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Ebbs D, Taricia M, Funaro MC, O’Daniel M, Cappello M. Prehospital use of point-of-care tests by community health workers: a scoping review. Front Public Health 2024; 12:1360322. [PMID: 38721545 PMCID: PMC11076783 DOI: 10.3389/fpubh.2024.1360322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/06/2024] [Indexed: 05/15/2024] Open
Abstract
Introduction Point-of-Care Tests (POCTs) are utilized daily in resource abundant regions, however, are limited in the global south, particularly in the prehospital setting. Few studies exist on the use of non-malarial POCTs by Community Health Workers (CHWs). The purpose of this scoping review is to delineate the current diversity in and breadth of POCTs evaluated in the prehospital setting. Methods A medical subject heading (MeSH) analysis of known key articles was done by an experienced medical librarian and scoping searches were performed in each database to capture "point of care testing" and "community health workers." This review was guided by the PRISMA Extension for scoping reviews. Results 2735 publications were returned, 185 were nominated for full-text review, and 110 studies were confirmed to meet study criteria. Majority focused on malaria (74/110; 67%) or HIV (25/110; 23%); 9/110 (8%) described other tests administered. Results from this review demonstrate a broad geographic range with significant heterogeneity in terminology for local CHWs. Conclusion The use of new POCTs is on the rise and may improve early risk stratification in limited resource settings. Current evidence from decades of malaria POCTs can guide future implementation strategies.
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Affiliation(s)
- Daniel Ebbs
- Department of Pediatrics, Yale University, New Haven, CT, United States
| | - Max Taricia
- Department of Pediatrics, Yale University, New Haven, CT, United States
| | - Melissa C. Funaro
- Department of Medicine, Harvey Cushing/John Hay Whitney Medical Library, New Haven, CT, United States
| | - Maggie O’Daniel
- University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Michael Cappello
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States
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Kua KP, Lee SWH, Chongmelaxme B. The impact of home-based management of malaria on clinical outcomes in sub-Saharan African populations: a systematic review and meta-analysis. Trop Med Health 2024; 52:7. [PMID: 38191459 PMCID: PMC10773121 DOI: 10.1186/s41182-023-00572-2] [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: 09/05/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Malaria remains a significant cause of morbidity and mortality globally and continues to disproportionately afflict the African population. We aimed to evaluate the effect of home management of malaria intervention on health outcomes. METHODS In our systematic review and meta-analysis, six databases (Pubmed, Cochrane CENTRAL, EMBASE, CAB Abstracts and Global Health, CINAHL Complete, and BIOSIS) were searched for studies of home management of malaria from inception until November 15, 2023. We included before-after studies, observational studies, and randomised controlled trials of home management intervention delivered in community settings. The primary outcomes were malaria mortality and all-cause mortality. The risk of bias in individual observational studies was assessed using the ROBINS-I tool, whilst randomised controlled trials were judged using a revised Cochrane risk of bias tool and cluster-randomised controlled trials were evaluated using an adapted Cochrane risk of bias tool for cluster-randomised trials. We computed risk ratios with accompanying 95% confidence intervals for health-related outcomes reported in the studies and subsequently pooled the results by using a random-effects model (DerSimonian-Laird method). RESULTS We identified 1203 citations through database and hand searches, from which 56 articles from 47 studies encompassing 234,002 participants were included in the systematic review. All studies were conducted in people living in sub-Saharan Africa and were rated to have a low or moderate risk of bias. Pooled analyses showed that mortality rates due to malaria (RR = 0.40, 95% CI = 0.29-0.54, P = 0.00001, I2 = 0%) and all-cause mortality rates (RR = 0.62, 95% CI = 0.53-0.72, P = 0.00001, I2 = 0%) were significantly lower among participants receiving home management intervention compared to the control group. However, in children under 5 years of age, there was no significant difference in mortality rates before and after implementation of home management of malaria. In terms of secondary outcomes, home management of malaria was associated with a reduction in the risk of febrile episodes (RR = 1.27, 95% CI = 1.09-1.47, P = 0.002, I2 = 97%) and higher effective rates of antimalarial treatments (RR = 2.72, 95% CI = 1.90-3.88, P < 0.00001, I2 = 96%) compared to standard care. Home malaria management combined with intermittent preventive treatment showed a significantly lower incidence risk of malaria than home management intervention that exclusively provided treatment to individuals with febrile illness suggestive of malaria. The risks for adverse events were found to be similar for home management intervention using different antimalarial drugs. Cost-effectiveness findings depicted that home malaria management merited special preferential scale-up. CONCLUSIONS Home management of malaria intervention was associated with significant reductions in malaria mortality and all-cause mortality. The intervention could help decrease health and economic burden attributable to malaria. Further clinical studies are warranted to enable more meaningful interpretations with regard to wide-scale implementation of the intervention, settings of differing transmission intensity, and new antimalarial drugs.
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Affiliation(s)
- Kok Pim Kua
- Department of Civil and Environmental Engineering, School of Engineering and Doerr School of Sustainability, Stanford University, Stanford, CA, 94305, USA
- MIT Alumni Association, Massachusetts Institute of Technology, Cambridge, MA, 02139-4822, USA
- Pharmacy Unit, Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, 47100, Puchong, Selangor, Malaysia
- A.S. Watson Group, Watson's Personal Care Stores, 55188, Kuala Lumpur, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- Asian Center for Evidence Synthesis in Population, Implementation, and Clinical Outcomes (PICO), Health and Well-Being Cluster, Global Asia in the 21st Century (GA21) Platform, Monash University, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- Gerontechnology Laboratory, Global Asia in the 21st Century (GA21) Platform, Monash University, Bandar Sunway, 47500, Subang Jaya, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, 47500, Lakeside CampusSelangor, Malaysia
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Bunchai Chongmelaxme
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, 254 Phayathai Road, Patumwan, Bangkok, 10330, Thailand.
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Digital Technologies to Enhance Infectious Disease Surveillance in Tanzania: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11040470. [PMID: 36833004 PMCID: PMC9957254 DOI: 10.3390/healthcare11040470] [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: 12/07/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Mobile phones and computer-based applications can speed up disease outbreak detection and control. Hence, it is not surprising that stakeholders in the health sector are becoming more interested in funding these technologies in Tanzania, Africa, where outbreaks occur frequently. The objective of this situational review is, therefore, to summarize available literature on the application of mobile phones and computer-based technologies for infectious disease surveillance in Tanzania and to inform on existing gaps. Four databases were searched-Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PubMed, and Scopus-yielding a total of 145 publications. In addition, 26 publications were obtained from the Google search engine. Inclusion and exclusion criteria were met by 35 papers: they described mobile phone-based and computer-based systems designed for infectious disease surveillance in Tanzania, were published in English between 2012 and 2022, and had full texts that could be read online. The publications discussed 13 technologies, of which 8 were for community-based surveillance, 2 were for facility-based surveillance, and 3 combined both forms of surveillance. Most of them were designed for reporting purposes and lacked interoperability features. While undoubtedly useful, the stand-alone character limits their impact on public health surveillance.
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Li Y, Huang Y, Chen R, Huang W, Xu H, Ye R, Huang S, Zhen J, Wen X, Wang G, Liu Y, Li H, Zheng Z, Wang J, Wang G, Chen C, Zeng W, Meng F, Huang X, Wang G, Yang B, Chen Y. An innovative three-layer strategy in response to a quartan malaria outbreak among forest goers in Hainan Island, China: a retrospective study. Infect Dis Poverty 2022; 11:97. [PMID: 36104737 PMCID: PMC9473465 DOI: 10.1186/s40249-022-01015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An outbreak of Plasmodium malariae infection among forest goers in Sanya City of Hainan Island, China was reported in 2015. In response to this outbreak, an innovative three-layer strategy (TLS) targeted forest goers was adapted based on the 1-3-7 approach. MAIN TEXT Key elements of TLS are: (i) The village with five malaria cases and adjacent villages were set as the first layer. All residents including forest goers were taken as the high-risk population (HRP). Active case detection (ACD) by blood smear microscopy and PCR was selected as the primary measure, and passive case detection (PCD) as complementary measure. One case was identified under TLS implementation. (ii) The township with cases (Gaofeng Town) and the nearby towns were chosen as the second layer. Only forest goers were screened by ACD, while PCD as a routine screening method. 7831 blood smears collected by ACD and PCD and tested with negative results. (iii) The city with cases (Sanya City) and others 12 counties/county-level cities were selected as the third layer. Malaria cases were monitored passively. A total of 77,555 blood slides were screened by PCD with zero positive sample. For each layer, the malaria vector mosquitoes were monitored using light traps, cattle-baited/human-bait traps. Anopheles minimus (dominant species), An. sinensis and An. dirus were captured. Vector control measures mainly include insecticide residual spraying and long-lasting insecticide nets. The capacity of clinicians, public health practitioners and laboratory technicians has been improved through training. During 2016‒2018, TLS and chemoprophylaxis were implemented in the same areas. In the first layer, all residents were monitored by ACD, and malaria chemoprophylaxis were distributed, 89.5% of forest goers were using chemoprophylaxis against malaria. The blood smears (3126 by ACD plus 1516 by PCD) were with zero positive results. Chemoprophylaxis and ACD were offered to forest goers once a year, and PCD in residents as a complementary measure in the second and third layer, 77.8% and 95.1% of forest goers received chemoprophylaxis. In each layer, vector surveillance and control of malaria and trainings for medical staff were still in place. CONCLUSIONS TLS was effective in blocking the outbreak by P. malariae among forest goers in Hainan in malaria elimination stage. However, whether it could prevent the malaria resurgence in the post-elimination phase needs to be further assessed.
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Affiliation(s)
- Yuchun Li
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China
| | - Yingjuan Huang
- Sanya City's Center for Disease Control and Prevention, No.674, Jiefang Third Road, Sanya, 570203, People's Republic of China
| | - Renqiang Chen
- Sanya City's Center for Disease Control and Prevention, No.674, Jiefang Third Road, Sanya, 570203, People's Republic of China
| | - Weizhen Huang
- Wuzhishan City's Center for Disease Control and Prevention, No. 26, Aoya Road, Wuzhishan, 572200, People's Republic of China
| | - Huanzhi Xu
- Wuzhishan City's Center for Disease Control and Prevention, No. 26, Aoya Road, Wuzhishan, 572200, People's Republic of China
| | - Rongshen Ye
- Baoting County's Center for Disease Control and Prevention, No. 2 Wenquan South Road, Baoting County, 572300, People's Republic of China
| | - Shaoling Huang
- Wanning City's Center for Disease Control and Prevention, No.70 Guangming South Road, Wanning City, 571500, People's Republic of China
| | - Ji Zhen
- Dongfang City's Center for Disease Control and Prevention, Intersection of Liberation West Road and Harvest Road, Dongfang City, 572600, People's Republic of China
| | - Xiaodan Wen
- Danzhou City's Center for Disease Control and Prevention, No. 2000 Zhongxing Avenue, Danzhou City, 571700, People's Republic of China
| | - Guoyi Wang
- Qiongzhong County's Center for Disease Control and Prevention, Intersection of Baihua Road and Education Road, Qiongzhong County, 572900, People's Republic of China
| | - Yong Liu
- Tunchang County's Center for Disease Control and Prevention, No. 6 Jiefang Road, Tunchang County, 571600, People's Republic of China
| | - Haishan Li
- Ledong County's Center for Disease Control and Prevention, Nearby Secondary Health Vocational and Technical School, Ledong County, 572500, People's Republic of China
| | - Zaichun Zheng
- Changjiang County's Center for Disease Control and Prevention, Intersection People North Road and Huimin Road, Changjiang County, 572700, People's Republic of China
| | - Jian Wang
- Baisha County's Center for Disease Control and Prevention, Weisheng Road, Baisha County, 572800, People's Republic of China
| | - Guoshen Wang
- Qionghai County's Center for Disease Control and Prevention, No. 17 Fuhaiheng South Road, Qionghai County, 571400, People's Republic of China
| | - Chong Chen
- Lingshui County's Institute of Health Supervision, Shuangyong Road, Lingshui County, 572400, People's Republic of China
| | - Wen Zeng
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China
| | - Feng Meng
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China
| | - Xiaoming Huang
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China
| | - Guangze Wang
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China.
| | - Bing Yang
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China.
| | - Yan Chen
- Hainan Provincial Center for Disease Control and Prevention, No. 40 Haifu Road, Haikou, 570203, People's Republic of China.
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Ruyobeza B, Grobbelaar SS, Botha A. Hurdles to developing and scaling remote patients' health management tools and systems: a scoping review. Syst Rev 2022; 11:179. [PMID: 36042505 PMCID: PMC9427160 DOI: 10.1186/s13643-022-02033-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite all the excitement and hype generated regarding the expected transformative impact of digital technology on the healthcare industry, traditional healthcare systems around the world have largely remained unchanged and resultant improvements in developed countries are slower than anticipated. One area which was expected to significantly improve the quality of and access to primary healthcare services in particular is remote patient monitoring and management. Based on a combination of rapid advances in body sensors and information and communication technologies (ICT), it was hoped that remote patient management tools and systems (RPMTSs) would significantly reduce the care burden on traditional healthcare systems as well as health-related costs. However, the uptake or adoption of above systems has been extremely slow and their roll out has not yet properly taken off especially in developing countries where they ought to have made the greatest positive impact. AIM The aim of the study was to assess whether or not recent, relevant literature would support the development of in-community, design, deployment and implementation framework based on three factors thought to be important drivers and levers of RPMTS's adoption and scalability. METHODS A rapid, scoping review conducted on relevant articles obtained from PubMed, MEDLINE, PMC and Cochrane databases and grey literature on Google and published between 2012 and May 2020, by combining a number of relevant search terms and phrases. RESULTS Most RPMTSs are targeted at and focused on a single disease, do not extensively involve patients and clinicians in their early planning and design phases, are not designed to best serve a specific catchment area and are mainly directed at post-hospital, disease management settings. This may be leading to a situation where patients, potential patients and clinicians simply do not make use of these tools, leading to low adoption and scalability thereof. CONCLUSION The development of a user-centred, context-dependent, customizable design and deployment framework could potentially increase the adoption and scalability of RPMTSs, if such framework addressed a combination of diseases, prevalent in a given specific catchment area, especially in developing countries with limited financial resources.
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Affiliation(s)
- Barimwotubiri Ruyobeza
- Department of Industrial Engineering, Stellenbosch University, Stellenbosch, South Africa
| | - Sara S Grobbelaar
- Department of Industrial Engineering, Stellenbosch University, South Africa AND DSI-NRF Centre of Excellence in Scientometrics and Science, Technology and Innovation Policy (SciSTIP), Stellenbosch University, Stellenbosch, South Africa.
| | - Adele Botha
- Department of Industrial Engineering, Stellenbosch University and CSIR Next Generation Enterprises and Institutions, Stellenbosch, South Africa
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Jenetzky E, Schwarz S, Fingerhut I, Kerdar SH, Gwiasda M, Rathjens L, Kulikova O, Martin D. [The FeverApp Registry - A Way to Empower Parents through their Own Documentation to a Graduated Decision]. DAS GESUNDHEITSWESEN 2021; 83:S4-S11. [PMID: 34731887 DOI: 10.1055/a-1581-8155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM OF THE STUDY To demonstrate the feasibility and exemplarity of an app-based parent registry. METHODS The app as an elaborated interactive electronic case report form and the underlying data structure of the registry are presented. The initial recruitment efforts are illustrated and the temperature distribution, as well as the distribution of fever events in 2020, are analyzed. RESULTS The FeverApp successfully collects data into a central registry. Like every study, it also provides information on the current knowledge. The ecological momentary assessment can represent the illness situation at several levels (measurement, fever episode, individual, family, practice, country). Methods for data collection needed to be developed in a flexible manner due to pandemic conditions. The initial recruitment goal of 2400 fever phases in the first two years was met, with nationwide dissemination pending. It is shown that body temperature does not rise indefinitely; fevers reach an average of 39 degrees without antipyretics, although in rare cases temperatures beyond 41 degrees are reached without harm. Furthermore, a comparison with a reference practice shows that fever episodes can be recorded more comprehensively in the app, including infections that do not come to the presentation in a pediatrician's office. Thus, the FeverApp fulfills in a model-like fashion the use of registers in persons basically healthy and maps a multi-level diagnostics. CONCLUSION The FeverApp could basically establish itself as a supporting tool, the registry can reliably collect data with the method used and maps the current infection situation. In researching the question of how infections develop in the post-Covid period, the app could perform an important task.
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Affiliation(s)
- Ekkehart Jenetzky
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, - und -psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Silke Schwarz
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland
| | - Ingo Fingerhut
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland.,Inhaber, Praxis Kleiner Piks, Bochum, Deutschland
| | - Sara Hamideh Kerdar
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland
| | - Moritz Gwiasda
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland
| | - Larisa Rathjens
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland
| | - Olga Kulikova
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland
| | - David Martin
- Department für Humanmedizin, Fakultät für Gesundheit Universität Witten/Herdecke, Witten, Deutschland.,Kinderklinik, Eberhard-Karls-Universität Tübingen Medizinische Fakultät, Tübingen, Deutschland
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Sociodemographic Characteristics and Interests of FeverApp Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063121. [PMID: 33803541 PMCID: PMC8002853 DOI: 10.3390/ijerph18063121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022]
Abstract
The FeverApp Registry is a model registry focusing on pediatric fever using a mobile app to collect data and present recommendations. The recorded interactions can clarify the relationship between user documentation and user information. This initial evaluation regarding features of participants and usage intensity of educational video, information library, and documentation of fever events covers the runtime of FeverApp for the first 14 months. Of the 1592 users, the educational opening video was viewed by 41.5%, the Info Library was viewed by 37.5%, and fever events were documented by 55.5%. In the current sample, the role of a mother (p < 0.0090), having a higher level of education (p = 0.0013), or being registered at an earlier date appear to be cues to take note of the training video, Info Library, and to document. The FeverApp was used slightly less by people with a lower level of education or who had a migration background, but at the current stage of recruitment no conclusion can be made. The user analyses presented here are plausible and should be verified with further dissemination of the registry. Ecological momentary assessment is used more than the information option, in line with the task of a registry. Data collection via app seems feasible.
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Asadzadeh A, Pakkhoo S, Saeidabad MM, Khezri H, Ferdousi R. Information technology in emergency management of COVID-19 outbreak. INFORMATICS IN MEDICINE UNLOCKED 2020; 21:100475. [PMID: 33204821 PMCID: PMC7661942 DOI: 10.1016/j.imu.2020.100475] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/20/2022] Open
Abstract
Emergency management of the emerging infectious disease outbreak is critical for public health threats. Currently, control of the COVID-19 outbreak is an international concern and has become a crucial challenge in many countries. This article reviews significant information technologyIT) applications in emergency management of COVID-19 by considering the prevention/mitigation, preparedness, response, and recovery phases of the crisis. This review was conducted using MEDLINE PubMed), Embase, IEEE, and Google Scholar. Expert opinions were collected to show existence gaps, useful technologies for each phase of emergency management, and future direction. Results indicated that various IT-based systems such as surveillance systems, artificial intelligence, computational methods, Internet of things, remote sensing sensor, online service, and GIS geographic information system) could have different outbreak management applications, especially in response phases. Information technology was applied in several aspects, such as increasing the accuracy of diagnosis, early detection, ensuring healthcare providers' safety, decreasing workload, saving time and cost, and drug discovery. We categorized these applications into four core topics, including diagnosis and prediction, treatment, protection, and management goals, which were confirmed by five experts. Without applying IT, the control and management of the crisis could be difficult on a large scale. For reducing and improving the hazard effect of disaster situations, the role of IT is inevitable. In addition to the response phase, communities should be considered to use IT capabilities in prevention, preparedness, and recovery phases. It is expected that IT will have an influential role in the recovery phase of COVID-19. Providing IT infrastructure and financial support by the governments should be more considered in facilitating IT capabilities.
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Affiliation(s)
- Afsoon Asadzadeh
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saba Pakkhoo
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Mirzaei Saeidabad
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hero Khezri
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ferdousi
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Bajaria S, Abdul R. Preparedness of health facilities providing HIV services during COVID-19 pandemic and assessment of their compliance to COVID-19 prevention measures: findings from the Tanzania Service Provision Assessment (SPA) survey. Pan Afr Med J 2020; 37:18. [PMID: 33343797 DOI: 10.11604/pamj.supp.2020.37.18.25443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/26/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction the increased demands of health facilities and workers due to coronavirus overwhelm the already burdened Tanzanian health systems. This study evaluates the current capacity of facilities and providers for HIV care and treatment services and their preparedness to adhere to the national and global precaution guidelines for HIV service providers and patients. Methods data for this study come from the latest available, Tanzania Service Provision Assessment survey 2014-15. Frequencies and percentages described the readiness and availability of HIV services and providers. Chi-square test compared the distribution of services by facility location and availability and readiness of precaution commodities and HIV services by managing authorities. Results availability of latex gloves was high (83% at OPD and 95.3% laboratory). Availability of medical masks, alcohol-based hand rub and disinfectants was low. Availability of medical mask at outpatient department (OPD) was 28.7% urban (23.5% public; 33.8% private, p=0.02) and 13.5% rural (10.1% public; 25.4% private, p=0.001) and lower at laboratories. Fewer facilities in rural area (68.4%) had running water in OPD than urban (86.3%). Higher proportions of providers at public than private facilities in urban (82.8% versus 73.1%) and rural (88.2% versus 81.6%) areas provided HIV test counseling and at least two other HIV services. Conclusion availability of commodities such as medical masks, alcohol-based hand rub, and disinfectant was low while the readiness of providers to multitask HIV related services was high. Urgent distribution and re-assessment of these supplies are necessary, to protect HIV patients, their caregivers, and health providers from COVID-19.
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Kweka EJ, Mazigo HD, Lyaruu LJ, Mausa EA, Venter N, Mahande AM, Coetzee M. Anopheline Mosquito Species Composition, Kdr Mutation Frequency, and Parasite Infectivity Status in Northern Tanzania. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:933-938. [PMID: 31923308 DOI: 10.1093/jme/tjz245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Indexed: 06/10/2023]
Abstract
The scaling-up of malaria control interventions in northern Tanzania has resulted in a decline in malaria prevalence and vector species composition. Despite this achievement, residual malaria transmission remains a concern in the area. The main aim of this study was to investigate malaria vector species composition, parasite infectivity rates, and the presence of insecticide knockdown resistance (kdr) mutations in three sites that have experienced a significant decline in malaria in northern Tanzania. Adult mosquitoes were sampled using light traps in houses and hand-aspirators in cowsheds, whereas the standard dipping method was used for sampling mosquito larvae. Adult mosquitoes identified as Anopheles gambiae s.l. and An. funestus s.l. and larval stages III and IV of An. gambiae s.l. were stored in absolute ethanol for further laboratory molecular identification. The identified species in the An. gambiae complex were An. gambiae s.s., An. merus, An. quadriannulatus, and An. arabiensis, whereas the An. funestus group comprised An. funestus s.s., An. rivulorum, and An. leesoni. For An. gambiae s.s. analyzed from Zeneth, 47.6% were kdr-East homozygous susceptible, 35.7% kdr-East heterozygous resistant, 9.6% kdr-East homozygous resistant, and 7.1% undefined, whereas specimens from Kwakibuyu were 45.5% kdr-East homozygous susceptible, 32.7% kdr-East heterozygous resistant, 16.3% kdr-East homozygous resistant, and 5.5% undefined. There were no kdr-West alleles identified from any specimen. The overall malaria parasite infectivity rate was 0.75%. No infections were found in Moshi. The findings indicate that populations of the major malaria vector mosquitoes are still present in the study area, with An. funestus taking a lead in malaria transmission.
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Affiliation(s)
- Eliningaya J Kweka
- Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania
- Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Lucile J Lyaruu
- Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania
| | - Emmanuel A Mausa
- National Plant Genetic Resource Centre, Tropical Pesticides Research Institute, Arusha, Tanzania
| | - Nelius Venter
- Wits Research Institute for Malaria and Wits/MRC Collaborating Centre for Multi-disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Aneth M Mahande
- Mabogini Field Station, Tropical Pesticides Research Institute, Moshi, Tanzania
| | - Maureen Coetzee
- Wits Research Institute for Malaria and Wits/MRC Collaborating Centre for Multi-disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa
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11
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Mihreteab S, Lubinda J, Zhao B, Rodriguez-Morales AJ, Karamehic-Muratovic A, Goitom A, Shad MY, Haque U. Retrospective data analyses of social and environmental determinants of malaria control for elimination prospects in Eritrea. Parasit Vectors 2020; 13:126. [PMID: 32164770 PMCID: PMC7068948 DOI: 10.1186/s13071-020-3974-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background The present study focuses on both long- and short-term malaria transmission in Eritrea and investigates the risk factors. Annual aggregates of information on malaria cases, deaths, diagnostics and control interventions from 2001 to 2008 and monthly reported data from 2009 to 2017 were obtained from the National Malaria Control Programme. We used a generalized linear regression model to examine the associations among total malaria cases, death, insecticide-treated net coverage, indoor residual spraying and climatic parameters. Results Reduction in malaria mortality is demonstrated by the milestone margins of over 97% by the end of 2017. Malaria incidence likewise declined during the period (from 33 to 5 per 1000 population), representing a reduction of about 86% (R2 = 0.3) slightly less than the decline in mortality. The distribution of insecticide treated nets generally declined between 2001 and 2014 (R2 = 0.16) before increasing from 2015 to 2017, while the number of people protected by indoor residual spraying slightly increased (R2 = 0.27). Higher rainfall was significantly associated with an increased number of malaria cases. The covariates rainfall and temperature are a better pair than IRS and LLIN to predict incidences. On the other hand, IRS and LLIN is a more significant pair to predict mortality cases. Conclusions While Eritrea has made significant progress towards malaria elimination, this progress should be maintained and further improved. Distribution, coverage and utilization of malaria control and elimination tools should be optimized and sustained to safeguard the gains made. Additionally, consistent annual performance evaluation of malaria indicators would ensure a continuous learning process from gains/threats of epidemics and resurgence in regions already earmarked for elimination.
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Affiliation(s)
- Selam Mihreteab
- National Malaria Control Programme, Ministry of Health, Asmara, Eritrea.
| | - Jailos Lubinda
- School of Geography and Environmental Sciences, Ulster University, Coleraine, UK
| | - Bingxin Zhao
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Medical School, Faculty of Health Sciences, UniFranz, Cochabamba, Bolivia.,Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia
| | | | - Aman Goitom
- National Malaria Control Programme, Ministry of Health, Asmara, Eritrea
| | | | - Ubydul Haque
- Department of Geography, University of Florida, Gainesville, FL, USA.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA.,Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
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12
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Kadam R, White W, Banks N, Katz Z, Dittrich S, Kelly-Cirino C. Target Product Profile for a mobile app to read rapid diagnostic tests to strengthen infectious disease surveillance. PLoS One 2020; 15:e0228311. [PMID: 31995628 PMCID: PMC6988927 DOI: 10.1371/journal.pone.0228311] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/07/2020] [Indexed: 02/06/2023] Open
Abstract
The essential role of rapid diagnostic tests (RDTs) in disease control is compromised every time a test is not performed correctly or its result is not reported accurately and promptly. A mobile app that utilizes the camera and connectivity of a common smartphone can fill this role of supporting the test's proper execution and the automatic transmission of results. In a consensus process with 51 expert participants representing the needs of clinical users, healthcare programs, health information systems, surveillance systems, and global public health stakeholders, we developed a Target Product Profile describing the minimal and optimal characteristics of such an app. We collected feedback over two rounds and refined the characteristics to arrive at a preferred agreement level of greater than 75%, with an average of 92% agreement (range: 79-100%). As per this feedback, such an app should be compatible with many RDTs and mobile devices without needing accessories. The app should assist the user with RDT-specific instructions, include checks to facilitate quality control of the testing process and suggest results with ≥ 95% accuracy across common lighting conditions while allowing the user to determine the final result. Data from the app must be under the control of the health program that operates it, and the app should support at least one of the common data exchange formats HL7, FHIR, ASTM or JSON. The Target Product Profile also lays out the minimum data security and privacy requirements for the app.
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Affiliation(s)
- Rigveda Kadam
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
| | - Wallace White
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
| | - Nicholas Banks
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
| | - Zachary Katz
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
| | - Sabine Dittrich
- Foundation for Innovative Diagnostics (FIND), Geneva, Switzerland
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Kaehler N, Adhikari B, Cheah PY, von Seidlein L, Day NPJ, Paris DH, Tanner M, Pell C. Prospects and strategies for malaria elimination in the Greater Mekong Sub-region: a qualitative study. Malar J 2019; 18:203. [PMID: 31221145 PMCID: PMC6585139 DOI: 10.1186/s12936-019-2835-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/09/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND As malaria elimination becomes a goal in malaria-endemic nations, questions of feasibility become critical. This article explores the potential challenges associated with this goal and future strategies for malaria elimination in the Greater Mekong Sub-region. METHODS Thirty-two semi-structured interviews were conducted with policy makers (n = 17) and principal investigators (n = 15) selected based on their involvement in malaria prevention, control and elimination in the GMS. Interviews were audio-recorded and transcribed for qualitative content (thematic) analysis using QSR NVivo. RESULTS All respondents described current malaria control and elimination strategies, such as case detection and management, prevention and strengthening of surveillance systems as critical and of equal priority. Aware of the emergence of multi-drug resistance in the GMS, researchers and policy makers outlined the need for additional elimination tools. As opposed to a centralized strategy, more targeted and tailored approaches to elimination were recommended. These included targeting endemic areas, consideration for local epidemiology and malaria species, and strengthening the peripheral health system. A decline in malaria transmission could lead to complacency amongst funders and policy makers resulting in a reduction or discontinuation of support for malaria elimination. Strong commitment of policymakers combined with strict monitoring and supervision by funders were considered pivotal to successful elimination programmes. CONCLUSION Against a backdrop of increasing anti-malarial resistance and decreasing choices of anti-malarial regimens, policy makers and researchers stressed the urgency of finding new malaria elimination strategies. There was consensus that multi-pronged strategies and approaches are needed, that no single potential tool/strategy can be appropriate to all settings. Hence there is a need to customize malaria control and elimination strategies based on the better surveillance data.
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Affiliation(s)
- Nils Kaehler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, 4051, Basel, Switzerland.
- Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Bipin Adhikari
- Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Phaik Yeong Cheah
- Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Lorenz von Seidlein
- Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Nicholas P J Day
- Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK
| | - Daniel H Paris
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, 4051, Basel, Switzerland
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, 4051, Basel, Switzerland
| | - Christopher Pell
- Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands
- Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands
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McCool J, Tanielu H, Umali E, Whittaker R. Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study. JMIR Mhealth Uhealth 2018; 6:e173. [PMID: 30170994 PMCID: PMC6138826 DOI: 10.2196/mhealth.9033] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/07/2018] [Accepted: 06/21/2018] [Indexed: 12/19/2022] Open
Abstract
Background Samoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable. Objective This study aimed to adopt a text message (short message service, SMS) smoking cessation program designed in New Zealand (stop smoking with mobile phones, STOMP) for use in Samoa to assist national objectives in reducing the tobacco use. Methods Using focus groups with smokers and ex-smokers, we explored the context for tobacco use and preferences for SMS text messages. Postintervention focus groups were held after participants received SMS text messages for 1 week. Frequent face-to-face meetings with the primary partner (Ministry of Health Samoa) and key stakeholders contributed to the adaptation process. Participatory feedback and collaboration from stakeholders became an integral part of the cultural adaptation and translation of the program. Furthermore, detailed document analyses were included as part of the formal evaluation of the initiative to explore the core determinants of success in adapting the program to the Samoan cultural context. Results The SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program. The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa. Adapting messages required simultaneous multilevel processes, including complex high-level engagement, between the team and the stakeholders, along with crafting the precise content for (character limited) messages. Conclusions Receiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support. Adapting a text-based program in Samoa requires fastidious attention to the nuances of culture, language, and sociopolitical structures in the country.
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Affiliation(s)
- Judith McCool
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Helen Tanielu
- Department of Sociology, National University of Samoa, Apia, Samoa
| | - Elaine Umali
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand.,Institute for Health Innovation and Improvement (i3), Waitemata District Health Board, Auckland, New Zealand
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