Person: Bonds, Matthew
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Bonds, Matthew
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Publication Madagascar can build stronger health systems to fight plague and prevent the next epidemic(Public Library of Science, 2018) Bonds, Matthew; Ouenzar, Mohammed A.; Garchitorena, Andres; Cordier, Laura F.; McCarty, Meg G.; Rich, Michael; Andriamihaja, Benjamin; Haruna, Justin; Farmer, PaulPublication Early changes in intervention coverage and mortality rates following the implementation of an integrated health system intervention in Madagascar(BMJ Publishing Group, 2018) Garchitorena, Andres; Miller, Ann; Cordier, Laura F; Rabeza, Victor R; Randriamanambintsoa, Marius; Razanadrakato, Hery-Tiana R; Hall, Lara; Gikic, Djordje; Haruna, Justin; McCarty, Meg; Randrianambinina, Andriamihaja; Thomson, Dana R; Atwood, Sidney; Rich, Michael; Murray, Megan; Ratsirarson, Josea; Ouenzar, Mohammed Ali; Bonds, MatthewIntroduction: The Sustainable Development Goals framed an unprecedented commitment to achieve global convergence in child and maternal mortality rates through 2030. To meet those targets, essential health services must be scaled via integration with strengthened health systems. This is especially urgent in Madagascar, the country with the lowest level of financing for health in the world. Here, we present an interim evaluation of the first 2 years of a district-level health system strengthening (HSS) initiative in rural Madagascar, using estimates of intervention coverage and mortality rates from a district-wide longitudinal cohort. Methods: We carried out a district representative household survey at baseline of the HSS intervention in over 1500 households in Ifanadiana district. The first follow-up was after the first 2 years of the initiative. For each survey, we estimated maternal, newborn and child health (MNCH) coverage, healthcare inequalities and child mortality rates both in the initial intervention catchment area and in the rest of the district. We evaluated changes between the two areas through difference-in-differences analyses. We estimated annual changes in health centre per capita utilisation from 2013 to 2016. Results: The intervention was associated with 19.1% and 36.4% decreases in under-five and neonatal mortality, respectively, although these were not statistically significant. The composite coverage index (a summary measure of MNCH coverage) increased by 30.1%, with a notable 63% increase in deliveries in health facilities. Improvements in coverage were substantially larger in the HSS catchment area and led to an overall reduction in healthcare inequalities. Health centre utilisation rates in the catchment tripled for most types of care during the study period. Conclusion: At the earliest stages of an HSS intervention, the rapid improvements observed for Ifanadiana add to preliminary evidence supporting the untapped and poorly understood potential of integrated HSS interventions on population health.Publication Poverty, Disease, and the Ecology of Complex Systems(Public Library of Science, 2014) Ngonghala, Calistus N.; Pluciński, Mateusz M.; Murray, Megan; Farmer, Paul; Barrett, Christopher B.; Keenan, Donald C.; Bonds, MatthewUnderstanding why some human populations remain persistently poor remains a significant challenge for both the social and natural sciences. The extremely poor are generally reliant on their immediate natural resource base for subsistence and suffer high rates of mortality due to parasitic and infectious diseases. Economists have developed a range of models to explain persistent poverty, often characterized as poverty traps, but these rarely account for complex biophysical processes. In this Essay, we argue that by coupling insights from ecology and economics, we can begin to model and understand the complex dynamics that underlie the generation and maintenance of poverty traps, which can then be used to inform analyses and possible intervention policies. To illustrate the utility of this approach, we present a simple coupled model of infectious diseases and economic growth, where poverty traps emerge from nonlinear relationships determined by the number of pathogens in the system. These nonlinearities are comparable to those often incorporated into poverty trap models in the economics literature, but, importantly, here the mechanism is anchored in core ecological principles. Coupled models of this sort could be usefully developed in many economically important biophysical systems—such as agriculture, fisheries, nutrition, and land use change—to serve as foundations for deeper explorations of how fundamental ecological processes influence structural poverty and economic development.Publication Environmental transmission of Mycobacterium ulcerans drives dynamics of Buruli ulcer in endemic regions of Cameroon(Nature Publishing Group, 2015) Garchitorena, Andrés; Ngonghala, Calistus N.; Texier, Gaëtan; Landier, Jordi; Eyangoh, Sara; Bonds, Matthew; Guégan, Jean-François; Roche, BenjaminBuruli Ulcer is a devastating skin disease caused by the pathogen Mycobacterium ulcerans. Emergence and distribution of Buruli ulcer cases is clearly linked to aquatic ecosystems, but the specific route of transmission of M. ulcerans to humans remains unclear. Relying on the most detailed field data in space and time on M. ulcerans and Buruli ulcer available today, we assess the relative contribution of two potential transmission routes –environmental and water bug transmission– to the dynamics of Buruli ulcer in two endemic regions of Cameroon. The temporal dynamics of Buruli ulcer incidence are explained by estimating rates of different routes of transmission in mathematical models. Independently, we also estimate statistical models of the different transmission pathways on the spatial distribution of Buruli ulcer. The results of these two independent approaches are corroborative and suggest that environmental transmission pathways explain the temporal and spatial patterns of Buruli ulcer in our endemic areas better than the water bug transmission.Publication Acquired and Transmitted Multidrug Resistant Tuberculosis: The Role of Social Determinants(Public Library of Science, 2016) Odone, Anna; Calderon, Roger; Becerra, Mercedes; Zhang, Zibiao; Contreras, Carmen C.; Yataco, Rosa; Galea, Jerome; Lecca, Leonid; Bonds, Matthew; Mitnick, Carole; Murray, MeganAlthough risk factors for multi-drug resistant tuberculosis are known, few studies have differentiated between acquired and transmitted resistance. It is important to identify factors associated with these different mechanisms to optimize control measures. We conducted a prospective cohort study of index TB patients and their household contacts in Lima, Peru to identify risk factors associated with acquired and transmitted resistance, respectively. Patients with higher socioeconomic status (SES) had a 3-fold increased risk of transmitted resistance compared to those with lower SES when acquired resistance served as the baseline. Quality of housing mediated most of the impact of SES.Publication Modeling the burden of poultry disease on the rural poor in Madagascar(Elsevier, 2015) Rist, Cassidy L.; Ngonghala, Calistus N.; Garchitorena, Andres; Brook, Cara E.; Ramananjato, Ranto; Miller, Ann; Randrianarivelojosia, Milijaona; Wright, Patricia C.; Gillespie, Thomas R.; Bonds, MatthewLivestock represent a fundamental economic and nutritional resource for many households in the developing world; however, a high burden of infectious disease limits their production potential. Here we present an ecological framework for estimating the burden of poultry disease based on coupled models of infectious disease and economics. The framework is novel, as it values humans and livestock as co-contributors to household wellbeing, incorporating feedbacks between poultry production and human capital in disease burden estimates. We parameterize this coupled ecological–economic model with household-level data to provide an estimate of the overall burden of poultry disease for the Ifanadiana District in Madagascar, where over 72% of households rely on poultry for economic and food security. Our models indicate that households may lose 10–25% of their monthly income under current disease conditions. Results suggest that advancements in poultry health may serve to support income generation through improvements in both human and animal health.Publication Contagious disruptions and complexity traps in economic development(Springer Science and Business Media LLC, 2017-09) Brummitt, Charles D.; Huremovic, Kenan; Pin, Paolo; Bonds, Matthew; Vega-Redondo, FernandoPoor economies not only produce less; they typically produce things that involve fewer inputs and fewer intermediate steps. Yet the supply chains of poor countries face more frequent disruptions—delivery failures, faulty parts, delays, power outages, theft and government failures—that systematically thwart the production process. To understand how these disruptions affect economic development, we modelled an evolving input–output network in which disruptions spread contagiously among optimizing agents. The key finding was that a poverty trap can emerge: agents adapt to frequent disruptions by producing simpler, less valuable goods, yet disruptions persist. Growing out of poverty requires that agents invest in buffers to disruptions. These buffers rise and then fall as the economy produces more complex goods, a prediction consistent with global patterns of input inventories. Large jumps in economic complexity can backfire. This result suggests why ‘big push’ policies can fail and it underscores the importance of reliability and gradual increases in technological complexity.Publication Baseline population health conditions ahead of a health system strengthening program in rural Madagascar(Informa UK Limited, 2017) Miller, Ann; Ramananjato, Ranto H.; Garchitorena, Andres; Rabeza, Victor R.; Gikic, Djordje; Cripps, Amber; Cordier, Laura; Rahaniraka Razanadrakato, Hery-Tiana; Randriamanambintsoa, Marius; Hall, Lara; Murray, Megan; Safara Razanavololo, Felicite; Rich, Michael; Bonds, MatthewPublication Disease Ecology, Biodiversity, and the Latitudinal Gradient in Income(Public Library of Science, 2012) Bonds, Matthew; Dobson, Andrew P.; Keenan, Donald C.While most of the world is thought to be on long-term economic growth paths, more than one-sixth of the world is roughly as poor today as their ancestors were hundreds of years ago. The majority of the extremely poor live in the tropics. The latitudinal gradient in income is highly suggestive of underlying biophysical drivers, of which disease conditions are an especially salient example. However, conclusions have been confounded by the simultaneous causality between income and disease, in addition to potentially spurious relationships. We use a simultaneous equations model to estimate the relative effects of vector-borne and parasitic diseases (VBPDs) and income on each other, controlling for other factors. Our statistical model indicates that VBPDs have systematically affected economic development, evident in contemporary levels of per capita income. The burden of VBDPs is, in turn, determined by underlying ecological conditions. In particular, the model predicts it to rise as biodiversity falls. Through these positive effects on human health, the model thus identifies measurable economic benefits of biodiversity.Publication Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention(Taylor & Francis, 2018) McCuskee, Sarah; Garchitorena, Andres; Miller, Ann; Hall, Lara; Ouenzar, Mohammed Ali; Rabeza, Victor R.; Ramananjato, Ranto H.; Razanadrakato, Hery-Tiana Rahaniraka; Randriamanambintsoa, Marius; Barry, Michele; Bonds, MatthewABSTRACT Background:: Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-for-age) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering. Objective:: This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar. Methods:: We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted. Results:: Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02–1.04) for each additional month), very small birth size (OR = 2.32 (1.24–4.32)), low maternal weight (OR = 0.94 (0.91–0.97) for each kilogram, kg) and height (OR = 0.95 (0.92–0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92–0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97–0.99)), very small birth size (OR = 2.48 (1.23–4.99)), and low maternal BMI (OR = 0.84 (0.75–0.94) for each kg/m2). Height-for-age faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median. Conclusion:: Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth faltering, in the first 1000 days, is similar to international populations; however, child growth does not recover to the median.