ABSTRACT
A mathematical model for transmission of schistosomes is useful to predict effects of various control measures on suppression of these parasites. This review focuses on epidemiological and environmental factors in Schistosoma japonicum and Schistosoma mekongi infections and recent advances in mathematical models of Schistosoma transmission.
Subject(s)
Animals , Humans , Asia, Southeastern/epidemiology , Communicable Disease Control , Disease Reservoirs/parasitology , Models, Theoretical , Schistosoma/physiology , Schistosomiasis/epidemiologyABSTRACT
On Ishigaki Island, <I>Plasmodium falciparum</I> and <I>Plasmodium vivax</I> epidemics occurred in 1945-1946 and were successfully suppressed. The epidemic re-emerged in 1949 because many settlers immigrated to the former endemic areas, but it terminated in 1961. The present study aimed at predicting an outbreak of a new epidemic based on the situation in which <I>P. falciparum</I> malaria patients stay on Ishigaki Island and also examined the re-emergence of the <I>P. falciparum</I> epidemic in 1951-1960 to determine the reliability of the model.<br>A stochastic transmission model of <I>P. falciparum</I> was constructed to detect a small number of infected persons. The seasonal fluctuation of the <I>Anopheles minimus</I> population obtained by observational data and meteorological data through statistical processing was introduced into the model.<br>Simulations were carried out to predict the risk of a new epidemic with scenarios in which the attribute of index patient, visiting season, and reduced inoculation rates of <I>An. minimus</I> were assumed. When an infected person visited the island in summer, a small number of patients with primary infections derived from the index patient appeared for all 1,000-iterations. On the other hand, when an infected person visited the island in winter, few or no patients with primary infections appeared for any of the 1,000-iterations because of the low mosquito density. In realistic conditions, the simulation results showed that there was little possibility of the occurrence of <I>P. falciparum</I> infection.
ABSTRACT
<b>Introduction</b><br>Republic of Indonesia was badly affected by the economic crisis that began in Thailand in mid 1997. The crisis increased the incidence of poverty in Indonesia, and now it is time to grapple with this chronic poverty from various angles. The objective of this paper was to assess the impacts of the Social Safety Net (SSN) program on the health sector, which aimed to mitigate the effects of economic crisis. We focused on one of the SSN's health sector programs, the health card program, which provided free medical service for poor families. <br>We examined the usefulness and limitations of this program from an administration perspective.<br><b>Methods</b><br>Based on the ‘wealth ranking’ which is used in the field of development assistance, we chose 26 and 34 households that were classed as ‘relatively poor families’ from two villages in a rural area of Central Java, and interviewed households to understand how the health card program was delivered to them.<br><b>Results</b><br>The results indicated that 30 % (8/26) and 56 % (19/34) of the ‘relatively poor families’ have a health card, although half of these households had never used their cards, and half of them couldn't find their cards. Lack of awareness and indifference of medical staffs to the health card are considered to be possible reasons hindering people from using the card. Another reason was that some households felt ashamed to use the health card.<br><b>Conclusions</b><br>We suggest two methods to promote the increased usage of the SSN's health card as follows; first, choose the target household objectively, and secondly, enhance the management of the health sector program by taking advantage of midwives and teachers, as they have experience and can view the situation from a broader perspective. In addition, like any kind of public service, accessibility is an important factor to promote the usage of this health card.