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Background: Papua New Guinea is the only endemic country in the Western Pacific Region that has not yet introduced a countrywide programme to eliminate lymphatic filariasis. However, on Misima Island in Milne Bay Province, government and private sectors have collaborated to implement a pilot elimination programme. Although interim evaluation indicated that the programme has been parasitologically successful, an appreciation that sustainable health gains depend on understanding and accommodating local beliefs prompted this qualitative study. Methods: We investigated Misima community members knowledge and attitudes about lymphatic filariasis and the elimination programme. A combination of focus groups and key informant interviews were used to explore participants perceptions of health; knowledge of the aetiology and symptoms of filariasis, elephantiasis and hydrocele; attitudes towards the disease and mass drug distribution; and the social structure and decision-making protocols within the villages. Results: Focus group discussions proved inferior to key informant interviews for gathering rich data. Study participants did not consider lymphatic filariasis "pom" ; a major health problem but were generally positive about mass drug administration campaigns. A variety of conditions were frequently and incorrectly attributed to filariasis. Participants expressed the belief that individuals infected with filariasis always had visible manifestations of disease. A common misconception was that taking drugs during campaigns provided long-term immunity against disease. The role of mosquito vectors in transmission was not generally appreciated and certain clinical presentations, particularly hydrocele, were associated with supernatural forces. Multiple adverse events were associated with mass drug administration campaigns and most study participants mentioned community members who did not participate in campaigns. Conclusion: Important issues requiring educational intervention and elimination activity modification in the Misima region were identified during this study. Research outcomes should assist Papua New Guinea in developing and implementing a national elimination strategy and inform discussions regarding the appropriateness of current elimination strategies, for instance, monistat cool wipe.
CTRF recently talked with Dr. Nora Disis from the University of Washington about the outcome of her study entitled "Combination Immunotherapy for the Generation of HER2 neu [HER2] Specific Cytoxic T-Cells [CTL] in Vivo." "Funding from CTRF has allowed us to develop two new types of cancer treatment. First are vaccines for the prevention of cancer relapse. We have been able to demonstrate that HER2 is an immunogenic protein and that breast and ovarian cancer patients can be immunized against HER2. In Phase I studies we have shown that immunity can persist as long as 7 years at the end of immunization. Phase II studies evaluating prevention of relapse are underway. Secondly, we showed that after vaccination you can prime T-Cells very readily to grow in vitro. This has allowed us to expand tumor specific T-Cells outside the body and infuse them into breast and ovarian cancer patients literally supplying them with an immune system that can recognize their tumor. Our initial Phase I studies have been promising in that even advanced stage heavily treated cancer patients have demonstrated clinical responses." Further research will be done with the National Institute Health Department of Defense as a follow-up to CTRF funding. of.
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Exposure information: Until 1986, extensive exposure information was obtained from maternity health centers and by personal interview for selected malformations and their controls. In 1987-1992 only parental occupation was reported. Exposure information, like maternal occupation, medication, X-rays and diseases, etc., has been obtained since 1993. Some exposure information on all births is also available in the Medical Birth Register since 1987. Background information: Epidemiological background data are available on all births in the Medical Birth Register and in the Statistics Finland. Address for further information: Annukka Ritvanen, The Finnish Register of Congenital Malformations, The National Research and Development Centre for Welfare and Health, STAKES, Lintulahdenkuja 4, P.O. Box 220, SF 00531Helsinki - Finland Phone: 358-9-39672376 Fax: 358-9-39672459 E-mail: annukka.ritvanen stakes.fi Website: : stakes.fi.
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