Hundreds of clinicians in the US conduct asylum evaluations, to document evidence of torture and persecution of people fleeing their home countries. Participating in these encounters puts clinicians at risk for vicarious trauma (VT). Little research addressed VT in physicians. Even less is known about VT among asylum evaluators. A survey was distributed to members of the asylum network of Physicians for Human Rights in Spring 2012. The majority (65%) of survey participants denied having experienced VT. However, being female, being a mental health professional and having performed a greater number of evaluations was associated with a higher likelihood of reporting VT. We present preliminary data about VT in asylum evaluators. Recruiters and trainers should make every effort to address the issue and educate their volunteers about means of identifying and managing symptoms. Formal and informal support services and resources should be developed and shared with volunteers.

Interactions in situations involving the disclosure of personal information require trust-based relationships. However, trust manifests in different ways, depending on the cultural and contextual environment. An in-depth understanding of how culture influences trust is therefore of considerable importance to managing situations that require the disclosure of sensitive health information, both from an academic and practical perspective. Drawing on the Model of National Culture and the Development of Trust, our study investigates culture as a determinant of trust in data-requesting organizations. We link the model's three cultural dimensions (relation to self, risk, and authority) with Hofstede's study cultural dimensions and the privacy calculus (Laufer and Wolfe's study). To test our hypotheses, we analyze survey data collected in Nigeria, in cooperation with a non-governmental organization working on data-driven healthcare solutions. Our results confirm an influence of culture on trust in data-requesting organizations which is, however, dependent on the cultural dimension. In addition, we show that perceived benefits increase trust significantly and provide a theoretical starting point for extending the Model of National Culture and the Development of Trust by the dimension relation to benefit.

Background Malaria is the top public health problem in the Republic of Guinea, with more than 4 million cases and 10,000 deaths in 2021 among a population of approximately 13 million. It is also the second highest cause of death there. The purpose of this quantitative survey in a rural area of Guinea was to understand knowledge, attitudes, and practices (KAP) about malaria and to assess water and sanitation practices among community members. Methods In 2016, the authors conducted a cross-sectional household survey in Timbi-Touni, Guinea using community workers. The survey included respondent demographic characteristics, malaria knowledge, child health, water and sanitation, and health services access. Malaria knowledge and sleeping under bed nets were the primary outcome variables and multiple logistic regression was used to determine odds ratios. Results Majority of the respondents were women (89.41%) and had never been to school (71.18%). Slightly more than half the children were reported to have ever had malaria and 45% reported to have ever had diarrhoea. There was no statistically significant association between gender or level of education and malaria knowledge. Eighty six percent of respondents had received a free bed net during national campaigns and 61% slept under a bed net the night before the survey. Knowing mosquitoes to be the cause of malaria and receiving free bed net were significantly associated with sleeping under a bed net. There was no statistically significant association between drinking water source and malaria or diarrhoea. Conclusions Both malaria and diarrhoea were considered to be serious illnesses for adults and children by nearly all respondents. Receiving free bed nets and having correct knowledge about malaria were the greatest predictors of sleeping under a bed net. Insights from this detailed KAP survey—such as focusing on radio to transmit malaria prevention information and reinforcing free malaria treatments—can guide policy makers and practitioners who design and implement malaria control and prevention measures in Guinea.

It is currently estimated that 67% of malaria deaths occur in children under-five years (WHO, 2020). To improve the identification of children at clinical risk for malaria, the WHO developed community (iCCM) and clinic-based (IMCI) protocols for frontline health workers using paper-based forms or digital mobile health (mHealth) platforms. To investigate improving the accuracy of these point-of-care clinical risk assessment protocols for malaria in febrile children, we embedded a malaria rapid diagnostic test (mRDT) workflow into THINKMD’s (IMCI) mHealth clinical risk assessment platform. This allowed us to perform a comparative analysis of THINKMD-generated malaria risk assessments with mRDT truth data to guide modification of THINKMD algorithms, as well as develop new supervised machine learning (ML) malaria risk algorithms. We utilized paired clinical data and malaria risk assessments acquired from over 555 children presenting to five health clinics in Kano, Nigeria to train ML algorithms to identify malaria cases using symptom and location data, as well as confirmatory mRDT results. Supervised ML random forest algorithms were generated using 80% of our field-based data as the ML training set and 20% to test our new ML logic. New ML-based malaria algorithms showed an increased sensitivity and specificity of 60 and 79%, and PPV and NPV of 76 and 65%, respectively over THINKD initial IMCI-based algorithms. These results demonstrate that combining mRDT “truth” data with digital mHealth platform clinical assessments and clinical data can improve identification of children with malaria/non-malaria attributable febrile illnesses.