Seasonal malaria chemoprevention: successes and missed opportunities

Seasonal malaria chemoprevention (SMC) was recommended in 2012 for young children in the Sahel during the peak malaria transmission season. Children are given a single dose of sulfadoxine/pyrimethamine combined with a 3-day course of amodiaquine, once a month for up to 4 months. Roll-out and scale-up of SMC has been impressive, with 12 million children receiving the intervention in 2016. There is evidence of its overall benefit in routine implementation settings, and a meta-analysis of clinical trial data showed a 75% decrease in clinical malaria compared to placebo. SMC is not free of shortcomings. Its target zone includes many hard-to-reach areas, both because of poor infrastructure and because of political instability. Treatment adherence to a 3-day course of preventive treatment has not been fully documented, and could prove challenging. As SMC is scaled up, integration into a broader, community-based paradigm which includes other preventive and curative activities may prove beneficial, both for health systems and for recipients.     

Development of renal scars in children: missed opportunities in management. South Bedfordshire Practitioners' Group.

OBJECTIVE--To assess the antecedent medical care of children with renal scars. DESIGN--Retrospective study of both general practice and hospital records. SETTING--12 Group practices in south Bedfordshire and the radiology and paediatric outpatient departments of a district general hospital. SUBJECTS--23 Children with renal scars (six boys, 17 girls) from the 12 group practices, identified from outpatient, radiology, and general practice records. MAIN OUTCOME MEASURES--Number of children in whom a diagnosis of urinary tract infection had been made without prior examination of a mid-stream specimen of urine; number of children who had had a confirmed urinary tract infection that had not been investigated further; number who had experienced delays in investigation or referral; and number who had received inadequate follow up. RESULTS--In all, 11 of the children had received suboptimal medical care, but the management of the other 12 could not have been better. The most common error was failure to investigate possible urinary tract infections, but follow up of confirmed infections was also inadequate. These problems occurred in hospital as well as in general practice. CONCLUSION--Opportunities for intervention had been missed in nearly half of this sample of children with renal scars.     

Status of medical parasitology in South Africa: new challenges and missed opportunities

In South Africa medical parasitology is neglected due to a shift in funding priorities to focus on HIV, tuberculosis and malaria. Evidence suggests that helminth infections have deleterious effects on HIV and tuberculosis. A multisectoral approach involving key government and research institutions is required to rekindle interest in medical parasitology.     

The first independent Ukrainian census in Crimea: Myths,miscoding, and missed opportunities

State-defined identity categories can have a profound impact on individuals’ conception of themselves. Like birth certificates and migration documents, the census is a crucial instrument in producing and maintaining ethnic and racial identities. Recent research suggests that censuses measure preferences, rather than objective data, and can profitably be studied along the lines of political campaigns. This article advances the idea that the next question is whose preference is being recorded. Ethnographic research on the micropolitics of census-taking in Crimea, Ukraine suggest the dynamics between census-takers and ethnic constituencies, as well as instructions from census officials with various ethnic loyalties, have a crucial role to play.