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Ghebrehiwet S, Ogundare T, Owusu M, Harris BL, Ojediran B, Touma M, Durham MP, Hook K, Borba CPC, Henderson DC. Building a postgraduate psychiatry training program in Liberia through cross-country collaborations: initiation stages, challenges, and opportunities. Front Public Health 2023; 11:1020723. [PMID: 37727607 PMCID: PMC10505824 DOI: 10.3389/fpubh.2023.1020723] [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: 08/16/2022] [Accepted: 08/17/2023] [Indexed: 09/21/2023] Open
Abstract
Background About 80% of the nearly 2 billion people experiencing psychiatric conditions worldwide do not have access to quality, affordable mental health care. In Africa, there are 0.004 psychiatrists per 10,000 people, with the shortage exacerbated by a limited number of postgraduate psychiatry training opportunities. As of 2018, there were only two psychiatrists in Liberia. Methods This paper aims to offer a framework for developing postgraduate (i.e., residency) psychiatry training in resource-constrained settings to disseminate best practices and lessons learned. This article describes the approach to developing the formal global academic partnership that supported the initiation of Liberia's first postgraduate psychiatry training program in July 2019. Results Authors describe strengths, challenges, and opportunities for improvement in the planning and initiation stages of the postgraduate program. Key strengths of the program planning process include: (1) collaboration with a coalition of local and national stakeholders committed to improving mental health care in Liberia; (2) early procurement of quality video conferencing equipment and internet service to facilitate remote learning and broaden access to digital materials; and (3) leveraging of intra-continental partnerships for subspecialty training. Challenges experienced include: (1) navigating the intricacies of local political and administrative processes; (2) recruiting candidates to a medical specialty with historically lower salaries; and (3) the added burden placed on the limited number of local specialists. Identified opportunities include building a monitoring, evaluation, and learning (MEL) framework, further diversifying subspecialty areas of psychiatric and neurological training, and obtaining full accreditation of the postgraduate psychiatry program through the West African College of Physicians (WACP). Conclusion The successful launch of the postgraduate psychiatry training program in Liberia is attributed to several factors, including a long-standing academic collaboration of over 10 years and support for mental health capacity-building efforts at national and local levels.
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Affiliation(s)
- Senait Ghebrehiwet
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
| | - Temitope Ogundare
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Micaela Owusu
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Benjamin L. Harris
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Babawale Ojediran
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia
| | - Mia Touma
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Michelle P. Durham
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Kimberly Hook
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Christina P. C. Borba
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - David C. Henderson
- Department of Psychiatry, Boston Medical Center, Boston, MA, United States
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
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2
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Liu Y, Zhu Y, Sun X, Ma T, Lao X, Zheng H. DRAVP: A Comprehensive Database of Antiviral Peptides and Proteins. Viruses 2023; 15:v15040820. [PMID: 37112801 PMCID: PMC10141206 DOI: 10.3390/v15040820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 03/18/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Viruses with rapid replication and easy mutation can become resistant to antiviral drug treatment. With novel viral infections emerging, such as the recent COVID-19 pandemic, novel antiviral therapies are urgently needed. Antiviral proteins, such as interferon, have been used for treating chronic hepatitis C infections for decades. Natural-origin antimicrobial peptides, such as defensins, have also been identified as possessing antiviral activities, including direct antiviral effects and the ability to induce indirect immune responses to viruses. To promote the development of antiviral drugs, we constructed a data repository of antiviral peptides and proteins (DRAVP). The database provides general information, antiviral activity, structure information, physicochemical information, and literature information for peptides and proteins. Because most of the proteins and peptides lack experimentally determined structures, AlphaFold was used to predict each antiviral peptide's structure. A free website for users (http://dravp.cpu-bioinfor.org/, accessed on 30 August 2022) was constructed to facilitate data retrieval and sequence analysis. Additionally, all the data can be accessed from the web interface. The DRAVP database aims to be a useful resource for developing antiviral drugs.
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Affiliation(s)
- Yanchao Liu
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
| | - Youzhuo Zhu
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
| | - Xin Sun
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
| | - Tianyue Ma
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
| | - Xingzhen Lao
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
| | - Heng Zheng
- School of Life Science and Technology, China Pharmaceutical University, 24 Tongjiaxiang, Nanjing 210009, China
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Onyekuru N, Ihemezie E, Ezea C, Apeh C, Onyekuru B. Impacts of Ebola disease outbreak in West Africa: Implications for government and public health preparedness and lessons from COVID-19. SCIENTIFIC AFRICAN 2023; 19:e01513. [PMID: 36570591 PMCID: PMC9759305 DOI: 10.1016/j.sciaf.2022.e01513] [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: 09/17/2020] [Revised: 11/26/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
There has been an increase in the outbreak of communicable diseases in recent times; the most recent ones are Ebola Virus Disease (EVD) and COVID-19. These diseases have had different impacts on society and the ecosystem. However, underlying these impacts are the levels of preparedness of governments and public health institutions to mitigate and control these diseases. Therefore, this paper aims to explore these impacts, government and institutional interventions and their nexus towards the effective management of such crises. A critical review of empirical literature was adopted for the methodological approach and narrative synthesis used for analysis. Results show that EVD had diverse impacts on West Africa; economically through the loss of income from economic activities due to widespread sickness among workers and movement restrictions. EVD also had significant social impacts, such as reduced community cohesion, school and business closures, job losses, food insecurity, and high morbidity and mortality. Though some good efforts have been made by different countries in collaboration with international organisations like the World Health Organization to control disease outbreaks more effectively, the recent COVID-19 pandemic has however exposed major weaknesses in the capacity of most African countries to cope. Poor capacity for testing and treatment, inadequate health facilities, poor incentives for health care workers, poor governance systems, poor border control, and awareness and research capacities impacted negatively on the capacity to control disease outbreaks. There is, therefore, a need to strengthen health systems across Africa through improved resource mobilisation, staff training, and coordination of investment strategies to sustain health system preparedness to manage future emerging or re-emerging outbreaks.
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Affiliation(s)
- N.A. Onyekuru
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom
| | - E.J. Ihemezie
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,Corresponding author:
| | - C.P. Ezea
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,School of Life Science, University of Warwick, Coventry, United Kingdom
| | - C.C. Apeh
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom
| | - B.O. Onyekuru
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,Centre for Distant and E-learning, University of Nigeria, Nsukka
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4
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Mulenga-Cilundika P, Ekofo J, Kabanga C, Criel B, Van Damme W, Chenge F. Indirect Effects of Ebola Virus Disease Epidemics on Health Systems in the Democratic Republic of the Congo, Guinea, Sierra Leone and Liberia: A Scoping Review Supplemented with Expert Interviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13113. [PMID: 36293703 PMCID: PMC9602680 DOI: 10.3390/ijerph192013113] [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] [Received: 08/31/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Ebola Virus Disease (EVD) epidemics have been extensively documented and have received large scientific and public attention since 1976. Until July 2022, 16 countries worldwide had reported at least one case of EVD, resulting in 43 epidemics. Most of the epidemics occurred in the Democratic Republic of Congo (DRC) but the largest epidemic occurred from 2014-2016 in Guinea, Sierra Leone and Liberia in West Africa. The indirect effects of EVD epidemics on these countries' health systems, i.e., the consequences beyond infected patients and deaths immediately related to EVD, can be significant. The objective of this review was to map and measure the indirect effects of the EVD epidemics on the health systems of DRC, Guinea, Sierra Leone and Liberia and, from thereon, draw lessons for strengthening their resilience vis-à-vis future EVD outbreaks and other similar health emergencies. A scoping review of published articles from the PubMed database and gray literature was conducted. It was supplemented by interviews with experts. Eighty-six articles were included in this review. The results were structured based on WHO's six building blocks of a health system. During the EVD outbreaks, several healthcare services and activities were disrupted. A significant decline in indicators of curative care utilization, immunization levels and disease control activities was noticeable. Shortages of health personnel, poor health data management, insufficient funding and shortages of essential drugs characterized the epidemics that occurred in the above-mentioned countries. The public health authorities had virtually lost their leadership in the management of an EVD response. Governance was characterized by the development of a range of new initiatives to ensure adequate response. The results of this review highlight the need for countries to invest in and strengthen their health systems, through the continuous reinforcement of the building blocks, even if there is no imminent risk of an epidemic.
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Affiliation(s)
- Philippe Mulenga-Cilundika
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
| | - Joel Ekofo
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Chrispin Kabanga
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Bart Criel
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Wim Van Damme
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | - Faustin Chenge
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- School of Public Health, Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
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5
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Agamennone M, Fantacuzzi M, Vivenzio G, Scala MC, Campiglia P, Superti F, Sala M. Antiviral Peptides as Anti-Influenza Agents. Int J Mol Sci 2022; 23:11433. [PMID: 36232735 PMCID: PMC9569631 DOI: 10.3390/ijms231911433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Influenza viruses represent a leading cause of high morbidity and mortality worldwide. Approaches for fighting flu are seasonal vaccines and some antiviral drugs. The development of the seasonal flu vaccine requires a great deal of effort, as careful studies are needed to select the strains to be included in each year's vaccine. Antiviral drugs available against Influenza virus infections have certain limitations due to the increased resistance rate and negative side effects. The highly mutative nature of these viruses leads to the emergence of new antigenic variants, against which the urgent development of new approaches for antiviral therapy is needed. Among these approaches, one of the emerging new fields of "peptide-based therapies" against Influenza viruses is being explored and looks promising. This review describes the recent findings on the antiviral activity, mechanism of action and therapeutic capability of antiviral peptides that bind HA, NA, PB1, and M2 as a means of countering Influenza virus infection.
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Affiliation(s)
- Mariangela Agamennone
- Department of Pharmacy, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Marialuigia Fantacuzzi
- Department of Pharmacy, University “G. d’Annunzio” of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Giovanni Vivenzio
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
| | - Maria Carmina Scala
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
| | - Fabiana Superti
- National Centre for Innovative Technologies in Public Health, National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
| | - Marina Sala
- Department of Pharmacy, University of Salerno, Via Giovanni Paolo II 132, 84084 Fisciano, Italy
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6
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Hemingway-Foday JJ, Diallo BI, Compaore S, Bah S, Keita S, Diallo IT, Martel LD, Standley CJ, Bah MB, Bah M, Camara D, Kaba AK, Keita L, Kone M, Reynolds E, Souare O, Stolka KB, Tchwenko S, Wone A, Worrell MC, MacDonald PDM. Lessons learned for surveillance system strengthening through capacity building and partnership engagement in post-Ebola Guinea, 2015-2019. Front Public Health 2022; 10:715356. [PMID: 36033803 PMCID: PMC9403137 DOI: 10.3389/fpubh.2022.715356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/27/2022] [Indexed: 01/21/2023] Open
Abstract
The 2014-2016 Ebola outbreak in Guinea revealed systematic weaknesses in the existing disease surveillance system, which contributed to delayed detection, underreporting of cases, widespread transmission in Guinea and cross-border transmission to neighboring Sierra Leone and Liberia, leading to the largest Ebola epidemic ever recorded. Efforts to understand the epidemic's scale and distribution were hindered by problems with data completeness, accuracy, and reliability. In 2017, recognizing the importance and usefulness of surveillance data in making evidence-based decisions for the control of epidemic-prone diseases, the Guinean Ministry of Health (MoH) included surveillance strengthening as a priority activity in their post-Ebola transition plan and requested the support of partners to attain its objectives. The U.S. Centers for Disease Control and Prevention (US CDC) and four of its implementing partners-International Medical Corps, the International Organization for Migration, RTI International, and the World Health Organization-worked in collaboration with the Government of Guinea to strengthen the country's surveillance capacity, in alignment with the Global Health Security Agenda and International Health Regulations 2005 objectives for surveillance and reporting. This paper describes the main surveillance activities supported by US CDC and its partners between 2015 and 2019 and provides information on the strategies used and the impact of activities. It also discusses lessons learned for building sustainable capacity and infrastructure for disease surveillance and reporting in similar resource-limited settings.
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Affiliation(s)
| | | | | | | | | | | | - Lise D. Martel
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Claire J. Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States
| | | | | | | | | | | | | | | | | | | | - Samuel Tchwenko
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Abdoulaye Wone
- International Organization for Migration, Conakry, Guinea
| | - Mary Claire Worrell
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Pia D. M. MacDonald
- RTI International, Durham, NC, United States,Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, United States
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Kavulikirwa OK, Sikakulya FK. Recurrent Ebola outbreaks in the eastern Democratic Republic of the Congo: A wake-up call to scale up the integrated disease surveillance and response strategy. One Health 2022; 14:100379. [PMID: 35313715 PMCID: PMC8933533 DOI: 10.1016/j.onehlt.2022.100379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/03/2022] Open
Abstract
Ebola virus disease (EVD) is a dangerous viral zoonotic hemorrhagic fever caused by a deadly pathogenic filovirus. Frugivorous bats are recognized as being the natural reservoir, playing a pivotal role in the epidemiological dynamics. Since its discovery in 1976, the disease has been shown to be endemic in the Democratic Republic of the Congo (DRC). So far, thirteen outbreaks have occurred, and EVD has been prioritized in the national surveillance system. Additionally, EVD is targeted by the Integrated Disease Surveillance and Response (IDSR) strategy in DRC. The IDSR strategy is a collaborative, comprehensive and innovative surveillance approach developed and adopted by WHO's African region member states (WHO/Afro) to strengthen their surveillance capacity at all levels for early detection, response and recovery from priority diseases and public health events. We provide an overview of the IDSR strategy and the issues that can prevent its expected outcome (early detection for timely response) in eastern DRC where there are still delays in EVD outbreaks detection and weaknesses in response capacity and health crisis recovery. Therefore, this paper highlights the advantages linked to the implementation of the IDSR and calls for an urgent need to scale up its materialization against the recurrent Ebola outbreaks in eastern DRC. Consequently, the paper advocates for rapidly addressing the obstacles hindering its operationalization and adapting the approach to the local context using implementation science.
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Jalloh MF, Sengeh P, Ibrahim N, Kulkarni S, Sesay T, Eboh V, Jalloh MB, Abu Pratt S, Webber N, Thomas H, Kaiser R, Singh T, Prybylski D, Omer SB, Brewer NT, Wallace AS. Association of community engagement with vaccination confidence and uptake: A cross-sectional survey in Sierra Leone, 2019. J Glob Health 2022; 12:04006. [PMID: 35265325 PMCID: PMC8876869 DOI: 10.7189/jogh.12.04006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background The 2014-2016 Ebola epidemic disrupted childhood immunization in Sierra Leone, Liberia, and Guinea. After the epidemic, the Government of Sierra Leone prioritized community engagement to increase vaccination confidence and uptake. To support these efforts, we examined potential drivers of vaccination confidence and uptake in Sierra Leone. Methods We conducted a population-based household survey with primary caregivers of children in a birth cohort of 12 to 23 months in four districts with low vaccination coverage in Sierra Leone in 2019. Modified Poisson regression modeling with robust variance estimation was used to examine if perceived community engagement in planning the immunization program in the community was associated with vaccination confidence and having a fully vaccinated child. Results The sample comprised 621 age-eligible children and their caregivers (91% response rate). Half of the caregivers (52%) reported that it usually takes too long to get to the vaccination site, and 36% perceived that health workers expect money for vaccination services that are supposed to be given at no charge. When mothers were the decision-makers of the children’s vaccination, 80% of the children were fully vaccinated versus 69% when fathers were the decision-makers and 56% when other relatives were the decision-makers. Caregivers with high confidence in vaccination were more likely to have fully vaccinated children compared to caregivers with low confidence (78% versus 53%). For example, caregivers who thought vaccines are ‘very much’ safe were more likely to have fully vaccinated children than those who thought vaccines are ‘somewhat’ safe (76% versus 48%). Overall, 53% of caregivers perceived high level of community engagement, 41% perceived medium level of engagement, and 6% perceived low level of engagement. Perceiving high community engagement was associated with expressing high vaccination confidence (adjusted prevalence ratio (aPR) = 2.60; 95% confidence interval (CI) = 1.67-4.04) and having a fully vaccinated child (aPR = 1.67; 95% CI = 1.18-2.38). Conclusions In these four low coverage districts in Sierra Leone, the perceived level of community engagement was strongly associated with vaccination confidence among caregivers and vaccination uptake among children. We have provided exploratory cross-sectional evidence to inform future longitudinal assessments to further investigate the potential causal effect of community engagement on vaccination confidence and uptake.
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Affiliation(s)
- Mohamed F Jalloh
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Shibani Kulkarni
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tom Sesay
- Expanded Program on Immunization, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Victor Eboh
- Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | - Harold Thomas
- Health Education Division, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Reinhard Kaiser
- Sierra Leone Country Office of U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Tushar Singh
- Sierra Leone Country Office of U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Dimitri Prybylski
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Saad B Omer
- Yale Institute of Global Health, Yale University, New Haven, Connecticut, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Aaron S Wallace
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Essa RZ, Wu YS, Batumalaie K, Sekar M, Poh CL. Antiviral peptides against SARS-CoV-2: therapeutic targets, mechanistic antiviral activity, and efficient delivery. Pharmacol Rep 2022; 74:1166-1181. [PMID: 36401119 PMCID: PMC9676828 DOI: 10.1007/s43440-022-00432-6] [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: 10/05/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022]
Abstract
The global pandemic of COVID-19 is a serious public health concern. Over 625 million confirmed cases and more than 6 million deaths have been recorded worldwide. Although several vaccines and antiviral medications have been developed, their efficacy is limited by the emerging new SARS-CoV-2 strains. Peptide-based therapeutics is a fast-growing class of new drugs and have unique advantages over large proteins and small molecules. Antiviral peptides (AVPs) are short polycationic antivirals with broad-spectrum effects, which have been shown to exert both prophylactic and therapeutic actions against reported coronaviruses. The potential therapeutic targets of AVPs are located either on the virus (e.g., E-protein and S-protein) to prohibit viral binding or host cells, particularly, those present on the cell surface (e.g., ACE2 and TMPRSS2). Despite AVPs having promising antiviral effects, their efficacy is limited by low bioavailability. Thus, nanoformulation is a prerequisite for prolonged bioavailability and efficient delivery. This review aimed to present an insight into the therapeutic AVP targets on both virus and host cells by discussing their antiviral activities and associated molecular mechanisms. Besides, it described the technique for discovering and developing possible AVPs based on their targets, as well as the significance of using nanotechnology for their efficient delivery against SARS-CoV-2.
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Affiliation(s)
- Raahilah Zahir Essa
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, 47500 Selangor, Malaysia
| | - Yuan-seng Wu
- Centre for Virus and Vaccine Research, School of Medical and Life Sciences, Sunway University, 47500 Selangor, Malaysia ,Department of Biological Sciences, School of Medical and Life Sciences, Sunway University, 47500 Selangor, Malaysia
| | - Kalaivani Batumalaie
- Department of Biomedical Sciences, Faculty of Health Sciences, Asia Metropolitan University, 81750 Johor, Malaysia
| | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, 30450 Ipoh, Perak Malaysia
| | - Chit-laa Poh
- Centre for Virus and Vaccine Research, School of Medical and Life Sciences, Sunway University, 47500 Selangor, Malaysia
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10
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Yu M, Chen Z. The effect of aviation responses to the control of imported COVID-19 cases. JOURNAL OF AIR TRANSPORT MANAGEMENT 2021; 97:102140. [PMID: 34511752 PMCID: PMC8423995 DOI: 10.1016/j.jairtraman.2021.102140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/05/2021] [Accepted: 09/05/2021] [Indexed: 05/12/2023]
Abstract
The outbreak of the COVID-19 pandemic has a lasting and unprecedented negative impact on the global aviation industry. While countries such as China have successfully curbed the domestic outbreak of the virus with various restrictive and preventive measures, the challenge of avoiding imported cases remains. More importantly, it is still unclear to what extent these implemented aviation emergency responses have effectively mitigated the transmission risk of the virus. This paper provides an empirical assessment of aviation responses to the control of imported COVID-19 cases, with a focus on the following three strategies: the "circuit breaker" policy, the "negative Nucleic Acid testing (NAT)", and the "double negative tests" requirement. Non-recursive structural equation models (SEM) with latent variables were applied to detailed international flight data and individual epidemic survey data of Guangzhou, China, between May 1 and November 30, 2020. The results show that the "double negative tests" measure has a positive effect on eliminating the number of SARS-CoV-2 carriers, while the effects of single "circuit breaker" and its co-intervention with "negative NAT" are conterproductive. This study provides important implications to civil aviation agencies in regard to medium and long-term risk control of imported cases. Specifically, although the circuit breaker mechanism was designed to target on the risk control of imported COVID-19 cases, it may be more effective to carefully maintain a timely and reliable pre-boarding screening and testing to curb the number of imported cases.
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Affiliation(s)
- Meng Yu
- City and Regional Planning, The Ohio State University, Columbus, OH, 43210, USA
| | - Zhenhua Chen
- City and Regional Planning, The Ohio State University, Columbus, OH, 43210, USA
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11
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Barriers and Opportunities for Sustainable Hand Hygiene Interventions in Rural Liberian Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168588. [PMID: 34444337 PMCID: PMC8391939 DOI: 10.3390/ijerph18168588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 01/23/2023]
Abstract
Hand hygiene is central to hospital infection control. During the 2014–2016 West Africa Ebola virus disease epidemic in Liberia, gaps in hand hygiene infrastructure and health worker training contributed to hospital-based Ebola transmission. Hand hygiene interventions were undertaken post-Ebola, but many improvements were not sustainable. This study characterizes barriers to, and facilitators of, hand hygiene in rural Liberian hospitals and evaluates readiness for sustainable, locally derived interventions to improve hand hygiene. Research enumerators collected data at all hospitals in Bong and Lofa counties, Liberia, in the period March–May 2020. Enumerators performed standardized spot checks of hand hygiene infrastructure and supplies, structured observations of hand hygiene behavior, and semi-structured key informant interviews for thematic analysis. During spot checks, hospital staff reported that handwashing container water was always available in 89% (n = 42) of hospital wards, piped running water in 23% (n = 11), and soap in 62% (n = 29). Enumerators observed 5% of wall-mounted hand sanitizer dispensers (n = 8) and 95% of pocket-size dispensers (n = 53) to be working. In interviews, hospital staff described willingness to purchase personal hand sanitizer dispensers when hospital-provided supplies were unavailable. Low-cost, sustainable interventions should address supply and infrastructure-related obstacles to hospital hand hygiene improvement.
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12
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Turki H, Hadj Taieb MA, Ben Aouicha M, Pouris A. Infectious epidemics and the research output of nations: A data-driven analysis. J Inf Sci 2021. [DOI: 10.1177/01655515211006605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
During the last years, several infectious diseases have caused widespread nationwide epidemics that affected information seeking behaviours, people mobility, economics and research trends. Examples of these epidemics are 2003 severe acute respiratory syndrome (SARS) epidemic in mainland China and Hong Kong, 2014–2016 Ebola epidemic in Guinea and Sierra Leone, 2015–2016 Zika epidemic in Brazil, Colombia and Puerto Rico and the recent COVID-19 epidemic in China and other countries. In this research article, we investigate the effect of large-scale outbreaks of infectious diseases on the research productivity and landscape of nations through the analysis of the research outputs of main countries affected by SARS, Zika and Ebola epidemics as returned by Web of Science Core Collection. Despite the mobility restrictions and the limitations of work conditions due to the epidemics, we surprisingly found that the research characteristics and productivity of the countries that have excellent or moderate research traditions and communities are not affected by infectious epidemics due to their robust long-term research structures and policy. Similarly, large-scale infectious outbreaks can even boost the research productivity of countries with limited research traditions thanks to international capacity building collaborations provided by organisations and associations from leading research countries.
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Affiliation(s)
- Houcemeddine Turki
- Faculty of Medicine of Sfax, University of Sfax, Tunisia
- Data Engineering and Semantics Research Unit, Faculty of Sciences of Sfax, University of Sfax, Tunisia
| | - Mohamed Ali Hadj Taieb
- Data Engineering and Semantics Research Unit, Faculty of Sciences of Sfax, University of Sfax, Tunisia
| | - Mohamed Ben Aouicha
- Data Engineering and Semantics Research Unit, Faculty of Sciences of Sfax, University of Sfax, Tunisia
| | - Anastassios Pouris
- Institute for Technological Innovation, University of Pretoria, South Africa
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Mitchell EMH, Adejumo OA, Abdur-Razzaq H, Ogbudebe C, Chukwueme N, Olorunju SB, Gidado M. Hybrid Approach to Estimation of Underreporting of Tuberculosis Case Notification in High-Burden Settings With Weak Surveillance Infrastructure: Design and Implementation of an Inventory Study. JMIR Public Health Surveill 2021; 7:e22352. [PMID: 33720030 PMCID: PMC8088841 DOI: 10.2196/22352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The greatest risk of infectious disease undernotification occurs in settings with limited capacity to detect it reliably. World Health Organization guidance on the measurement of misreporting is paradoxical, requiring robust, independent systems to assess surveillance rigor. Methods are needed to estimate undernotification in settings with incomplete, flawed, or weak surveillance systems. This study attempted to design a tuberculosis (TB) inventory study that balanced rigor with feasibility for high-need settings. OBJECTIVE This study aims to design a hybrid TB inventory study for contexts without World Health Organization preconditions. We estimated the proportion of TB cases that were not reported to the Ministry of Health in 2015. The study sought to describe TB surveillance coverage and quality at different levels of TB care provision. Finally, we aimed to identify structural-, facility-, and provider-level barriers to notification and reasons for underreporting, nonreporting, and overreporting. METHODS Retrospective partial digitalization of paper-based surveillance and facility records preceded deterministic and probabilistic record linkage; a hybrid of health facilities and laboratory census with a stratified sampling of HFs with no capacity to notify leveraged a priori knowledge. Distinct extrapolation methods were applied to the sampled health facilities to estimate bacteriologically confirmed versus clinical TB. In-depth interviews and focus groups were used to identify causal factors responsible for undernotification and test the acceptability of remedies. RESULTS The hybrid approach proved viable and instructive. High-specificity verification of paper-based records in the field was efficient and had minimal errors. Limiting extrapolation to clinical cases improved precision. Probabilistic record linkage is computationally intensive, and the choice of software influences estimates. Record absence, decay, and overestimation of the private sector TB treatment behavior threaten validity, meriting mitigation. Data management demands were underestimated. Treatment success was modest in all sectors (R=37.9%-72.0%) and did not align with treatment success reported by the state (6665/8770, 75.99%). One-fifth of TB providers (36/178, 20%) were doubtful that the low volume of patients with TB treated in their facility merited mastery of the extensive TB notification forms and procedures. CONCLUSIONS Subnational inventory studies can be rigorous, relevant, and efficient in countries that need them even in the absence of World Health Organization preconditions, if precautions are taken. The use of triangulation techniques, with minimal recourse to sampling and extrapolation, and the privileging of practical information needs of local decision makers yield reasonable misreporting estimates and viable policy recommendations.
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Affiliation(s)
- Ellen M H Mitchell
- Tropical Infectious Diseases, Department of Public Health, Institute for Tropical Medicine, Antwerp, Belgium
| | | | | | | | | | - Samson Bamidele Olorunju
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, University of Ibadan, Ibadan, Nigeria
| | - Mustapha Gidado
- KNCV TB Foundation, Koninklijke Centrale Vereniging tot bestrijding der Tuberculose (KNCV), The Hague, Netherlands
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Donia A, Hassan SU, Zhang X, Al-Madboly L, Bokhari H. COVID-19 Crisis Creates Opportunity towards Global Monitoring & Surveillance. Pathogens 2021; 10:pathogens10030256. [PMID: 33668358 PMCID: PMC7996165 DOI: 10.3390/pathogens10030256] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/13/2021] [Accepted: 02/22/2021] [Indexed: 01/07/2023] Open
Abstract
The spectrum of emerging new diseases as well as re-emerging old diseases is broadening as infectious agents evolve, adapt, and spread at enormous speeds in response to changing ecosystems. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recent phenomenon and may take a while to understand its transmission routes from less traveled territories, ranging from fomite exposure routes to wastewater transmission. The critical challenge is how to negotiate with such catastrophic pandemics in high-income countries (HICs ~20% of the global population) and low-and middle-income countries (LMICs ~ 80% of the global population) with a total global population size of approximately eight billion, where practical mass testing and tracing is only a remote possibility, particularly in low-and middle-income countries (LMICs). Keeping in mind the population distribution disparities of high-income countries (HICs) and LMICs and urbanisation trends over recent years, traditional wastewater-based surveillance such as that used to combat polio may help in addressing this challenge. The COVID-19 era differs from any previous pandemics or global health challenges in the sense that there is a great deal of curiosity within the global community to find out everything about this virus, ranging from diagnostics, potential vaccines/therapeutics, and possible routes of transmission. In this regard, the fact that the gut is the common niche for both poliovirus and SARS-CoV-2, and due to the shedding of the virus through faecal material into sewerage systems, the need for long-term wastewater surveillance and developing early warning systems for better preparedness at local and global levels is increasingly apparent. This paper aims to provide an insight into the ongoing COVID-19 crisis, how it can be managed, and what measures are required to deal with a current global international public health concern. Additionally, it shed light on the importance of using wastewater surveillance strategy as an early warning practical tool suitable for massive passive screening, as well as the urgent need for microfluidic technology as a rapid and cost-effective approach tracking SARS-CoV-2 in wastewater.
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Affiliation(s)
- Ahmed Donia
- Biosciences Department, Faculty of Science, Comsats University Islamabad, Islamabad 45550, Pakistan;
| | - Sammer-ul Hassan
- Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, UK;
- Correspondence: (S.-u.H.); (H.B.)
| | - Xunli Zhang
- Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton SO17 1BJ, UK;
| | - Lamiaa Al-Madboly
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta 31527, Egypt;
| | - Habib Bokhari
- Biosciences Department, Faculty of Science, Comsats University Islamabad, Islamabad 45550, Pakistan;
- Correspondence: (S.-u.H.); (H.B.)
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15
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Bielecki M, Patel D, Hinkelbein J, Komorowski M, Kester J, Ebrahim S, Rodriguez-Morales AJ, Memish ZA, Schlagenhauf P. Reprint of: Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review. Travel Med Infect Dis 2020; 38:101939. [PMID: 33291000 PMCID: PMC7831384 DOI: 10.1016/j.tmaid.2020.101939] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Air travel during the COVID-19 pandemic is challenging for travellers, airlines, airports, health authorities, and governments. We reviewed multiple aspects of COVID peri-pandemic air travel, including data on traveller numbers, peri-flight prevention, and testing recommendations and in-flight SARS-CoV-2 transmission, photo-epidemiology of mask use, the pausing of air travel to mass gathering events, and quarantine measures and their effectiveness. Flights are reduced by 43% compared to 2019. Hygiene measures, mask use, and distancing are effective, while temperature screening has been shown to be unreliable. Although the risk of in-flight transmission is considered to be very low, estimated at one case per 27 million travellers, confirmed in-flight cases have been published. Some models exist and predict minimal risk but fail to consider human behavior and airline procedures variations. Despite aircraft high-efficiency filtering, there is some evidence that passengers within two rows of an index case are at higher risk. Air travel to mass gatherings should be avoided. Antigen testing is useful but impaired by time lag to results. Widespread application of solutions such as saliva-based, rapid testing or even detection with the help of “sniffer dogs” might be the way forward. The “traffic light system” for traveling, recently introduced by the Council of the European Union is a first step towards normalization of air travel. Quarantine of travellers may delay introduction or re-introduction of the virus, or may delay the peak of transmission, but the effect is small and there is limited evidence. New protocols detailing on-arrival, rapid testing and tracing are indicated to ensure that restricted movement is pragmatically implemented. Guidelines from airlines are non-transparent. Most airlines disinfect their flights and enforce wearing masks and social distancing to a certain degree. A layered approach of non-pharmaceutical interventions, screening and testing procedures, implementation and adherence to distancing, hygiene measures and mask use at airports, in-flight and throughout the entire journey together with pragmatic post-flight testing and tracing are all effective measures that can be implemented. Ongoing research and systematic review are indicated to provide evidence on the utility of preventive measures and to help answer the question “is it safe to fly?“.
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Affiliation(s)
- Michel Bielecki
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland
| | - Dipti Patel
- National Travel Health Network and Centre, UCLH NHS Foundation Trust, 250 Euston Road London, NW1 2PG, United Kingdom
| | - Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty, Cologne, Germany; Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany; German Society of Aerospace Medicine (DGLRM), Munich, Germany
| | - Matthieu Komorowski
- Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, St Mary's Campus, Praed St, Paddington, London, W2 1NY, UK; Intensive Care Unit, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - John Kester
- Independent Researcher and Expert on Tourism, Former Director of Statistics, Trends and Policy at the United Nations World Tourism Organization (UNWTO), Spain
| | - Shahul Ebrahim
- Faculty of Medicine, University of Sciences, Techniques, and Technology, Bamako, Mali
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación, Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Risaralda, Colombia
| | - Ziad A Memish
- Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland.
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16
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Bielecki M, Patel D, Hinkelbein J, Komorowski M, Kester J, Ebrahim S, Rodriguez-Morales AJ, Memish ZA, Schlagenhauf P. Air travel and COVID-19 prevention in the pandemic and peri-pandemic period: A narrative review. Travel Med Infect Dis 2020; 39:101915. [PMID: 33186687 PMCID: PMC7655026 DOI: 10.1016/j.tmaid.2020.101915] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 02/07/2023]
Abstract
Air travel during the COVID-19 pandemic is challenging for travellers, airlines, airports, health authorities, and governments. We reviewed multiple aspects of COVID peri-pandemic air travel, including data on traveller numbers, peri-flight prevention, and testing recommendations and in-flight SARS-CoV-2 transmission, photo-epidemiology of mask use, the pausing of air travel to mass gathering events, and quarantine measures and their effectiveness. Flights are reduced by 43% compared to 2019. Hygiene measures, mask use, and distancing are effective, while temperature screening has been shown to be unreliable. Although the risk of in-flight transmission is considered to be very low, estimated at one case per 27 million travellers, confirmed in-flight cases have been published. Some models exist and predict minimal risk but fail to consider human behavior and airline procedures variations. Despite aircraft high-efficiency filtering, there is some evidence that passengers within two rows of an index case are at higher risk. Air travel to mass gatherings should be avoided. Antigen testing is useful but impaired by time lag to results. Widespread application of solutions such as saliva-based, rapid testing or even detection with the help of "sniffer dogs" might be the way forward. The "traffic light system" for traveling, recently introduced by the Council of the European Union is a first step towards normalization of air travel. Quarantine of travellers may delay introduction or re-introduction of the virus, or may delay the peak of transmission, but the effect is small and there is limited evidence. New protocols detailing on-arrival, rapid testing and tracing are indicated to ensure that restricted movement is pragmatically implemented. Guidelines from airlines are non-transparent. Most airlines disinfect their flights and enforce wearing masks and social distancing to a certain degree. A layered approach of non-pharmaceutical interventions, screening and testing procedures, implementation and adherence to distancing, hygiene measures and mask use at airports, in-flight and throughout the entire journey together with pragmatic post-flight testing and tracing are all effective measures that can be implemented. Ongoing research and systematic review are indicated to provide evidence on the utility of preventive measures and to help answer the question "is it safe to fly?".
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Affiliation(s)
- Michel Bielecki
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland
| | - Dipti Patel
- National Travel Health Network and Centre, UCLH NHS Foundation Trust, 250 Euston Road London, NW1 2PG, United Kingdom
| | - Jochen Hinkelbein
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty, Cologne, Germany; Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany; German Society of Aerospace Medicine (DGLRM), Munich, Germany
| | - Matthieu Komorowski
- Space Medicine Group, European Society of Aerospace Medicine (ESAM), Cologne, Germany Department of Surgery & Cancer, Imperial College Healthcare NHS Trust, St Mary's Campus, Praed St, Paddington, London, W2 1NY, UK; Intensive Care Unit, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - John Kester
- Independent Researcher and Expert on Tourism, Former Director of Statistics, Trends and Policy at the United Nations World Tourism Organization (UNWTO), Spain
| | - Shahul Ebrahim
- Faculty of Medicine, University of Sciences, Techniques, and Technology, Bamako, Mali
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Grupo de Investigación, Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de Las Américas, Pereira, Risaralda, Colombia
| | - Ziad A Memish
- Alfaisal University, Riyadh, Saudi Arabia; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patricia Schlagenhauf
- University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology Biostatistics and Prevention Institute, Hirschengraben 84, CH-8001, Zürich, Switzerland.
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17
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Durski KN, Naidoo D, Singaravelu S, Shah AA, Djingarey MH, Formenty P, Ihekweazu C, Banjura J, Kebela B, Yinka-Ogunleye A, Fall IS, Eteng W, Vandi M, Keimbe C, Abubakar A, Mohammed A, Williams DE, Lamunu M, Briand S, Changa Changa JC, Minkoulou E, Jernigan D, Lubambo D, Khalakdina A, Mamadu I, Talisuna A, Mbule Kadiobo A, Jambai A, Aylward B, Osterholm M. Systems thinking for health emergencies: use of process mapping during outbreak response. BMJ Glob Health 2020; 5:bmjgh-2020-003901. [PMID: 33033054 PMCID: PMC7545503 DOI: 10.1136/bmjgh-2020-003901] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022] Open
Abstract
Process mapping is a systems thinking approach used to understand, analyse and optimise processes within complex systems. We aim to demonstrate how this methodology can be applied during disease outbreaks to strengthen response and health systems. Process mapping exercises were conducted during three unique emerging disease outbreak contexts with different: mode of transmission, size, and health system infrastructure. System functioning improved considerably in each country. In Sierra Leone, laboratory testing was accelerated from 6 days to within 24 hours. In the Democratic Republic of Congo, time to suspected case notification reduced from 7 to 3 days. In Nigeria, key data reached the national level in 48 hours instead of 5 days. Our research shows that despite the chaos and complexities associated with emerging pathogen outbreaks, the implementation of a process mapping exercise can address immediate response priorities while simultaneously strengthening components of a health system.
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Affiliation(s)
- Kara N Durski
- World Health Organization, Geneve, Switzerland
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | | | | | | | | | | | | | - James Banjura
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Benoit Kebela
- Ministry of Health Democratic Republic of Congo, Kinshasa, Democratic Republic of Congo
| | | | | | - Womi Eteng
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Mohamed Vandi
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Charles Keimbe
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Abulazeez Mohammed
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | | | | | | | | | - Dan Jernigan
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Demba Lubambo
- World Health Organization, Brazzaville, Republic of Congo
| | | | | | | | | | - Amara Jambai
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | - Michael Osterholm
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
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18
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Williams SG, Fontaine RE, Turcios Ruiz RM, Walke H, Ijaz K, Baggett HC. One Field Epidemiologist per 200,000 Population: Lessons Learned from Implementing a Global Public Health Workforce Target. Health Secur 2020; 18:S113-S118. [PMID: 32004135 DOI: 10.1089/hs.2019.0119] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The World Health Organization monitoring and evaluation framework for the International Health Regulations (IHR, 2005) describes the targets for the Joint External Evaluation (JEE) indicators. For workforce development, the JEE defines the optimal target for attaining and complying with the IHR (2005) as 1 trained field epidemiologist (or equivalent) per 200,000 population. We explain the derivation and use of the current field epidemiology workforce development target and identify the limitations and lessons learned in applying it to various countries' public health systems. This article also proposes a way forward for improvements and implementation of this workforce development target.
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Affiliation(s)
- Seymour G Williams
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Robert E Fontaine
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Reina M Turcios Ruiz
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Henry Walke
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Kashef Ijaz
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Henry C Baggett
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
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19
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Sloan ML, Gleason BL, Squire JS, Koroma FF, Sogbeh SA, Park MJ. Cost Analysis of Health Facility Electronic Integrated Disease Surveillance and Response in One District in Sierra Leone. Health Secur 2020; 18:S64-S71. [PMID: 32004122 DOI: 10.1089/hs.2019.0082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Global health security depends on effective surveillance systems to prevent, detect, and respond to disease threats. Real-time surveillance initiatives aim to develop electronic systems to improve reporting and analysis of disease data. Sierra Leone, with the support of Global Health Security Agenda partners, developed an electronic Integrated Disease Surveillance and Response (eIDSR) system capable of mobile reporting from health facilities. We estimated the economic costs associated with rollout of health facility eIDSR in the Western Area Rural district in Sierra Leone and projected annual direct operational costs. Cost scenarios with increased transport costs, decreased use of partner personnel, and altered cellular data costs were modeled. Cost data associated with activities were retrospectively collected and were assessed across rollout phases. Costs were organized into cost categories: personnel, office operating, transport, and capital. We estimated costs by category and phase and calculated per health facility and per capita costs. The total economic cost to roll out eIDSR to the Western Area Rural district over the 14-week period was US$64,342, a per health facility cost of $1,021. Equipment for eIDSR was the primary cost driver (45.5%), followed by personnel (35.2%). Direct rollout costs were $38,059, or 59.2% of total economic costs. The projected annual direct operational costs were $14,091, or $224 per health facility. Although eIDSR equipment costs are a large portion of total costs, annual direct operational costs are projected to be minimal once the system is implemented. Our findings can be used to make decisions about establishing and maintaining electronic, real-time surveillance in Sierra Leone and other low-resource settings.
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Affiliation(s)
- Michelle L Sloan
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
| | - Brigette L Gleason
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
| | - James S Squire
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
| | - Fanny F Koroma
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
| | - Solomon Aiah Sogbeh
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
| | - Michael J Park
- Michelle L. Sloan, MA, and Michael J. Park, PhD, are Health Scientists, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead, and Fanny F. Koroma, MSc, is a Public Health Surveillance Specialist; both at the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. James S. Squire, MIPH, is Program Manager, and Solomon Aiah Sogbeh is Senior Public Health Superintendent; both at the National Disease Surveillance Program, Ministry of Health and Sanitation, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Ministry of Health and Sanitation or the US Centers for Disease Control and Prevention
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Jalloh MF, Namageyo-Funa A, Gleason B, Wallace AS, Friedman M, Sesay T, Ocansey D, Jalloh MS, Feldstein LR, Conklin L, Hersey S, Singh T, Kaiser R. Assessment of VaxTrac electronic immunization registry in an urban district in Sierra Leone: Implications for data quality, defaulter tracking, and policy. Vaccine 2020; 38:6103-6111. [PMID: 32753291 PMCID: PMC10869104 DOI: 10.1016/j.vaccine.2020.07.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND In 2016, the Sierra Leone Ministry of Health and Sanitation (MoHS) piloted VaxTrac, an electronic immunization registry (EIR), in an urban district to improve management of vaccination records and tracking of children who missed scheduled doses. We aimed to document lessons learned to inform decision-making on VaxTrac and similar EIRs' future use. METHODS Ten out of 50 urban health facilities that implemented VaxTrac were purposively selected for inclusion in a rapid mixed-method assessment from November to December 2017. For a one-month period, records of six scheduled vaccine doses among children < 2 years old in VaxTrac were abstracted and compared to three paper-based records (register of under-two children, daily tally sheet, and monthly summary form). We used the under-two register as the reference gold standard for comparison purposes. We interviewed and observed 10 heath workers, one from each selected facility, who were using VaxTrac. RESULTS Overall, VaxTrac captured < 65% of the vaccine doses reported in the paper-based sources, but in the largest health facility VaxTrac captured the highest number of doses. Two additional notable patterns emerged: 1) the aggregated data sources reported higher doses administered compared to the under-two register and VaxTrac; 2) data sources that need real-time data capture during the vaccination session reported fewer doses administered compared to the monthly HF2 summary form. Health workers expressed that the EIR helped them to shorten the time to manage, summarize, and report vaccination records. Workflows for data entry in VaxTrac were inconsistent among facilities and rarely integrated into existing processes. Data sharing restrictions contributed to duplicate records. CONCLUSION Although VaxTrac helped to shorten the time to manage, summarize, and report vaccination records, data sharing restrictions coupled with inconsistent and inefficient workflows were major implementation challenges. Readiness-to-introduce and sustainability should be carefully considered before implementing an EIR.
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Affiliation(s)
- Mohamed F Jalloh
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States.
| | - Apophia Namageyo-Funa
- Strategic Information and Workforce Development Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States
| | - Brigette Gleason
- Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Aaron S Wallace
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States
| | - Michael Friedman
- Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Tom Sesay
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | | | | | - Leora R Feldstein
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States
| | - Laura Conklin
- Immunization Systems Branch, Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, United States
| | - Sara Hersey
- Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Tushar Singh
- Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
| | - Reinhard Kaiser
- Sierra Leone Country Office, Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, Freetown, Sierra Leone
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Nakamura H, Managi S. Airport risk of importation and exportation of the COVID-19 pandemic. TRANSPORT POLICY 2020; 96:40-47. [PMID: 32834679 PMCID: PMC7328638 DOI: 10.1016/j.tranpol.2020.06.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 05/19/2023]
Abstract
On March 11, 2020, the Director-General of the World Health Organization (WHO) characterized the spread of the coronavirus disease, COVID-19, as a pandemic on the basis of "alarming levels of spread and severity, and by the alarming levels of inaction." Hence, it is urgent and imperative to evaluate the risk of COVID-19 for as many global locations as possible. This study calculates the relative risk of the importation and exportation of the COVID-19 virus. The study's most important contribution is the calculation of the overall relative risk of the importation and exportation of COVID-19 from every airport in local municipalities around the world, based on global spatial and mapping information. Three scenarios of air travel restriction are considered, and the change in the risk of importation and exportation of COVID-19 is calculated. The relative risk of importation and exportation of COVID-19 clearly shows that not only China, Europe, Middle East, and East Asia, but also the U.S., Australia, and countries in northeast Asia and Latin America are subject to risk. Further, a larger reduction in air travel through airports in a large part of the cumulative incidence area would lead to a gradual decrease in the risk flow. Importantly, the exportation risk of the disease from some airports in China, Iran, and European countries has a higher global spread than the importation risk during the pandemic stage. Therefore, every airport, or government with airports in their jurisdiction, should implement strict countermeasures. It is also indispensable for these countries to undertake countermeasures for COVID-19, such as home quarantine within each country and restricting infected or suspected individuals from flying on airplanes.
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Affiliation(s)
- Hiroki Nakamura
- Institute of Social Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Corresponding author.
| | - Shunsuke Managi
- Urban Institute & Department of Civil Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
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Jalloh MF, Kaiser R, Diop M, Jambai A, Redd JT, Bunnell RE, Castle E, Alpren C, Hersey S, Ekström AM, Nordenstedt H. National reporting of deaths after enhanced Ebola surveillance in Sierra Leone. PLoS Negl Trop Dis 2020; 14:e0008624. [PMID: 32810138 PMCID: PMC7480832 DOI: 10.1371/journal.pntd.0008624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/09/2020] [Accepted: 07/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background Sierra Leone experienced the largest documented epidemic of Ebola Virus Disease in 2014–2015. The government implemented a national tollfree telephone line (1-1-7) for public reporting of illness and deaths to improve the detection of Ebola cases. Reporting of deaths declined substantially after the epidemic ended. To inform routine mortality surveillance, we aimed to describe the trends in deaths reported to the 1-1-7 system and to quantify people’s motivations to continue reporting deaths after the epidemic. Methods First, we described the monthly trends in the number of deaths reported to the 1-1-7 system between September 2014 and September 2019. Second, we conducted a telephone survey in April 2017 with a national sample of individuals who reported a death to the 1-1-7 system between December 2016 and April 2017. We described the reported deaths and used ordered logistic regression modeling to examine the potential drivers of reporting motivations. Findings Analysis of the number of deaths reported to the 1-1-7 system showed that 12% of the expected deaths were captured in 2017 compared to approximately 34% in 2016 and over 100% in 2015. We interviewed 1,291 death reporters in the survey. Family members reported 56% of the deaths. Nearly every respondent (94%) expressed that they wanted the 1-1-7 system to continue. The most common motivation to report was to obey the government’s mandate (82%). Respondents felt more motivated to report if the decedent exhibited Ebola-like symptoms (adjusted odds ratio 2.3; 95% confidence interval 1.8–2.9). Conclusions Motivation to report deaths that resembled Ebola in the post-outbreak setting may have been influenced by knowledge and experiences from the prolonged epidemic. Transitioning the system to a routine mortality surveillance tool may require a robust social mobilization component to match the high reporting levels during the epidemic, which exceeded more than 100% of expected deaths in 2015. By November 2015 when the World Health Organization declared the Ebola epidemic in Sierra Leone to be over, approximately 95% of the population had become aware of the risk of Ebola transmission linked to physical contact with infected corpses, especially during traditional burials. Enhanced Ebola surveillance was implemented between November 2015 and June 2016, i.e. after the epidemic had officially ended to improve detection of possible new cases. Reporting to the 1-1-7 system declined nationally after enhanced Ebola surveillance ended even though the Government of Sierra Leone continued to mandate that all deaths must be reported. Based on a request from the Sierra Leone Ministry of Health and Sanitation, we conducted a telephone survey with a national sample of people who had reported a death in 2017 after the end of enhanced surveillance to understand their motivations for reporting and describe the deaths that they reported. In addition, we analyzed the five-year trends (2014–2019) in the number of deaths reported through the system. Analysis of monthly summary data of deaths reported showed that on the last month of enhanced surveillance, 3,851 deaths were reported compared to 2,456 deaths in the month immediately after (July 2016). The monthly numbers of reported deaths continued to plummet and reached as low as 1,550 in January 2017, 673 in January 2018, and 586 in January 2019. In the survey, we uncovered that people who reported deaths were mainly motivated to do so in order to comply with the Government’s mandate. After adjusting for potential confounders, motivations to report were strongly associated with the presence of Ebola-like symptoms in the decedent. Additional investigations are needed to unveil reporting barriers among people who failed to report household deaths to the 1-1-7 system to optimize reporting levels. It has been shown that during the Ebola epidemic that it is possible to reach high levels of death reporting in Sierra Leone as exemplified by the fact that in 2015 more than 100% of the expected deaths nationally were reported; albeit not counting potential duplicates. The post-Ebola-outbreak setting provides a unique opportunity to improve future overall mortality surveillance in Sierra Leone and contribute to the establishment of civil registration of vital statistics.
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Affiliation(s)
- Mohamed F. Jalloh
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Reinhard Kaiser
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Amara Jambai
- Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - John T. Redd
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Rebecca E. Bunnell
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Charles Alpren
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Sara Hersey
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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A Resource for Planning for Disasters and Outbreaks: Lessons From the West African Ebola Epidemic. Disaster Med Public Health Prep 2020; 15:143. [PMID: 32452332 DOI: 10.1017/dmp.2020.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jalloh MF, Wallace AS, Bunnell RE, Carter RJ, Redd JT, Nur SA, Zeebari Z, Ekström AM, Nordenstedt H. Ebola vaccine? Family first! Evidence from using a brief measure on Ebola vaccine demand in a national household survey during the outbreak in Sierra Leone. Vaccine 2020; 38:3854-3861. [PMID: 32291102 PMCID: PMC10831169 DOI: 10.1016/j.vaccine.2020.03.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Vaccination against Ebolavirus is an emerging public health tool during Ebola Virus Disease outbreaks. We examined demand issues related to deployment of Ebolavirus vaccine during the 2014-2015 outbreak in Sierra Leone. METHODS A cluster survey was administered to a population-based sample in December 2014 (N = 3540), before any Ebola vaccine was available to the general public in Sierra Leone. Ebola vaccine demand was captured in this survey by three Likert-scale items that were used to develop a composite score and dichotomized into a binary outcome to define high demand. A multilevel logistic regression model was fitted to assess the associations between perceptions of who should be first to receive an Ebola vaccine and the expression of high demand for an Ebola vaccine. RESULTS The largest proportion of respondents reported that health workers (35.1%) or their own families (29.5%) should receive the vaccine first if it became available, rather than politicians (13.8%), vaccination teams (9.8%), or people in high risk areas (8.2%). High demand for an Ebola vaccine was expressed by 74.2% of respondents nationally. The odds of expressing high demand were 13 times greater among those who said they or their families should be the first to take the vaccine compared to those who said politicians should be the first recipients (adjusted odds ratio [aOR] 13.0 [95% confidence interval [CI] 7.8-21.6]). The ultra-brief measure of the Ebola vaccine demand demonstrated acceptable scale reliability (Cronbach's α = 0.79) and construct validity (single-factor loadings > 0.50). CONCLUSION Perceptions of who should be the first to get the vaccine was associated with high demand for Ebola vaccine around the peak of the outbreak in Sierra Leone. Using an ultra-brief measure of Ebola vaccine demand is a feasible solution in outbreak settings and can help inform development of future rapid assessment tools.
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Affiliation(s)
- Mohamed F Jalloh
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Aaron S Wallace
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rebecca E Bunnell
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA
| | - Rosalind J Carter
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, USA
| | - John T Redd
- Center for Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Sophia A Nur
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, USA
| | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Jönköping International Business School, Jönköping, Sweden
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Gorina Y, Redd JT, Hersey S, Jambai A, Meyer P, Kamara AS, Kamara A, Harding JD, Bangura B, Kamara MAM. Ensuring ethical data access: the Sierra Leone Ebola Database (SLED) model. Ann Epidemiol 2020; 46:1-4. [PMID: 32532366 DOI: 10.1016/j.annepidem.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/23/2020] [Accepted: 04/02/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Organizations responding to the 2014-2016 Ebola epidemic in Sierra Leone collected information from multiple sources and kept it in separate databases, including distinct data systems for Ebola hot line calls, patient information collected by field surveillance officers, laboratory testing results, clinical information from Ebola treatment and isolation facilities, and burial team records. METHODS After the conclusion of the epidemic, the Sierra Leone Ministry of Health and Sanitation and the U.S. Centers for Disease Control and Prevention partnered to collect these disparate records and consolidate them in the Sierra Leone Ebola Database. RESULTS The Sierra Leone Ebola Database data are providing a lasting resource for postepidemic data analysis and epidemiologic research, including identifying best strategies in outbreak response, and are used to help families locate the graves of family members who died during the epidemic. CONCLUSION This report describes the Ministry of Health and Sanitation and Centers for Disease Control and Prevention processes to safeguard Ebola records while making the data available for public health research.
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Affiliation(s)
- Yelena Gorina
- National Center for Health Statistics, Division of Analysis and Epidemiology, Hyattsville, MD.
| | - John T Redd
- The Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Washington, DC
| | | | - Amara Jambai
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Peter Meyer
- NORC at The University of Chicago, Bethesda, MD
| | | | - Alimamy Kamara
- Centers for Disease Control and Prevention, Center for Global Health, Division of Global Health Protection, Freetown, Sierra Leone
| | - Jadnah D Harding
- Columbia Mailman School of Public Health, ICAP, Sierra Leone Ebola Database (SLED) Data Team, Freetown, Sierra Leone
| | - Brima Bangura
- Columbia Mailman School of Public Health, ICAP, Sierra Leone Ebola Database (SLED) Data Team, Freetown, Sierra Leone
| | - Mohamed A M Kamara
- Columbia Mailman School of Public Health, ICAP, Sierra Leone Ebola Database (SLED) Data Team, Freetown, Sierra Leone
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020. [PMID: 32087820 DOI: 10.1016/s0140‐6736(20)30411‐6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020; 395:871-877. [PMID: 32087820 PMCID: PMC7159277 DOI: 10.1016/s0140-6736(20)30411-6] [Citation(s) in RCA: 616] [Impact Index Per Article: 154.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/13/2020] [Accepted: 02/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020. [PMID: 32087820 DOI: 10.1016/s0140-6736-20-30411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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Martin DW, Sloan M, Gleason BL, de Wit L, Vandi MA, Kargbo DK, Clemens N, Kamara AS, Njuguna C, Sesay S, Singh T. Implementing Nationwide Facility-based Electronic Disease Surveillance in Sierra Leone: Lessons Learned. Health Secur 2020; 18:S72-S80. [PMID: 32004124 PMCID: PMC7465552 DOI: 10.1089/hs.2019.0081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Global Health Security Agenda aims to improve countries' ability to prevent, detect, and respond to infectious disease threats by building or strengthening core capacities required by the International Health Regulations (2005). One of those capacities is the development of surveillance systems to rapidly detect and respond to occurrences of diseases with epidemic potential. Since 2015, the US Centers for Disease Control and Prevention (CDC) has worked with partners in Sierra Leone to assist the Ministry of Health and Sanitation in developing an Integrated Disease Surveillance and Response (IDSR) system. Beginning in 2016, CDC, in collaboration with the World Health Organization and eHealth Africa, has supported the ministry in the development of Android device mobile data entry at the health facility for electronic IDSR (eIDSR), also known as health facility-based eIDSR. Health facility-based eIDSR was introduced via a pilot program in 1 district, and national rollout began in 2018. With more than 1,100 health facilities now reporting, the Sierra Leone eIDSR system is substantially larger than most mobile-device health (mHealth) projects found in the literature. Several technical innovations contributed to the success of health facility-based eIDSR in Sierra Leone. Among them were data compression and dual-mode (internet and text) message transmission to mitigate connectivity issues, user interface design tailored to local needs, and a continuous-feedback process to iteratively detect user or system issues and remediate challenges identified. The resultant system achieved high user acceptance and demonstrated the feasibility of an mHealth-based surveillance system implemented on a national scale.
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Schaduangrat N, Nantasenamat C, Prachayasittikul V, Shoombuatong W. Meta-iAVP: A Sequence-Based Meta-Predictor for Improving the Prediction of Antiviral Peptides Using Effective Feature Representation. Int J Mol Sci 2019; 20:ijms20225743. [PMID: 31731751 PMCID: PMC6888698 DOI: 10.3390/ijms20225743] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/07/2019] [Accepted: 11/13/2019] [Indexed: 12/31/2022] Open
Abstract
In spite of the large-scale production and widespread distribution of vaccines and antiviral drugs, viruses remain a prominent human disease. Recently, the discovery of antiviral peptides (AVPs) has become an influential antiviral agent due to their extraordinary advantages. With the avalanche of newly-found peptide sequences in the post-genomic era, there is a great demand to develop a sequence-based predictor for timely identifying AVPs as this information is very useful for both basic research and drug development. In this study, we propose a novel sequence-based meta-predictor with an effective feature representation, called Meta-iAVP, for the accurate prediction of AVPs from given peptide sequences. Herein, the effective feature representation was extracted from a set of prediction scores derived from various machine learning algorithms and types of features. To the best of our knowledge, the model proposed herein represents the first meta-based approach for the prediction of AVPs. An overall accuracy and Matthews correlation coefficient of 95.20% and 0.90, respectively, was achieved from the independent test set on an objective benchmark dataset. Comparative analysis suggested that Meta-iAVP was superior to that of existing methods and therefore represents a useful tool for AVP prediction. Finally, in an effort to facilitate high-throughput prediction of AVPs, the model was deployed as the Meta-iAVP web server and is made freely available online at http://codes.bio/meta-iavp/ where users can submit query peptide sequences for determining the likelihood of whether or not these peptides are AVPs.
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Affiliation(s)
- Nalini Schaduangrat
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand; (N.S.); (C.N.)
| | - Chanin Nantasenamat
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand; (N.S.); (C.N.)
| | - Virapong Prachayasittikul
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand;
| | - Watshara Shoombuatong
- Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand; (N.S.); (C.N.)
- Correspondence: ; Tel.: +66-2441-4371 (ext. 2715)
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Mboussou F, Ndumbi P, Ngom R, Kamassali Z, Ogundiran O, Van Beek J, Williams G, Okot C, Hamblion EL, Impouma B. Infectious disease outbreaks in the African region: overview of events reported to the World Health Organization in 2018. Epidemiol Infect 2019; 147:e299. [PMID: 31709961 PMCID: PMC6873157 DOI: 10.1017/s0950268819001912] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/03/2022] Open
Abstract
The WHO African region is characterised by the largest infectious disease burden in the world. We conducted a retrospective descriptive analysis using records of all infectious disease outbreaks formally reported to the WHO in 2018 by Member States of the African region. We analysed the spatio-temporal distribution, the notification delay as well as the morbidity and mortality associated with these outbreaks. In 2018, 96 new disease outbreaks were reported across 36 of the 47 Member States. The most commonly reported disease outbreak was cholera which accounted for 20.8% (n = 20) of all events, followed by measles (n = 11, 11.5%) and Yellow fever (n = 7, 7.3%). About a quarter of the outbreaks (n = 23) were reported following signals detected through media monitoring conducted at the WHO regional office for Africa. The median delay between the disease onset and WHO notification was 16 days (range: 0-184). A total of 107 167 people were directly affected including 1221 deaths (mean case fatality ratio (CFR): 1.14% (95% confidence interval (CI) 1.07%-1.20%)). The highest CFR was observed for diseases targeted for eradication or elimination: 3.45% (95% CI 0.89%-10.45%). The African region remains prone to outbreaks of infectious diseases. It is therefore critical that Member States improve their capacities to rapidly detect, report and respond to public health events.
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Affiliation(s)
- F. Mboussou
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - P. Ndumbi
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - R. Ngom
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Z. Kamassali
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - O. Ogundiran
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - J. Van Beek
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - G. Williams
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - C. Okot
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - E. L. Hamblion
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - B. Impouma
- Health Emergencies programme, World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Vilas Boas LCP, Campos ML, Berlanda RLA, de Carvalho Neves N, Franco OL. Antiviral peptides as promising therapeutic drugs. Cell Mol Life Sci 2019; 76:3525-3542. [PMID: 31101936 PMCID: PMC7079787 DOI: 10.1007/s00018-019-03138-w] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/04/2019] [Accepted: 05/07/2019] [Indexed: 01/28/2023]
Abstract
While scientific advances have led to large-scale production and widespread distribution of vaccines and antiviral drugs, viruses still remain a major cause of human diseases today. The ever-increasing reports of viral resistance and the emergence and re-emergence of viral epidemics pressure the health and scientific community to constantly find novel molecules with antiviral potential. This search involves numerous different approaches, and the use of antimicrobial peptides has presented itself as an interesting alternative. Even though the number of antimicrobial peptides with antiviral activity is still low, they already show immense potential to become pharmaceutically available antiviral drugs. Such peptides can originate from natural sources, such as those isolated from mammals and from animal venoms, or from artificial sources, when bioinformatics tools are used. This review aims to shed some light on antimicrobial peptides with antiviral activities against human viruses and update the data about the already well-known peptides that are still undergoing studies, emphasizing the most promising ones that may become medicines for clinical use.
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Affiliation(s)
| | - Marcelo Lattarulo Campos
- Centro de Análises Bioquímicas e Proteômicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, 70790-160, Brazil
- Departamento de Botânica e Ecologia, Instituto de Biociências, Universidade Federal de Mato Grosso, Cuiabá, MT, 78060-900, Brazil
| | - Rhayfa Lorrayne Araujo Berlanda
- Centro de Análises Bioquímicas e Proteômicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, 70790-160, Brazil
| | - Natan de Carvalho Neves
- Centro de Análises Bioquímicas e Proteômicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, 70790-160, Brazil
| | - Octávio Luiz Franco
- Universidade de Brasília, Pós-Graduação em Patologia Molecular, Campus Darcy Ribeiro, Brasília, DF, 70910-900, Brazil.
- Centro de Análises Bioquímicas e Proteômicas, Pós-graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, Brasília, DF, 70790-160, Brazil.
- S-Inova Biotech, Pós-graduação em Biotecnologia Universidade Católica Dom Bosco, Campo Grande, MS, 79117-900, Brazil.
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Morgan J, Kennedy ED, Pesik N, Angulo FJ, Craig AS, Knight NW, Bunnell RE. Building Global Health Security Capacity: The Role for Implementation Science. Health Secur 2019; 16:S5-S7. [PMID: 30480494 DOI: 10.1089/hs.2018.0119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Juliette Morgan
- Juliette Morgan, MD, was, during the preparation of this publication, Associate Director for Science, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Erin D Kennedy
- Erin D. Kennedy, DVM, MS, MPH, is Associate Director for Science, Epidemiology, Informatics, Surveillance, and Laboratory Branch, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Nicki Pesik
- Nicki Pesik, MD, is Associate Director for Infectious Disease Preparedness, National Center for Emerging and Zoonotic Infectious Diseases, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Frederick J Angulo
- Frederick J. Angulo, DVM, PhD, was Associate Director for Science, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Allen S Craig
- Allen S. Craig, MD, is Deputy Director, National Center for Immunization and Respiratory Diseases, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Nancy W Knight
- Nancy W. Knight, MD, is a captain in the US Public Health Service and Director, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
| | - Rebecca E Bunnell
- Rebecca E. Bunnell, PhD, is Deputy Director for Science, Policy, and Communications, Division of Global Health Protection, Center for Global Health, the Centers for Disease Control and Prevention , Atlanta, GA
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Impact of poorly controlled epilepsy in the Republic of Guinea. Seizure 2018; 61:71-77. [PMID: 30114675 DOI: 10.1016/j.seizure.2018.07.018] [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: 05/02/2018] [Revised: 07/19/2018] [Accepted: 07/24/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To characterize people with epilepsy (PWE) presenting to a free neurology consultation and antiepileptic drug (AED) service in the Republic of Guinea. METHODS Guinea is a low-income country in West Africa that recently experienced an Ebola Virus Disease epidemic. Community-dwelling PWE were seen at a public referral hospital in Conakry, the capital city. During two visits in 2017, an African-U.S. team performed structured interviews and electroencephalograms and provided AEDs. RESULTS Of 257 participants (143 children, 122 female), 25% had untreated epilepsy and 72% met our criteria for poorly controlled epilepsy. 59% had >100 lifetime seizures, and 58% reported a history consistent with status epilepticus. 38 school-aged children were not in school and 26 adults were unemployed. 115 were not currently taking an AED, including 50 participants who had previously taken an AED and stopped. Commonly cited reasons for AED discontinuation were perceived side effects, unaffordability, and unavailability of AEDs. Traditional medicine use was more frequent among children versus adults (92/143 vs. 60/114, p = 0.048). 57 participants had head injuries, 29 had burns, and 18 had fractures. In a multivariable regression analysis, >100 lifetime seizure count was strongly associated with seizure-related injury (p < 0.001). Burns were more likely to occur among females (p = 0.02). CONCLUSIONS There is an urgent need to improve the standard of care for PWE in Guinea. Several missed opportunities were identified, including low use of AEDs and high use of traditional medicines, particularly in children. Targeted programs should be developed to prevent unintentional injury and improve seizure control.
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Intelligence and Stakeholders. INTELLIGENCE, BIOSECURITY AND BIOTERRORISM 2018. [PMCID: PMC7153403 DOI: 10.1057/978-1-137-51700-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This chapter underscores the need for more explicit and strategic engagement of stakeholders (scientists, clinicians, first responders, amongst others) by the intelligence community. The chapter argues that the intelligence community will increasingly rely on their expertise to build more valid and reliable assessments of emerging bio-threats and risks. However, the discussion also identifies some of the limitations and challenges stakeholders themselves have to understanding complex threats and risks.
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