Novel Approaches to Control Malaria in Forested Areas of Southeast Asia.

The emergence and spread of drug resistance in the Greater Mekong Subregion (GMS) have added urgency to accelerate malaria elimination while reducing the treatment options. The remaining foci of malaria transmission are often in forests, where vectors tend to bite during daytime and outdoors, thus reducing the effectiveness of insecticide-treated bed nets. Limited periods of exposure suggest that chemoprophylaxis could be a promising strategy to protect forest workers against malaria. Here we discuss three major questions in optimizing malaria chemoprophylaxis for forest workers: which antimalarial drug regimens are most appropriate, how frequently the chemoprophylaxis should be delivered, and how to motivate forest workers to use, and adhere to, malaria prophylaxis.

System Failure: Work Organization and Injury Outcomes among Latino Forest Workers.

OBJECTIVES: Forestry services is a hazardous industry with high job-related injury, illness, and fatality rates. The Northwest workforce is largely Spanish-speaking, Latino, and immigrant, working in poor conditions with insufficient attention paid to safety and health. Institutional racism fundamentally shapes the structural vulnerability of Latino immigrant workers. Given this context, we sought to understand how workplace organizational factors and safety climate affect job-related injuries in this industry. METHODS: We developed 23 case studies from personal interviews after selecting from an initial participant survey pool of 99 Latino forest workers in southern Oregon who had been injured at work in the previous 2 years. Workers were recruited through snowball sampling and door-to-door canvassing. Questions spanned work conditions, tasks, employer safety practices, injury experience, medical treatment, and workers' compensation benefits. RESULTS: Workers reported broken bones, chainsaw lacerations, back pain, heat and pesticide illnesses, and other occupational injuries. One-third of the cases fell into a Systems Functional category in which they reported their injuries to their supervisors and received medical treatment and workers' compensation benefits. The remaining two-thirds experienced System Failures with difficulties in receiving medical treatment and/or workers' compensation benefits, employer direction to not report, being fired, or seeking alternative home remedies. CONCLUSION: Workers employed by companies with more indicators of safety climate were more likely to obtain adequate treatment for their injuries and fully recover. Workers for whom interpretation at medical exams was provided by someone unaffiliated with their employers also reported better treatment and recovery outcomes.

Seroprevalence of Borrelia burgdorferi in forest workers from inspectorates with different forest types in Lower Silesia, SW Poland: preliminary study.

To estimate the Lyme borreliosis (LB) risk for forest workers, totally 646 blood samples were tested for IgG and IgM anti-Borrelia burgdorferi s.l. (anti-B.b.) antibody occurrence using ELISA tests confirmed with western blot. To clarify the varied LB risk, additionally, the data from the Forest Data Bank determining the detailed forest habitat type in particular forest inspectorates were used. The occurrence of the anti-B.b. antibody was confirmed in 22% (8.7% IgM, 17.8% IgG) of forest workers. Analysis of the influence of the habitat type (forest types) indicated the significant positive impact of the occurrence of the deciduous and mixed-deciduous forests on the seroprevalence of anti-B.b. IgG level among forestry workers. However, the share of forest type cannot be the only factor taken into account when assessing risk.

Sustainable Forest Operations (SFO): A new paradigm in a changing world and climate.

The effective implementation of sustainable forest management depends largely on carrying out forest operations in a sustainable manner. Climate change, as well as the increasing demand for forest products, requires a re-thinking of forest operations in terms of sustainability. In this context, it is important to understand the major driving factors for the future development of forest operations that promote economic, environmental and social well-being. The main objective of this paper is to identify important issues concerning forest operations and to propose a new paradigm towards sustainability in a changing climate, work and environmental conditions. Previously developed concepts of forest operations are reviewed, and a newly developed concept - Sustainable Forest Operations (SFO), is presented. Five key performance areas to ensure the sustainability of forest operations include: (i) environment; (ii) ergonomics; (iii) economics; (iv) quality optimization of products and production; and (v) people and society. Practical field examples are presented to demonstrate how these five interconnected principles are relevant to achieving sustainability, namely profit and wood quality maximization, ecological benefits, climate change mitigation, carbon sequestration, and forest workers' health and safety. The new concept of SFO provides integrated perspectives and approaches to effectively address ongoing and foreseeable challenges the global forest communities face, while balancing forest operations performance across economic, environmental and social sustainability. In this new concept, we emphasize the role of wood as a renewable and environmentally friendly material, and forest workers' safety and utilization efficiency and waste management as additional key elements of sustainability.

Improving access to health care amongst vulnerable populations: a qualitative study of village malaria workers in Kampot, Cambodia.

BACKGROUND: There is growing interest in the expansion of community health workers programmes in low- and middle-income countries as a cost-effective approach to address shortages of health professionals. However, our understanding of the reception of large-scale programmes and how to improve them remains limited, with knowledge gaps about factors that may promote or discourage equitable access to services. This paper examines the case of the Village Malaria Workers (VMW) programme in Cambodia, an extensive community-based intervention for the management of malaria cases in remote rural areas. METHOD: Fieldwork was conducted in Kampot province, in six case villages characterised by different programme configuration, population size, and distance to the nearest public health facility. In these locations, in-depth interviews (n = 71) with VMWs, village authorities, and residents were conducted to identify facilitators and challenges to service utilisation. Data analysis was informed by a conceptual framework based on five domains of access to services: awareness, accessibility, accommodation, availability, and acceptability. RESULTS: Factors that influenced the utilisation of VMW services in our research sites include: the nature of dissemination activities and their ability to reach different population groups; the village topography and the changing road infrastructure; the involvement of VMWs in other community roles and activities; perceptions about the type of disease after the onset of symptoms; the need for comprehensive diagnosis and care; perceptions about the status of VMWs as medical providers; length of VMW appointment. CONCLUSIONS: This study highlights the complexity and diversity of contextual factors that may influence the uptake of a community health programme. As in other countries, continued use of lay health workers in Cambodia to deliver diagnostic and curative services has the potential for great health and economic impact. However, further consideration should be given to the problem of access in different categories of residents and different contexts of implementation. In addition, a comprehensive mapping of changes in disease epidemiology, road infrastructure and the geography of access to services is crucial to inform policy development in this area.

The Hitchhiking Parasite: Why Human Movement Matters to Malaria Transmission and What We Can Do About It.

The failure of the Global Malaria Eradication Program (GMEP) during the 1960s highlighted the relevance of human movement to both re-introducing parasites in elimination settings and spreading drug-resistant parasites widely. Today, given the sophisticated surveillance of human movement patterns and key traveler groups, it is hoped that interventions can be implemented to protect and treat travelers, prevent onward transmission in low transmission settings, and eliminate sources of transmission, including sources of drug-resistant parasites.

Working in the Shadows: Safety and Health in Forestry Services in Southern Oregon.

We conducted a small participatory survey to document occupational injuries and illnesses, medical treatment, wage issues, and general working conditions among 150 forest workers in southern Oregon who are mostly Spanish-speaking immigrants from Latin America. We used snowball sampling in administering the survey. Survey results showed a high rate of job-related injury among the workers who responded to our survey. Results also suggested that many forestry services contractors licensed in Jackson and Josephine counties may not always follow labor laws. The vast majority of workers surveyed reported being fearful of retaliation for reporting injuries. There were no differences in reported working conditions and wage issues between workers with H-2B visas and other workers in the sample. This finding suggests that current US labor and health and safety laws are not effectively protecting Oregon's forest workers, owing to forest workers' structural vulnerability-their low positioning in social structures supported by immigration and economic status-compounded by fear of retaliation. Immigration policies and enforcement practices that contribute to creating a labor system with these inherent vulnerabilities and power imbalances need to be further examined and changed.

Evaluation of a pilot promotora program for Latino forest workers in southern Oregon.

BACKGROUND: Forest work, an occupation with some of the highest injury and illness rates, is conducted primarily by Latino immigrant workers. This study evaluates a pilot program where promotoras (lay community health educators) provided occupational health and safety trainings for Latino forest workers. METHODS: Evaluation methods included a focus group, post-tests, and qualitative feedback. RESULTS: Community capacity to address working conditions increased through (i) increased leadership and community access to information and resources; and (ii) increased worker awareness of workplace health and safety rights and resources. Fear of retaliation remains a barrier to workers taking action; nevertheless, the promotoras supported several workers in addressing-specific workplace issues. CONCLUSIONS: For working conditions to significantly improve, major structural influences need to be addressed. A long-term, organizationally supported promotora program can play a key role in linking and supporting change at the individual, interpersonal and community levels, contributing to and supporting structural change.

Nutrient intakes of Greek forest workers and researchers do not meet all Reference Dietary Intakes.

In heavy work such as forest work, nutrient demand and energy expenditure are high. Therefore, adequate nutrient and energy intake of forest workers is of paramount importance. The objective of this cross-sectional study was to investigate the daily nutrient intake of forest workers and to determine if it meets the Reference Dietary Intakes (RDIs). A total of 21 forest workers and 21 researchers, who served as a control group, were enrolled. Nutrient intake was assessed on the basis of a 24-hour diet recall questionnaire, repeated for 3 consecutive weekdays. Daily nutrient intake was calculated using the NutriBase IV Clinical Edition Software package. Energy, protein, total lipids, saturated fatty acids, cholesterol, phosphorus, and sodium intake of forest workers was higher than the RDIs and significantly higher (P < .05) than that of researchers. Most forest workers (90.47%) and researchers (95.32%) consumed less carbohydrate than the RDIs. Dietary fiber, riboflavin, vitamin E, vitamin D, and minerals intake was less than the RDI in both groups. Especially low was the daily intake of vitamin D and iodine in forest workers in comparison to RDIs and researchers. The results indicate that fundamental changes in daily nutrient intake for both groups are recommended.