The Boar-Operated-System: a Novel Method to Deliver Baits to Wild Pigs

ABSTRACT Bait-delivered pharmaceuticals, increasingly used to manage populations of wild boar (Sus scrofa) and feral pigs, may be ingested by nontarget species. Species-specificity could be achieved through a delivery system. We designed the BOS^TM (Boar-Operated-System) as a device to deliver baits to wild pigs. The BOS^TM consists of a metal pole onto which a round perforated base is attached. A metal cone with a wide rim slides up and down the pole and fully encloses the base onto which the baits are placed. We conducted a pilot, captive trial and found that captive wild boar fed from the BOS^TM either directly, by lifting the cone, or indirectly, by feeding once another animal had lifted the cone. Thus, we tested whether free-living wild boar fed from the BOS^TM and whether the BOS^TM could prevent bait uptake by nontarget species. We observed that free-living wild boar fed regularly from the BOS^TM and that the device successfully prevented bait uptake by nontarget species. The BOS^TM should be trialed more extensively to confirm its effectiveness and species-specificity to distribute pharmaceuticals to wild suids. If successful, the BOS^TM could be used to deliver vaccines in disease control programs as well as contraceptives to manage overabundant populations of wild suids.     

Antibody-Targeted Liposomes to Deliver Doxorubicin to Ovarian Cancer Cells

Abstract

Ovarian cancer is the leading cause of death in women with a gynecologic malignancy. The main reason for the high mortality is the late occurrence of symptoms, resulting in an advanced diseased state at the time of diagnosis. Since ovarian cancer remains confined to the peritoneal cavity virtually throughout its entire clinical course, this type of cancer is an attractive candidate for intraperitoneal chemotherapy. Local instillation of anticancer agents has been used with some success, although systemic absorption of drug, as well as local drug effects, can produce substantial toxicity. This contribution deals with the use of antibody-targeted liposomes (immunoliposomes) for the delivery of doxorubicin to ovarian cancer cells. After a brief discussion of pharmaceutical aspects of the preparation, characterization and stability of OV-17L3 immunoliposomes (anti-ovarian carcinoma Fab' liposomes), me in vitro and in vivo interaction between these specific immunoliposomes and ovarian carcinoma cells are described. A rapid, highly efficient and long-lasting adherence of i.p. administered specific immunoliposomes to i.p. located target cells was observed in a xenograft model of i.p. growing human ovarian carcinoma. However, our preliminary findings on the antitumor activity of doxorubicin-containing immunoliposomes in this xenograft model do not show a therapeutic advantage of specific immunoliposomes over nonspecific liposomes containing doxorubicin. The last part of the article is devoted to an evaluation of the results and discusses potential research directions in the near future.     

Determinants of Performance of Health Systems Concerning Maternal and Child Health: A Global Approach

Aims

To assess the association of social determinants on the performance of health systems around the world.

Methods

A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010.

Results

Health determinants with a significant association on child mortality(<1year): higher access to water (βa Quartile 4(Q4) vs Quartile 1(Q1) = -6,14; 95%CI: -11,63 to -0,73), sanitation systems, (Q4 vs Q1 = -25,58; 95%CI: -31,91 to -19,25), % measles vaccination coverage (Q4 vs Q1 = -7.35; 95%CI: -10,18 to -4,52), % of births attended by a healthcare professional (Q4 vs Q1 = -7,91; 95%CI: -11,36 to -4,52) and a % of the total health expenditure (Q3 vs Q1 = -2,85; 95%CI: -4,93 to -0,7). Ethnic fragmentation (Q4 vs Q1 = 9,93; 95%CI: -0.03 to 19.89) had a marginal effect. For child mortality<5 years, an association was found for these variables and democratization (not free vs free = 11,23; 95%CI: -0,82 to 23,29), out-of-pocket expenditure (Q1 vs Q4 = 17,71; 95%CI: 5,86 to 29,56). For MMR (Maternal mortality ratio), % of access to water for all the quartiles, % of access to sanitation systems, (Q3 vs Q1 = -171,15; 95%CI: -281,29 to -61), birth attention by a healthcare professional (Q4 vs Q1 = -231,23; 95%CI: -349,32 to -113,15), and having corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133).

Conclusions

Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.     

Maternal Time Allocation in Two Cooperative Childrearing Societies

This paper examines maternal trade-offs between subsistence/economic activities and caregiving, and it explores the effect of allomaternal investment on maternal time allocation and child care. I examine how nonmaternal investment in two multiple caregiving populations may offset possible risk factors associated with reductions in maternal caregiving. Behavioral observations were conducted on 8- to 12-month-old infants and their caregivers among the Aka tropical forest foragers and Ngandu farmers of Central Africa. Analysis demonstrates that mothers face trade-offs between subsistence/economic activities and infant care. Infants receive less investment when their mothers engage in subsistence/economic activities, indicating a potential risk to those infants. However, results indicate that allomothers target their assistance during times when mothers are engaged in work activities, partially offsetting potential risks associated with the maternal trade-off. The effects of intercultural variability on maternal time allocation and allomaternal investment are also explored as a means of examining the potential impact of their behaviors on infant care.     

Impact of Community-Based Maternal Health Workers on Coverage of Essential Maternal Health Interventions among Internally Displaced Communities in Eastern Burma: The MOM Project

Background

Access to essential maternal and reproductive health care is poor throughout Burma, but is particularly lacking among internally displaced communities in the eastern border regions. In such settings, innovative strategies for accessing vulnerable populations and delivering basic public health interventions are urgently needed.

Methods

Four ethnic health organizations from the Shan, Mon, Karen, and Karenni regions collaborated on a pilot project between 2005 and 2008 to examine the feasibility of an innovative three-tiered network of community-based providers for delivery of maternal health interventions in the complex emergency setting of eastern Burma. Two-stage cluster-sampling surveys among ever-married women of reproductive age (15–45 y) conducted before and after program implementation enabled evaluation of changes in coverage of essential antenatal care interventions, attendance at birth by those trained to manage complications, postnatal care, and family planning services.

Results

Among 2,889 and 2,442 women of reproductive age in 2006 and 2008, respectively, population characteristics (age, marital status, ethnic distribution, literacy) were similar. Compared to baseline, women whose most recent pregnancy occurred during the implementation period were substantially more likely to receive antenatal care (71.8% versus 39.3%, prevalence rate ratio [PRR] = 1.83 [95% confidence interval (CI) 1.64–2.04]) and specific interventions such as urine testing (42.4% versus 15.7%, PRR = 2.69 [95% CI 2.69–3.54]), malaria screening (55.9% versus 21.9%, PRR = 2.88 [95% CI 2.15–3.85]), and deworming (58.2% versus 4.1%, PRR = 14.18 [95% CI 10.76–18.71]. Postnatal care visits within 7 d doubled. Use of modern methods to avoid pregnancy increased from 23.9% to 45.0% (PRR = 1.88 [95% CI 1.63–2.17]), and unmet need for contraception was reduced from 61.7% to 40.5%, a relative reduction of 35% (95% CI 28%–40%). Attendance at birth by those trained to deliver elements of emergency obstetric care increased almost 10-fold, from 5.1% to 48.7% (PRR = 9.55 [95% CI 7.21–12.64]).

Conclusions

Coverage of maternal health interventions and higher-level care at birth was substantially higher during the project period. The MOM Project''s focus on task-shifting, capacity building, and empowerment at the community level might serve as a model approach for similarly constrained settings. Please see later in the article for the Editors'' Summary     

Improving Maternal and Newborn Health: Effectiveness of a Community Health Worker Program in Rural Kenya

Background

Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance.

Methods

The study utilized a quasi-experimental nonequivalent design that examined relevant demographic items and knowledge about maternal and newborn health combined with a comprehensive retrospective birth history of women’s children using oral interviews of women who were exposed to health messages delivered by CHWs and those who were not exposed. The project trained CHWs in three geographically distinct areas.

Results

Mean knowledge scores were higher in those women who reported being exposed to the health messages from CHWs, Eburru 32.3 versus 29.2, Kinale 21.8 vs 20.7, Nyakio 26.6 vs 23.8. The number of women delivering under skilled attendance was higher for those mothers who reported exposure to one or more health messages, compared to those who did not. The percentage of facility deliveries for women exposed to health messages by CHWs versus non-exposed was: Eburru 46% versus 19%; Kinale 94% versus 73%: and Nyakio 80% versus 78%.

Conclusion

The delivery of health messages by CHWs increased knowledge of maternal and newborn care among women in the local community and encouraged deliveries under skilled attendance.