Publications by authors named "P E Milligan"

Background: In Africa, the scale-up of malaria-control interventions has reduced malaria burden, but progress towards elimination has stalled. Mass drug administration (MDA) is promising as a transmission-reducing strategy, but evidence from low-to-moderate transmission settings is needed. We aimed to assess the safety, coverage, and effect of three cycles of MDA with dihydroartemisinin-piperaquine plus single, low-dose primaquine on Plasmodium falciparum incidence and prevalence in southeast Senegal.

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Article Synopsis
  • In Senegal, a study evaluated the effectiveness of mass drug administration (MDA) as a strategy to reduce malaria incidence, comparing it to the standard seasonal malaria chemoprevention (SMC) methods.
  • The trial was conducted in 60 villages, with one group receiving MDA treatment and the other receiving SMC, both delivered door-to-door.
  • Results showed MDA significantly reduced malaria cases by 55% during the peak transmission season, indicating it may be a more effective intervention than standard care without serious side effects reported.
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  • The RTS,S/AS01 malaria vaccine was launched in Ghana, Kenya, and Malawi in 2019 to evaluate its feasibility, impact, and safety after concerns about potential health risks emerged during earlier trials.
  • A prospective evaluation involved randomly assigning 158 geographical clusters to receive the vaccine either early or later, monitoring various health outcomes in children over four years.
  • Key outcomes included overall mortality, severe malaria rates, hospital admissions for meningitis, and vaccine coverage, with a specific focus on monitoring potential safety issues, particularly among girls.
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In studies of infectious disease prevention, the level of protective efficacy of medicinal products such as vaccines and prophylactic drugs tends to vary over time. Many products require administration of multiple doses at scheduled times, as opposed to one-off or continual intervention. Accurate information on the trajectory of the level of protective efficacy over time facilitates informed clinical recommendations and implementation strategies, for example, with respect to the timing of administration of the doses.

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There has been an increasing awareness of the importance of physician mental health. Several South African studies show a high prevalence of burnout among doctors. Burnout is characterised by three components: exhaustion, depersonalisation, and a sense of a lack of efficacy.

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