Amit Jain

© 2015 Baum et al.; licensee BioMed Central. Background: Malaria is a public health problem in parts of Thailand, where Plasmodium falciparum and Plasmodium vivax are the main causes of infection. In the northwestern border province of Tak parasite prevalence is now estimated to be less than 1% by microscopy. Nonetheless, microscopy is insensitive at low-level parasitaemia. The objective of this study was to assess the current epidemiology of falciparum and vivax malaria in Tak using molecular methods to detect exposure to and infection with parasites; in particular, the prevalence of asymptomatic infections and infections with submicroscopic parasite levels. Methods: Three-hundred microlitres of whole blood from finger-prick were collected into capillary tubes from residents of a sentinel village and from patients at a malaria clinic. Pelleted cellular fractions were screened by quantitative PCR to determine parasite prevalence, while plasma was probed on a protein microarray displaying hundreds of P. falciparum and P. vivax proteins to obtain antibody response profiles in those individuals. Results: Of 219 samples from the village, qPCR detected 25 Plasmodium sp. infections, of which 92% were asymptomatic and 100% were submicroscopic. Of 61 samples from the clinic patients, 27 were positive by qPCR, of which 25.9% had submicroscopic parasite levels. Cryptic mixed infections, misdiagnosed as single-species infections by microscopy, were found in 7 malaria patients. All sample donors, parasitaemic and non-parasitaemic alike, had serological evidence of parasite exposure, with 100% seropositivity to at least 54 antigens. Antigens significantly associated with asymptomatic infections were P. falciparum MSP2, DnaJ protein, putative E1E2 ATPase, and three others. Conclusion: These findings suggest that parasite prevalence is higher than currently estimated by local authorities based on the standard light microscopy. As transmission levels drop in Thailand, it may be necessary to employ higher throughput and sensitivity methods for parasite detection in the phase of malaria elimination.

Purpose This research aims to study the coping experience of visually impaired bankers in India after they have received reasonable accommodation from their employers, that is, the work process or environment has been suitably modified to ensure a barrier-free environment for them. Design/methodology/approach Data were collected through semi-structured interviews with 12 VI bankers working with public sector banks in India. A phenomenological approach was adopted during data analysis. Findings Despite the provision of reasonable accommodations, VI employees often find it difficult to fulfill their job responsibilities. This is on account of extensive paperwork required for completion of their jobs and the partially accessible information systems available to them. As a result, these VI employees are found resorting to workarounds to carry out their jobs, with the nature of workarounds adopted varying with the type and extent of visual impairment. Furthermore, it is observed that VI employees require social support not only from their superiors and peers but also from their subordinates and customers to carry out their tasks. Research limitations/implications Data collection was done through snowball sampling which could have resulted in sampling bias. Due to confidentiality issues, observation of workarounds in practice by VI employees could not be carried out as part of the study. Originality/value The study contributes to the literature on integration of persons with disabilities by examining their coping experience after provision of reasonable accommodations. It emphasizes the role of workarounds, an under-studied area in PwD integration, as well as support of other stakeholders in the experience.