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Article ; Online: Applying the photovoice method with adolescents in mining areas in rural Mozambique: critical reflections and lessons learned.

Cambaco, Olga / Cossa, Hermínio / Farnham, Andrea / Macete, Eusébio / Winkler, Mirko S / Gross, Karin / Munguambe, Khátia

Global health action

2024 Volume 17, Issue 1, Page(s) 2305506

Abstract: There is a recognised need for innovative methods to elicit the perspective of adolescents on public health issues, particularly when addressing sensitive topics such as the impact of mining projects on their health. Participatory approaches such as " ... ...

Abstract	There is a recognised need for innovative methods to elicit the perspective of adolescents on public health issues, particularly when addressing sensitive topics such as the impact of mining projects on their health. Participatory approaches such as "photovoice" allow for deep engagement of vulnerable and marginalised populations, including adolescents. However, few existing studies have used the photovoice method to reflect on issues related to the environment and its impact on public health. To date, no studies have been found that have used photovoice to gain insight into adolescents' perspectives in mining areas. In this paper, we discuss the application of the photovoice method to understand adolescents' perceptions about the impact of mining on their health and well-being in rural areas in Mozambique. The study was conducted in northern and central Mozambique. Photovoice was successfully integrated into eight focus group discussions with adolescent girls and boys aged 15 to 17 years. Several lessons for guiding future research were learned. First, it provided an understanding of the perceived impacts of mining on their health and well-being. Second, photovoice promoted active engagement and interest in the study by the adolescents. Finally, compared to its ability to capture perceptions of physical and environmental aspects affecting adolescents' well-being, the method was less straightforward in revealing their concerns regarding social, relational and community aspects that are less tangible. Programs can make use of photovoice to address health issues without setting adolescents' views and priorities aside, allowing them to influence health decisions on issues that are meaningful to them. Future studies should explore strategies to minimise the role of the power dynamics that affect the engagement and contribution of adolescents in advocating for necessary and meaningful changes. Additionally, it is important to investigate how health programs and policies can help to reduce the impact of existing inequalities.
MeSH term(s)	Male ; Female ; Humans ; Adolescent ; Mozambique ; Focus Groups ; Health Promotion ; Public Health ; Rural Population
Language	English
Publishing date	2024-02-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2540569-X
ISSN	1654-9880 ; 1654-9880
ISSN (online)	1654-9880
ISSN	1654-9880
DOI	10.1080/16549716.2024.2305506
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Article ; Online: A roadmap for using DHIS2 data to track progress in key health indicators in the Global South: experience from sub-saharan Africa.

Farnham, Andrea / Loss, Georg / Lyatuu, Isaac / Cossa, Herminio / Kulinkina, Alexandra V / Winkler, Mirko S

BMC public health

2023 Volume 23, Issue 1, Page(s) 1030

Abstract: High quality health data as collected by health management information systems (HMIS) is an important building block of national health systems. District Health Information System 2 (DHIS2) software is an innovation in data management and monitoring for ... ...

Abstract	High quality health data as collected by health management information systems (HMIS) is an important building block of national health systems. District Health Information System 2 (DHIS2) software is an innovation in data management and monitoring for strengthening HMIS that has been widely implemented in low and middle-income countries in the last decade. However, analysts and decision-makers still face significant challenges in fully utilizing the capabilities of DHIS2 data to pursue national and international health agendas. We aimed to (i) identify the most relevant health indicators captured by DHIS2 for tracking progress towards the Sustainable Development goals in sub-Saharan African countries and (ii) present a clear roadmap for improving DHIS2 data quality and consistency, with a special focus on immediately actionable solutions. We identified that key indicators in child and maternal health (e.g. vaccine coverage, maternal deaths) are currently being tracked in the DHIS2 of most countries, while other indicators (e.g. HIV/AIDS) would benefit from streamlining the number of indicators collected and standardizing case definitions. Common data issues included unreliable denominators for calculation of incidence, differences in reporting among health facilities, and programmatic differences in data quality. We proposed solutions for many common data pitfalls at the analysis level, including standardized data cleaning pipelines, k-means clustering to identify high performing health facilities in terms of data quality, and imputation methods. While we focus on immediately actionable solutions for DHIS2 analysts, improvements at the point of data collection are the most rigorous. By investing in improving data quality and monitoring, countries can leverage the current global attention on health data to strengthen HMIS and progress towards national and international health priorities.
MeSH term(s)	Child ; Humans ; Health Information Systems ; Data Collection/methods ; Data Accuracy ; Health Facilities ; Africa South of the Sahara/epidemiology
Language	English
Publishing date	2023-05-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15979-z
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Article ; Online: How do disease control measures impact spatial predictions of schistosomiasis and hookworm? The example of predicting school-based prevalence before and after preventive chemotherapy in Ghana.

Kulinkina, Alexandra V / Farnham, Andrea / Biritwum, Nana-Kwadwo / Utzinger, Jürg / Walz, Yvonne

PLoS neglected tropical diseases

2023 Volume 17, Issue 6, Page(s) e0011424

Abstract: Background: Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and ... ...

Abstract	Background: Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and hence, geospatial predictive modeling based on remotely sensed (RS) environmental data is widely used to characterize disease transmission and treatment needs. However, as large-scale preventive chemotherapy has become a widespread practice, resulting in reduced prevalence and intensity of infection, the validity and relevance of these models should be re-assessed. Methodology: We employed two nationally representative school-based prevalence surveys of Schistosoma haematobium and hookworm infections from Ghana conducted before (2008) and after (2015) the introduction of large-scale preventive chemotherapy. We derived environmental variables from fine-resolution RS data (Landsat 8) and examined a variable distance radius (1-5 km) for aggregating these variables around point-prevalence locations in a non-parametric random forest modeling approach. We used partial dependence and individual conditional expectation plots to improve interpretability of results. Principal findings: The average school-level S. haematobium prevalence decreased from 23.8% to 3.6% and that of hookworm from 8.6% to 3.1% between 2008 and 2015. However, hotspots of high-prevalence locations persisted for both infections. The models with environmental data extracted from a buffer radius of 2-3 km around the school location where prevalence was measured had the best performance. Model performance (according to the R2 value) was already low and declined further from approximately 0.4 in 2008 to 0.1 in 2015 for S. haematobium and from approximately 0.3 to 0.2 for hookworm. According to the 2008 models, land surface temperature (LST), modified normalized difference water index, elevation, slope, and streams variables were associated with S. haematobium prevalence. LST, slope, and improved water coverage were associated with hookworm prevalence. Associations with the environment in 2015 could not be evaluated due to low model performance. Conclusions/significance: Our study showed that in the era of preventive chemotherapy, associations between S. haematobium and hookworm infections and the environment weakened, and thus predictive power of environmental models declined. In light of these observations, it is timely to develop new cost-effective passive surveillance methods for NTDs as an alternative to costly surveys, and to focus on persisting hotspots of infection with additional interventions to reduce reinfection. We further question the broad application of RS-based modeling for environmental diseases for which large-scale pharmaceutical interventions are in place.
MeSH term(s)	Animals ; Ancylostomatoidea ; Prevalence ; Ghana/epidemiology ; Schistosomiasis/epidemiology ; Schistosomiasis/prevention & control ; Hookworm Infections/epidemiology ; Hookworm Infections/prevention & control ; Feces ; Water
Chemical Substances	Water (059QF0KO0R)
Language	English
Publishing date	2023-06-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0011424
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Article ; Online: Low prevalence of asymptomatic mpox in populations at high risk.

Hampel, Benjamin / Farnham, Andrea / Lamothe-Molina, Paul J / Capelli, Céline / Schibler, Manuel / Ustero Alonso, Pilar / Calmy, Alexandra / Fehr, Jan S

The Lancet. Microbe

2023 Volume 4, Issue 11, Page(s) e856

MeSH term(s)	Humans ; Prevalence ; Mpox (monkeypox)
Language	English
Publishing date	2023-08-16
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't
ISSN	2666-5247
ISSN (online)	2666-5247
DOI	10.1016/S2666-5247(23)00248-3
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Article ; Online: The COVID-19 pandemic offers a key moment to reflect on travel medicine practice.

Hatz, Christoph / Bühler, Silja / Farnham, Andrea

Journal of travel medicine

2020 Volume 27, Issue 8

MeSH term(s)	COVID-19/epidemiology ; COVID-19/prevention & control ; Forecasting ; Humans ; Interdisciplinary Communication ; Noncommunicable Diseases/epidemiology ; Noncommunicable Diseases/prevention & control ; Preventive Health Services/methods ; Preventive Health Services/organization & administration ; Preventive Health Services/trends ; Risk Adjustment/methods ; SARS-CoV-2 ; Travel Medicine/methods ; Travel Medicine/organization & administration ; Travel Medicine/trends ; Travel-Related Illness
Keywords	covid19
Language	English
Publishing date	2020-09-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1212504-0
ISSN	1708-8305 ; 1195-1982
ISSN (online)	1708-8305
ISSN	1195-1982
DOI	10.1093/jtm/taaa149
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Article ; Online: Association of Livestock Ownership and Household Dietary Quality: Results from a Cross-Sectional Survey from Rural India.

Pradyumna, Adithya / Winkler, Mirko S / Utzinger, Jürg / Farnham, Andrea

International journal of environmental research and public health

2021 Volume 18, Issue 11

Abstract: Studies from India and several eastern African countries found that the impact of dairy animal ownership on household nutrition varied greatly, depending on the socio-geographic context. The purpose of this study was to examine the association between ... ...

Abstract	Studies from India and several eastern African countries found that the impact of dairy animal ownership on household nutrition varied greatly, depending on the socio-geographic context. The purpose of this study was to examine the association between livestock ownership and household dietary quality in rural Kolar district, India. We collected data from a household survey in four study villages (
MeSH term(s)	Africa ; Animals ; Cross-Sectional Studies ; Female ; Humans ; India ; Livestock ; Ownership ; Rural Population
Language	English
Publishing date	2021-06-04
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18116060
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Article: Health of Farming Communities Prior to Modification of the Occupational Environment through a Watershed Development Project in Kolar, India.

Pradyumna, Adithya / Farnham, Andrea / Utzinger, Jürg / Winkler, Mirko S

Indian journal of occupational and environmental medicine

2021 Volume 25, Issue 2, Page(s) 84–90

Abstract: Background: Watershed development (WSD) projects, aimed primarily at enhancing soil and water conservation and supporting livelihoods in semi-arid areas, have the potential to impact health by modifying the occupational and household environments in ... ...

Abstract	Background: Watershed development (WSD) projects, aimed primarily at enhancing soil and water conservation and supporting livelihoods in semi-arid areas, have the potential to impact health by modifying the occupational and household environments in agrarian communities. To identify and address potential health concerns arising from a planned WSD project in Kolar district, India, a health impact assessment (HIA) was conducted. This necessitated understanding the health status and concerns in the project villages. Objective: To characterize the health of farmers and their household members in close proximity of the planned WSD project. Methods: We carried out a cross-sectional survey between April and July 2019. The study comprised: (i) a household survey covering the four project villages and two comparison villages (e.g. socio-demographic characteristics, occurrence of vector-borne diseases (VBDs), access to safe water, sanitation and hygiene, and utilization of healthcare); and (ii) an anthropometric survey for children under the age of 5 years in the four project villages and four comparison villages. Results: Respondents (n = 333) reported household-level occurrences of VBDs (chikungunya, 3.3%; and dengue, 1.5%), consuming unsafe water (54.5%) and frequent pesticide application in fields (26.7%). The prevalence of child underweight was 23.8%. Conclusions: VBDs, poor water quality and child undernutrition were found to be important local health concerns, amenable for preventive and promotive measures through the planned WSD project. Occupational environments in agricultural settings affect the workers and their households, and comprehensive projects such as WSD can seize the opportunity for improving health of farming and other rural households.
Language	English
Publishing date	2021-07-09
Publishing country	India
Document type	Journal Article
ZDB-ID	1456082-3
ISSN	1998-3670 ; 0973-2284 ; 0019-5278
ISSN (online)	1998-3670
ISSN	0973-2284 ; 0019-5278
DOI	10.4103/ijoem.IJOEM_270_20
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Article ; Online: A roadmap for using DHIS2 data to track progress in key health indicators in the Global South

Andrea Farnham / Georg Loss / Isaac Lyatuu / Herminio Cossa / Alexandra V. Kulinkina / Mirko S. Winkler

BMC Public Health, Vol 23, Iss 1, Pp 1-

experience from sub-saharan Africa

2023 Volume 8

Abstract: Abstract High quality health data as collected by health management information systems (HMIS) is an important building block of national health systems. District Health Information System 2 (DHIS2) software is an innovation in data management and ... ...

Abstract	Abstract High quality health data as collected by health management information systems (HMIS) is an important building block of national health systems. District Health Information System 2 (DHIS2) software is an innovation in data management and monitoring for strengthening HMIS that has been widely implemented in low and middle-income countries in the last decade. However, analysts and decision-makers still face significant challenges in fully utilizing the capabilities of DHIS2 data to pursue national and international health agendas. We aimed to (i) identify the most relevant health indicators captured by DHIS2 for tracking progress towards the Sustainable Development goals in sub-Saharan African countries and (ii) present a clear roadmap for improving DHIS2 data quality and consistency, with a special focus on immediately actionable solutions. We identified that key indicators in child and maternal health (e.g. vaccine coverage, maternal deaths) are currently being tracked in the DHIS2 of most countries, while other indicators (e.g. HIV/AIDS) would benefit from streamlining the number of indicators collected and standardizing case definitions. Common data issues included unreliable denominators for calculation of incidence, differences in reporting among health facilities, and programmatic differences in data quality. We proposed solutions for many common data pitfalls at the analysis level, including standardized data cleaning pipelines, k-means clustering to identify high performing health facilities in terms of data quality, and imputation methods. While we focus on immediately actionable solutions for DHIS2 analysts, improvements at the point of data collection are the most rigorous. By investing in improving data quality and monitoring, countries can leverage the current global attention on health data to strengthen HMIS and progress towards national and international health priorities.
Keywords	DHIS2 ; Routine health management information system ; Health systems ; Public aspects of medicine ; RA1-1270
Subject code	306
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: How do disease control measures impact spatial predictions of schistosomiasis and hookworm? The example of predicting school-based prevalence before and after preventive chemotherapy in Ghana.

Alexandra V Kulinkina / Andrea Farnham / Nana-Kwadwo Biritwum / Jürg Utzinger / Yvonne Walz

PLoS Neglected Tropical Diseases, Vol 17, Iss 6, p e

2023 Volume 0011424

Abstract: Background Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and ... ...

Abstract	Background Schistosomiasis and soil-transmitted helminth infections are among the neglected tropical diseases (NTDs) affecting primarily marginalized communities in low- and middle-income countries. Surveillance data for NTDs are typically sparse, and hence, geospatial predictive modeling based on remotely sensed (RS) environmental data is widely used to characterize disease transmission and treatment needs. However, as large-scale preventive chemotherapy has become a widespread practice, resulting in reduced prevalence and intensity of infection, the validity and relevance of these models should be re-assessed. Methodology We employed two nationally representative school-based prevalence surveys of Schistosoma haematobium and hookworm infections from Ghana conducted before (2008) and after (2015) the introduction of large-scale preventive chemotherapy. We derived environmental variables from fine-resolution RS data (Landsat 8) and examined a variable distance radius (1-5 km) for aggregating these variables around point-prevalence locations in a non-parametric random forest modeling approach. We used partial dependence and individual conditional expectation plots to improve interpretability of results. Principal findings The average school-level S. haematobium prevalence decreased from 23.8% to 3.6% and that of hookworm from 8.6% to 3.1% between 2008 and 2015. However, hotspots of high-prevalence locations persisted for both infections. The models with environmental data extracted from a buffer radius of 2-3 km around the school location where prevalence was measured had the best performance. Model performance (according to the R2 value) was already low and declined further from approximately 0.4 in 2008 to 0.1 in 2015 for S. haematobium and from approximately 0.3 to 0.2 for hookworm. According to the 2008 models, land surface temperature (LST), modified normalized difference water index, elevation, slope, and streams variables were associated with S. haematobium prevalence. LST, slope, and improved water ...
Keywords	Arctic medicine. Tropical medicine ; RC955-962 ; Public aspects of medicine ; RA1-1270
Subject code	333
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Industrial mining and HIV risk: evidence from 39 mine openings across 16 countries in sub-Saharan Africa.

Dietler, Dominik / Farnham, Andrea / Lyatuu, Isaac / Fink, Günther / Winkler, Mirko S

AIDS (London, England)

2022 Volume 36, Issue 11, Page(s) 1573–1581

Abstract: Objectives: The aim of this study was to assess the impact of natural resource extraction projects on HIV transmission risks in local communities in sub-Saharan Africa.: Design: Difference-in-differences design using repeated cross-sectional data ... ...

Abstract	Objectives: The aim of this study was to assess the impact of natural resource extraction projects on HIV transmission risks in local communities in sub-Saharan Africa. Design: Difference-in-differences design using repeated cross-sectional data from around newly opened mines. Methods: We combined data on mine openings with HIV data from the Demographic and Health Surveys (DHS). Using logistic regression models, we compared HIV-related indicators between mining (i.e. up to 10 km distance from the mine) and comparison (i.e. 10-50 km) areas before and after mine opening to identify their impact on HIV prevalence, sexual behavior and HIV knowledge. Results: A total of 33 086 individuals across 39 mine openings were analyzed. Adjusting for baseline differences and temporal trends in the study regions, mine opening increased the odds of HIV infection almost two-fold [odds ratio (OR): 1.93, 95% confidence interval (CI): 1.19-3.14]. Strongest effects were seen in high-prevalence countries and in the 20-29 years age group. In mining communities around operational mines, there was a tendency towards lower HIV knowledge (OR: 0.81, 95% CI: 0.63-1.04). New mine openings increased the odds of risky sexual behaviors, such as having multiple sex partners (OR: 1.61, 95% CI: 1.02-2.55), high-risk sexual partners (OR: 1.45, 95% CI: 1.03-2.05) and unprotected sex with high-risk partners (OR: 1.77, 95% CI: 1.18-2.67). Conclusion: The findings suggest that in our sample of households surrounding industrial mines, HIV infection risks substantially increase upon mine opening. Existing strategies for addressing mining-related risks for HIV transmission seem to be insufficient. Further efforts for mitigating and monitoring impacts of mines are needed.
MeSH term(s)	Africa South of the Sahara/epidemiology ; Cross-Sectional Studies ; HIV Infections/epidemiology ; Humans ; Sexual Behavior ; Sexual Partners
Language	English
Publishing date	2022-07-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003294
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