A research Report submitted to the faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Rural Health Johannesburg, June, 2017. / Introduction: Knowing the burden of severe malaria in children and the predictors of outcomes for children with severe malaria would help to put up interventions that would reduce the risk of poor outcomes and promote survival. Aim: The aim of this study was to determine the predictors of outcomes for the children with severe malaria admitted at Mchinji district hospital, in Malawi. Methods: This was a cross sectional study and 201 randomly sampled files of children admitted to Mchinji district hospital with severe malaria in 2013 and 2014 were reviewed. Univariate and multivariate logistic regression models were used to predict outcomes for the children with severe malaria. Results: During the study period there were 2603(N) children admitted with severe malaria. A sample of 202 (n) files for children admitted with malaria was randomly selected, and 201(n) were included in the final analysis. The majority of the children were under the age of five years 155 (78.3%), 106 (53.5%) were male, with 147 (73.1%) being self-referrals and 54 (26.9%) health centre referrals. Fever was the most common presenting complaint, 177 (88.1%), while 76 (37.8%) had convulsions and 58 (28.9%) had vomiting. All patients were treated as per Malawi National Malaria Control Program treatment guidelines. The outcomes of the children were either discharged home alive, died, missing (referred to a specialised unit, or absconded from hospital). The case fatality rate was 7.5%. Of the children that died 11 (73.3%) were children under the age of five years and 9 (60%) were children referred from the health centre. Children who were referred from the health centres were more likely to die than children who were self referred by guardians from their homes [OR=4.84 1.63-14.35] Conclusion and Recommendations: The study found that being referred from health centre, presenting with unconsciousness, long stay in hospital and receiving LA in the course of treatment are predictors of outcomes in children admitted with severe malaria. The predictors are a combination of patient and health systems factors that influence delay in accessing prompt treatment for malaria in general. Therefore, there is need to improve patient care right from home and in the hospital with special attention on the patient referral system. Further research on community and health system factors to improve the system for caring of children with malaria may be required. / MT2017

Thesis (Ph. D.)--University of Hawaii at Manoa, 1995. / Includes bibliographical references (leaves 101-108). / Microfiche. / 108 leaves, bound ill., maps 29 cm

Diss. (sammanfattning) Göteborg : Univ., 2007. / Härtill 6 uppsatser.

Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.S.P.)--University of Michigan, 1943.

Thesis (M.P.H.)--University of Michigan, 1946.

Thesis (M.S.P.)--University of Michigan, 1943.

A Research Report Submitted to the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Master of Science in Medicine in Tropical Diseases (Epidemiology and Biostatistics Option). Johannesburg, January 2001 / Background: increasing spread of drug resistance among Plasmodium falciparum poses a serious threat to malaria treatment. The situation is complicated not only because new drugs are expensive and slow in development but also because they must be effective, preferably have a novel method of action, with an acceptable level of adverse effects, and be deployed in such a way as to prolong their use. / IT2018

Tourism is the world's largest earner of foreign currency. It brings an estimated R20 billion a year into the South African economy, second only to the manufacturing and mining industry in its contribution to the Gross Domestic Product (GDP). An estimated 1.7 million overseas and African tourists visited South Africa in 1999. Of the 1.7 million approximately 500 000 or 30% of these tourists visited KwazuluNatal. Forty seven percent of the foreign tourists visited the Zululand and Maputaland area, which falls within a malaria transmission zone. An estimated 8 million domestic tourists from outside or within this province travelled to one or more destinations within KwaZulu-Natal on an annual basis. The Lubombo Spatial Development Initiative is a tri-Iateral initiative between the governments of Swaziland, Mozambique and South Africa to develop the Lubombo region into a globally competitive economic zone. The geographical area targeted by this initiative is broadly defined as eastem Swaziland, southem Mozambique and north-eastem KwaZulu-Natal. Accelerated development with regards to agriculture and tourism is the main objective of the Lubombo Spatial Development Initiative (LSD!). The Lubombo corridor has the potential to develop into an intemational tourist destination but malaria is hampering the growth and development of the region. Perceived malaria risk by tourists is believed to be an important factor that has a negative influence on the tourism industry in the study area. The risk factor, as defined in this study, is the possibility of contracting malaria whilst visiting a tourism facility in the area. It is therefore essential to understand perceptions relating to malaria and malaria risk in the LSDI area. Malaria control plays a pivotal role in the Lubombo Spatial Development Initiative (LSD!). The objective of the malaria control component of the LSDI is to put in place a malaria control programme that will protect the economic interest of the Lubombo Spatial Development Initiative (LSD!) and stimulate development. Malaria control activities have been taking place in the three countries since 1999. Residual house spraying is the method used to control malaria in the Lubombo corridor. Major reductions in both malaria cases and parasite prevalence have been recorded. Swaziland's malaria incidence reduced by 64%, South Africa's malaria incidence plummeted by a staggering 76% and Mozambique saw a parasite prevalence reduction of40% in the first year of residual house spraying in 1999. This study focuses on the scientific study of malaria incidence and distribution as well as on both tourists and tourism operator's perceptions of malaria risk. It considers the factors that drive people's perceptions of risk and investigates how tourists and tourism operators respond to malaria risk. It draws conclusions about how malaria impacts on tourism in the LSDI and recommends how malaria control can play a positive role in tourism development in the area. / Thesis (M.Sc.)-University of Natal, Durban, 2003.

A thesis submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy. December 2, 2014. / Malaria is a public health problem for more than 2 billion people globally. About 219 million cases of malaria occur worldwide and 660, 000 people die, most (91%) in the African region despite decades of efforts to control the disease. Although the disease is preventable, it is life-threatening and parasitically transmitted by the bite of the female Anopheles mosquito. A deterministic mathematical model with intervention strategies is developed in order to investigate the effectiveness, optimal control and cost effectiveness of Indoor Residual Spraying (IRS), Insecticide Treated Nets (ITNs) and treatment on the transmission dynamics of malaria in Karonga District, Malawi. The effective reproduction number is analytically computed, and existence and stability conditions of the equilibria are explored. The model does not exhibit backward bifurcation. A structured questionnaire was developed, a one-toone interview with a randomly sampled set of individuals conducted to assess the knowledge level of inhabitants of Karonga district about the disease in general and their awareness and application of the intervention strategies. Applying Pontryagin’s Maximum Principle which uses both the Langragian and Hamiltonian principles with respect to a constant time dependent, we derive the necessary conditions for the optimal control of the disease. An economic evaluation of the strategies is carried out by performing a cost-effectiveness analysis to determine the most cost-effective combination of the three intervention measures. The incremental cost-effectiveness ratio (ICER) is calculated in order to compare the costs and effectiveness of all the possible combinations of the three measures. The results show that the combination of treatment, ITNs and IRS is the most cost-effective combination strategy for malaria control. Numerical simulations indicate that the prevention strategies lead to the reduction of both the mosquito population and infected human individuals. Effective treatment consolidates the prevention strategies. Thus, malaria can be eradicated by deployment of combined strategies such as vector control via ITNs and IRS complemented with timely treatment of infected people.