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Sahani MK, Maat H, Balabanova D, Woldie M, Richards P, Mayhew S. Engaging communities as partners in health crisis response: a realist-informed scoping review for research and policy. Health Res Policy Syst 2024; 22:56. [PMID: 38711067 PMCID: PMC11075189 DOI: 10.1186/s12961-024-01139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/30/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health is increasingly affected by multiple types of crises. Community engagement is recognised as being a critical element in successful crisis response, and a number of conceptual frameworks and global guideline documents have been produced. However, little is known about the usefulness of such documents and whether they contain sufficient information to guide effective community engagement in crisis response. We undertake a scoping review to examine the usefulness of conceptual literature and official guidelines on community engagement in crisis response using a realist-informed analysis [exploring contexts, mechanisms, and outcomes(CMOs)]. Specifically, we assess the extent to which sufficient detail is provided on specific health crisis contexts, the range of mechanisms (actions) that are developed and employed to engage communities in crisis response and the outcomes achieved. We also consider the extent of analysis of interactions between the mechanisms and contexts which can explain whether successful outcomes are achieved or not. SCOPE AND FINDINGS We retained 30 documents from a total of 10,780 initially identified. Our analysis found that available evidence on context, mechanism and outcomes on community engagement in crisis response, or some of their elements, was promising, but few documents provided details on all three and even fewer were able to show evidence of the interactions between these categories, thus leaving gaps in understanding how to successfully engage communities in crisis response to secure impactful outcomes. There is evidence that involving community members in all the steps of response increases community resilience and helps to build trust. Consistent communication with the communities in time of crisis is the key for effective responses and helps to improve health indicators by avoiding preventable deaths. CONCLUSIONS Our analysis confirms the complexity of successful community engagement and the need for strategies that help to deal with this complexity to achieve good health outcomes. Further primary research is needed to answer questions of how and why specific mechanisms, in particular contexts, can lead to positive outcomes, including what works and what does not work and how to measure these processes.
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Affiliation(s)
- Mateus Kambale Sahani
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Harro Maat
- Knowledge, Technology, and Innovation Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands
| | - Dina Balabanova
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mirkuzie Woldie
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Paul Richards
- School of Environmental Sciences, Njala University, Freetown, Sierra Leone
| | - Susannah Mayhew
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Smith ED. Sustaining Preparedness in Hospitals. Adv Health Care Manag 2024; 22:161-178. [PMID: 38262015 DOI: 10.1108/s1474-823120240000022008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents. SEARCH METHODS This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 - SARS, MERS, Ebola, and COVID-19. SEARCH RESULTS The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study. DISCUSSION AND CONCLUSIONS Comparison of key issues and lessons learned among the four major events described in this article - SARS, MERS, Ebola, and COVID-19 - highlight that several lessons are "relearned" with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.
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Abdul-Rahman T, Lawal L, Meale E, Ajetunmobi OA, Toluwalashe S, Alao UH, Ghosh S, Garg N, Aborode AT, Wireko AA, Mehta A, Sikora K. Inequitable access to Ebola vaccines and the resurgence of Ebola in Africa: A state of arts review. J Med Virol 2023; 95:e28986. [PMID: 37534818 DOI: 10.1002/jmv.28986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/29/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023]
Abstract
The Ebola virus, a member of the filoviridae family of viruses, is responsible for causing Ebola Virus Disease (EVD) with a case fatality rate as high as 50%. The largest EVD outbreak was recorded in West Africa from March 2013 to June 2016, leading to over 28 000 cases and 11 000 deaths. It affected several countries, including Nigeria, Senegal, Guinea, Liberia, and Sierra Leone. Until then, EVD was predominantly reported in remote villages in central and west Africa close to tropical rainforests. Human mobility, behavioral and cultural norms, the use of bushmeat, burial customs, preference for traditional remedies and treatments, and resistance to health interventions are just a few of the social factors that considerably aid and amplify the risk of transmission. The scale and persistence of recent ebola outbreaks, as well as the risk of widespread global transmission and its ability for bioterrorism, have led to a rethinking of public health strategies to curb the disease, such as the expedition of Ebola vaccine production. However, as vaccine production lags in the subcontinent, among other challenges, the risk of another ebola outbreak is likely and feared by public health authorities in the region. This review describes the inequality of vaccine production in Africa and the resurgence of EVD, emphasizing the significance of health equality.
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Affiliation(s)
- Toufik Abdul-Rahman
- Medical Institute, Sumy State University, Sumy, Ukraine
- ICORMed Collaborative, Sumy, Ukraine
| | - Lukman Lawal
- Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Emily Meale
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Soyemi Toluwalashe
- Lagos State University of College of Medicine, Faculty of Clinical Sciences, Ikeja, Nigeria
| | - Uthman Hassan Alao
- Department of Biomedical Laboratory Science, Faculty of Basic Medical Sciences, University of Ibadan, Ibadan, Nigeria
| | - Shankhaneel Ghosh
- Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan, Bhubaneswar, India
| | - Neil Garg
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Andrew Awuah Wireko
- Medical Institute, Sumy State University, Sumy, Ukraine
- ICORMed Collaborative, Sumy, Ukraine
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Mbachu CO, Ekenna AC, Agbawodikeizu UP, Onwujekwe O. Role and use of evidence in health system response to COVID-19 in Nigeria: a mixed method study. Pan Afr Med J 2023; 44:191. [PMID: 37484579 PMCID: PMC10362686 DOI: 10.11604/pamj.2023.44.191.38990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/18/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction evidence-based decision-making in health is an aspiration needed to effectively respond to current outbreaks and prepare for future occurrences. This paper examines the roles and use of evidence in health systems response to COVID-19 in Nigeria. Methods this was a mixed method study comprising nine key informant interviews and rapid review of 126 official online documents, journal articles and media reports published from December 2019 to December 2020 with a national and sub-national focus. Key informants were drawn from the government agencies that were involved in making or implementing decisions on the health sector response to COVID-19. Data collection was performed by three researchers. Thematic analysis and narrative synthesis of data was done. Results various forms of evidence were used to make decisions on Nigeria´s health system response to COVID-19, and these are broadly classified into three, namely, i) lessons learned from past experiences such as community engagement activities, early recognition of risks and deployment of non-pharmaceutical pandemic control measures, ii) proven interventions with contextual relevance like the emphasis on hand hygiene education for health workers, and iii) risk assessment and situation analysis reports like adopting a multi-sector response to COVID-19 control, expanding COVID-19 diagnostic laboratories to new sites across the country, and relax lockdown restrictions while maintaining key limitations to curb a spike in COVID-19 cases. Conclusion Nigeria´s health system response to COVID-19 upheld the use of evidence in making critical decisions on the prevention and control of the pandemic.
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Affiliation(s)
| | - Adanma Chidinma Ekenna
- Health Policy Research Group, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Uju Patricia Agbawodikeizu
- Health Policy Research Group, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Social Work, Faculty of Social Sciences, University of Nigeria, Nsukka, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Traore T, Shanks S, Haider N, Ahmed K, Jain V, Rüegg SR, Razavi A, Kock R, Erondu N, Rahman-Shepherd A, Yavlinsky A, Mboera L, Asogun D, McHugh TD, Elton L, Oyebanji O, Okunromade O, Ansumana R, Djingarey MH, Ali Ahmed Y, Diallo AB, Balde T, Talisuna A, Ntoumi F, Zumla A, Heymann D, Socé Fall I, Dar O. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a One Health approach. Lancet 2023; 401:673-687. [PMID: 36682374 DOI: 10.1016/s0140-6736(22)01589-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic has exposed faults in the way we assess preparedness and response capacities for public health emergencies. Existing frameworks are limited in scope, and do not sufficiently consider complex social, economic, political, regulatory, and ecological factors. One Health, through its focus on the links among humans, animals, and ecosystems, is a valuable approach through which existing assessment frameworks can be analysed and new ways forward proposed. Although in the past few years advances have been made in assessment tools such as the International Health Regulations Joint External Evaluation, a rapid and radical increase in ambition is required. To sufficiently account for the range of complex systems in which health emergencies occur, assessments should consider how problems are defined across stakeholders and the wider sociopolitical environments in which structures and institutions operate. Current frameworks do little to consider anthropogenic factors in disease emergence or address the full array of health security hazards across the social-ecological system. A complex and interdependent set of challenges threaten human, animal, and ecosystem health, and we cannot afford to overlook important contextual factors, or the determinants of these shared threats. Health security assessment frameworks should therefore ensure that the process undertaken to prioritise and build capacity adheres to core One Health principles and that interventions and outcomes are assessed in terms of added value, trade-offs, and cobenefits across human, animal, and environmental health systems.
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Affiliation(s)
- Tieble Traore
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal.
| | - Sarah Shanks
- Institute of Zoology, Zoological Society of London, London, UK
| | - Najmul Haider
- Royal Veterinary College, University of London, London, UK; School of Life Sciences, Keele University, Keele, UK
| | - Kanza Ahmed
- Global Operations, UK Health Security Agency, London, UK
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmed Razavi
- Global Operations, UK Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Ngozi Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Alexei Yavlinsky
- Infectious Disease Informatics, Institute of Health Informatics, University College London, London, UK
| | - Leonard Mboera
- Southern African Centre for Infectious Disease Surveillance Foundation for One Health, Morogoro, Tanzania
| | - Danny Asogun
- Ekpoma and Irrua Specialist Teaching Hospital, Ambrose Alli University, Irrua, Nigeria
| | - Timothy D McHugh
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Linzy Elton
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Oyeronke Oyebanji
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rashid Ansumana
- School of Community Health Sciences, Niala University, Bo Campus, Bo, Sierra Leone
| | - Mamoudou Harouna Djingarey
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Yahaya Ali Ahmed
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Amadou Bailo Diallo
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Thierno Balde
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ambrose Talisuna
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Osman Dar
- Global Operations, UK Health Security Agency, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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Jain S, Khaiboullina S, Martynova E, Morzunov S, Baranwal M. Epidemiology of Ebolaviruses from an Etiological Perspective. Pathogens 2023; 12:pathogens12020248. [PMID: 36839520 PMCID: PMC9963726 DOI: 10.3390/pathogens12020248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/21/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Since the inception of the ebolavirus in 1976, 32 outbreaks have resulted in nearly 15,350 deaths in more than ten countries of the African continent. In the last decade, the largest (2013-2016) and second largest (2018-2020) ebolavirus outbreaks have occurred in West Africa (mainly Guinea, Liberia, and Sierra Leone) and the Democratic Republic of the Congo, respectively. The 2013-2016 outbreak indicated an alarming geographical spread of the virus and was the first to qualify as an epidemic. Hence, it is imperative to halt ebolavirus progression and develop effective countermeasures. Despite several research efforts, ebolaviruses' natural hosts and secondary reservoirs still elude the scientific world. The primary source responsible for infecting the index case is also unknown for most outbreaks. In this review, we summarize the history of ebolavirus outbreaks with a focus on etiology, natural hosts, zoonotic reservoirs, and transmission mechanisms. We also discuss the reasons why the African continent is the most affected region and identify steps to contain this virus.
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Affiliation(s)
- Sahil Jain
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, Punjab, India
- Department of Biochemistry and Molecular Biology, Faculty of Life Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | - Svetlana Khaiboullina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Tatarstan, Russia
| | - Ekaterina Martynova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, 420008 Kazan, Tatarstan, Russia
| | - Sergey Morzunov
- Department of Pathology, School of Medicine, University of Nevada, Reno, NV 89557, USA
- Correspondence: (S.M.); or (M.B.); Tel.: +1-775-682-6230 (S.M.); +91-175-2393118 (M.B.); Fax: +91-175-2364498 (M.B.)
| | - Manoj Baranwal
- Department of Biotechnology, Thapar Institute of Engineering and Technology, Patiala 147004, Punjab, India
- Correspondence: (S.M.); or (M.B.); Tel.: +1-775-682-6230 (S.M.); +91-175-2393118 (M.B.); Fax: +91-175-2364498 (M.B.)
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Singh S, Charles V, Pandey U. Examining operational efficiency with prudent risks of Covid-19: a contextual DEA analysis with an undesirable intermediate measure. ANNALS OF OPERATIONS RESEARCH 2023:1-31. [PMID: 36777412 PMCID: PMC9896465 DOI: 10.1007/s10479-023-05207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
In the wake of the losses of human lives and disruption to the world economy caused by the spread of the COVID-19 pandemic, it has become imperative to assess the effectiveness of containment strategies adopted by countries. The success of any containment strategy of achieving low mortality and high recovery rate depends on the efficient utilization of available but limited resources, such as number of hospital beds and healthcare workers. While the spreading pattern of the pandemic has been researched heavily, there is limited research that comprehensively focuses on the efficient utilization of available resources to achieve the desired aims of low mortality and high recovery. In order to close this research gap, we employ a two-stage network data envelopment analysis (DEA) to identify the inefficiency in the process and resolve the resource constraints by considering medical and non-medical (administrative) interventions as two serial stages. The number of infected people is treated as the intermediate product, which is an undesirable output of the first stage and subsequently enters the second stage as an input. This network DEA model successfully addresses the conflict between the two stages over the handling of infected people and assesses the vulnerabilities of the countries against the transmission rates of the disease in the respective countries. Thus, the objective of this study is to develop a well-coordinated plan for different government agencies to jointly mitigate the risk under constrained resources. The findings reveal that almost 60 % of the Organization for Economic Cooperation and Development (OECD) countries have used their resources suboptimally and are producing, on average, almost half the amount of the maximum possible outputs. As a sizeable amount of inefficiency can be explained by varying economic and demographic factors, such as health expenditure and the proportion of the aged population, the efficiency evaluation has been revisited with adjustments for unfavorable externalities. The analysis and its implications can help policymakers formulate optimal resource plans and identify potential areas for improvement.
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Affiliation(s)
- Sanjeet Singh
- Decision Sciences Area, Indian Institute of Management Lucknow, IIM Road, Lucknow, UP 226013 India
| | - Vincent Charles
- CENTRUM Católica Graduate Business School, Lima, Peru
- Pontifical Catholic University of Peru, Lima, Peru
| | - Utsav Pandey
- School of Management and Entrepreneurship, Shiv Nadar University, Gautam Budh Nagar, 201314 India
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Hu B, Jiang G, Yao X, Chen W, Yue T, Zhao Q, Wen Z. Allocation of emergency medical resources for epidemic diseases considering the heterogeneity of epidemic areas. Front Public Health 2023; 11:992197. [PMID: 36908482 PMCID: PMC9998515 DOI: 10.3389/fpubh.2023.992197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/06/2023] [Indexed: 02/26/2023] Open
Abstract
Background The resources available to fight an epidemic are typically limited, and the time and effort required to control it grow as the start date of the containment effort are delayed. When the population is afflicted in various regions, scheduling a fair and acceptable distribution of limited available resources stored in multiple emergency resource centers to each epidemic area has become a serious problem that requires immediate resolution. Methods This study presents an emergency medical logistics model for rapid response to public health emergencies. The proposed methodology consists of two recursive mechanisms: (1) time-varying forecasting of medical resources and (2) emergency medical resource allocation. Considering the epidemic's features and the heterogeneity of existing medical treatment capabilities in different epidemic areas, we provide the modified susceptible-exposed-infected-recovered (SEIR) model to predict the early stage emergency medical resource demand for epidemics. Then we define emergency indicators for each epidemic area based on this. By maximizing the weighted demand satisfaction rate and minimizing the total vehicle travel distance, we develop a bi-objective optimization model to determine the optimal medical resource allocation plan. Results Decision-makers should assign appropriate values to parameters at various stages of the emergency process based on the actual situation, to ensure that the results obtained are feasible and effective. It is necessary to set up an appropriate number of supply points in the epidemic emergency medical logistics supply to effectively reduce rescue costs and improve the level of emergency services. Conclusions Overall, this work provides managerial insights to improve decisions made on medical distribution as per demand forecasting for quick response to public health emergencies.
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Affiliation(s)
- Bin Hu
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Guanhua Jiang
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Xinyi Yao
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Wei Chen
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Tingyu Yue
- School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Qitong Zhao
- Department of Logistics and Supply Chain Management School of Business, Singapore University of Social Science, Singapore, Singapore
| | - Zongliang Wen
- School of Management, Xuzhou Medical University, Xuzhou, China.,Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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After action review of the response to an outbreak of Lassa fever in Sierra Leone, 2019: Best practices and lessons learnt. PLoS Negl Trop Dis 2022; 16:e0010755. [PMID: 36197925 PMCID: PMC9534430 DOI: 10.1371/journal.pntd.0010755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two that were exported to the Netherlands. The outbreak tested multiple technical capacities in the International Health Regulations (2005) in a real-life setting. As such, an after action review (AAR) was undertaken as recommended by World Health Organization. We report on the findings of the AAR including best practices and lessons learnt. Methods A two stage review process was employed. The first stage involved national pillar level reviews for each technical pillar and one review of the district level response. The second stage brought together all pillars, including participants from the national and sub-national level as well as health sector partners. National guidelines were used as references during the deliberations. A standardized template was used to report on the key findings on what happened, what was supposed to happen, what went well and lessons learnt. Results This was a hospital associated outbreak that likely occurred due to a breach in infection prevention and control (IPC) practices resulting in three health workers being infected during a surgical operation. There was a delay in detecting the outbreak on time due to low index of suspicion among clinicians. Once detected, the outbreak response contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Notable gaps included delays in accessing local emergency funding and late distribution of IPC and laboratory supplies. Conclusions The incident management system worked optimally to contain this outbreak. The core technical gaps identified in surveillance, IPC and delay in deployment of resources should be addressed through systemic changes that can mitigate future outbreaks. The International Health Regulations (IHR) Monitoring and Evaluation Framework was developed by the World Health Organization to provide strategies to monitor and assess how countries are building their core public health capacities under IHR (2005). The framework has four components: annual reporting on IHR capacities (mandatory), Joint External Evaluation, simulation exercises and After Action Review (AAR). In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two deaths and two exported cases to the Netherlands. The outbreak tested multiple technical capacities in the IHR (2005) in a real-life setting. We therefore conducted an AAR to assess how well the country responded to the outbreak. This hospital associated outbreak likely occurred due to a breach in infection prevention and control (IPC) practices. The response launched after detection of the outbreak successfully contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Areas that needed improvement were clinicians’ knowledge on Lassa Fever, delays in accessing local emergency funding and late distribution of IPC and laboratory supplies.
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Frimpong LK, Okyere SA, Diko SK, Abunyewah M, Erdiaw-Kwasie MO, Commodore TS, Hernandez DO, Kita M. Actor-network analysis of community-based organisations in health pandemics: evidence from the COVID-19 response in Freetown, Sierra Leone. DISASTERS 2022; 46:903-927. [PMID: 34477244 PMCID: PMC8652973 DOI: 10.1111/disa.12508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Freetown, Sierra Leone, is confronted with health risks that are compounded by rapid unplanned urbanisation and weak capacities of local government institutions. Addressing them implies a shared responsibility between government and non-state actors. In low-income areas, the role of community-based organisations (CBOs) in combating health disasters is well-recognised. Yet, empirical evidence on how they have utilised their networks and coordinated community-level strategies in responding to the COVID-19 pandemic is scant. This paper, based on a qualitative study in two informal settlements in Freetown, employs actor-network theory to understand how CBOs problematise COVID-19 as a health risk, interact with other entities, and the subsequent tensions that arise. The findings show that community vulnerabilities and past experiences of health disasters informed CBOs' perception of COVID-19 as a communal emergency. In response, they coordinated sensitisation and mobilisation programmes by relying on a network of actors to support COVID-19 risk reduction strategies. Nonetheless, misunderstandings among them caused friction.
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Affiliation(s)
- Louis Kusi Frimpong
- Lecturer at the Department of Geography and Earth Science, University of Environment and Sustainable Development, Ghana
| | - Seth Asare Okyere
- Assistant Professor at the Graduate School of Engineering, Osaka University, Japan
| | - Stephen Kofi Diko
- Assistant Professor at the Department of City and Regional Planning, University of Memphis, United States
| | - Matthew Abunyewah
- Adjunct Senior Lecturer at the School of Architecture and Built Environment, University of Newcastle, Australia
| | | | - Tracy Sidney Commodore
- PhD Candidate at the Institute of Statistical, Social and Economic Research, University of Ghana, Ghana
| | - Daniel Oviedo Hernandez
- Lecturer at the Bartlett Development Planning Unit, University College London, United Kingdom
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Černý J, Potančok M, Castro Hernandez E. Toward a typology of weak-signal early alert systems: functional early warning systems in the post-COVID age. ONLINE INFORMATION REVIEW 2021. [DOI: 10.1108/oir-11-2020-0513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe study aims to expand on the concept of an early warning system (EWS) by introducing weak-signal detection, human-in-the-loop (HIL) verification and response tuning as integral parts of an EWS's design.Design/methodology/approachThe authors bibliographically highlight the evolution of EWS over the last 30+ years, discuss instances of EWSs in various types of organizations and industries and highlight limitations of current systems.FindingsProposed system to be used in the transforming of weak signals to early warnings and associated weak/strong responses.Originality/valueThe authors contribute to existing literature by presenting (1) novel approaches to dealing with some of the well-known issues associated with contemporary EWS and (2) an event-agnostic heuristic for dealing with weak signals.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-11-2020-0513.
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Colman E, Wanat M, Goossens H, Tonkin-Crine S, Anthierens S. Following the science? Views from scientists on government advisory boards during the COVID-19 pandemic: a qualitative interview study in five European countries. BMJ Glob Health 2021; 6:e006928. [PMID: 34580072 PMCID: PMC8478576 DOI: 10.1136/bmjgh-2021-006928] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/13/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In order to tackle the pandemic, governments have established various types of advisory boards to provide evidence and recommendations to policy makers. Scientists working on these boards have faced many challenges, including working under significant time constraints to produce 'evidence' as quickly as possible. However, their voices are still largely missing in the discussion. This study explores the views and experiences of scientists working on government advisory boards during the COVID-19 pandemic, with the aim to learn lessons for future pandemic management and preparedness. METHODS We conducted online video or telephone semi-structured interviews between December 2020 and April 2021 with 21 scientists with an official government advisory role during the COVID-19 pandemic in Belgium, the Netherlands, UK, Sweden and Germany. The interviews were audio-recorded and transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. RESULTS Scientists viewed the initial focus on biomedically oriented work during the pandemic as somewhat one-dimensional, but also highlighted difficulties of working in an interdisciplinary way. They found it difficult at times to ensure that the evidence is understood and taken on board by governments. They found themselves taking on new roles, the boundaries of which were not clearly defined. Consequently, they were often perceived and treated as a public figure. CONCLUSION Scientists working on advisory boards in European countries faced similar challenges, highlighting key lessons to be learnt. Future pandemic preparedness efforts should focus on building interdisciplinary collaboration through development of scientists' skills and appropriate infrastructure; ensuring transparency in how boards operate; defining and protecting the boundaries of the scientific advisor role; and supporting scientists to inform the public in the fight against disinformation, while dealing with potential hostile reactions.
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Affiliation(s)
- Elien Colman
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Sarah Tonkin-Crine
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford in Partnership with Public Health England, Oxford, UK
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerp, Antwerpen, Belgium
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13
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Nielsen SS, Alvarez J, Bicout DJ, Calistri P, Canali E, Drewe JA, Garin‐Bastuji B, Gonzales Rojas JL, Schmidt C, Herskin M, Michel V, Padalino B, Pasquali P, Roberts HC, Spoolder H, Stahl K, Velarde A, Winckler C, Blome S, Boklund A, Bøtner A, Dhollander S, Rapagnà C, Van der Stede Y, Miranda Chueca MA. Research priorities to fill knowledge gaps in wild boar management measures that could improve the control of African swine fever in wild boar populations. EFSA J 2021; 19:e06716. [PMID: 34354769 PMCID: PMC8319816 DOI: 10.2903/j.efsa.2021.6716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The European Commission asked EFSA to provide study designs for the investigation of four research domains (RDs) according to major gaps in knowledge identified by EFSA in a report published in 2019: (RD 1) African swine fever (ASF) epidemiology in wild boar; (RD 2) ASF transmission by vectors; (RD 3) African swine fever virus (ASFV) survival in the environment, and (RD 4) the patterns of seasonality of ASF in wild boar and domestic pigs in the EU. In this Scientific Opinion, the second RD on ASF epidemiology in wild boar is addressed. Twenty-nine research objectives were proposed by the working group and broader ASF expert networks and 23 of these research objectives met a prespecified inclusion criterion. Fourteen of these 23 research objectives met the predefined threshold for selection and so were prioritised based on the following set of criteria: (1) the impact on ASF management; (2) the feasibility or practicality to carry out the study; (3) the potential implementation of study results in practice; (4) a possible short time-frame study (< 1 year); (5) the novelty of the study; and (6) if it was a priority for risk managers. Finally, after further elimination of three of the proposed research objectives due to overlapping scope of studies published during the development of this opinion, 11 research priorities were elaborated into short research proposals, considering the potential impact on ASF management and the period of one year for the research activities.
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14
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Lin CP, Boufkhed S, Kizawa Y, Mori M, Hamzah E, Aggarwal G, Namisango E, Higginson IJ, Goh C, Harding R. Preparedness to Face the COVID-19 Pandemic in Hospice and Palliative Care Services in the Asia-Pacific Region: A Rapid Online Survey. Am J Hosp Palliat Care 2021; 38:861-868. [PMID: 33789503 DOI: 10.1177/10499091211002797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hospice and palliative care services provision for COVID-19 patients is crucial to improve their life quality. There is limited evidence on COVID-19 preparedness of such services in the Asia-Pacific region. AIM To evaluate the preparedness and capacity of hospice and palliative care services in the Asia-Pacific region to respond to the COVID-19 pandemic. METHOD An online cross-sectional survey was developed based on methodology guidance. Asia-Pacific Hospice and Palliative Care Network subscribers (n = 1551) and organizational members (n = 185) were emailed. Descriptive analysis was undertaken. RESULTS Ninety-seven respondents completed the survey. Around half of services were hospital-based (n = 47, 48%), and public-funded (n = 46, 47%). Half of services reported to have confirmed cases (n = 47, 49%) and the majority of the confirmed cases were patients (n = 28, 61%). Staff perceived moderate risk of being infected by COVID-19 (median: 7/10). > 85% of respondents reported they had up-to-date contact list for staff and patients, one-third revealed challenges to keep record of relatives who visited the services (n = 30, 31%), and of patients visited in communities (n = 29, 30%). Majority of services (60%) obtained adequate resources for infection control except face mask. More than half had no guidance on Do Not Resuscitate orders (n = 59, 66%) or on bereavement care for family members (n = 44, 51%). CONCLUSION Recommendations to strengthen the preparedness of palliative care services include: 1) improving the access to face mask; 2) acquiring stress management protocols for staff when unavailable; 3) reinforcing the contact tracing system for relatives and visits in the community and 4) developing guidance on patient and family care during patient's dying trajectory.
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Affiliation(s)
- Cheng-Pei Lin
- Institute of Community Health Care, School of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan.,Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, 12885Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | | | - Eve Namisango
- 108118African Palliative Care Association, Kampala, Uganda
| | - Irene J Higginson
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Cynthia Goh
- Division of Supportive and Palliative Care, 68751National Cancer Centre, Singapore, Singapore Cheng-Pei Lin and Sabah Boufkhed are joint first authors
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
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15
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A multi-stage stochastic programming approach to epidemic resource allocation with equity considerations. Health Care Manag Sci 2021; 24:597-622. [PMID: 33970390 PMCID: PMC8107811 DOI: 10.1007/s10729-021-09559-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 02/19/2021] [Indexed: 01/16/2023]
Abstract
Existing compartmental models in epidemiology are limited in terms of optimizing the resource allocation to control an epidemic outbreak under disease growth uncertainty. In this study, we address this core limitation by presenting a multi-stage stochastic programming compartmental model, which integrates the uncertain disease progression and resource allocation to control an infectious disease outbreak. The proposed multi-stage stochastic program involves various disease growth scenarios and optimizes the distribution of treatment centers and resources while minimizing the total expected number of new infections and funerals. We define two new equity metrics, namely infection and capacity equity, and explicitly consider equity for allocating treatment funds and facilities over multiple time stages. We also study the multi-stage value of the stochastic solution (VSS), which demonstrates the superiority of the proposed stochastic programming model over its deterministic counterpart. We apply the proposed formulation to control the Ebola Virus Disease (EVD) in Guinea, Sierra Leone, and Liberia of West Africa to determine the optimal and fair resource-allocation strategies. Our model balances the proportion of infections over all regions, even without including the infection equity or prevalence equity constraints. Model results also show that allocating treatment resources proportional to population is sub-optimal, and enforcing such a resource allocation policy might adversely impact the total number of infections and deaths, and thus resulting in a high cost that we have to pay for the fairness. Our multi-stage stochastic epidemic-logistics model is practical and can be adapted to control other infectious diseases in meta-populations and dynamically evolving situations.
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16
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Kostova D, Richter P, Van Vliet G, Mahar M, Moolenaar RL. The Role of Noncommunicable Diseases in the Pursuit of Global Health Security. Health Secur 2021; 19:288-301. [PMID: 33961498 PMCID: PMC8217593 DOI: 10.1089/hs.2020.0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Noncommunicable diseases and their risk factors are important for all aspects of outbreak preparedness and response, affecting a range of factors including host susceptibility, pathogen virulence, and health system capacity. This conceptual analysis has 2 objectives. First, we use the Haddon matrix paradigm to formulate a framework for assessing the relevance of noncommunicable diseases to health security efforts throughout all phases of the disaster life cycle: before, during, and after an event. Second, we build upon this framework to identify 6 technical action areas in global health security programs that are opportune integration points for global health security and noncommunicable disease objectives: surveillance, workforce development, laboratory systems, immunization, risk communication, and sustainable financing. We discuss approaches to integration with the goal of maximizing the reach of global health security where infectious disease threats and chronic disease burdens overlap.
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Affiliation(s)
- Deliana Kostova
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Patricia Richter
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Gretchen Van Vliet
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Michael Mahar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Ronald L Moolenaar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
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17
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Lopez VK, Shetty S, Kouch AT, Khol MT, Lako R, Bili A, Ayuen AD, Jukudu A, Kug AA, Mayen AD, Nyawel E, Berta K, Olu O, Clarke K, Bunga S. Lessons learned from implementation of a national hotline for Ebola virus disease emergency preparedness in South Sudan. Confl Health 2021; 15:27. [PMID: 33858478 PMCID: PMC8047513 DOI: 10.1186/s13031-021-00360-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/31/2021] [Indexed: 01/02/2023] Open
Abstract
Background The world’s second largest Ebola outbreak occurred in the Democratic Republic of Congo from 2018 to 2020. At the time, risk of cross-border spread into South Sudan was very high. Thus, the South Sudan Ministry of Health scaled up Ebola preparedness activities in August 2018, including implementation of a 24-h, toll-free Ebola virus disease (EVD) hotline. The primary purpose was the hotline was to receive EVD alerts and the secondary goal was to provide evidence-based EVD messages to the public. Methods To assess whether the hotline augmented Ebola preparedness activities in a protracted humanitarian emergency context, we reviewed 22 weeks of call logs from January to June 2019. Counts and percentages were calculated for all available data. Results The hotline received 2114 calls during the analysis period, and an additional 1835 missed calls were documented. Callers used the hotline throughout 24-h of the day and were most often men and individuals living in Jubek state, where the national capital is located. The leading reasons for calling were to learn more about EVD (68%) or to report clinical signs or symptoms (16%). Common EVD-related questions included EVD signs and symptoms, transmission, and prevention. Only one call was documented as an EVD alert, and there was no documentation of reported symptoms or whether the person met the EVD case definition. Conclusions Basic surveillance information was not collected from callers. To trigger effective outbreak investigation from hotline calls, the hotline should capture who is reporting and from where, symptoms and travel history, and whether this information should be further investigated. Electronic data capture will enhance data quality and availability of information for review. Additionally, the magnitude of missed calls presents a major challenge. When calls are answered, there is potential to provide health communication, so risk communication needs should be considered. However, prior to hotline implementation, governments should critically assess whether their hotline would yield actionable data and if other data sources for surveillance or community concerns are available.
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Affiliation(s)
- Velma K Lopez
- Division of Global Health Protection, Center for Global Health, CDC, Atlanta, Georgia, USA.
| | - Sharmila Shetty
- Division of Global Health Protection, Center for Global Health, CDC, Atlanta, Georgia, USA
| | | | | | | | | | | | | | | | | | | | | | | | - Kevin Clarke
- Division of Global Health Protection, Center for Global Health, CDC, Atlanta, Georgia, USA
| | - Sudhir Bunga
- Division of Global HIV and TB, Center for Global Health, CDC, Juba, South Sudan
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18
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Boufkhed S, Harding R, Kutluk T, Husseini A, Pourghazian N, Shamieh O. What Is the Preparedness and Capacity of Palliative Care Services in Middle-Eastern and North African Countries to Respond to COVID-19? A Rapid Survey. J Pain Symptom Manage 2021; 61:e13-e50. [PMID: 33227380 PMCID: PMC7679234 DOI: 10.1016/j.jpainsymman.2020.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 01/10/2023]
Abstract
CONTEXT Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. OBJECTIVE To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. METHODS A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. RESULTS Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives' details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1-10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). CONCLUSION Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
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Affiliation(s)
- Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Tezer Kutluk
- Department of Pediatric Oncology Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Nasim Pourghazian
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict, Department of Palliative Care, King Hussein Cancer Center, Amman, Jordan; College of Medicine, The University of Jordan, Amman, Jordan
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19
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Ryan J, Wiyeh A, Karamagi H, Okeibunor J, Tumusiime P, Wiysonge CS. A scoping review on research agendas to enhance prevention of epidemics and pandemics in Africa. Pan Afr Med J 2021; 37:40. [PMID: 33456664 DOI: 10.11604/pamj.supp.2020.37.40.23458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction research is not only needed to prioritise the best possible response during an epidemic and pandemic, it is also understood to be a core pillar of outbreak response. However, few African countries are equipped to perform the needed surveillance and research activities during an outbreak. Therefore, we mapped out research agendas aimed at increased research preparedness towards epidemics or pandemics in Africa. Methods eligible studies were searched for in in PubMed, Scopus, and Google Scholar. Additionally, grey literature was sought in Google, citation searches, as well as targeted sites such as the World Health Organization (WHO), Africa Centres for Disease Control and Prevention, African Union, and the Wellcome Trust. Searches were done in March 2020. Results the electronic searches yielded 7344 records, of which 34 articles were included in the study. The studies identified around 18 factors highlighted through various research agendas. Majority of the research agendas spoke to general epidemic preparedness and focused largely on understanding virus transmission such as its characteristics and dynamics, and the infrastructure needed to carry out vital research activities. Conclusion the review highlights the research needs in order to carry out vital research work but to also bridge knowledge gaps and harmonize outbreak response from key stakeholders. However, Africa needs to create its own health research agendas and capacitate itself to conduct and lead these studies. African health research decisions must center on Africa, with African researchers taking the lead not only on the science produced but ensuring inclusive and equitable involvement from fellow researchers, and in engaging national health ministries as well as the communities.
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Affiliation(s)
- Jill Ryan
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Alison Wiyeh
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Humphrey Karamagi
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Prosper Tumusiime
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa
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20
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Kanu S, James PB, Bah AJ, Kabba JA, Kamara MS, Williams CEE, Kanu JS. Healthcare Workers' Knowledge, Attitude, Practice and Perceived Health Facility Preparedness Regarding COVID-19 in Sierra Leone. J Multidiscip Healthc 2021; 14:67-80. [PMID: 33469299 PMCID: PMC7810694 DOI: 10.2147/jmdh.s287156] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background Healthcare workers (HCWs) are known to spearhead the fight against the COVID-19 pandemic. As such, their knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are considered critical to the success of the current COVID-19 response efforts. This study aims to determine HCWs’ KAP toward COVID-19 and assesses their perception of their healthcare facilities preparedness to respond appropriately to the ongoing COVID-19 pandemic in Sierra Leone. Methods We conducted an online cross-sectional study among HCWs (n=516) between 1st May 2020 and 30th June 2020. We collected our data using a self-administered structured questionnaire via email and online social media platforms. We analyzed our data using descriptive statistics and regression analysis (p<0.05). Results Close to three-fourth of HCWs (n=375, 72.7%) were knowledgeable regarding COVID-19. Doctors were more knowledgeable than community health workers and laboratory technicians (AOR= 2.48, 95% CI: 1.16–5.31, p=0.019) regarding COVID-19. Close to two-thirds of HCWs (n=301, 58.3%) HCWs show positive attitudes toward COVID-19. Being male (AOR=2.08, 95% CI: 1.36–3.20, p=0.001) and directly involved in COVID-19 patient care (AOR=3.21, 95% CI: 1.88–5.48, p<0.001) were identified as predictors of positive attitude towards COVID-19. HCWs are generally adhering to COVID-19 safe practices with majority indicating that they regularly wash or sanitize their hands (n=510, 98.8%) and used facemask at point of care (n=499, 96.7%). Majority of HCWs are of the view that their healthcare facilities are ill-prepared to adequately respond to COVID-19 with majority (n= 400, 77.5%) of them stating that their facilities lack enough personal protective equipment. Conclusion HCWs in Sierra Leone showed good knowledge, positive attitude and practice regarding COVID-19. However, HCWs are of the view that their healthcare facilities are ill-prepared to respond adequately to the COVID-19 outbreak. Health authorities and policymakers need to provide the necessary resources to allow HCWs to work in a safe environment.
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Affiliation(s)
- Sulaiman Kanu
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | - Peter Bai James
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007, Australia
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Musa Salieu Kamara
- University of Sierra Leone Teaching Hospital Complex, Connaught Hospital, Freetown, Sierra Leone
| | | | - Joseph Sam Kanu
- Directorate of Disease Prevention and Control, Ministry of Health and Sanitation, Freetown, Sierra Leone
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21
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Zhang L, Zhao J, Liu J, Chen K. Community Disaster Resilience in the COVID-19 Outbreak: Insights from Shanghai's Experience in China. Risk Manag Healthc Policy 2021; 13:3259-3270. [PMID: 33447106 PMCID: PMC7802019 DOI: 10.2147/rmhp.s283447] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Communities are central to the practice of public health emergency preparedness and response. This article mainly focuses on COVID-19 and discusses the formation and structure of community disaster resilience, which is an effective method for coping with such a public health emergency. Methods Based on the management of the COVID-19 outbreak in China, this article uses Shanghai's experience to illustrate how a community disaster resilience was formed for risk management. Resorting to the analytical framework of risk city, principles of community disaster resilience are given. Results Four actions can be recommended based on Shanghai's experience: 1) Applying a vulnerability analysis matrix for targeted risk governance, 2) empowering volunteer groups for emergency response, 3) policy and action for public health emergency prevention, and 4) risk communication for uncertainty-oriented planning. Conclusion Shanghai's experience offers a reference to tackle the COVID-19 at the global level. The COVID-19 outbreak highlights that humans still face various unpredictable health risks in the future. Forming a connection-based resilience at the community level is an effective way to risk management.
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Affiliation(s)
- Liwei Zhang
- School of Public Administration, Jilin University, Changchun, People's Republic of China
| | - Ji Zhao
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Jixin Liu
- School of Marxism, Tsinghua University, Beijing, People's Republic of China
| | - Kelin Chen
- Institute of Urban Governance, Shenzhen University, Shenzhen, People's Republic of China
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22
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Boufkhed S, Namisango E, Luyirika E, Sleeman KE, Costantini M, Peruselli C, Normand C, Higginson IJ, Harding R. Preparedness of African Palliative Care Services to Respond to the COVID-19 Pandemic: A Rapid Assessment. J Pain Symptom Manage 2020; 60:e10-e26. [PMID: 32949761 PMCID: PMC7493734 DOI: 10.1016/j.jpainsymman.2020.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/29/2022]
Abstract
CONTEXT Palliative care is an essential component of the coronavirus disease 2019 (COVID-19) pandemic response but is overlooked in national and international preparedness plans. The preparedness and capacity of African palliative care services to respond to COVID-19 is unknown. OBJECTIVES To evaluate the preparedness and capacity of African palliative care services to respond to the COVID-19 pandemic. METHODS We developed, piloted, and conducted a cross-sectional online survey guided by the 2005 International Health Regulations. It was electronically mailed to the 166 African Palliative Care Association's members and partners. Descriptive analyses were conducted. RESULTS About 83 participants from 21 countries completed the survey. Most services had at least one procedure for the case management of COVID-19 or another infectious disease (63%). Respondents reported concerns over accessing running water, soap, and disinfectant products (43%, 42%, and 59%, respectively) and security concerns for themselves or their staff (52%). Two in five services (41%) did not have any or make available additional personal protective equipment. Most services (80%) reported having the capacity to use technology instead of face-to-face appointment, and half (52%) reported having palliative care protocols for symptom management and psychological support that could be shared with nonspecialist staff in other health care settings. CONCLUSION Our survey suggests that African palliative care services could support the wider health system's response to the COVID-19 pandemic with greater resources such as basic infection control materials. It identified specific and systemic weaknesses impeding their preparedness to respond to outbreaks. The findings call for urgent measures to ensure staff and patient safety.
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Affiliation(s)
- Sabah Boufkhed
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Eve Namisango
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom; African Palliative Care Association, Kampala, Uganda
| | | | - Katherine E Sleeman
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | | | | | - Charles Normand
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Irene J Higginson
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Richard Harding
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
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Ippolito G, Lauria FN, Locatelli F, Magrini N, Montaldo C, Sadun R, Maeurer M, Strada G, Vairo F, Curiale S, Lafont A, di Caro A, Capobianchi MR, Meilicke R, Petersen E, Zumla A, Pletschette M. Lessons from the COVID-19 Pandemic-Unique Opportunities for Unifying, Revamping and Reshaping Epidemic Preparedness of Europe's Public Health Systems. Int J Infect Dis 2020; 101:361-366. [PMID: 33152511 PMCID: PMC9186783 DOI: 10.1016/j.ijid.2020.10.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Giuseppe Ippolito
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | | | - Franco Locatelli
- Sapienza, University of Rome and Department of Pediatric Hematology and Oncology IRCCS Ospedale Pediatrico Bambino Gesù, Italy.
| | | | - Chiara Montaldo
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | - Raffaella Sadun
- Harvard University, Harvard Business School, Boston, MA, USA.
| | - Markus Maeurer
- Champalimaud Centre for the Unknown, Lisbon, Portugal; I Medical Clinic, University of Mainz, Germany.
| | | | - Francesco Vairo
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | - Salvatore Curiale
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | | | - Antonino di Caro
- National Institute for Infectious Diseases, Lazzaro Spallanzani, Rome, Italy.
| | | | | | - Eskild Petersen
- Institute for Clinical Medicine, Faculty of Health Sciences, University of Aarhus, Denmark; European Society for Clinical Microbiology and Infectious Diseases [ESCMID] Task Force for Emerging Infections, Basel, Switzerland.
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals, London, UK.
| | - Michel Pletschette
- Department of Tropical and Infectious Diseases, Medical Center of the University of Munich, Munich, Germany.
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Halbwax M. Addressing the illegal wildlife trade in the European Union as a public health issue to draw decision makers attention. BIOLOGICAL CONSERVATION 2020; 251:108798. [PMID: 33071292 PMCID: PMC7550130 DOI: 10.1016/j.biocon.2020.108798] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 05/20/2023]
Abstract
The European Union is one of the most important markets for the trafficking of endangered species and a major transit point for illegal wildlife trade. The latter is not only one of the most important anthropogenic drivers of biodiversity loss, it also represents a growing risk for public health. Indeed, wildlife trade exposes humans to a plethora of severe emerging infectious diseases, some of which have contributed to the most dramatic global pandemics humankind has endured. Illegal wildlife trade is often considered as a problem of developing countries but it is first and foremost an international global business with a trade flow from developing to developed countries. The devastating effects of the ongoing SARS-CoV-2 outbreak should thus be an unassailable argument for European decision makers to change paradigm. Rather than deploying efforts and money to combat novel pathogens, mitigating the risk of spreading emerging infectious diseases should be addressed and be part of any sustainable socioeconomic development plan. Stricter control procedures at borders and policies should be enforced. Additionally, strengthening research in wildlife forensic science and developing a network of forensic laboratories should be the cornerstone of the European Union plan to tackle the illegal wildlife trade. Such proactive approach, that should further figure in the EU-Wildlife Action Plan, could produce a win-win situation: the curb of illegal wildlife trade would subsequently diminish the likelihood of importing new zoonotic diseases in the European Union.
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The Importance of Developing Rigorous Social Science Methods for Community Engagement and Behavior Change During Outbreak Response. Disaster Med Public Health Prep 2020; 15:685-690. [PMID: 32641188 DOI: 10.1017/dmp.2020.163] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite growing international attention, the anthropological and socio-behavioral elements of epidemics continue to be understudied and under resourced and lag behind the traditional outbreak response infrastructure. As seen in the current 2019 coronavirus disease (COVID-19) pandemic, the importance of socio-behavioral elements in understanding transmission and facilitating control of many outbreak-prone pathogens, this is problematic. Beyond the recent strengthening of global outbreak response capacities and global health security measures, a greater focus on the socio-behavioral components of outbreak response is required. We add to the current discussion by briefly highlighting the importance of socio-behavior in the Ebola virus disease (EVD) response, and describe vital areas of future development, including methods for community engagement and validated frameworks for behavioral modeling and change in outbreak settings.
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Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, Singh H, Praharaj I, Gangakhedkar RR, Bhargava B, Panda S. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res 2020; 151:459-467. [PMID: 32611916 PMCID: PMC7530442 DOI: 10.4103/ijmr.ijmr_2234_20] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND & OBJECTIVES Healthcare workers (HCWs) are at an elevated risk of contracting COVID-19. While intense occupational exposure associated with aerosol-generating procedures underlines the necessity of using personal protective equipment (PPE) by HCWs, high-transmission efficiency of the causative agent [severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)] could also lead to infections beyond such settings. Hydroxychloroquine (HCQ), a repurposed antimalarial drug, was empirically recommended as prophylaxis by the National COVID-19 Task Force in India to cover such added risk. Against this background, the current investigation was carried out to identify the factors associated with SARS-CoV-2 infection among HCWs in the country. METHODS A case-control design was adopted and participants were randomly drawn from the countrywide COVID-19 testing data portal maintained by the ICMR. The test results and contact details of HCWs, diagnosed as positive (cases) or negative (controls) for SARS-CoV-2 using real-time reverse transcription-polymerase chain reaction (qRT-PCR), were available from this database. A 20-item brief-questionnaire elicited information on place of work, procedures conducted and use of PPE. RESULTS Compared to controls, cases were slightly older (34.7 vs. 33.5 yr) and had more males (58 vs. 50%). In multivariate analyses, HCWs performing endotracheal intubation had higher odds of being SARS-CoV-2 infected [adjusted odds ratio (AOR): 4.33, 95% confidence interval (CI): 1.16-16.07]. Consumption of four or more maintenance doses of HCQ was associated with a significant decline in the odds of getting infected (AOR: 0.44; 95% CI: 0.22-0.88); a dose-response relationship existed between frequency of exposure to HCQ and such reductions (χ[2] for trend=48.88; P <0.001). In addition, the use of PPE was independently associated with the reduction in odds of getting infected with SARS-CoV-2. INTERPRETATIONS & CONCLUSIONS Until results of clinical trials for HCQ prophylaxis become available, this study provides actionable information for policymakers to protect HCWs at the forefront of COVID-19 response. The public health message of sustained intake of HCQ prophylaxis as well as appropriate PPE use need to be considered in conjunction with risk homoeostasis operating at individual levels.
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Affiliation(s)
| | - Tanu Anand
- Multidisciplinary Research Unit/Model Rural Health Research Unit, New Delhi, India
| | | | - Reeta Rasaily
- Division of Reproductive Biology, Maternal Health & Child Health, New Delhi, India
| | - Ravinder Singh
- Division of Non-Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Santasabuj Das
- Division of Clinical Medicine, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
| | - Harpreet Singh
- Informatics, Systems & Research Management Cell, Indian Council of Medical Research, New Delhi, India
| | - Ira Praharaj
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Raman R. Gangakhedkar
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Balram Bhargava
- Department of Health Research, Ministry of Health & Family Welfare, Indian Council of Medical Research, New Delhi, India
| | - Samiran Panda
- ICMR-National AIDS Research Institute, Pune, Maharashtra, India
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Owens MD, Lloyd ML, Brady TM, Gross R. Assessment of the Angolan (CHERRT) Mobile Laboratory Curriculum for Disaster and Pandemic Response. West J Emerg Med 2020; 21:526-531. [PMID: 32302277 PMCID: PMC7234718 DOI: 10.5811/westjem.2020.4.47385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/06/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction As of April 5, 2020, the World Health Organization reported over one million confirmed cases and more than 62,000 confirmed coronavirus (COVID-19) deaths affecting 204 countries/regions. The lack of COVID-19 testing capacity threatens the ability of both the United States (US) and low middle income countries (LMIC) to respond to this growing threat, The purpose of this study was to assess the effectiveness through participant self-assessment of a rapid response team (RRT) mobile laboratory curriculum Methods We conducted a pre and post survey for the purpose of a process improvement assessment in Angola, involving 32 individuals. The survey was performed before and after a 14-day training workshop held in Luanda, Angola, in December 2019. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α< 0.05 (95% confidence interval). Results All six of the questions – 1) “I feel confident managing a real laboratory sample test for Ebola or other highly contagious sample;” 2) “I feel safe working in the lab environment during a real scenario;” 3) “I feel as if I can appropriately manage a potentially highly contagious laboratory sample;” 4)“I feel that I can interpret a positive or negative sample during a suspected contagious outbreak;” 5) “I understand basic Biobubble/mobile laboratory concepts and procedures;” and 6) “I understand polymerase chain reaction (PCR) principles” – showed statistical significant change pre and post training. Additionally, the final two questions – “I can more effectively perform my role/position because of the training I received during this course;” and “This training was valuable” – received high scores on the Likert scale. Conclusion This Angolan RRT mobile laboratory training curriculum provides the nation of Angola with the confidence to rapidly respond and test at the national level a highly infectious contagion in the region and perform on-scene diagnostics. This mobile RRT laboratory provides a mobile and rapid diagnostic resource when epidemic/pandemic resource allocation may need to be prioritized based on confirmed disease prevalence.
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Affiliation(s)
| | | | - Tyler M Brady
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland
| | - Robin Gross
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland
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28
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Affiliation(s)
- Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, Fairfax 22030, VA, USA.
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29
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Aminizadeh M, Farrokhi M, Ebadi A, Masoumi GR, Kolivand P, Khankeh HR. Hospital management preparedness tools in biological events: A scoping review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:234. [PMID: 31867398 PMCID: PMC6905292 DOI: 10.4103/jehp.jehp_473_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The objective of the present study was to systematically review the current research knowledge on hospital preparedness tools used in biological events and factors affecting hospital preparedness in such incidents in using a scoping review methodology. MATERIALS AND METHODS The review process was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. Online databases (PubMed, Scopus, Web of Science, and Google Scholar) were used to identify papers published that evaluated instruments or tools for hospital preparedness in biological disasters (such as influenza, Ebola, and bioterrorism events). The search, article selection, and data extraction were carried out by two researchers independently. RESULTS A total of 3440 articles were screened, with 20 articles identified for final analysis. The majority of research studies identified were conducted in the United States (45%) and were focused on CBRN incident (20%), Ebola, infectious disease and bioterrorism events (15%), mass casualty incidents and influenza pandemic (10%), public health emergency, SARS, and biological events (5%). Factors that were identified in the study to hospitals preparedness in biological events classified in seven areas including planning, surge capacity, communication, training and education, medical management, surveillance and standard operation process. CONCLUSIONS Published evidences of hospital preparedness on biological events as well as the overall quality of the psychometric properties of most studies were limited. The results of the current scoping review could be used as a basis for designing and developing a standard assessment tool for hospital preparedness in biological events, and it can also be used as a clear vision for the healthcare managers and policymakers in their future plans to confront the challenges identified by healthcare institutes in biologic events.
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Affiliation(s)
- Mohsen Aminizadeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran
- Health in Emergency and Disaster Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Masoumi
- Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pirhossein Kolivand
- National Emergency Medical Organization, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Reza Khankeh
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Department of Clinical Science and Education, Karolinska Instituted, Stockholm, Sweden, Europe
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30
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Kodish SR, Bio F, Oemcke R, Conteh J, Beauliere JM, Pyne-Bailey S, Rohner F, Ngnie-Teta I, Jalloh MB, Wirth JP. A qualitative study to understand how Ebola Virus Disease affected nutrition in Sierra Leone-A food value-chain framework for improving future response strategies. PLoS Negl Trop Dis 2019; 13:e0007645. [PMID: 31504036 PMCID: PMC6736239 DOI: 10.1371/journal.pntd.0007645] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/19/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study sought understand how the 2014-2016 EVD Virus Disease (EVD) outbreak impacted the nutrition sector in Sierra Leone and use findings for improving nutrition responses during future outbreaks of this magnitude. METHODOLOGY This qualitative study was iterative and emergent. In-depth interviews (n = 42) were conducted over two phases by purposively sampling both key informants (n = 21; government stakeholders, management staff from United Nations (UN) agencies and non-governmental organizations (NGO)), as well as community informants (n = 21; EVD survivors, health workers, community leaders) until data saturation. Multiple analysts collaborated in a team-based coding approach to identify key themes using Dedoose software. Findings are presented as both quotations and tables/figures. RESULTS The EVD outbreak effects and the related response strategies, especially movement restriction policies including 21-day quarantines, contributed to disruptions across the food value-chain in Sierra Leone. System-wide impacts were similar to those typically seen in large-scale disasters such as earthquakes. Participants described an array of direct and indirect effects on agricultural production and food storage and processing, as well as on distribution, transport, trade, and retailing. Secondary data were triangulated by interviews which described the aggregate negative effect of this outbreak on key pillars of food security, infant and young child feeding practices, and nutrition. During the humanitarian response, nutrition-specific interventions, including food assistance, were highly accepted, although sharing was reported. Despite EVD impacts across the entire food value-chain, nutrition-sensitive interventions were not central to the initial response as EVD containment and survival took priority. Culturally-appropriate social and behavior change communications were a critical response component for improving health, nutrition, and hygiene-related behaviors through community engagement. CONCLUSIONS Infectious diseases such as EVD have far-reaching effects that impact health and nutrition through interrelated pathways. In Sierra Leone, the entire food value-chain was broken to the extent that the system-wide damage was on par with that typically resulting from large natural disasters. A food value-chain approach, at minimum, offers a foundational framework from which to position nutrition preparedness and response efforts for outbreaks in similar resource constrained settings.
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Kuisma E, Olson SH, Cameron KN, Reed PE, Karesh WB, Ondzie AI, Akongo MJ, Kaba SD, Fischer RJ, Seifert SN, Muñoz-Fontela C, Becker-Ziaja B, Escudero-Pérez B, Goma-Nkoua C, Munster VJ, Mombouli JV. Long-term wildlife mortality surveillance in northern Congo: a model for the detection of Ebola virus disease epizootics. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180339. [PMID: 31401969 DOI: 10.1098/rstb.2018.0339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ebolavirus (EBOV) has caused disease outbreaks taking thousands of lives, costing billions of dollars in control efforts and threatening great ape populations. EBOV ecology is not fully understood but infected wildlife and consumption of animal carcasses have been linked to human outbreaks, especially in the Congo Basin. Partnering with the Congolese Ministry of Health, we conducted wildlife mortality surveillance and educational outreach in the northern Republic of Congo (RoC). Designed for EBOV detection and to alert public health authorities, we established a low-cost wildlife mortality reporting network covering 50 000 km2. Simultaneously, we delivered educational outreach promoting behavioural change to over 6600 people in rural northern RoC. We achieved specimen collection by training project staff on a safe sampling protocol and equipping geographically distributed bases with sampling kits. We established in-country diagnostics for EBOV testing, reducing diagnostic turnaround time to 3 days and demonstrated the absence of EBOV in 58 carcasses. Central Africa remains a high-risk EBOV region, but RoC, home to the largest remaining populations of great apes, has not had an epidemic since 2005. This effort continues to function as an untested early warning system in RoC, where people and great apes have died from past Ebola virus disease outbreaks. This article is part of the theme issue 'Dynamic and integrative approaches to understanding pathogen spillover'.
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Affiliation(s)
- Eeva Kuisma
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Sarah H Olson
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - Kenneth N Cameron
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - Patricia E Reed
- Wildlife Conservation Society, Wildlife Health Program, 2300 Southern Boulevard, Bronx, New York, NY 10460, USA
| | - William B Karesh
- Health and Policy, EcoHealth Alliance, 460 West 34th Street, New York, NY 10001, USA
| | - Alain I Ondzie
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Marc-Joël Akongo
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Serge D Kaba
- Wildlife Conservation Society, Wildlife Health Program, 151 Avenue du General de Gaulle, BP14537 Brazzaville, Republic of Congo
| | - Robert J Fischer
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - Stephanie N Seifert
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - César Muñoz-Fontela
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection Research DZIF, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
| | | | - Beatriz Escudero-Pérez
- Bernhard Nocht Institute for Tropical Medicine and German Center for Infection Research DZIF, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
| | - Cynthia Goma-Nkoua
- Service d'Epidémiologie Moléculaire, Laboratoire National de Santé Publique, Avenue du General de Gaulle, BP120 Brazzaville, Republic of Congo
| | - Vincent J Munster
- Laboratory of Virology, Virus Ecology Unit, Division of Intramural Research, National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, 903s 4th street, Hamilton, MT, USA
| | - Jean-Vivien Mombouli
- Service d'Epidémiologie Moléculaire, Laboratoire National de Santé Publique, Avenue du General de Gaulle, BP120 Brazzaville, Republic of Congo
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Herstein JJ, Buehler SA, Le AB, Lowe JJ, Iwen PC, Gibbs SG. Clinical Laboratory Equipment Manufacturer Policies on Highly Hazardous Communicable Diseases. Public Health Rep 2019; 134:332-337. [PMID: 31216938 DOI: 10.1177/0033354919856936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Jocelyn J Herstein
- 1 Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,2 Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sean A Buehler
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
| | - Aurora B Le
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
| | - John J Lowe
- 1 Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.,2 Global Center for Health Security, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter C Iwen
- 4 Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shawn G Gibbs
- 3 Department of Environmental and Occupational Health, Indiana University School of Public Health, Bloomington, IN, USA
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Nasserie T, Brent SE, Tuite AR, Moineddin R, Yong JHE, Miniota J, Bogoch II, Watts AG, Khan K. Association between air travel and importation of chikungunya into the USA. J Travel Med 2019; 26:5476406. [PMID: 31011752 DOI: 10.1093/jtm/taz028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 11/13/2022]
Abstract
Background: During infectious disease outbreaks with pandemic potential, the number of air passengers travelling from the outbreak source to international destinations has been used as a proxy for disease importation risk to new locations. However, evaluations of the validity of this approach are limited. We sought to quantify the association between international air travel and disease importation using the 2014-2016 chikungunya outbreak in the Americas as a case study. Methods: We used country-level chikungunya case data to define a time period of epidemic activity for each of the 45 countries and territories in the Americas reporting outbreaks between 2014 and 2016. For each country, we identified airports within or proximate to areas considered suitable for chikungunya transmission and summed the number of commercial air passengers departing from these airports during the epidemic period to each US state. We used negative binomial models to quantify the association between the number of incoming air passengers from countries experiencing chikungunya epidemics and the annual rate of chikungunya importation into the USA at the state level. Results: We found a statistically significant positive association between passenger flows via airline travel from countries experiencing chikungunya epidemics and the number of imported cases in the USA at the state level (P < 0.0001). Additionally, we found that as the number of arriving airline passengers increased by 10%, the estimated number of imported cases increased by 5.2% (95% CI: 3.0-7.6). Conclusion: This validation study demonstrated that air travel was strongly associated with observed importation of chikungunya cases in the USA and can be a useful proxy for identifying areas at increased risk for disease importation. This approach may be useful for understanding exportation risk of other arboviruses.
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Affiliation(s)
- Tahmina Nasserie
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Department of Health Research & Policy, Stanford University School of Medicine, Stanford, California USA
| | - Shannon E Brent
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Michael G DeGroote School of Medicine, McMaster University, Hamilton, Canada
| | - Ashleigh R Tuite
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Rahim Moineddin
- BlueDot, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Family & Community Medicine, University of Toronto, Toronto, Canada
| | - Jean H E Yong
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Jennifer Miniota
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Isaac I Bogoch
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
| | - Alexander G Watts
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.,BlueDot, Toronto, Canada.,Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
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Brugnara L, Pervilhac C, Kohler F, Dramé ML, Sax S, Marx M. Quality improvement of health systems in an epidemic context: A framework based on lessons from the Ebola virus disease outbreak in West Africa. Int J Health Plann Manage 2019; 35:52-67. [PMID: 31120603 DOI: 10.1002/hpm.2814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 02/06/2023] Open
Abstract
Quality improvement (QI) in health generally focuses on the provision of health services with the aim of improving service delivery. Yet QI can be applied not only to health services but also to health systems overall. This is of growing relevance considering that due to deficiencies in health systems, the main countries affected by Ebola virus disease (EVD) outbreak in West Africa (2014-2016) were insufficiently prepared for the epidemic, and according to the WHO, epidemics are increasingly becoming a threat to global health. Our objective is to analyze QI constraints in health systems during that EVD epidemic and to propose a practical framework for QI in health systems for epidemics in developing countries. We applied a framework analysis using experiences shared at the "Second International Quality Forum" organized by the University of Heidelberg and partners in July 2015 and information gathered from a systematic literature review. Empirical results revealed multiple deficiencies in the health systems. We systemized these shortfalls as well as the QI measures taken as a response during the epidemic. On the basis of these findings, we identified six specific "priority intervention areas," which ultimately resulted in the synthesis of a practical QI framework. We deem that this framework that integrates the priority intervention areas with the WHO building blocks is suitable to improve, monitor, and evaluate health system performance in epidemic contexts in developing countries.
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Affiliation(s)
- Lucia Brugnara
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Cyril Pervilhac
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - François Kohler
- NGO Les Enfants de l'Aïr, et Faculté de Médecine de l'Université de Lorraine, Nancy, France
| | - Mohamed Lamine Dramé
- Success-in-Africa, Think Tank based at the Faculty of Medicine, University of Conakry, Conakry, Guinea
| | - Sylvia Sax
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Michael Marx
- Heidelberg Institute of Global Health and evaplan at the University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
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Palagyi A, Marais BJ, Abimbola S, Topp SM, McBryde ES, Negin J. Health system preparedness for emerging infectious diseases: A synthesis of the literature. Glob Public Health 2019; 14:1847-1868. [PMID: 31084412 DOI: 10.1080/17441692.2019.1614645] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This review reflects on what the literature to date has taught us about how health systems of low- and middle-income countries (LMICs) respond to emerging infectious disease (EID) outbreaks. These findings are then applied to propose a conceptual framework characterising an EID prepared health system. A narrative synthesis approach was adopted to explore the key elements of LMIC health systems during an EID outbreak. Overarching themes ('core health system constructs') and sub-themes ('elements') relevant to EID preparedness were extracted from 49 peer-reviewed articles. The resulting conceptual framework recognised six core constructs: four focused on material resources and structures (i.e. system 'hardware'), including (i) Surveillance, (ii) Infrastructure and medical supplies, (iii) Workforce, and (iv) Communication mechanisms; and two focused on human and institutional relationships, values and norms (i.e. system 'software'), including (i) Governance, and (ii) Trust. The article reinforces the interconnectedness of the traditional health system building blocks to EID detection, prevention and response, and highlights the critical role of system 'software' (i.e. governance and trust) in enabling LMIC health systems to achieve and maintain EID preparedness. The review provides recommendations for refining a set of indicators for an 'optimised' health system EID preparedness tool to aid health system strengthening efforts.
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Affiliation(s)
- Anna Palagyi
- Faculty of Medicine and Health, The University of Sydney School of Public Health , Sydney , Australia.,The George Institute for Global Health, University of New South Wales , Sydney , Australia
| | - Ben J Marais
- Marie Bashir Institute for Infectious Diseases and Biosecurity and the Children's Hospital at Westmead, University of Sydney , Sydney , Australia
| | - Seye Abimbola
- Faculty of Medicine and Health, The University of Sydney School of Public Health , Sydney , Australia.,The George Institute for Global Health, University of New South Wales , Sydney , Australia
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville , Australia.,Nossal Institute for Global Health, University of Melbourne , Melbourne , Australia
| | - Emma S McBryde
- Australian Institute of Tropical Health & Medicine, James Cook University , Townsville , Australia
| | - Joel Negin
- Faculty of Medicine and Health, The University of Sydney School of Public Health , Sydney , Australia
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The Angolan Pandemic Rapid Response Team: An Assessment, Improvement, and Development Analysis of the First Self-sufficient African National Response Team Curriculum. Disaster Med Public Health Prep 2018; 13:577-581. [DOI: 10.1017/dmp.2018.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ABSTRACTObjectiveThe purpose of this study was to assess, through participant self-assessment, the effectiveness of a rapid response team curriculum based on the World Health Organization (WHO) Ebola Virus Disease Consolidated Preparedness Checklist, Revision 1.MethodsA pre-and-post survey for the purpose of process improvement assessment involving 44 individuals was conducted in Angola. The survey was conducted before and after a 6-day training workshop held in Luanda, Angola, in December 2017. A paired t-test was used to identify any significant change on six 7-point Likert scale questions with α <.05 (95% CI).ResultsTwo of the 6 questions, “I feel confident the team can effectively work together to accomplish its assigned goals and objectives during a suspected contagious hemorrhagic fever disease outbreak” and “I understand basic pandemic response concepts” changed significantly from the presurvey to the postsurvey. The 4 remaining questions had near statistical significant change or an upward trend.ConclusionThis Angolan rapid response team training curriculum based on WHO guidelines, After Action Reports, and internationally accepted standard operating procedures provides the nation of Angola with the confidence to rapidly respond at the national level to a highly infectious contagion in the region. (Disaster Med Public Health Preparedness. 2019;13:577-581)
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Leiva-Suero LE, Morales JM, Villacís-Valencia SE, Escalona-Rabaza M, Quishpe-Jara GDLM, Hernández-Navarro EV, Fernández-Nieto M. Ébola, abordaje clínico integral. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n3.64545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. El virus del Ébola, antes llamado fiebre hemorrágica del Ébola, es una enfermedad altamente contagiosa con mortalidad entre 50% y 90%, para la cual existen prometedoras opciones de tratamiento que se encuentran en fase de evaluación y uso compasional.Objetivos. Revisar la mejor evidencia médica publicada y analizar el comportamiento de las epidemias por virus del Ébola, sus manifestaciones clínicas, sus complicaciones, los elementos más significativos para su diagnóstico y las nuevas opciones terapéuticas disponibles, para así aprender y aplicar estas experiencias en nuevos brotes.Materiales y métodos. Se realizó una búsqueda sistemática en las bases de datos PubMed, ProQuest, Embase, Redalyc, Ovid, Medline, DynaMed y ClinicalKey durante el periodo 2009-2017 en el contexto internacional, regional y local.Resultados. La revisión sistemática de artículos aportó un total de 51 430 registros, de los cuales 772 eran elegibles; de estos, 722 no eran relevantes, por lo que quedaron incluidos 50. A punto de partida se pudieron precisar los aspectos objeto de esta revisión.Conclusión. La enfermedad causada por el virus del Ébola, a pesar de su alta mortalidad, puede ser prevenida, diagnosticada oportunamente y tratada con efectividad, lo cual permite evaluar su impacto epidemiológico en las áreas endémicas y a nivel mundial. Existe un potencial arsenal terapéutico en fase de experimentación con resultados prometedores.
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Valeix SF. One Health Integration: A Proposed Framework for a Study on Veterinarians and Zoonotic Disease Management in Ghana. Front Vet Sci 2018; 5:85. [PMID: 29770324 PMCID: PMC5940747 DOI: 10.3389/fvets.2018.00085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 04/03/2018] [Indexed: 11/13/2022] Open
Abstract
In parallel with the recent world-wide promotion of One Health (OH) as a policy concept, a growing body of social science studies has raised questions about how successful OH policies and programs have been in managing some global health issues, such as zoonotic diseases. This paper briefly reviews this literature to clarify its critical perspective. Much of the literature on OH also is focused on health management at an international level and has paid less attention to implementation programs and policies for OH at the national and local levels, especially in low-and-middle-income countries (LMICs). Programs to implement OH often are linked to the concept of “integration”, a notion that lacks a universal definition, but is nonetheless a central tenet and goal in many OH programs. At the local and national levels, strong differences in perspectives about OH among different professions can be major barriers to integration of those professions into OH implementation. Policies based on integration among professions in sectors like animal, human and environmental health can threaten professions’ identities and thus may meet with resistance. Taking into account these criticisms of OH research and implementation, this paper proposes a research framework to probe the dominant social dimensions and power dynamics among professional participants that affect OH implementation programs at the local and national levels in a low-income country. The proposed research focus is the veterinary profession and one aspect of OH in which veterinarians are necessary actors: zoonotic disease management. Results from research framed in this way can have immediate application to the programs under study and can inform more expansive research on the social determinants of successful implementation of OH programs and policies.
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Conjugates and nano-delivery of antimicrobial peptides for enhancing therapeutic activity. J Drug Deliv Sci Technol 2018. [DOI: 10.1016/j.jddst.2017.12.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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40
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Singh RK, Dhama K, Malik YS, Ramakrishnan MA, Karthik K, Khandia R, Tiwari R, Munjal A, Saminathan M, Sachan S, Desingu PA, Kattoor JJ, Iqbal HMN, Joshi SK. Ebola virus - epidemiology, diagnosis, and control: threat to humans, lessons learnt, and preparedness plans - an update on its 40 year's journey. Vet Q 2017; 37:98-135. [PMID: 28317453 DOI: 10.1080/01652176.2017.1309474] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are underway for testing against EBOV. In the absence of any effective control measure, the adaptation of high standards of biosecurity measures, strict sanitary and hygienic practices, strengthening of surveillance and monitoring systems, imposing appropriate quarantine checks and vigilance on trade, transport, and movement of visitors from EVD endemic countries remains the answer of choice for tackling the EBOV spread. Herein, we converse with the current scenario of EBOV giving due emphasis on animal and veterinary perspectives along with advances in diagnosis and control strategies to be adopted, lessons learned from the recent outbreaks and the global preparedness plans. To retrieve the evolutionary information, we have analyzed a total of 56 genome sequences of various EBOV species submitted between 1976 and 2016 in public databases.
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Affiliation(s)
- Raj Kumar Singh
- a ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Kuldeep Dhama
- b Division of Pathology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Yashpal Singh Malik
- c Division of Biological Standardization, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | | | - Kumaragurubaran Karthik
- e Divison of Bacteriology and Mycology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Rekha Khandia
- f Department of Biochemistry and Genetics , Barkatullah University , Bhopal , India
| | - Ruchi Tiwari
- g Department of Veterinary Microbiology and Immunology , College of Veterinary Sciences, Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU) , Mathura , India
| | - Ashok Munjal
- f Department of Biochemistry and Genetics , Barkatullah University , Bhopal , India
| | - Mani Saminathan
- b Division of Pathology, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Swati Sachan
- h Immunology Section, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | | | - Jobin Jose Kattoor
- c Division of Biological Standardization, ICAR-Indian Veterinary Research Institute , Bareilly , India
| | - Hafiz M N Iqbal
- i School of Engineering and Science, Tecnologico de Monterrey , Monterrey , Mexico
| | - Sunil Kumar Joshi
- j Cellular Immunology Lab , Frank Reidy Research Center for Bioelectrics , School of Medical Diagnostics & Translational Sciences, Old Dominion University , Norfolk , VA , USA
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Garattini C, Raffle J, Aisyah DN, Sartain F, Kozlakidis Z. Big Data Analytics, Infectious Diseases and Associated Ethical Impacts. PHILOSOPHY & TECHNOLOGY 2017; 32:69-85. [PMID: 31024785 PMCID: PMC6451937 DOI: 10.1007/s13347-017-0278-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 08/02/2017] [Indexed: 12/16/2022]
Abstract
The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models. These are discussed by comparing the traditional and new models of data accumulation. Big data analytics is fast becoming a crucial component for the modelling of transmission-aiding infection control measures and policies-emergency response analyses required during local or international outbreaks. However, the application of big data analytics in infectious diseases is coupled with a number of ethical impacts. Four key areas are discussed in this paper: (i) automation and algorithmic reliance impacting freedom of choice, (ii) big data analytics complexity impacting informed consent, (iii) reliance on profiling impacting individual and group identities and justice/fair access and (iv) increased surveillance and population intervention capabilities impacting behavioural norms and practices. Furthermore, the extension of big data analytics to include information derived from personal devices, such as mobile phones and wearables as part of infectious disease frameworks in the near future and their potential ethical impacts are discussed. Considered together, the need for a constructive and transparent inclusion of ethical questioning in this rapidly evolving field becomes an increasing necessity in order to provide a moral foundation for the societal acceptance and responsible development of the technological advancement.
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Affiliation(s)
- Chiara Garattini
- Anthropology and UX Research, Health and Life Sciences, Intel, London, UK
| | - Jade Raffle
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT UK
| | - Dewi N Aisyah
- Department of Infectious Disease Informatics, University College London, Farr Institute of Health Informatics Research, 222 Euston Road, London, NW1 2DA UK
| | | | - Zisis Kozlakidis
- Division of Infection and Immunity, University College London, Cruciform Building, Gower Street, London, WC1E 6BT UK
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Adebayo G, Neumark Y, Gesser-Edelsburg A, Abu Ahmad W, Levine H. Zika pandemic online trends, incidence and health risk communication: a time trend study. BMJ Glob Health 2017; 2:e000296. [PMID: 29082006 PMCID: PMC5656128 DOI: 10.1136/bmjgh-2017-000296] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/02/2017] [Accepted: 04/12/2017] [Indexed: 01/25/2023] Open
Abstract
Objectives We aimed to describe the online search trends of Zika and examine their association with Zika incidence, assess the content of Zika-related press releases issued by leading health authorities and examine the association between online trends and press release timing. Design Using Google Trends, the 1 May 2015 to 30 May 2016 online trends of Zika and associated search terms were studied globally and in the five countries with the highest numbers of suspected cases. Correlations were then examined between online trends and Zika incidence in these countries. All Zika-related press releases issued by WHO/Pan America Health Organization (PAHO) and Centers for Disease Control and Prevention (CDC) during the study period were assessed for transparency, uncertainty and audience segmentation. Witte's Extended Parallel Process Model was applied to assess self-efficacy, response efficacy, susceptibility and severity. AutoRegressive Integrated Moving Average with an eXogenous predictor variable (ARIMAX) (p,d,q) regression modelling was used to quantify the association between online trends and the timing of press releases. Results Globally, Zika online search trends were low until the beginning of 2016, when interest rose steeply. Strong correlations (r=0.748–0.922; p<0.001) were observed between online trends and the number of suspected Zika cases in four of the five countries studied. Compared with press releases issued by WHO/PAHO, CDC press releases were significantly more likely to provide contact details and links to other resources, include figures/graphs, be risk-advisory in nature and be more readable and briefer. ARIMAX modelling results indicate that online trends preceded by 1 week press releases by WHO (stationary-R2=0.345; p<0.001) and CDC (stationary-R2=0.318; p=0.014). Conclusions These results suggest that online trends can aid in pandemic surveillance. Identification of shortcomings in the content and timing of Zika press releases can help guide health communication efforts in the current pandemic and future public health emergencies.
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Affiliation(s)
- Gbenga Adebayo
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Yehuda Neumark
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | | | - Wiessam Abu Ahmad
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
| | - Hagai Levine
- Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel
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Nahar N, Asaduzzaman M, Sultana R, Garcia F, Paul RC, Abedin J, Sazzad HMS, Rahman M, Gurley ES, Luby SP. A large-scale behavior change intervention to prevent Nipah transmission in Bangladesh: components and costs. BMC Res Notes 2017; 10:225. [PMID: 28651646 PMCID: PMC5485710 DOI: 10.1186/s13104-017-2549-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 06/17/2017] [Indexed: 11/28/2022] Open
Abstract
Background Nipah virus infection (NiV) is a bat-borne zoonosis transmitted to humans through consumption of NiV-contaminated raw date palm sap in Bangladesh. The objective of this analysis was to measure the cost of an NiV prevention intervention and estimate the cost of scaling it up to districts where spillover had been identified. Methods We implemented a behavior change communication intervention in two districts, testing different approaches to reduce the risk of NiV transmission using community mobilization, interpersonal communication, posters and TV public service announcements on local television during the 2012–2014 sap harvesting seasons. In one district, we implemented a “no raw sap” approach recommending to stop drinking raw date palm sap. In another district, we implemented an “only safe sap” approach, recommending to stop drinking raw date palm sap but offering the option of drinking safe sap. This is sap covered with a barrier, locally called bana, to interrupt bats’ access during collection. We conducted surveys among randomly selected respondents two months after the intervention to measure the proportion of people reached. We used an activity-based costing method to calculate the cost of the intervention. Results The implementation cost of the “no raw sap” intervention was $30,000 and the “only safe sap” intervention was $55,000. The highest cost was conducting meetings and interpersonal communication efforts. The lowest cost was broadcasting the public service announcements on local TV channels. To scale up a similar intervention in 30 districts where NiV spillover has occurred, would cost between $2.6 and $3.5 million for one season. Placing the posters would cost $96,000 and only broadcasting the public service announcement through local channels in 30 districts would cost $26,000. Conclusions Broadcasting a TV public service announcement is a potential low cost option to advance NiV prevention. It could be supplemented with posters and targeted interpersonal communication, in districts with a high risk of NiV spillover. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2549-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nazmun Nahar
- icddr,b, Dhaka, Bangladesh. .,Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | | | | | | | | | | | | | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | | | - Stephen P Luby
- Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA
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Enhancing preparedness for tackling new epidemic threats. THE LANCET RESPIRATORY MEDICINE 2017; 5:606-608. [PMID: 28529101 PMCID: PMC7134388 DOI: 10.1016/s2213-2600(17)30189-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 04/29/2017] [Indexed: 12/25/2022]
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Ebola outbreak preparedness planning: a qualitative study of clinicians' experiences. Public Health 2016; 143:103-108. [PMID: 28159021 PMCID: PMC7118746 DOI: 10.1016/j.puhe.2016.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/31/2016] [Accepted: 11/21/2016] [Indexed: 01/05/2023]
Abstract
Objectives The 2014–15 Ebola outbreak in West Africa highlighted the challenges many hospitals face when preparing for the potential emergence of highly contagious diseases. This study examined the experiences of frontline health care professionals in an Australian hospital during the outbreak, with a focus on participant views on information, training and preparedness, to inform future outbreak preparedness planning. Study design Semi-structured interviews were conducted with 21 healthcare professionals involved in Ebola preparedness planning, at a hospital in Australia. Methods The data were systematically coded to discover key themes in participants' accounts of Ebola preparedness. Results Three key themes identified were: 1) the impact of high volumes of—often inconsistent—information, which shaped participants' trust in authority; 2) barriers to engagement in training, including the perceived relative risk Ebola presented; and finally, 3) practical and environmental impediments to preparedness. Conclusions These clinicians' accounts of Ebola preparedness reveal a range of important factors which may influence the relative success of outbreak preparedness and provide guidance for future responses. In particular, they illustrate the critical importance of clear communication and guidelines for staff engagement with, and implementation of training. An important outcome of this study was how individual assessments of risk and trust are produced via, and overlap with, the dynamics of communication, training and environmental logistics. Consideration of the dynamic ways in which these issues intersect is crucial for fostering an environment that is suitable for managing an infectious threat such as Ebola. Outbreak communication needs to be rigorously controlled for consistency and transparency at all levels. Risk perception is influenced by lack of trust in the communication provided. Assessment of training effectiveness and feasibility for outbreak threats should include frontline clinicians. Dynamics of communication and mistrust can strongly influence the ability of an organisation to implement best practice.
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Serology in the Digital Age: Using Long Synthetic Peptides Created from Nucleic Acid Sequences as Antigens in Microarrays. MICROARRAYS 2016; 5:microarrays5030022. [PMID: 27600087 PMCID: PMC5040969 DOI: 10.3390/microarrays5030022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/23/2016] [Accepted: 08/05/2016] [Indexed: 11/19/2022]
Abstract
Background: Antibodies to microbes, or to autoantigens, are important markers of disease. Antibody detection (serology) can reveal both past and recent infections. There is a great need for development of rational ways of detecting and quantifying antibodies, both for humans and animals. Traditionally, serology using synthetic antigens covers linear epitopes using up to 30 amino acid peptides. Methods: We here report that peptides of 100 amino acids or longer (“megapeptides”), designed and synthesized for optimal serological performance, can successfully be used as detection antigens in a suspension multiplex immunoassay (SMIA). Megapeptides can quickly be created just from pathogen sequences. A combination of rational sequencing and bioinformatic routines for definition of diagnostically-relevant antigens can, thus, rapidly yield efficient serological diagnostic tools for an emerging infectious pathogen. Results: We designed megapeptides using bioinformatics and viral genome sequences. These long peptides were tested as antigens for the presence of antibodies in human serum to the filo-, herpes-, and polyoma virus families in a multiplex microarray system. All of these virus families contain recently discovered or emerging infectious viruses. Conclusion: Long synthetic peptides can be useful as serological diagnostic antigens, serving as biomarkers, in suspension microarrays.
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Plowright RK, Peel AJ, Streicker DG, Gilbert AT, McCallum H, Wood J, Baker ML, Restif O. Transmission or Within-Host Dynamics Driving Pulses of Zoonotic Viruses in Reservoir-Host Populations. PLoS Negl Trop Dis 2016; 10:e0004796. [PMID: 27489944 PMCID: PMC4973921 DOI: 10.1371/journal.pntd.0004796] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Progress in combatting zoonoses that emerge from wildlife is often constrained by limited knowledge of the biology of pathogens within reservoir hosts. We focus on the host–pathogen dynamics of four emerging viruses associated with bats: Hendra, Nipah, Ebola, and Marburg viruses. Spillover of bat infections to humans and domestic animals often coincides with pulses of viral excretion within bat populations, but the mechanisms driving such pulses are unclear. Three hypotheses dominate current research on these emerging bat infections. First, pulses of viral excretion could reflect seasonal epidemic cycles driven by natural variations in population densities and contact rates among hosts. If lifelong immunity follows recovery, viruses may disappear locally but persist globally through migration; in either case, new outbreaks occur once births replenish the susceptible pool. Second, epidemic cycles could be the result of waning immunity within bats, allowing local circulation of viruses through oscillating herd immunity. Third, pulses could be generated by episodic shedding from persistently infected bats through a combination of physiological and ecological factors. The three scenarios can yield similar patterns in epidemiological surveys, but strategies to predict or manage spillover risk resulting from each scenario will be different. We outline an agenda for research on viruses emerging from bats that would allow for differentiation among the scenarios and inform development of evidence-based interventions to limit threats to human and animal health. These concepts and methods are applicable to a wide range of pathogens that affect humans, domestic animals, and wildlife.
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Affiliation(s)
- Raina K. Plowright
- Montana State University, Department of Microbiology and Immunology, Bozeman, Montana, United States of America
- Center for Infectious Disease Dynamics, Pennsylvania State University, State College, Pennsylvania, United States of America
- * E-mail:
| | - Alison J. Peel
- Environmental Futures Research Institute, Griffith University, Brisbane, Queensland, Australia
| | - Daniel G. Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- MRC-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Amy T. Gilbert
- USDA/APHIS/WS National Wildlife Research Center, Fort Collins, Colorado, United States of America
| | - Hamish McCallum
- Griffith School of Environment, Griffith University, Brisbane, Queensland, Australia
| | - James Wood
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Michelle L. Baker
- CSIRO Health and Biosecurity Business Unit, Australian Animal Health Laboratory, Geelong, Victoria, Australia
| | - Olivier Restif
- Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Zumla A, Dar O, Kock R, Muturi M, Ntoumi F, Kaleebu P, Eusebio M, Mfinanga S, Bates M, Mwaba P, Ansumana R, Khan M, Alagaili AN, Cotten M, Azhar EI, Maeurer M, Ippolito G, Petersen E. Taking forward a 'One Health' approach for turning the tide against the Middle East respiratory syndrome coronavirus and other zoonotic pathogens with epidemic potential. Int J Infect Dis 2016; 47:5-9. [PMID: 27321961 PMCID: PMC7128966 DOI: 10.1016/j.ijid.2016.06.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/08/2016] [Indexed: 01/01/2023] Open
Abstract
The appearance of novel pathogens of humans with epidemic potential and high mortality rates have threatened global health security for centuries. Over the past few decades new zoonotic infectious diseases of humans caused by pathogens arising from animal reservoirs have included West Nile virus, Yellow fever virus, Ebola virus, Nipah virus, Lassa Fever virus, Hanta virus, Dengue fever virus, Rift Valley fever virus, Crimean-Congo haemorrhagic fever virus, severe acute respiratory syndrome coronavirus, highly pathogenic avian influenza viruses, Middle East Respiratory Syndrome Coronavirus, and Zika virus. The recent Ebola Virus Disease epidemic in West Africa and the ongoing Zika Virus outbreak in South America highlight the urgent need for local, regional and international public health systems to be be more coordinated and better prepared. The One Health concept focuses on the relationship and interconnectedness between Humans, Animals and the Environment, and recognizes that the health and wellbeing of humans is intimately connected to the health of animals and their environment (and vice versa). Critical to the establishment of a One Health platform is the creation of a multidisciplinary team with a range of expertise including public health officers, physicians, veterinarians, animal husbandry specialists, agriculturalists, ecologists, vector biologists, viral phylogeneticists, and researchers to co-operate, collaborate to learn more about zoonotic spread between animals, humans and the environment and to monitor, respond to and prevent major outbreaks. We discuss the unique opportunities for Middle Eastern and African stakeholders to take leadership in building equitable and effective partnerships with all stakeholders involved in human and health systems to take forward a 'One Health' approach to control such zoonotic pathogens with epidemic potential.
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Affiliation(s)
- Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Osman Dar
- Public Health England, London, Chatham House Centre on Global Health Security, Royal Institute of International Affairs, London, UK
| | - Richard Kock
- Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hertfordshire, UK
| | | | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Pontiano Kaleebu
- Medical Research Council/Uganda Virus Research Institute Research Unit on AIDS, Entebbe, Uganda
| | - Macete Eusebio
- Centro de Investigação em Saude de Manhiça, and National Directorate of Public Health, Ministry of Health, Maputo, Mozambique
| | - Sayoki Mfinanga
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Matthew Bates
- UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia
| | - Peter Mwaba
- UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia
| | - Rashid Ansumana
- Mercy Hospital Research Laboratory, Kulanda Town, Bo, Sierra Leone
| | - Mishal Khan
- London School of Hygiene and Tropical Medicine, London, UK; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Abdulaziz N Alagaili
- KSU Mammals Research Chair, Zoology Department, College of Science, King Saud University, Saudi Arabia
| | | | - Esam I Azhar
- Special Infectious Agents Unit, King Fahd Medical Research Centre, and Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Markus Maeurer
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Ippolito
- "Lazzaro Spallanzani" National Institute for Infectious Diseases - IRCCS, Rome, Italy
| | - Eskild Petersen
- University of Aarhus, Aarhus, Denmark; The Royal Hospital, Muscat, Oman.
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49
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Affiliation(s)
- Jean-François Delfraissy
- Institute of Immunology, Inflammation, Infectiology and Microbiology (AVIESAN) and ANRS, 75013 Paris, France.
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50
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Schleiss MR. Does public perception of exposure risks and transmission mechanisms drive antiviral vaccine awareness? What if cytomegalovirus was transmitted by mosquitoes? Curr Opin Virol 2016; 17:126-129. [PMID: 27107938 DOI: 10.1016/j.coviro.2016.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 03/29/2016] [Accepted: 03/30/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Mark R Schleiss
- Center for Infectious Diseases and Microbiology Translational Research, Division of Pediatric Infectious Diseases and Immunology, 2001 6th Street SE, Minneapolis, MN 55455, United States.
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