs described in the respective theories/models. Similarly, few identified how other mediating variables could influence disaster and emergency preparedness.
Conclusions: The existing evidence on the application of behavioral theories and models to disaster and emergency preparedness is chiefly from developed countries. This raises issues regarding their utility in countries, particularly in Asisa and the Middle East, where cultural characteristics are very different to those prevailing in the Western countries in which theories have been developed and tested. The theories and models discussed here have been applied predominantly to disease outbreaks and natural hazards, and information on their utility as guides to preparedness for man-made hazards is lacking. Hence, future studies related to behavioral theories and models addressing preparedness need to target developing countries where disaster risk and the consequent need for preparedness is high. A need for additional work on demonstrating the relationships of variables and constructs, including more clearly articulating roles for mediating effects was also identified in this analysis.

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Post Disaster Governance, Complexity and Network Theory
Evidence from Aceh, Indonesia After the Indian Ocean Tsunami 2004
July 1, 2015 · Research article
This research aims to understand the organizational network typology of large¬-scale disaster intervention in developing countries and to understand the complexity of post-¬disaster intervention, through the use of network theory based on empirical data from post-¬tsunami reconstruction in Aceh, Indonesia, during 2005/¬2007. The findings suggest that the ‘ degrees of separation’ (or network diameter) between any two organizations in the field is 5, thus reflecting ‘small¬ world’ realities and therefore making no significant difference with the real human networks, as found in previous experiments. There are also significant loops in the network reflecting the fact that some actors tend to not cooperate, which challenges post¬ disaster coordination. The findings show the landscape of humanitarian actors is not randomly distributed. Many actors were connected to each other through certain hubs, while hundreds of actors make ‘scattered’ single ‘principal-¬client’ links. The paper concludes that by understanding the distribution of degree, centrality, ‘degrees of separation’ and visualization of the network, authorities can improve their understanding of the realities of coordination, from macro to micro scales.

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Support Needs for Canadian Health Providers Responding to Disaster: New Insights from a Grounded Theory Approach
July 1, 2015 · Research article
Introduction: An earlier descriptive study exploring the various supports available to Canadian health and social service providers who deployed to the 2010 earthquake disaster in Haiti, indicated that when systems are compromised, professionals are at physical, emotional and mental risk during overseas deployment. While these risks are generally well-identified, there is little literature that explores the effectiveness of the supports in place to mitigate this risk. This study provides evidence to inform policy development regarding future disaster relief, and the effectiveness of supports available to responders assisting with international disaster response.
Methods: This study follows Strauss and Corbin’s 1990 structured approach to grounded theory to develop a framework for effective disaster support systems. N=21 interviews with Canadian health and social service providers, who deployed to Haiti in response to the 2010 earthquake, were conducted and analyzed. Resulting data were transcribed, coded and analysed for emergent themes.
Results and Discussion: Three themes were identified in the data and were used to develop the evolving theory. The interview data indicate that the experiences of responders are determined based on an interaction between the individual’s ‘lens’ or personal expectations, as well as the supports that an organization is able to provide. Therefore, organizations should consider the following factors: experience, expectations, and supports, to tailor a successful support initiative that caters to the needs of the volunteer workforce.

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Twitter as a Potential Disaster Risk Reduction Tool. Part I: Introduction, Terminology, Research and Operational Applications
June 29, 2015 · Research article
Twitter, a popular communications platform, is identified as contributing to improved mortality and morbidity outcomes resulting from the 2013 Hattiesburg, Mississippi EF-4 Tornado. This study describes the methodology by which Twitter was investigated as a potential disaster risk reduction and management tool at the community level and the process by which the at-risk population was identified from the broader Twitter user population. By understanding how various factors contribute to the superspreading of messages, one can better optimize Twitter as an essential communications and risk reduction tool. This study introduces Parts II, III and IV which further define the technological and scientific knowledge base necessary for developing future competency base curriculum and content for Twitter assisted disaster management education and training at the community level.

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Twitter as a Potential Disaster Risk Reduction Tool. Part II: Descriptive Analysis of Identified Twitter Activity during the 2013 Hattiesburg F4 Tornado
June 29, 2015 · Research article
Background: This article describes a novel triangulation methodological approach for identifying twitter activity of regional active twitter users during the 2013 Hattiesburg EF-4 Tornado.
Methodology: A data extraction and geographically centered filtration approach was utilized to generate Twitter data for 48 hrs pre- and post-Tornado. The data was further validated using six sigma approach utilizing GPS data. Results: The regional analysis revealed a total of 81,441 tweets, 10,646 Twitter users, 27,309 retweets and 2637 tweets with GPS coordinates.
Conclusions: Twitter tweet activity increased 5 fold during the response to the Hattiesburg Tornado. Retweeting activity increased 2.2 fold. Tweets with a hashtag increased 1.4 fold. Twitter was an effective disaster risk reduction tool for the Hattiesburg EF-4 Tornado 2013.

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Twitter as a Potential Disaster Risk Reduction Tool. Part III: Evaluating Variables that Promoted Regional Twitter Use for At-risk Populations During the 2013 Hattiesburg F4 Tornado
June 29, 2015 · Research article
Introduction: Study goals attempt to identify the variables most commonly associated with successful tweeted messages and determine which variables have the most influence in promoting exponential dissemination of information (viral spreading of the message) and trending (becoming popular) in the given disaster affected region.
Methods: Part II describes the detailed extraction and triangulation filtration methodological approach to acquiring twitter data for the 2013 Hattiesburg Tornado. The data was then divided into two 48 hour windows before and after the tornado impact with a 2 hour pre-tornado buffer to capture tweets just prior to impact. Criteria-based analysis was completed for Tweets and users. The top 100 pre-Tornado and post-Tornado retweeted users were compared to establish the variability among the top retweeted users during the 4 day span.
Results: Pre-Tornado variables that were correlated to higher retweeted rates include total user tweets (0.324), and total times message retweeted (0.530). Post-Tornado variables that were correlated to higher retweeted rates include total hashtags in a retweet (0.538) and hashtags #Tornado (0.378) and #Hattiesburg (0.254). Overall hashtags usage significantly increased during the storm. Pre-storm there were 5,763 tweets with a hashtag and post-storm there was 13,598 using hashtags.
Conclusions: Twitter’s unique features allow it to be considered a unique social media tool applicable for emergency managers and public health officials for rapid and accurate two way communication. Additionally, understanding how variables can be properly manipulated plays a key role in understanding how to use this social media platform for effective, accurate, and rapid mass information communication.

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Twitter as a Potential Disaster Risk Reduction Tool. Part IV: Competency-based Education and Training Guidelines to Promote Community Resiliency
June 29, 2015 · Perspective
Twitter can be an effective tool for disaster risk reduction but gaps in education and training exist in current public health and disaster management educational competency standards. Eleven core public health and disaster management competencies are proposed that incorporate Twitter as a tool for effective disaster risk reduction. Greater funding is required to promote the education and training of this tool for those in professional schools and in the current public health and disaster management workforce.

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 4 July 2015)

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Mistreatment of Women in Childbirth: Time for Action on This Important Dimension of Violence against Women
Rachel Jewkes, Loveday Penn-Kekana
Perspective | published 30 Jun 2015 | PLOS Medicine 10.1371/journal.pmed.1001849

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The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review
Meghan A. Bohren, Joshua P. Vogel, Erin C. Hunter, Olha Lutsiv, Suprita K. Makh, João Paulo Souza, Carolina Aguiar, Fernando Saraiva Coneglian, Alex Luíz Araújo Diniz, Özge Tunçalp, Dena Javadi, Olufemi T. Oladapo, Rajat Khosla, Michelle J. Hindin, A. Metin Gülmezoglu
Research Article | published 30 Jun 2015 | PLOS Medicine 10.1371/journal.pmed.1001847

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Inequitable and Ineffective: Exclusion of Mental Health from the Post-2015 Development Agenda
Alexander C. Tsai, Mark Tomlinson
Editorial | published 30 Jun 2015 | PLOS Medicine 10.1371/journal.pmed.1001846
The Millennium Development Goals (MDGs), adopted at the turn of the century, represented a milestone in global development by committing United Nations member states to eradicating extreme poverty and achieving specific targets over the subsequent decade and a half. At this time the world’s attention is increasingly focused on the post-2015 development agenda, which will be unveiled in September of this year in the form of Sustainable Development Goals (SDGs). Given that mental health and other non-communicable diseases were conspicuously omitted from the MDGs, and have only been weakly mentioned in draft SDG targets, in this essay we argue for a place for mental health on the post-2015 development agenda. Its continued exclusion will not only contribute to the failure of the SDGs given the centrality of mental health in most aspects of human development and well-being but also formalize our collective failure to care for the most vulnerable among us.

Stability: International Journal of Security & Development
http://www.stabilityjournal.org/articles
[accessed 4 July 2015]

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Research Article
In Search of Local Knowledge on ICTs in Africa
Iginio Gagliardone , Ashnah Kalemera, Lauren Kogen, Lillian Nalwoga, Nicole Stremlau, Wakabi Wairagala
Abstract
This article explores whether, and to what extent, local knowledge features in research on the role of ICTs in statebuilding and peacebuilding in Africa, with a particular focus on neighboring Somalia, Kenya, and Ethiopia. We question whether the claims of the transformative power of ICTs are backed by ‘evidence’ and whether local knowledge – e.g., traditional mechanisms for conflict resolution – is taken into consideration by ICT-based development initiatives. To assess this, we systematically reviewed literature in the region, focusing on academic outputs as well as research published by non-governmental and governmental organizations. Several key findings emerged, including: 1) empirical evidence on the successful use of ICTs to promote peacebuilding and statebuilding is thin; 2) few differences exist between scholarship emanating from the Global North and from Africa; and 3) overall, the literature exhibits a simplistic assumption that ICTs will drive democratic development without sufficient consideration of how ICTs are actually used by the public.

World Heritage Review
n°77 – June 2015
http://whc.unesco.org/en/review/77

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Special Issue on Iraq
Cultural World Heritage sites are representative of the creativity and genius of humanity. While World Heritage belongs to everyone, and we share the responsibility to protect it, each site embodies the history, values, beliefs and skills of the people who created it. Whenever a cultural site is destroyed, it is a particularly devastating loss for those who hold the site as a reflection of their history, culture and identity.