STUDY TYPE: Mixed methods.
METHODS: A desk review was conducted relating to HPSR funding, followed by in-depth interviews. Eight countries and areas were selected to represent characteristics of different health systems. Literature reviews included an analysis of available data relating to HPSR funding and national research and development (R&D) budgets, between 2010 and 2019 (inclusive). In-depth interviews were conducted with 23 stakeholders using an approved interview guide, to assess the attitudes of HPSR funding decision makers towards HPSR, determinants for HPSR and health research funding decisions, and proposals to strengthen HPSR funding and output.
RESULTS: There are four main characteristics of HPSR funding in the WPRO: 1) a general absence of studies on HPSR funding and its determinants; 2) no universally accepted understanding of HPSR; 3) an absence of granular health research funding data in general and for HPSR in particular; and 4) HPSR funding is generally perceived to be minimal. In-depth interviews show that HPSR has different interpretations and emphases across WPRO countries, leading to a fragmented landscape where decision makers generally favour biomedical or clinical research. Participants indicate that political involvement increases overall research funding, especially if there is a clear connection between funders, producers and HPSR users. Suggestions from participants to strengthen HPSR include: appropriately using central agencies to generate demand and raise HPSR as a national priority; adopting interdisciplinary HPSR; and building HPSR capacity and organisational structures.
CONCLUSIONS: HPSR in the Western Pacific region is generally not well funded, with biomedical and public health research often perceived as a higher priority. Although funding is a crucial component of the quality, quantity and relevance of HPSR outputs, HPSR practitioners and organisations must also generate demand for HPSR, build capacity for increasing the quantity and quality of HPSR outputs, and build pathways to translate HPSR outputs into real-world policies.
METHODS: A review protocol constructed by a panel of experienced academic reviewers was used to formulate the methodology, research design, search strategy and selection criteria. An extensive literature search was conducted between March-June 2020 in various major electronic biomedical databases including PubMed, EMBASE, MEDLINE and ScienceDirect. A systematic review and meta-analysis (PRISMA) were selected as the preferred item reporting method.
RESULTS: Out of a total of 34 peer-reviewed dengue-related KAP studies that were identified, 15 published from 2000 to April 2020 met the inclusion criteria. Based on the meta-analysis, a poor mean score was obtained for each of knowledge (68.89), attitude (49.86) and preventive practice (64.69). Most respondents were equipped with a good knowledge of the major clinical signs of dengue. Worryingly, 95% of respondents showed several negative attitudes towards dengue prevention, claiming that this was not possible and that enacting preventive practices was not their responsibility. Interestingly, television or radio was claimed as the main source of gaining dengue information (range 50-95%). Lastly, only five articles (33.3%) piloted or pretested their questionnaire before surveying, of which three reported Cronbach's alpha coefficient (range 0.70 to 0.90).
CONCLUSION: This review indicates that to combat the growing public health threat of dengue to the Philippines, we need the active participation of resident communities, full engagement of healthcare personnel, promotion of awareness campaigns, and access to safe complementary and alternative medicines. Importantly, the psychometric properties of each questionnaire should be assessed rigorously.
METHODS: On Ambae Island, blood samples were collected from 231 and 282 individuals in 2003 and 2007, respectively. Parasite prevalence was determined by microscopy. Antibodies to three Plasmodium falciparum (PfSE, PfMSP-119, and PfAMA-1) and three Plasmodium vivax (PvSE, PvMSP-119, and PvAMA-1) antigens, as well as the Anopheles-specific salivary antigen gSG6, were detected by ELISA. Age-specific seroprevalence was analysed using a reverse catalytic modelling approach to estimate seroconversion rates (SCRs).
RESULTS: Parasite rate decreased significantly (P
METHODS: Surveys were conducted in April 2009. Analysis data from the Asia cohort were collected in March 2009 from 12 centres in Cambodia, India, Indonesia, Malaysia, and Thailand. Data from the IeDEA Southern Africa cohort were finalized in February 2008 from 10 centres in Malawi, Mozambique, South Africa and Zimbabwe.
RESULTS: Survey responses reflected inter-regional variations in drug access and national guidelines. A total of 1301 children in the TREAT Asia and 4561 children in the IeDEA Southern Africa cohorts met inclusion criteria for the cross-sectional analysis. Ten percent of Asian and 3.3% of African children were on second-line ART at the time of data transfer. Median age (interquartile range) in months at second-line initiation was 120 (78-145) months in the Asian cohort and 66 (29-112) months in the southern African cohort. Regimens varied, and the then current World Health Organization-recommended nucleoside reverse transcriptase combination of abacavir and didanosine was used in less than 5% of children in each region.
CONCLUSIONS: In order to provide life-long ART for children, better use of current first-line regimens and broader access to heat-stable, paediatric second-line and salvage formulations are needed. There will be limited benefit to earlier diagnosis of treatment failure unless providers and patients have access to appropriate drugs for children to switch to.