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Malaria is a serious infectious disease that leads to massive casualties globally. Myanmar is a key battleground for the global fight against malaria because it is where the emergence of drug-resistant malaria parasites has been documented. Controlling the spread of malaria in Myanmar thus carries global significance, because the failure to do so would lead to devastating consequences in vast areas where malaria is prevalent in tropical/subtropical regions around the world. Thanks to its wide and consistent spatial coverage, remote sensing has become increasingly used in the public health domain. Specifically, remote sensing-based land cover/land use (LCLU) maps present a powerful tool that provides critical information on population distribution and on the potential human-vector interactions interfaces on a large spatial scale. Here, we present a 30-meter LCLU map that was created specifically for the malaria control and eradication efforts in Myanmar. This bottom-up approach can be modified and customized to other vector-borne infectious diseases in Myanmar or other Southeastern Asian countries.
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Despite progress toward malaria elimination in the Greater Mekong Subregion, challenges remain owing to the emergence of drug resistance and the persistence of focal transmission reservoirs. Malaria transmission foci in Myanmar are heterogeneous and complex, and many remaining infections are clinically silent, rendering them invisible to routine monitoring. The goal of this research is to define criteria for easy-to-implement methodologies, not reliant on routine monitoring, that can increase the efficiency of targeted malaria elimination strategies. Studies have shown relationships between malaria risk and land cover and land use (LCLU), which can be mapped using remote sensing methodologies. Here we aim to explain malaria risk as a function of LCLU for five rural villages in Myanmar's Rakhine State. Malaria prevalence and incidence data were analyzed through logistic regression with a land use survey of ~1,000 participants and a 30-m land cover map. Malaria prevalence per village ranged from 5% to 20% with the overwhelming majority of cases being subclinical. Villages with high forest cover were associated with increased risk of malaria, even for villagers who did not report visits to forests. Villagers living near croplands experienced decreased malaria risk unless they were directly engaged in farm work. Finally, land cover change (specifically, natural forest loss) appeared to be a substantial contributor to malaria risk in the region, although this was not confirmed through sensitivity analyses. Overall, this study demonstrates that remotely sensed data contextualized with field survey data can be used to inform critical targeting strategies in support of malaria elimination.
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By building relationships with referring physicians and educating them about the clinical trial process, oncologists can help increase trial accrual among patients with cancer.
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This article illustrates common patient and provider concerns about donating tissue for the purpose of research, discusses best practices, and provides answers to common patient questions.
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Informed consent is fundamental to the conduct of clinical trials. Prospective participants need to be adequately informed and given the opportunity to ask questions and consult with relatives or friends without feeling pressured or rushed.
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The AccrualNet Web site is a helpful compilation of resources for sites aspiring to improve trial accrual.
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Part two of this series focuses on the remaining three exemplary attributes: quality assurance, multidisciplinary involvement in the clinical trial process, and clinical trials awareness programs.
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When conducting a clinical trial, it is important that clinical investigators successfully meet all research expectations, including regulatory requirements and the Guidelines for Good Clinical Practice.
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Developing and maintaining an exemplary research team is essential to the success of a quality clinical research program.
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Establishing a clinical trial infrastructure is an important step when developing a successful research program. Two areas required for success include financial oversight and a qualified research team.
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In this two-part series, members of the Exemplary Attributes Working Group outline in detail the seven attributes of exemplary clinical trial sites, as described in the ASCO Statement.
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Translating research on genomic changes into novel interventions for patients with cancer requires increased analysis of biospecimens and biomarkers in cancer clinical trials, which involve certain procedural requirements.
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Developing successful contracts is imperative for research sites conducting company-sponsored or investigator-initiated clinical trials. Good contracts help ensure sustainability and guide how research will be conducted.
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As the need for patient participation in biospecimen and correlative research increases, challenging ethical and potentially legal questions are emerging.
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Increasing efficiency in the clinical trials development process ensures a vibrant clinical trials system that makes best use of resources, and keeps pace with scientific discoveries in the field of cancer research.
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Anecdotal information regarding clinical research sites limiting participation in NCI-funded cooperative group studies prompted ASCO to collect data on and investigate the reasons behind this trend.