Malaria Vaccine Introduction in Cameroon: Early Results 30 Days into Rollout.

Cameroon introduced the malaria vaccine in its routine immunization program on 22 January 2024 in the 42 districts out of 200 that are among the most at risk of malaria. A cross-sectional analysis of the data on key vaccine events in the introduction roadmap and the vaccine uptake during the first 30 days was conducted. In addition to available gray literature related to the introduction of the malaria vaccine, data on the malaria vaccine uptake by vaccination session, collected through a digital platform, were analyzed. A total of 1893 reports were received from 22 January 2024 to 21 February 2024 from 766 health facilities (84% of overall completeness). Two regions out of ten recorded less than 80% completeness. As of 21 February 2024, 13,811 children had received the first dose of the malaria vaccine, including 7124 girls (51.6%) and 6687 boys (48.4%). In total, 36% of the children were vaccinated through outreach sessions, while 61.5% were vaccinated through sessions in fixed posts. The overall monthly immunization coverage with the first dose was 37%. Early results have shown positive attitudes towards and acceptance of malaria vaccines. Suboptimal completeness of data reporting and a low coverage highlight persistent gaps and challenges in the vaccine rollout.

Strengthening the WHO Regional Office for Africa (WHO AFRO) COVID-19 vaccination information system.

This manuscript describes the process and impact of strengthening the WHO Regional Office for Africa (WHO AFRO)'s COVID-19 vaccination information system. This system plays a critical role in tracking vaccination coverage, guiding resource allocation and supporting vaccination campaign roll-out for countries in the African region. Recognising existing data management issues, including complex reporting prone to human error, compromised data quality and underutilisation of collected data, WHO AFRO introduced significant system improvements during the COVID-19 pandemic. These improvements include shifting from an Excel-based to an online Azure-based data collection system, automating data processing and validation, and expansion of collected data. These changes have led to improvements in data quality and quantity including a decrease in data non-validity, missingness, and record duplication, and expansion of data collection forms to include a greater number of data fields, offering a more comprehensive understanding of vaccination efforts. Finally, the creation of accessible information products-including an interactive public dashboard, a weekly data pack and a public monthly bulletin-has improved data use and reach to relevant partners. These resources provide crucial insights into the region's vaccination progress at national and subnational levels, thereby enabling data-driven decision-making to improve programme performance. Overall, the strengthening of the WHO AFRO COVID-19 vaccination information system can serve as a model for similar efforts in other WHO regions and contexts. The impact of system strengthening on data quality demonstrated here underscores the vital role of robust data collection, capacity building and management systems in achieving high-quality data on vaccine distribution and coverage. Continued investment in information systems is essential for effective and equitable public health efforts.

Studying neural responses for multi-component economic choices in human and non-human primates using concept-based behavioral choice experiments.

Realistic, everyday rewards contain multiple components, such as taste and size. However, our reward valuations and the associated neural reward signals are single dimensional (vector to scalar transformation). Here, we present a protocol to identify these single-dimensional neural responses for multi-component choice options in humans and monkeys using concept-based behavioral choice experiments. We describe the use of stringent economic concepts to develop and implement behavioral tasks. We detail regional neuroimaging in humans and fine-grained neurophysiology in monkeys and describe approaches for data analysis. For complete details on the use and execution of this protocol, please refer to our work on humans Seak et al.1 and Pastor-Bernier et al.2 and monkeys Pastor-Bernier et al. 3, Pastor-Bernier et al.4, and Pastor-Bernier et al.5.

Single-Dimensional Human Brain Signals for Two-Dimensional Economic Choice Options.

Rewarding choice options typically contain multiple components, but neural signals in single brain voxels are scalar and primarily vary up or down. In a previous study, we had designed reward bundles that contained the same two milkshakes with independently set amounts; we had used psychophysics and rigorous economic concepts to estimate two-dimensional choice indifference curves (ICs) that represented revealed stochastic preferences for these bundles in a systematic, integrated manner. All bundles on the same ICs were equally revealed preferred (and thus had same utility, as inferred from choice indifference); bundles on higher ICs (higher utility) were preferred to bundles on lower ICs (lower utility). In the current study, we used the established behavior for testing with functional magnetic resonance imaging (fMRI). We now demonstrate neural responses in reward-related brain structures of human female and male participants, including striatum, midbrain, and medial orbitofrontal cortex (mid-OFC) that followed the characteristic pattern of ICs: similar responses along ICs (same utility despite different bundle composition), but monotonic change across ICs (different utility). Thus, these brain structures integrated multiple reward components into a scalar signal, well beyond the known subjective value coding of single-component rewards.SIGNIFICANCE STATEMENT Rewards have several components, like the taste and size of an apple, but it is unclear how each component contributes to the overall value of the reward. While choice indifference curves (ICs) of economic theory provide behavioral approaches to this question, it is unclear whether brain responses capture the preference and utility integrated from multiple components. We report activations in striatum, midbrain, and orbitofrontal cortex (OFC) that follow choice ICs representing behavioral preferences over and above variations of individual reward components. In addition, the concept-driven approach encourages future studies on natural, multicomponent rewards that are prone to irrational choice of normal and brain-damaged individuals.

Experimentally revealed stochastic preferences for multicomponent choice options.

Realistic, everyday rewards contain multiple components. An apple has taste and size. However, we choose in single dimensions, simply preferring some apples to others. How can such single-dimensional preference relationships refer to multicomponent choice options? Here, we measured how stochastic choices revealed preferences for 2-component milkshakes. The preferences were intuitively graphed as indifference curves that represented the orderly integration of the 2 components as trade-off: parts of 1 component were given up for obtaining 1 additional unit of the other component without a change in preference. The well-ordered, nonoverlapping curves satisfied leave-one-out tests, followed predictions by machine learning decoders and correlated with single-dimensional Becker-DeGroot-Marschak (BDM) auction-like bids for the 2-component rewards. This accuracy suggests a decision process that integrates multiple reward components into single-dimensional estimates in a systematic fashion. In interspecies comparisons, human performance matched that of highly experienced laboratory monkeys, as measured by accuracy of the critical trade-off between bundle components. These data describe the nature of choices of multicomponent choice options and attest to the validity of the rigorous economic concepts and their convenient graphic schemes for explaining choices of human and nonhuman primates. The results encourage formal behavioral and neural investigations of normal, irrational, and pathological economic choices. (PsycInfo Database Record (c) 2020 APA, all rights reserved).