Integrating insecticide-treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher-based methods.

Population coverage of insecticide-treated nets (ITNs) in Africa falls well below the Abuja target of 60% while coverage levels achieved during vaccination campaigns in the same populations typically exceed 90%. Household (HH) cost of ITNs is an important barrier to their uptake. We investigated the coverage, equity and cost of linking distribution of free ITNs to a measles vaccination campaign. During a national measles vaccination campaign in Zambia, children in four rural districts were given a free ITN when they received their measles vaccination. In one urban district, children were given a voucher, which could be redeemed for a net at a commercial distribution site. About 1700 HHs were asked whether they received vaccination and an ITN during a measles campaign, as well as questions on assets (e.g. type roofing material or bicycle ownership) to assess HH wealth. Net ownership was calculated for children in each wealth quintile. In the rural areas, ITN coverage among children rose from 16.7% to 81.1% and the equity ratio from 0.32 to 0.88 and in the urban area from 50.7% to 76.2% (equity ratio: 0.66-1.19). The operational cost per ITN delivered was dollar 0.35 in the rural area with direct distribution and $1.89 in the urban areas with voucher distribution. Mass distribution of ITNs through vaccination campaigns achieves rapid, high and equitable coverage at low cost.

Identification of non-cross-resistant platinum compounds with novel cytotoxicity profiles using the NCI anticancer drug screen and clustered image map visualizations.

The widespread clinical use of platinum compounds in cancer chemotherapy has prompted a search for new platinum agents. To search for platinum agents with novel profiles of activity, we used clustered image maps, the COMPARE algorithm, and other numerical methods to analyze platinum compounds submitted to the National Cancer Institute's anticancer drug screen and tested against the screen's 60 diverse human cancer cell lines (the NCI-60). A total of 107 platinum compounds for which the data were adequate could be clustered into 12 groups, 11 of which were characterized by distinctive activity profiles against the cell lines. Each group (except the mixed one) was then found to have a characteristic chemical structure as well. Four of the groups were subjected to further analysis. Mean graph representations of the averaged activity profiles of the different groups served to highlight their similarities and differences. To identify compounds that might retain activity in the setting of resistance to clinically used platinum compounds, we determined the activity levels of 38 of the compounds (representative of the different activity-structure groups) against cisplatin and oxaliplatin-resistant ovarian cancer cell lines. Many of the compounds retained activity against the resistant cells, providing evidence that they differ from cisplatin and oxaliplatin, not only in their selective activity against the various NCI-60 cell types, but are also in their susceptibility to mechanisms of resistance. Since platinum compounds have generally been classified as alkylating agents, we also compared their patterns of activity with those of representative alkylating agents, with NCI-60 growth rates, and with the profiles of 1582 molecular markers in the NCI-60 cells. Much more analysis remains to be done, but the absence of any definitive, biologically interpretable molecular predictor of activity is consistent with the idea that platinum compounds have multiple intracellular targets and that cells can have multiple mechanisms of resistance.