Journal Article > ResearchFull Text
Trans R Soc Trop Med Hyg. 1 December 2004; Volume 98 (Issue 12); DOI:10.1016/j.trstmh.2004.01.012
Spencer S, Grant AD, Piola P, Tukpo K, Okia M, et al.
Trans R Soc Trop Med Hyg. 1 December 2004; Volume 98 (Issue 12); DOI:10.1016/j.trstmh.2004.01.012
Malaria is a key health problem among displaced populations in malaria-endemic areas. Mass distribution of insecticide-treated bednets (ITN) to prevent malaria is often carried out in complex emergencies, but there are few data on the outcome or operational effectiveness of such programmes. In June 2001, Medecins Sans Frontieres completed a mass distribution of ITNs (Permanet) to internally displaced persons in Bundibugyo, southwest Uganda, distributing one to four nets per household, and aiming to provide coverage for all residents. In July 2002, we did a cross-sectional survey using three-stage cluster sampling to evaluate the programme. A total of 1245 individuals from 835 households were interviewed. An ITN was present in 75.6% (95% CI 72.7-78.5) of the households, but only 56.5% (95% CI 52.3-60.4) of individuals were sleeping under an ITN, and nets were often damaged. The prevalence of malarial parasitaemia was 11.2% (95% CI 9.4-13.0), and was significantly lower in ITN users compared to non-users (9.2% vs. 13.8%, relative risk [RR] 0.63, 95% CI 0.46-0.87); ITNs with severe damage remained effective (RR for severely damaged net 0.58, 95% CI 0.35-0.98). There was no significant difference in haemoglobin concentration between ITN users and non-users.
Journal Article > ResearchFull Text
Confl Health. 10 September 2009; Volume 3; 8.; DOI:10.1186/1752-1505-3-8
Grais RF, Luquero FJ, Grellety E, Pham H, Coghlan B, et al.
Confl Health. 10 September 2009; Volume 3; 8.; DOI:10.1186/1752-1505-3-8
Survey estimates of mortality and malnutrition are commonly used to guide humanitarian decision-making. Currently, different methods of conducting field surveys are the subject of debate among epidemiologists. Beyond the technical arguments, decision makers may find it difficult to conceptualize what the estimates actually mean. For instance, what makes this particular situation an emergency? And how should the operational response be adapted accordingly. This brings into question not only the quality of the survey methodology, but also the difficulties epidemiologists face in interpreting results and selecting the most important information to guide operations. As a case study, we reviewed mortality and nutritional surveys conducted in North Kivu, Democratic Republic of Congo (DRC) published from January 2006 to January 2009. We performed a PubMed/Medline search for published articles and scanned publicly available humanitarian databases and clearinghouses for grey literature. To evaluate the surveys, we developed minimum reporting criteria based on available guidelines and selected peer-review articles. We identified 38 reports through our search strategy; three surveys met our inclusion criteria. The surveys varied in methodological quality. Reporting against minimum criteria was generally good, but presentation of ethical procedures, raw data and survey limitations were missed in all surveys. All surveys also failed to consider contextual factors important for data interpretation. From this review, we conclude that mechanisms to ensure sound survey design and conduct must be implemented by operational organisations to improve data quality and reporting. Training in data interpretation would also be useful. Novel survey methods should be trialled and prospective data gathering (surveillance) employed wherever feasible.
Journal Article > CommentarySubscription Only
Lancet. 18 November 2000; Volume 356 (Issue 9243); 1762.; DOI: 10.1016/S0140-6736(00)03217-7
Salignon P, Cabrol JC, Liu J, Legros D, Brown V, et al.
Lancet. 18 November 2000; Volume 356 (Issue 9243); 1762.; DOI: 10.1016/S0140-6736(00)03217-7