Applying the disability-adjusted life year to track health impact of social franchise programs in low- and middle-income countries.

Background: Developing effective methods for measuring the health impact of social franchising programs is vital for demonstrating the value of this innovative service delivery model, particularly given its rapid expansion worldwide. Currently, these programs define success through patient volume and number of outlets, widely acknowledged as poor reflections of true program impact. An existing metric, the disability-adjusted life years averted (DALYs averted), offers promise as a measure of projected impact.

Modeling health impact of global health programs implemented by Population Services International.

Background: Global health implementing organizations benefit most from health impact estimation models that isolate the individual effects of distributed products and services - a feature not typically found in intervention impact models, but which allow comparisons across interventions and intervention settings. Population Services International (PSI), a social marketing organization, has developed a set of impact models covering seven health program areas, which translate product/service distribution data into impact estimates. Each model's primary output is the number of disability-adjusted life-years (DALYs) averted by an intervention within a specific country and population context.

Validity of verbal autopsy procedures for determining malaria deaths in different epidemiological settings in Uganda.

Background: Verbal autopsy (VA) procedures can be used to estimate cause of death in settings with inadequate vital registries. However, the sensitivity of VA for determining malaria-specific mortality may be low, and may vary with transmission intensity. We assessed the diagnostic accuracy of VA procedures as compared to hospital medical records for determining cause of death in children under five in three different malaria transmission settings in Uganda, including Tororo (high), Kampala (medium), and Kisoro (low).

An assessment of Lot Quality Assurance Sampling to evaluate malaria outcome indicators: extending malaria indicator surveys.

Background: Large investments and increased global prioritization of malaria prevention and treatment have resulted in greater emphasis on programme monitoring and evaluation (M&E) in many countries. Many countries currently use large multistage cluster sample surveys to monitor malaria outcome indicators on a regional and national level. However, these surveys often mask local-level variability important to programme management.

Viewpoint: evaluating the impact of malaria control efforts on mortality in sub-Saharan Africa.

Objective: To describe an approach for evaluating the impact of malaria control efforts on malaria-associated mortality in sub-Saharan Africa, where disease-specific mortality trends usually cannot be measured directly and most malaria deaths occur among young children.

Methods: Methods for evaluating changes in malaria-associated mortality are examined; advantages and disadvantages are presented.

Results: All methods require a plausibility argument-i.

The association between refractive cutoffs for spectacle provision and visual improvement among school-aged children in South Africa.

Objectives: To evaluate different refractive cutoffs for spectacle provision with regards to their impact on visual improvement and spectacle compliance.

Design: Prospective study of visual improvement and spectacle compliance.

Participants: South African school children aged 6-19 years receiving free spectacles in a programme supported by Helen Keller International.

Factors associated with spectacle-wear compliance in school-aged Mexican children.

Purpose: To study the prevalence and determinants of compliance with spectacle wear among school-age children in Oaxaca, Mexico, who were provided spectacles free of charge.

Methods: A cohort of 493 children aged 5 to 18 years chosen by random cluster sampling from primary and secondary schools in Oaxaca, Mexico, all of whom had received free spectacles through a local program, underwent unannounced, direct examination to determine compliance with spectacle wear within 18 months after initial provision of spectacles. Potential determinants of spectacle wear including age, gender, urban versus rural residence, presenting visual acuity, refractive error, and time since dispensing of the spectacles were examined in univariate and multivariate regression models.

The value of electromyography of the lumbar paraspinal muscles in discriminating between chronic-low-back-pain sufferers and normal subjects.

The authors studied the surface electromyographic (EMG) spectrum of the paraspinal muscles of 350 subjects. They were classified by their history as normal (n=175), chronic low back pain (n=145), or past history (n=30). They pulled upwards on a floor-mounted load cell at two-thirds of their maximum voluntary contraction for 30 s, while the EMG was measured from the paraspinal muscles at the L4/L5 level.

Role of flies and provision of latrines in trachoma control: cluster-randomised controlled trial.

Background: Eye-seeking flies have received much attention as possible trachoma vectors, but this remains unproved. We aimed to assess the role of eye-seeking flies as vectors of trachoma and to test provision of simple pit latrines, without additional health education, as a sustainable method of fly control.

Methods: In a community-based, cluster-randomised controlled trial, we recruited seven sets of three village clusters and randomly assigned them to either an intervention group that received regular insecticide spraying or provision of pit latrines (without additional health education) to each household, or to a control group with no intervention.

Herpes simplex 2 risk among women in a polygynous setting in rural West Africa.

Objectives: To determine risk factors for herpes simplex 2 (HSV2) infection in women in a polygynous rural Gambian population.

Methods: Data from women who participated in a cross-sectional survey of reproductive health were matched to their own and, for women who had been or were married (ever-married), their spouses' data collected in a cross-sectional survey of fertility interests, including information on marital histories.

Results: Data were available on 150 never-married and 525 ever-married women.

Reporting of fertility events by men and women in rural Gambia.

We conducted a survey of male and female fertility in rural villages in The Gambia and compared men and women's reports of recent pregnancy events in the aggregate and of children ever born for matched couples. Despite widespread polygyny and sex differences in fertility, men's and women's reports were similar. Small sex differences in reports of recent stillbirths and neonatal deaths were found.