Mphande-Nyasulu, Fingani

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Preferred name
Mphande-Nyasulu, Fingani
Alternative Name
Mphande-Nyasulu, Fingani Annie
Mphande- Nyasulu, Fingani Annie
Main Affiliation
Email
fingani.mp@kmitl.ac.th

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    Item type:Publication,
    Task sharing for point-of-care testing: Review of national health policies and implementation landscape in 19 African countries
    (2025-12-01)
    Ndlovu, Zibusiso
    ;
    Assane, Mariamo Ibraimo
    ;
    Ocen, Francis
    ;
    Lamou, Ki Zerbo Charles
    ;
    Mandona, Musonda
    World Health Organization recommends task sharing (TS) for point-of-care testing (POCT) with lay health workers (LHW) to improve access when professional capacity is limited. Despite many benefits of POCT, TS remains underutilized. This study examined uptake of TS for POCT in national policies and the implementation landscape in 19 African countries from November 2024 to March 2025. A mixed-methods approach included an online cross-sectional survey with stakeholders (national ministries of health, medical associations, private laboratories, implementation supporting partners, LHWs); review of national health strategic and policy documents and key informant interviews (KII) with national laboratory directors. Standardized emails recruited participants, whilst documents came from requests and online searches. Quantitative data were analysed descriptively, and KII data with framework analysis. Of 217 policy documents collected, 197 (91%) were relevant. Over half of national health strategic plans (10/19; 53%) recognize LHWs as vital for expansion of primary healthcare services, but fewer (7/19; 37%) mention TS. While 58% (11/19) of national laboratory strategic plans aimed to expand POCT access and quality, 84% did not mention LHW to support TS. Among national HIV/AIDS strategic plans, 53% (9/17) referenced TS for POCT, mainly for HIV diagnosis; with only one addressing POCT for advanced HIV disease. Outside HIV and malaria, LHW POCT was rarely emphasised in disease-specific strategic plans. Seventy-five stakeholders (67% male) completed the online survey, and six KII were conducted. All reported that LHW conduct POCT, mainly with donor-support. HIV rapid testing was cited as having the most structured training program. National laboratory leaders acknowledged implementation challenges but saw opportunities to expand LHW-led POCT. Shifting from fragmented, disease-specific approaches to multi-disease TS model is crucial for sustainable POCT. Coherent policy and implementation reforms are needed to institutionalize TS amid declining resources. National laboratory leadership should drive the adoption of training and quality assurance for TS for multi-disease POCT.
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    Prevalence of tuberculosis (TB), including multi-drug-resistant and extensively-drug-resistant TB, and association with occupation in adults at Sirindhorn Hospital, Bangkok
    (2022-03-01)
    Mphande-Nyasulu, Fingani Annie
    ;
    Puengpipattrakul, Paisal
    ;
    Praipruksaphan, Mathuwadee
    ;
    Keeree, Arada
    ;
    Ruanngean, Karakade
    Background: Tuberculosis (TB) affects both child and adult populations worldwide. Objectives: This retrospective study was conducted to survey the prevalence of TB and its association with patient occupation in an adult population diagnosed with TB at Sirindhorn Hospital in 2018. Methods: Data were extracted from the medical records of 186 patients with TB, and prevalence and odds ratios were calculated. Results: Pulmonary (83.3%) and extrapulmonary TB (17.7%) were observed among the cases. Overall, 70.4% of cases were male and 29.6% were female. Mono-drug-resistant TB, multi-drug-resistant TB and extensively-drug-resistant TB were observed in 2.72%, 4.1% and 0.68% of cases, respectively. Although not statistically significant, individuals with comorbidities had a 2.16-fold [95% confidence interval (CI) 0.33–13.98] higher risk of TB compared with those without comorbidities. Unemployed patients with TB were 4-fold (95% CI 0.82–19.42) more likely to have hypertension than employed patients or traders. The risk of TB among patients with human immunodeficiency virus (HIV) infection was 2.22-fold (95% CI 0.93–5.31) higher among females compared with males, and relapsed patients had a 0.92-fold (95% CI 0.19–4.47) lower risk of HIV infection as a comorbidity compared with new TB cases. Conclusion: Patient occupation could play a role in the prevalence of TB among communities. The highest prevalence of TB was observed among unemployed subjects, and unemployed patients with TB were more likely to have hypertension as a comorbidity. Mapping the zones/areas of residence for patients with TB could assist in identifying TB hot spots, and could improve understanding of the drivers of the high TB burden and associated socio-economic factors. More studies are required to further understand the drivers that are leading to the high TB burden and the risks posed by occupations.
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    Outbreak preparedness and response strategies in ASEAN member states: a scoping review
    (2024-09-01)
    Mphande-Nyasulu, Fingani Annie
    ;
    Yap, Nan Jiun
    ;
    Teo, Chin Hai
    ;
    Chang, Li Yen
    ;
    Tay, Sun Tee
    Objectives: The 21<sup>st</sup> century has witnessed significant disease outbreaks with severe impact in Association of Southeast Asian Nations (ASEAN) countries, including SARS, H1N1, H5N1, and COVID-19. This review aimed to compile and analyze outbreak preparedness and response strategies, highlighting the success of coordinated multi-sectoral approaches and policy responses within the ASEAN region. Methods: The protocol for this review was registered on the Open Science Framework and PROSPERO. A systematic analysis of publications from the 2002-2022 period was conducted following PRISMA guidelines on 4522 records retrieved from PubMed, CINAHL, Web of Science, and Scopus. The titles and abstracts were screened, and 229 articles were selected for full-text screening. Finally, 34 articles were included in this review. Results: Four preparedness pillars were identified: governance and stewardship, disease detection, disease prevention, and health care management. The pillars were crucial in preparing for and responding to the COVID-19 pandemic. Coordinated responses among the ASEAN countries and local and international stakeholders were reported. Conclusions: The findings emphasize that understanding the transmission dynamics of infectious diseases is paramount for effective disease prevention, surveillance, and timely response efforts to prevent the next pandemic. A well-coordinated multi-country and multi-agency policy response and understanding the different disease management models are crucial in addressing future outbreaks in the region. Future post-pandemic publications will shed more light on lessons learned and preparedness and response plans for future pandemics.
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    Plasmodium falciparum surf4.1 in clinical isolates: From genetic variation and variant diversity to in silico design immunopeptides for vaccine development
    (2024-12-01)
    Noranate, Nitchakarn
    ;
    Sripanomphong, Jariya
    ;
    Mphande- Nyasulu, Fingani Annie
    ;
    Chaorattanakawee, Suwanna
    SURFINs protein family expressed on surface of both infected red blood cell and merozoite surface making them as interesting vaccine candidate for erythrocytic stage of malaria infection. In this study, we analyze genetic variation of Pfsurf<inf>4.1</inf> gene, copy number variation, and frequency of SURFIN<inf>4.1</inf> variants of P. falciparum in clinical isolates. In addition, secondary structure prediction and immunoinformatic were employed to identify immunogenic epitopes in humoral response as proposed vaccine candidates. Overall, our data demonstrate extensive polymorphism of SURFIN<inf>4.1</inf> in both genetic and protein level. The surf<inf>4.1</inf> gene showed extensive genetic variation with total of 447 polymorphic sites with maximum of three variants as well as singlet/triplet bases indels and mini/microsatellites in the coding sequence. The exon1 encoding extracellular region exhibited higher variation compared to exon2 which coding for intracellular domain. Interestingly, selective pressure was detected on both extracellular region (Var1 and Var2) as well as intracellular region (WRD2 and WRD3). Importantly, extensive full gene analysis suggests adenosine insertion at three key points nucleotide bases (nt 2409/2410, 3809/3810, and 4439/4440) of exon2 could lead to frameshift mutation resulted in four different SURFIN<inf>4.1</inf> variants (TMs, WD1, WD2 and WD3). The SURFIN<inf>4.1</inf> variant TMs was the most observed type with 67% frequency (51/76). Along with more than one copy number of surf<inf>4.1</inf> gene was observed with frequency of 13% (9/ 70). Despite substantial polymorphism, analysis of relatedness within P. falciparum population using full coding sequence was able to group SURFIN<inf>4.1</inf> protein into five distinct clades and reduced into four clades when using only exon1 coding sequence. Also, predicted secondary structure revealed conserved structure of five helix domains of extracellular region which similar among four SURFIN<inf>4.1</inf> variant types. In addition, in silico design eight immunopeptides derived from SURFIN<inf>4.1</inf>, four of which are highly conserved and four of dimorphic epitopes, as potential vaccine candidates.