Scholars@Duke
Wendy P O'Meara

Wendy P O'Meara

Professor of Medicine
Medicine, Infectious Diseases
wendy.omeara@duke.edu
Eldoret Kenya, Box 90519, Durham, NC 27710

Selected Publications

Relationship between malaria vector survival, infectivity and insecticide treated net use in western Kenya.

Journal Article Res Sq · March 18, 2024 BACKGROUND: Much effort and resources have been invested to control malaria transmission in Sub-Saharan Africa, but it remains a major public health problem. For the disease to be transmitted from one person to another, the female Anopheles vector must sur ... Full text Link to item Cite

bistro: An R package for vector bloodmeal identification by short tandem repeat overlap.

Journal Article Methods Ecol Evol · February 2024 Measuring vector-human contact in a natural setting can inform precise targeting of interventions to interrupt transmission of vector-borne diseases. One approach is to directly match human DNA in vector bloodmeals to the individuals who were bitten using ... Full text Link to item Cite

A cluster-randomized trial of client and provider-directed financial interventions to align incentives with appropriate case management in retail medicine outlets: Results of the TESTsmART Trial in western Kenya.

Journal Article PLOS Glob Public Health · 2024 ACTs are responsible for a substantial proportion of the global reduction in malaria mortality over the last ten years, made possible by publicly-funded subsidies making these drugs accessible and affordable in the private sector. However, inexpensive ACTs ... Full text Open Access Link to item Cite

Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya.

Journal Article PLOS Glob Public Health · 2024 While many studies have characterized mobility patterns and disease dynamics of settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may increase the vari ... Full text Open Access Link to item Cite

Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya.

Journal Article medRxiv · December 9, 2023 While many studies have characterized mobility patterns and disease dynamics of individuals from settled populations, few have focused on more mobile populations. Highly mobile groups are often at higher disease risk due to their regular movement that may ... Full text Link to item Cite

Detection of Anopheles stephensi Mosquitoes by Molecular Surveillance, Kenya.

Journal Article Emerg Infect Dis · December 2023 The Anopheles stephensi mosquito is an invasive malaria vector recently reported in Djibouti, Ethiopia, Sudan, Somalia, Nigeria, and Ghana. The World Health Organization has called on countries in Africa to increase surveillance efforts to detect and repor ... Full text Link to item Cite

Plasmodium vivax Prevalence in Semiarid Region of Northern Kenya, 2019.

Journal Article Emerg Infect Dis · November 2023 In urban and rural areas of Turkana County, Kenya, we found that 2% of household members of patients with Plasmodium falciparum infections were infected with P. vivax. Enhanced surveillance of P. vivax and increased clinical resources are needed to inform ... Full text Link to item Cite

Adherence to national malaria treatment guidelines in private drug outlets: a cross-sectional survey in the malaria-endemic Kisumu County, Kenya.

Journal Article Malar J · October 11, 2023 BACKGROUND: Malaria prevalence in Kenya is 6%, with a three-fold higher prevalence in western Kenya. Adherence to malaria treatment guidelines improves care for suspected malaria cases and can reduce unnecessary anti-malarial use. Data on adherence to guid ... Full text Link to item Cite

A cluster-randomized trial of client and provider-directed financial interventions to align incentives with appropriate case management in retail medicine outlets: results of the TESTsmART Trial in western Kenya.

Journal Article medRxiv · September 15, 2023 ACTs are responsible for a substantial proportion of the global reduction in malaria mortality over the last ten years. These reductions would not have been possible without publicly-funded subsidies making these drugs accessible and affordable in the priv ... Full text Link to item Cite

Supply-side and demand-side factors influencing uptake of malaria testing services in the community: lessons for scale-up from a post-hoc analysis of a cluster randomised, community-based trial in western Kenya.

Journal Article BMJ Open · June 26, 2023 OBJECTIVES: Maximising the impact of community-based programmes requires understanding how supply of, and demand for, the intervention interact at the point of delivery. DESIGN: Post-hoc analysis from a large-scale community health worker (CHW) study desig ... Full text Link to item Cite

How do malaria testing and treatment subsidies affect drug shop client expenditures? A cross-sectional analysis in Western Kenya.

Journal Article BMJ Open · December 6, 2022 OBJECTIVES: To examine how drug shop clients' expenditures are affected by subsidies for malaria diagnostic testing and for malaria treatment, and also to examine how expenditures vary by clients' malaria test result and by the number of medications they p ... Full text Link to item Cite

Monthly sulfadoxine/pyrimethamine-amodiaquine or dihydroartemisinin-piperaquine as malaria chemoprevention in young Kenyan children with sickle cell anemia: A randomized controlled trial.

Journal Article PLoS Med · October 2022 BACKGROUND: Children with sickle cell anemia (SCA) in areas of Africa with endemic malaria transmission are commonly prescribed malaria chemoprevention. Chemoprevention regimens vary between countries, and the comparative efficacy of prevention regimens is ... Full text Link to item Cite

Experience and confidence in health technologies: evidence from malaria testing and treatment in Western Kenya.

Journal Article BMC Public Health · September 6, 2022 BACKGROUND: Low adoption of effective health technologies increases illness morbidity and mortality worldwide. In the case of malaria, effective tools such as malaria rapid diagnostic tests (RDTs) and artemisinin-combination therapies (ACTs) are both under ... Full text Link to item Cite

Community-Based Malaria Testing Reduces Polypharmacy in a Population-Based Survey of Febrile Illness in Western Kenya.

Journal Article Int J Public Health · 2022 Objective: The objective was to describe the relationship between the location of care, the malaria test result, and the type of medicine consumed for the fever, and to determine whether community-based access to malaria testing reduced polypharmacy. Metho ... Full text Link to item Cite

Plasmodium falciparum importation does not sustain malaria transmission in a semi-arid region of Kenya.

Journal Article PLOS Glob Public Health · 2022 Human movement impacts the spread and transmission of infectious diseases. Recently, a large reservoir of Plasmodium falciparum malaria was identified in a semi-arid region of northwestern Kenya historically considered unsuitable for malaria transmission. ... Full text Link to item Cite

Exposure to Diverse Plasmodium falciparum Genotypes Shapes the Risk of Symptomatic Malaria in Incident and Persistent Infections: A Longitudinal Molecular Epidemiologic Study in Kenya.

Journal Article Clin Infect Dis · October 5, 2021 BACKGROUND: Repeated exposure to malaria infections could protect against symptomatic progression as people develop adaptive immunity to infections acquired over time. METHODS: We investigated how new, recurrent, and persistent Plasmodium falciparum infect ... Full text Link to item Cite

The prevalence and density of asymptomatic Plasmodium falciparum infections among children and adults in three communities of western Kenya.

Journal Article Malar J · September 17, 2021 BACKGROUND: Further reductions in malaria incidence as more countries approach malaria elimination require the identification and treatment of asymptomatic individuals who carry mosquito-infective Plasmodium gametocytes that are responsible for furthering ... Full text Link to item Cite

Effect of health systems context on infant and child mortality in sub-Saharan Africa from 1995 to 2015, a longitudinal cohort analysis.

Journal Article Sci Rep · August 11, 2021 Each year, > 3 million children die in sub-Saharan Africa before their fifth birthday. Most deaths are preventable or avoidable through interventions delivered in the primary healthcare system. However, evidence regarding the impact of health system charac ... Full text Link to item Cite

Epidemiology of Plasmodium falciparum Infections in a Semi-Arid Rural African Setting: Evidence from Reactive Case Detection in Northwestern Kenya.

Journal Article Am J Trop Med Hyg · August 2, 2021 In northwestern Kenya, Turkana County has been historically considered unsuitable for stable malaria transmission because of its unfavorable climate and predominantly semi-nomadic population; consequently, it is overlooked during malaria control planning. ... Full text Link to item Cite

Impact of asymptomatic Plasmodium falciparum infection on the risk of subsequent symptomatic malaria in a longitudinal cohort in Kenya.

Journal Article Elife · July 23, 2021 BACKGROUND: Asymptomatic Plasmodium falciparum infections are common in sub-Saharan Africa, but their effect on subsequent symptomaticity is incompletely understood. METHODS: In a 29-month cohort of 268 people in Western Kenya, we investigated the associat ... Full text Link to item Cite

Relationship between changing malaria burden and low birth weight in sub-Saharan Africa: A difference-in-differences study via a pair-of-pairs approach.

Journal Article Elife · July 14, 2021 BACKGROUND: According to the World Health Organization (WHO), in 2018, an estimated 228 million malaria cases occurred worldwide with most cases occurring in sub-Saharan Africa. Scale-up of vector control tools coupled with increased access to diagnosis an ... Full text Link to item Cite

Can individuals’ beliefs help us understand nonadherence to malaria test results? Evidence from rural Kenya

Journal Article Review of Development Economics · February 1, 2021 In malaria-endemic countries about a quarter of test-negative individuals take antimalarials (artemisinin-based combination therapies [ACTs]). ACT overuse depletes scarce resources for subsidies and contributes to parasite resistance. As part of an experim ... Full text Cite

Incentivizing appropriate malaria case management in the private sector: a study protocol for two linked cluster randomized controlled trials to evaluate provider- and client-focused interventions in western Kenya and Lagos, Nigeria.

Journal Article Implement Sci · January 20, 2021 BACKGROUND: A large proportion of artemisinin-combination therapy (ACT) anti-malarial medicines is consumed by individuals that do not have malaria. The over-consumption of ACTs is largely driven by retail sales in high malaria-endemic countries to clients ... Full text Link to item Cite

MALARIA IMPORTATION INTO AN EPIDEMIC-PRONE SETTING IN ARID NORTHWEST KENYA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · 2021 Cite

Subsidise the test, the treatment or both? Results of an individually randomised controlled trial of the management of suspected malaria fevers in the retail sector in western Kenya.

Journal Article BMJ Glob Health · November 2020 INTRODUCTION: In many malaria-endemic countries, the private retail sector is a major source of antimalarial drugs. However, the rarity of malaria diagnostic testing in the retail sector leads to overuse of the first-line class of antimalarial drugs known ... Full text Link to item Cite

Does improving appropriate use of malaria medicines change population beliefs in testing and treatment? Evidence from a randomized controlled trial.

Journal Article Health Policy Plan · June 1, 2020 A major puzzle in malaria treatment remains the dual problem of underuse and overuse of malaria medications, which deplete scarce public resources used for subsidies and lead to drug resistance. One explanation is that health behaviour, especially in the c ... Full text Link to item Cite

Mosquito Exposure and Malaria Morbidity: A Microlevel Analysis of Household Mosquito Populations and Malaria in a Population-Based Longitudinal Cohort in Western Kenya.

Journal Article J Infect Dis · March 16, 2020 BACKGROUND: Malaria morbidity is highly overdispersed in the population. Fine-scale differences in mosquito exposure may partially explain this heterogeneity in individual malaria outcomes. METHODS: In 38 households we explored the effect of household-leve ... Full text Link to item Cite

The relative importance of material and non-material incentives for community health workers: Evidence from a discrete choice experiment in Western Kenya.

Journal Article Soc Sci Med · February 2020 Motivating community health workers (CHWs), many of whom are volunteers, is important for the sustainability of integrated community case management programs. Given the limited budgets of many of these programs, and the increasingly important role played b ... Full text Link to item Cite

High-resolution micro-epidemiology of parasite spatial and temporal dynamics in a high malaria transmission setting in Kenya.

Journal Article Nat Commun · December 9, 2019 Novel interventions that leverage the heterogeneity of parasite transmission are needed to achieve malaria elimination. To better understand spatial and temporal dynamics of transmission, we applied amplicon next-generation sequencing of two polymorphic ge ... Full text Link to item Cite

Direct Estimation of Sensitivity of Plasmodium falciparum Rapid Diagnostic Test for Active Case Detection in a High-Transmission Community Setting.

Journal Article Am J Trop Med Hyg · December 2019 Community-based active case detection of malaria parasites with conventional rapid diagnostic tests (cRDTs) is a strategy used most commonly in low-transmission settings. We estimated the sensitivity of this approach in a high-transmission setting in Weste ... Full text Link to item Cite

MALARIA VECTOR POPULATION DENSITIES AND MALARIA TRANSMISSION IN A HOLOENDEMIC AREA OF WESTERN KENYA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2019 Link to item Cite

Improving rational use of ACTs through diagnosis-dependent subsidies: Evidence from a cluster-randomized controlled trial in western Kenya.

Journal Article PLoS Med · July 2018 BACKGROUND: More than half of artemisinin combination therapies (ACTs) consumed globally are dispensed in the retail sector, where diagnostic testing is uncommon, leading to overconsumption and poor targeting. In many malaria-endemic countries, ACTs sold o ... Full text Open Access Link to item Cite

Dynamic malaria hotspots in an open cohort in western Kenya.

Journal Article Sci Rep · January 12, 2018 Malaria hotspots, defined as areas where transmission intensity exceeds the average level, become more pronounced as transmission declines. Targeting hotspots may accelerate reductions in transmission and could be pivotal for malaria elimination. Determina ... Full text Link to item Cite

A mobile health technology platform for quality assurance and quality improvement of malaria diagnosis by community health workers.

Journal Article PLoS One · 2018 BACKGROUND: Community health workers (CHWs) play an important role in improving access to services in areas with limited health infrastructure or workforce. Supervision of CHWs by qualified health professionals is the main link between this lay workforce a ... Full text Link to item Cite

HAPLOTYPE INFERENCE FROM AMPLICON DEEP SEQUENCING TO IDENTIFY MICRO- SCALE PARASITE POPULATION MIXING

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2018 Link to item Cite

A CROSS-SECTIONAL STUDY OF HEMATOLOGIC AND INFECTIOUS MORBIDITY IN KENYAN CHILDREN WITH SICKLE CELL ANEMIA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2018 Link to item Cite

QUALITY IMPROVEMENT STRATEGIES TO MONITOR CHVS MRDT PERFORMANCE: A CASE OF MALARIA TESTING IN WESTERN KENYA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2017 Link to item Cite

IDENTIFYING AVENUES IN THE MANAGEMENT OF FEBRILE ILLNESS BY EXAMINING COMMUNITY HEALTH SEEKING PATTERNS

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2017 Link to item Cite

MULTIPLEX BARCODED NEXT-GENERATION SEQUENCING OF MULTICLONAL PLASMODIUM FALCIPARUM GENOTYPES

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · November 1, 2017 Link to item Cite

malERA: An updated research agenda for characterising the reservoir and measuring transmission in malaria elimination and eradication.

Journal Article PLoS Med · November 2017 This paper summarises key advances in defining the infectious reservoir for malaria and the measurement of transmission for research and programmatic use since the Malaria Eradication Research Agenda (malERA) publication in 2011. Rapid and effective progre ... Full text Link to item Cite

Household beliefs about malaria testing and treatment in Western Kenya: the role of health worker adherence to malaria test results.

Journal Article Malar J · August 22, 2017 BACKGROUND: Although use of malaria diagnostic tests has increased in recent years, health workers often prescribe anti-malarial drugs to individuals who test negative for malaria. This study investigates how health worker adherence to malaria case managem ... Full text Link to item Cite

A longitudinal cohort study of malaria exposure and changing serostatus in a malaria endemic area of rural Tanzania.

Journal Article Malar J · August 2, 2017 BACKGROUND: Measurements of anti-malarial antibodies are increasingly used as a proxy of transmission intensity. Most serological surveys are based on the use of cross-sectional data that, when age-stratified, approximates historical patterns of transmissi ... Full text Open Access Link to item Cite

Use of malaria RDTs in various health contexts across sub-Saharan Africa: a systematic review.

Journal Article BMC Public Health · May 18, 2017 BACKGROUND: The World Health Organization recommends parasitological confirmation of malaria prior to treatment. Malaria rapid diagnostic tests (RDTs) represent one diagnostic method that is used in a variety of contexts to overcome limitations of other di ... Full text Link to item Cite

Innovative public-private partnership to target subsidised antimalarials: a study protocol for a cluster randomised controlled trial to evaluate a community intervention in Western Kenya.

Journal Article BMJ Open · March 20, 2017 INTRODUCTION: There are concerns of inappropriate use of subsidised antimalarials due to the large number of fevers treated in the informal sector with minimal access to diagnostic testing. Targeting antimalarial subsidies to confirmed malaria cases can le ... Full text Link to item Cite

A retrospective cohort study to quantify the contribution of health systems to child survival in Kenya: 1996-2014.

Journal Article Sci Rep · March 14, 2017 Globally, the majority of childhood deaths in the post-neonatal period are caused by infections that can be effectively treated or prevented with inexpensive interventions delivered through even very basic health facilities. To understand the role of inade ... Full text Link to item Cite

Changes in Malaria Epidemiology in Africa and New Challenges for Elimination.

Journal Article Trends Parasitol · February 2017 Although the burden of Plasmodium falciparum malaria is gradually declining in many parts of Africa, it is characterized by spatial and temporal variability that presents new and evolving challenges for malaria control programs. Reductions in the malaria b ... Full text Link to item Cite

Overlap Extension Barcoding for the Next Generation Sequencing and Genotyping of Plasmodium falciparum in Individual Patients in Western Kenya.

Journal Article Sci Rep · January 24, 2017 Large-scale molecular epidemiologic studies of Plasmodium falciparum parasites have provided insights into parasite biology and transmission, can identify the spread of drug resistance, and are useful in assessing vaccine targets. The polyclonal nature inf ... Full text Link to item Cite

Multicenter Pivotal Clinical Trial of Urine Malaria Test for Rapid Diagnosis of Plasmodium falciparum Malaria.

Journal Article J Clin Microbiol · January 2017 The need to expand malaria diagnosis capabilities alongside policy requirements for mandatory testing before treatment motivates exploration of noninvasive rapid diagnostic tests (RDTs). We report the outcome of the first cross-sectional, single-blind clin ... Full text Link to item Cite

Contribution of urinary tract infection to the burden of febrile illnesses in young children in rural Kenya.

Journal Article PLoS One · 2017 INTRODUCTION: The clinical features of UTI in young children may not localize to the urinary tract and closely resemble other febrile illnesses. In malaria endemic areas, a child presenting with fever is often treated presumptively for malaria without inve ... Full text Open Access Link to item Cite

IMPLICATIONS OF REDUCED SUSCEPTIBILITY TO INSECTICIDES IN MALARIA VECTORS IN AN AREA WITH HIGH ITN COVERAGE

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2017 Link to item Cite

DOES THE EXPERIENCE OF MALARIA TESTING INCREASE TRUST IN THE TEST? EVIDENCE FROM WESTERN KENYA

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2017 Link to item Cite

ESTIMATING THE EFFECT OF HEALTH SYSTEMS ON CHILDHOOD MORTALITY IN SUB-SAHARAN AFRICA FROM 1996-2013

Conference AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · January 1, 2017 Link to item Cite

Clinical and geographic patterns of rheumatic heart disease in outpatients attending cardiology clinic in western Kenya.

Journal Article Int J Cardiol · November 15, 2016 INTRODUCTION: Rheumatic heart disease (RHD) remains a leading cause of cardiovascular mortality in sub-Saharan Africa. Identifying high risk populations and geographic patterns of disease is crucial to developing RHD prevention and screening strategies in ... Full text Link to item Cite

Development and validation of a rapid assessment tool for malaria prevention.

Journal Article Malar J · November 8, 2016 BACKGROUND: Insecticide-treated bed nets (ITN) have been shown to be efficacious in reducing malaria morbidity and mortality in many regions. Unfortunately in some areas, malaria has persisted despite the scale up of ITNs. Recent reports indicate that huma ... Full text Link to item Cite

Q Fever, Scrub Typhus, and Rickettsial Diseases in Children, Kenya, 2011-2012.

Journal Article Emerg Infect Dis · May 2016 To increase knowledge of undifferentiated fevers in Kenya, we tested paired serum samples from febrile children in western Kenya for antibodies against pathogens increasingly recognized to cause febrile illness in Africa. Of patients assessed, 8.9%, 22.4%, ... Full text Open Access Link to item Cite

Assessing the independent and combined effects of subsidies for antimalarials and rapid diagnostic testing on fever management decisions in the retail sector: results from a factorial randomised trial in western Kenya.

Journal Article BMJ Glob Health · 2016 OBJECTIVES: There is an urgent need to understand how to improve targeting of artemisinin combination therapy (ACT) to patients with confirmed malaria infection, including subsidised ACTs sold over-the-counter. We hypothesised that offering an antimalarial ... Full text Link to item Cite

Using pay for performance incentives (P4P) to improve management of suspected malaria fevers in rural Kenya: a cluster randomized controlled trial.

Journal Article BMC Med · October 16, 2015 BACKGROUND: Inappropriate treatment of non-malaria fevers with artemisinin-based combination therapies (ACTs) is a growing concern, particularly in light of emerging artemisinin resistance, but it is a behavior that has proven difficult to change. Pay for ... Full text Link to item Cite

Evaluating Spatial Interaction Models for Regional Mobility in Sub-Saharan Africa.

Journal Article PLoS Comput Biol · July 2015 Simple spatial interaction models of human mobility based on physical laws have been used extensively in the social, biological, and physical sciences, and in the study of the human dynamics underlying the spread of disease. Recent analyses of commuting pa ... Full text Link to item Cite

Etiology of pediatric fever in western Kenya: a case-control study of falciparum malaria, respiratory viruses, and streptococcal pharyngitis.

Journal Article Am J Trop Med Hyg · May 2015 In Kenya, more than 10 million episodes of acute febrile illness are treated annually among children under 5 years. Most are clinically managed as malaria without parasitological confirmation. There is an unmet need to describe pathogen-specific etiologies ... Full text Link to item Cite

Quantifying the impact of accessibility on preventive healthcare in sub-Saharan Africa using mobile phone data.

Journal Article Epidemiology · March 2015 BACKGROUND: Poor physical access to health facilities has been identified as an important contributor to reduced uptake of preventive health services and is likely to be most critical in low-income settings. However, the relation among physical access, tra ... Full text Link to item Cite

What Is Threatening the Effectiveness of Insecticide-Treated Bednets? A Case-Control Study of Environmental, Behavioral, and Physical Factors Associated with Prevention Failure.

Journal Article PLoS One · 2015 BACKGROUND: Insecticide-treated nets are the cornerstone of global malaria control and have been shown to reduce malaria morbidity by 50-60%. However, some areas are experiencing a resurgence in malaria following successful control. We describe an efficacy ... Full text Link to item Cite

Heterogeneity in health seeking behaviour for treatment, prevention and urgent care in four districts in western Kenya.

Journal Article Public Health · November 2014 OBJECTIVES: The impact of effective, life-saving health interventions is limited by access to and use of health services. Health seeking behaviour is likely to vary geographically and by type of health concern. However, little is known about the extent of ... Full text Link to item Cite

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

Journal Article Am J Trop Med Hyg · September 2014 Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in re ... Full text Link to item Cite

"Not too far to walk": the influence of distance on place of delivery in a western Kenya health demographic surveillance system.

Journal Article BMC Health Serv Res · May 10, 2014 BACKGROUND: Maternal health service coverage in Kenya remains low, especially in rural areas where 63% of women deliver at home, mainly because health facilities are too far away and/or they lack transport. The objectives of the present study were to (1) d ... Full text Link to item Cite

Spatial autocorrelation in uptake of antenatal care and relationship to individual, household and village-level factors: results from a community-based survey of pregnant women in six districts in western Kenya.

Journal Article Int J Health Geogr · December 7, 2013 BACKGROUND: The majority of maternal deaths, stillbirths, and neonatal deaths are concentrated in a few countries, many of which have weak health systems, poor access to health services, and low coverage of key health interventions. Early and consistent an ... Full text Link to item Cite

The association between price, competition, and demand factors on private sector anti-malarial stocking and sales in western Kenya: considerations for the AMFm subsidy.

Journal Article Malar J · June 5, 2013 BACKGROUND: Households in sub-Saharan Africa are highly reliant on the retail sector for obtaining treatment for malaria fevers and other illnesses. As donors and governments seek to promote the use of artemisinin combination therapy in malaria-endemic are ... Full text Link to item Cite

An innovative pay-for-performance (P4P) strategy for improving malaria management in rural Kenya: protocol for a cluster randomized controlled trial.

Journal Article Implement Sci · May 8, 2013 BACKGROUND: In high-resource settings, 'pay-for-performance' (P4P) programs have generated interest as a potential mechanism to improve health service delivery and accountability. However, there has been little or no experimental evidence to guide the deve ... Full text Link to item Cite

High prevalence of malaria parasitemia and anemia among hospitalized children in Rakai, Uganda.

Journal Article PLoS One · 2013 BACKGROUND: There is a paucity of data on malaria among hospitalized children in malaria endemic areas. We determined the prevalence, presentation and treatment outcomes of malaria and anemia among children in two hospitals in Rakai, Uganda. METHODS: Child ... Full text Link to item Cite

Webuye Health and Demographic Surveillance Systems Baseline Survey of Soil-Transmitted Helminths and Intestinal Protozoa among Children up to Five Years.

Journal Article J Trop Med · 2013 Background. The intestinal parasitic infections (IPIs) are globally endemic, and they constitute the greatest cause of illness and disease worldwide. Transmission of IPIs occurs as a result of inadequate sanitation, inaccessibility to potable water, and po ... Full text Link to item Cite

Expanding Access to Malaria Diagnosis through Retail Shops in Western Kenya: What Do Shop Workers Think?

Journal Article Malar Res Treat · 2013 Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. ... Full text Link to item Cite

Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya.

Journal Article Malar J · August 6, 2012 BACKGROUND: Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of ... Full text Link to item Cite

Developmental allometry and paediatric malaria.

Journal Article Malar J · March 6, 2012 WHO estimates that 80% of mortality due to malaria occurs among infants and young children. Though it has long been established that malaria disproportionately affects children under age five, our understanding of the underlying biological mechanisms for t ... Full text Link to item Cite

Accessibility, availability and affordability of anti-malarials in a rural district in Kenya after implementation of a national subsidy scheme.

Journal Article Malar J · October 26, 2011 BACKGROUND: Poor access to prompt and effective treatment for malaria contributes to high mortality and severe morbidity. In Kenya, it is estimated that only 12% of children receive anti-malarials for their fever within 24 hours. The first point of care fo ... Full text Open Access Link to item Cite

Community and facility-level engagement in planning and budgeting for the government health sector--a district perspective from Kenya.

Journal Article Health Policy · March 2011 Health systems reform processes have increasingly recognized the essential contribution of communities to the success of health programs and development activities in general. Here we examine the experience from Kilifi district in Kenya of implementing ann ... Full text Link to item Cite

Spatial distribution of bednet coverage under routine distribution through the public health sector in a rural district in Kenya.

Journal Article PLoS One · 2011 Insecticide-treated nets (ITNs) are one of the most important and cost-effective tools for malaria control. Maximizing individual and community benefit from ITNs requires high population-based coverage. Several mechanisms are used to distribute ITNs, inclu ... Full text Open Access Link to item Cite

Changes in the burden of malaria in sub-Saharan Africa.

Journal Article Lancet Infect Dis · August 2010 The burden of malaria in countries in sub-Saharan Africa has declined with scaling up of prevention, diagnosis, and treatment. To assess the contribution of specific malaria interventions and other general factors in bringing about these changes, we review ... Full text Link to item Cite

Malaria vaccine trial endpoints - bridging the gaps between trial design, public health and the next generation of vaccines.

Journal Article Parasite Immunol · September 2009 A recent working group convened by the World Health Organization recommended that time to first or only episode of clinical malaria should be used to evaluate vaccine efficacy in phase III trials. However, calculating vaccine efficacy based on this endpoin ... Full text Link to item Cite

The impact of primary health care on malaria morbidity--defining access by disease burden.

Journal Article Trop Med Int Health · January 2009 OBJECTIVES: Primary care facilities are increasingly becoming the focal point for distribution of malaria intervention strategies, but physical access to these facilities may limit the extent to which communities can be reached. To investigate the impact o ... Full text Link to item Cite

THE IMPACT OF ACCESS TO PRIMARY HEALTH CARE ON THE INCIDENCE OF CLINICAL MALARIA IN CHILDREN

Journal Article AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · December 1, 2008 Link to item Cite

Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya.

Journal Article Lancet · November 1, 2008 BACKGROUND: As efforts to control malaria are expanded across the world, understanding the role of transmission intensity in determining the burden of clinical malaria is crucial to the prediction and measurement of the effectiveness of interventions to re ... Full text Link to item Cite

Relationship between exposure, clinical malaria, and age in an area of changing transmission intensity.

Journal Article Am J Trop Med Hyg · August 2008 The relationship between malaria transmission intensity and clinical disease is important for predicting the outcome of control measures that reduce transmission. Comparisons of hospital data between areas of differing transmission intensity suggest that t ... Link to item Cite

Pilot assessment of the sensitivity of the malaria thin film.

Journal Article Malar J · January 28, 2008 BACKGROUND: Malaria microscopy remains the reference standard for malaria diagnosis in clinical trials (drug and vaccine), new diagnostic evaluation, as well as in clinical care in much of the world today. It is known that microscopy is an imperfect gold s ... Full text Link to item Cite

Strain theory of malaria: the first 50 years.

Journal Article Adv Parasitol · 2008 From the 1920s to the 1970s, a large body of principles and evidence accumulated about the existence and character of 'strains' among the Plasmodium species responsible for human malaria. An extensive research literature examined the degree to which strain ... Full text Link to item Cite

Parasite prevalence: a static measure of dynamic infections.

Journal Article Am J Trop Med Hyg · August 2007 The intensity of malaria transmission is often measured by looking at the fraction of individuals infected at a given point in time. However, malaria infections in individuals are dynamic, leading to uncertainty about whether a cross-sectional survey that ... Link to item Cite

Establishing a malaria diagnostics centre of excellence in Kisumu, Kenya.

Journal Article Malar J · June 12, 2007 BACKGROUND: Malaria microscopy, while the gold standard for malaria diagnosis, has limitations. Efficacy estimates in drug and vaccine malaria trials are very sensitive to small errors in microscopy endpoints. This fact led to the establishment of a Malari ... Full text Link to item Cite

Malaria vaccine efficacy: the difficulty of detecting and diagnosing malaria.

Journal Article Malar J · March 26, 2007 New sources of funding have revitalized efforts to control malaria. An effective vaccine would be a tremendous asset in the fight against this devastating disease and increasing financial and scientific resources are being invested to develop one. A few ca ... Full text Link to item Cite

Reader technique as a source of variability in determining malaria parasite density by microscopy.

Journal Article Malar J · December 12, 2006 BACKGROUND: Accurate identification and quantification of malaria parasites are critical for measuring clinical trial outcomes. Positive and negative diagnosis is usually sufficient for the assessment of therapeutic outcome, but vaccine or prophylactic dru ... Full text Link to item Cite

Gametocytemia in Plasmodium vivax and Plasmodium falciparum infections.

Journal Article J Parasitol · December 2006 Two expert research microscopists, each blinded to the other's reports, diagnosed single-species malaria infections in 2,141 adults presenting at outpatient malaria clinics in Tak Province, Thailand, and Iquitos, Peru, in May-August 1998, May-July 1999, an ... Full text Link to item Cite

Production and validation of durable, high quality standardized malaria microscopy slides for teaching, testing and quality assurance during an era of declining diagnostic proficiency.

Journal Article Malar J · October 25, 2006 BACKGROUND: Sets of Giemsa-stained, blood smear slides with systematically verified composite diagnoses would contribute substantially to development of externally validated quality assurance systems for the microscopic diagnosis of malaria. METHODS: whole ... Full text Link to item Cite

Reporting of non-communicable disease research in low- and middle-income countries: a pilot bibliometric analysis.

Journal Article J Med Libr Assoc · October 2006 OBJECTIVE: The paper identifies the relative amount of research devoted to non-communicable disease in low- and middle-income countries (LMICs). DESIGN: A bibliometric analysis of a subset of journals published in LMICs was performed. MEASUREMENTS: Seventy ... Link to item Cite

Systematic comparison of two methods to measure parasite density from malaria blood smears.

Journal Article Parasitol Res · September 2006 This study was designed to directly compare the accuracy, reproducibility, and efficiency of three methods commonly used to measure blood-stage malaria parasite density from Giemsa-stained blood films. Parasites and white blood cells (WBCs) were counted in ... Full text Link to item Cite

Fever in patients with mixed-species malaria.

Journal Article Clin Infect Dis · June 15, 2006 BACKGROUND: Clinical symptoms of mixed-species malaria infections have been variously reported as both less severe and more severe than those of single-species infections. METHODS: Oral temperatures were taken from and blood slides were prepared for 2308 a ... Full text Link to item Cite

Potential impact of intermittent preventive treatment (IPT) on spread of drug-resistant malaria.

Journal Article PLoS Med · May 2006 BACKGROUND: Treatment of asymptomatic individuals, regardless of their malaria infection status, with regularly spaced therapeutic doses of antimalarial drugs has been proposed as a method for reducing malaria morbidity and mortality. This strategy, called ... Full text Link to item Cite

The impact of diagnostic technique on vaccine efficacy measurements in clinical trials

Journal Article AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · December 1, 2005 Link to item Cite

Potential impact of intermittent preventive treatment for infants on the spread of drug resistant malaria

Journal Article AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE · December 1, 2005 Link to item Cite

White blood cell counts in Plasmodium vivax malaria.

Journal Article J Infect Dis · November 1, 2005 Full text Link to item Cite

Reply to Rodríguez‐Morales et al.

Journal Article The Journal of Infectious Diseases · November 2005 Full text Cite

Sources of variability in determining malaria parasite density by microscopy.

Journal Article Am J Trop Med Hyg · September 2005 Enumeration of parasites by microscopic examination of blood smears is the only method available for quantifying parasitemia in infected blood. However, the sources and scale of error inherent in this technique have not been systematically investigated. He ... Link to item Cite

The promise and potential challenges of intermittent preventive treatment for malaria in infants (IPTi).

Journal Article Malar J · July 20, 2005 Intermittent preventive treatment (IPT) administers a full therapeutic course of an anti-malarial drug at predetermined intervals, regardless of infection or disease status. It is recommended by the World Health Organization (WHO) for protecting pregnant w ... Full text Link to item Cite

White blood cell counts and malaria.

Journal Article J Infect Dis · July 15, 2005 White blood cells (WBCs) were counted in 4697 individuals who presented to outpatient malaria clinics in Maesod, Tak Province, Thailand, and Iquitos, Peru, between 28 May and 28 August 1998 and between 17 May and 9 July 1999. At each site and in each year, ... Full text Link to item Cite

Bayesian analysis of signaling networks governing embryonic stem cell fate decisions.

Journal Article Bioinformatics · March 2005 MOTIVATION: Signaling events that direct mouse embryonic stem (ES) cell self-renewal and differentiation are complex and accordingly difficult to understand in an integrated manner. We address this problem by adapting a Bayesian network learning algorithm ... Full text Link to item Cite

Cell population dynamics model for deconvolution of murine embryonic stem cell self-renewal and differentiation responses to cytokines and extracellular matrix.

Journal Article Biotechnol Bioeng · November 5, 2004 Stem cell self-renewal versus differentiation fate decisions are difficult to characterize and analyze due to multiple competing rate processes occurring simultaneously among heterogeneous cell subpopulations. To address this challenge, we describe a mathe ... Full text Link to item Cite

Multivariate proteomic analysis of murine embryonic stem cell self-renewal versus differentiation signaling.

Journal Article Proc Natl Acad Sci U S A · March 2, 2004 A number of extracellular stimuli, including soluble cytokines and insoluble matrix factors, are known to influence murine embryonic stem cell self-renewal and differentiation behavioral responses via intracellular signaling pathways, but their net effects ... Full text Link to item Cite