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Kadokura K, Kato H, Yoshizumi K, Kamikuri M, Kamenosono A, Shinkawa N, Hamada Y, Kawamura H, Shimada T, Kuroda M, Sunagawa T. Rapid response to a COVID-19 outbreak at a nightclub in Kagoshima prefecture, Japan, in the early phase of the COVID-19 pandemic, June and July 2020: A descriptive epidemiological study. J Infect Chemother 2024:S1341-321X(24)00098-9. [PMID: 38521457 DOI: 10.1016/j.jiac.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/23/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION During COVID-19 pandemic in Japan, nightclubs were identified as high-risk locations for COVID-19 outbreaks, but an outbreak investigation in this setting is challenging because of the anonymous and opportunistic nature of interactions. METHODS The joint rapid response team collected epidemiological data, conducted descriptive epidemiology to determine the characteristics of cases associated with the nightclub, and implemented countermeasures. Polymerase chain reaction (PCR) tests were performed by the Local Institute of Public Health, Kagoshima University, and several commercial laboratories. RESULTS Between June 15 and July 20, 2020, 121 individuals tested positive for SARS-CoV-2 (59 confirmed and 62 asymptomatic) of whom 8 were nightclub staff who had no travel history of outside Kagoshima, 66 were guests, and 47 were subsequent contacts. The median age was 32 years (interquartile range: 24-43 years). One individual showed severe symptoms but there were no fatal. The epidemic curve showed one peak on June 30 and July 1 with a limited number of cases subsequently. Of the 121 cases, 116 and 5 were in individuals living in and outside Kagoshima Prefecture, respectively. Haplotype network analysis showed 5 genome-wide single-nucleotide variants between the isolates before and during this outbreak. CONCLUSIONS There is a possibility that unidentified guests from outside Kagoshima Prefecture could infect staff who could subsequently spread the virus to guests and other staff, who were mainly a younger population. The rapid outbreak response enabled onward transmission in the community to be minimized. This outbreak investigation could provide insights for effective responses to challenging situations in future pandemic.
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Affiliation(s)
- Keisuke Kadokura
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Chiba Prefectural Institute of Public Health, Chiba, Japan
| | - Hirofumi Kato
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Kayoko Yoshizumi
- Kagoshima City Public Health and Welfare Bureau, Kagoshima, Japan
| | - Miyuki Kamikuri
- Kagoshima City Public Health and Welfare Bureau, Kagoshima, Japan
| | - Akira Kamenosono
- Kagoshima Prefectural Health Promotion Division, Life, Health and Social Welfare Department, Kagoshima, Japan
| | - Naomi Shinkawa
- Department of Microbiology, Kagoshima Prefectural Institute for Environmental Research and Public Health, Kagoshima, Japan
| | - Yuka Hamada
- Department of Microbiology, Kagoshima Prefectural Institute for Environmental Research and Public Health, Kagoshima, Japan
| | - Hideki Kawamura
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan
| | - Tomoe Shimada
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan.
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Yang S, Zhang L, Huang H, Wang J, Wu L, Bao Z. Inflection Point Age in the Middle and Older Women - Jiangxi Province, China, 2020-2022. China CDC Wkly 2024; 6:162-167. [PMID: 38495590 PMCID: PMC10937185 DOI: 10.46234/ccdcw2024.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/09/2024] [Indexed: 03/19/2024] Open
Abstract
What is already known about this topic? Previous studies have predominantly examined the micro-level aspects of women aging inflection points, while macro-level research using big data on the inflection points of aging among middle-aged and elderly women in China is currently limited. What is added by this report? This study determined the inflection ages for physiological, psychological, social, and total dimensions in middle-aged, young elderly, and elderly women [(48.0-53.2) vs. (66.3-70.0) vs. (78.4-81.2) years old]. What are the implications for public health practice? This study is important for gaining a deeper understanding of aging, identifying patterns of aging, and implementing targeted interventions to promote the overall health of Chinese women.
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Affiliation(s)
- Shanlan Yang
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Department of Gerontology, Huadong Hospital Affiliated to Fudan University, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Langlang Zhang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Helang Huang
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Jiaofeng Wang
- Department of Gerontology, Huadong Hospital Affiliated to Fudan University, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Fudan University, Shanghai, China
| | - Lei Wu
- Jiangxi Provincial Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang City, Jiangxi Province, China
| | - Zhijun Bao
- Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China
- Department of Gerontology, Huadong Hospital Affiliated to Fudan University, Shanghai Key Laboratory of Clinical Geriatric Medicine, Research Center on Aging and Medicine, Fudan University, Shanghai, China
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Obradovic A. Celebrating the third World Field Epidemiology Day: a focus on MediPIET the field epidemiology training programme in Mediterranean and Black Sea countries. Euro Surveill 2023; 28:2300474. [PMID: 37676149 PMCID: PMC10486194 DOI: 10.2807/1560-7917.es.2023.28.36.2300474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/08/2023] Open
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Collins D, Diallo BI, Bah MB, Bah M, Standley CJ, Corvil S, Martel LD, MacDonald PDM. Evaluation of the first two Frontline cohorts of the field epidemiology training program in Guinea, West Africa. Hum Resour Health 2022; 20:40. [PMID: 35549712 PMCID: PMC9097411 DOI: 10.1186/s12960-022-00729-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/25/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND The 2014-2016 Ebola virus disease outbreak in West Africa revealed weaknesses in the health systems of the three most heavily affected countries, including a shortage of public health professionals at the local level trained in surveillance and outbreak investigation. In response, the Frontline Field Epidemiology Training Program (FETP) was created by CDC in 2015 as a 3-month, accelerated training program in field epidemiology that specifically targets the district level. In Guinea, the first two FETP-Frontline cohorts were held from January to May, and from June to September 2017. Here, we report the results of a cross-sectional evaluation of these first two cohorts of FETP-Frontline in Guinea. METHODS The evaluation was conducted in April 2018 and consisted of interviews with graduates, their supervisors, and directors of nearby health facilities, as well as direct observation of data reports and surveillance tools at health facilities. Interviews and site visits were conducted using standardized questionnaires and checklists. Qualitative data were coded under common themes and analyzed using descriptive statistics. RESULTS The evaluation revealed a significant perception of improvement in all assessed skills by the graduates, as well as high levels of self-reported involvement in key activities related to data collection, analysis, and reporting. Supervisors highlighted improvements to systematic and quality case and summary reporting as key benefits of the FETP-Frontline program. At the health facility level, staff reported the training had resulted in improvements to information sharing and case notifications. Reported barriers included lack of transportation, available support personnel, and other resources. Graduates and supervisors both emphasized the importance of continued and additional training to solidify and retain skills. CONCLUSIONS The evaluation demonstrated a strongly positive perceived benefit of the FETP-Frontline training on the professional activities of graduates as well as the overall surveillance system. However, efforts are needed to ensure greater gender equity and to recruit more junior trainee candidates for future cohorts. Moreover, although improvements to the surveillance system were observed concurrent with the completion of the two cohorts, the evaluation was not designed to directly measure impact on surveillance or response functions. Combined with the rapid implementation of FETP-Frontline around the world, this suggests an opportunity to develop standardized evaluation toolkits, which could incorporate metrics that would directly assess the impact of equitable field epidemiology workforce development on countries' abilities to prevent, detect, and respond to public health threats.
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Affiliation(s)
| | | | | | | | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | | | - Lise D Martel
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Cooke E, Lopez G, Hilmers A, Addiss DG. Ethical challenges and moral distress among field epidemiologists. BMC Public Health 2022; 22:510. [PMID: 35296269 PMCID: PMC8924561 DOI: 10.1186/s12889-022-12950-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background As ‘disease detectives’ and directors of public health programs, field epidemiologists play essential roles in protecting public health. Although ethical issues receive considerable attention in medical and research settings, less is known about ethical challenges faced by field epidemiologists in public health programs. Similarly, little is known about moral distress among field epidemiologists, i.e., situations in which they are constrained from acting on what they know to be morally right. Moral distress is strongly associated with empathy fatigue, burnout, reduced job retention, and disengagement. To better understand ethics training needs for field epidemiologists, in February 2019, members of TEPHIConnect, an online and mobile networking platform for Field Epidemiology Training Program (FETP) alumni, were invited to participate in an anonymous survey about ethical challenges and moral distress. Results Among 126 respondents from 54 countries, leading causes of ethical dilemmas included inadequate informed consent (61%), inequitable allocation of resources (49%), and conflicts of interest (43%). These occur primarily in settings of disease outbreaks (60%); research (55%); and public health programs at the state, province, or national level (45%) or community level (43%). Work-related moral distress was reported by 91% of respondents, including 26% who experience it “frequently” or “almost always.” Field epidemiologists working in low- and low-middle income countries were more likely to report moral distress “frequently” or “almost always” than those in higher-income countries (33.0% vs 9.1%, P = 0.006). The most common perceived contributors to moral distress included excessive stress and work demands (30%) and inadequate support from leaders (25%). Conclusions Field epidemiologists face significant work-related ethical challenges, which are endemic to public health and political systems. A substantial proportion of field epidemiologists also experience some degree of moral distress, often in association with these challenges. These findings indicate an unmet need among field epidemiologists for support in navigating ethical challenges, as well as for resources to address the human and professional consequences of moral distress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12950-2.
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Affiliation(s)
- Emma Cooke
- School of Medicine and Ethics Center, Emory University, Atlanta, GA, 30322, USA
| | - George Lopez
- Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Angela Hilmers
- TEPHINET, The Task Force for Global Health, 325 Swanton Way, Decatur, GA, 30030, USA
| | - David G Addiss
- Focus Area for Compassion and Ethics, The Task Force for Global Health, 330 W. Ponce de Leon Ave, Decatur, GA, 30030, USA.
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Hu AE, Fontaine R, Turcios-Ruiz R, Abedi AA, Williams S, Hilmers A, Njoh E, Bell E, Reddy C, Ijaz K, Baggett HC. Field epidemiology training programs contribute to COVID-19 preparedness and response globally. BMC Public Health 2022; 22:63. [PMID: 35012482 PMCID: PMC8747444 DOI: 10.1186/s12889-021-12422-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 12/10/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Field epidemiology training programs (FETPs) have trained field epidemiologists who strengthen global capacities for surveillance and response to public health threats. We describe how FETP residents and graduates have contributed to COVID-19 preparedness and response globally. METHODS We conducted a cross-sectional survey of FETPs between March 13 and April 15, 2020 to understand how FETP residents or graduates were contributing to COVID-19 response activities. The survey tool was structured around the eight Pillars of the World Health Organization's (WHO) Strategic Preparedness and Response Plan for COVID-19. We used descriptive statistics to summarize quantitative results and content analysis for qualitative data. RESULTS Among 88 invited programs, 65 (74%) responded and indicated that FETP residents and graduates have engaged in the COVID-19 response across all six WHO regions. Response efforts focused on country-level coordination (98%), surveillance, rapid response teams, case investigations (97%), activities at points of entry (92%), and risk communication and community engagement (82%). Descriptions of FETP contributions to COVID-19 preparedness and response are categorized into seven main themes: conducting epidemiological activities, managing logistics and coordination, leading risk communication efforts, providing guidance, supporting surveillance activities, training and developing the workforce, and holding leadership positions. CONCLUSIONS Our findings demonstrate the value of FETPs in responding to public health threats like COVID-19. This program provides critical assistance to countries' COVID-19 response efforts but also enhances epidemiologic workforce capacity, public health emergency infrastructure and helps ensure global health security as prescribed in the WHO's International Health Regulations.
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Affiliation(s)
- Audrey E Hu
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
- Public Health - Seattle & King County, Seattle, WA, USA
| | - Robert Fontaine
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Reina Turcios-Ruiz
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Aisha A Abedi
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Seymour Williams
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Angela Hilmers
- Training Programs in Epidemiology and Public Health Interventions Network, The Task Force for Global Health, Atlanta, GA, 30345, USA
| | - Eni Njoh
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Elizabeth Bell
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
| | - Carl Reddy
- Training Programs in Epidemiology and Public Health Interventions Network, The Task Force for Global Health, Atlanta, GA, 30345, USA
| | - Kashef Ijaz
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA
- The Carter Center, Atlanta, GA, USA
| | - Henry C Baggett
- Division of Global Health Protection, U.S. Centers for Disease Control and Prevention, 1825 Century Blvd NE, Atlanta, GA, USA.
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Mas-Coma S, Funatsu IR, Angles R, Buchon P, Mas-Bargues C, Artigas P, Valero MA, Bargues MD. Domestic pig prioritized in one health action against fascioliasis in human endemic areas: Experimental assessment of transmission capacity and epidemiological evaluation of reservoir role. One Health 2021; 13:100249. [PMID: 33997234 PMCID: PMC8091924 DOI: 10.1016/j.onehlt.2021.100249] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 12/12/2022] Open
Abstract
The Northern Bolivian Altiplano is the human fascioliasis hyperendemic area where the highest prevalences and intensities in humans have been reported. Preventive chemotherapy was implemented in the last ten years. Surveillance showed high human infection and re-infection rates in between the annual triclabendazole monodose treatments. A complementary One Health control action was launched to decrease the infection risk. Among the multidisciplinary axes, there is the need to establish animal reservoir species priorities for a more efficient control. Laboratory and field studies were performed for the first time to assess the Fasciola hepatica transmission capacity of the pig and its potential reservoir role. The experimental follow-up of altiplanic pig isolates through altiplanic Galba truncatula snail vector isolates were performed at different miracidial doses and different day/night temperatures. Experiments included egg embryonation, miracidial infectivity, lymnaeid snail infection, intramolluscan larval development, cercarial production, chronobiology of the cercarial shedding, vector survival to infection, metacercarial infectivity of mammal host, and adult stage development. Surveys included the assessment of prevalence, intensity, egg measurements and egg shedding rates in nature. Pig contribution was evaluated by comparing with the main altiplanic reservoirs sheep and cattle. Results demonstrated that the pig assures the whole F. hepatica life cycle and participates in its transmission in this area. The fast egg embryonation, high cercarial production, long multi-wave shedding chronobiological pattern in monomiracidial infections at permanent 20 °C temperature, and the high daily egg outputs per pig are worth mentioning. The high infection risk suggests early infection of freely running piglets and evolutionary long-term adaptation of the liver fluke to this omnivorous mammal, despite its previously evoked resistance or non-suitability. Genetic, physiological and immune similarities with humans may also underlie the parasite adaptation to humans in this area. The pig should be accordingly included for appropriate control measures within a One Health action against human fascioliasis. The pig should henceforth be considered in epidemiological studies and control initiatives not only in fascioliasis endemic areas with human infection risk on other Andean countries, but also in rural areas of Latin America, Africa and Asia where domestic pigs are allowed to run freely.
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Affiliation(s)
- Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Ilra R. Funatsu
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Rene Angles
- Cátedra de Parasitología, Facultad de Medicina, Universidad Mayor de San Andrés (UMSA), Av. Saavedra, Miraflores, La Paz, Bolivia
| | - Paola Buchon
- Unidad de Limnología, Instituto de Ecología, Universidad Mayor de San Andrés (UMSA), Calle 27 y Andrés Bello s/n, Cota Cota, La Paz, Bolivia
| | - Cristina Mas-Bargues
- Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Av. Blasco Ibañez No. 15, 46010, Valencia, Spain
| | - Patricio Artigas
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - M. Adela Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - M. Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
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Mulchandani R, Brehmer C, Butt S, Vishram B, Harrison M, Marchant E, Ferris S, Jorgensen F, Smith R, Godbole G, Jenkins C, Dallman TJ, Verlander NQ, Phin N, Todkill D, Gharbia S, Hawker J. Outbreak of Shiga toxin-producing Escherichia coli O157 linked with consumption of a fast-food product containing imported cucumbers, United Kingdom, August 2020. Int J Infect Dis 2021:S1201-9712(21)00312-X. [PMID: 33895409 DOI: 10.1016/j.ijid.2021.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In August 2020, an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 occurred in the United Kingdom. Whole genome sequencing revealed that these cases formed a genetically distinct cluster. METHODS Hypotheses generated from case interviews were tested in analytical studies, and results informed environmental sampling and food chain analysis. A case-case study used non-outbreak 'comparison' STEC cases; a case-control study used a market research panel to recruit controls. RESULTS A total of 36 cases were identified; all cases reported symptom onset between August 3 and August 16, 2020. The majority of cases (83%) resided in the Midlands region of England and in Wales. A high proportion of cases reported eating out, with one fast-food restaurant chain mentioned by 64% (n = 23) of cases. Both the case-case study (adjusted odds ratio (aOR) 31.8, 95% confidence interval (CI) 1.6-624.9) and the case-control study (aOR 9.19, 95% CI 1.0-82.8) revealed statistically significant results, showing that the consumption of a specific fast-food product was independently associated with infection. CONCLUSIONS Consumption of a specific fast-food product was a likely cause of this outbreak. The only ingredient specific to the product was cucumbers. The supply of cucumbers was immediately halted, and no further cases have been identified.
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Moura CAA, Philips R, Silva GS, Ramirez A, Gauger PC, Holtkamp DJ, Linhares DCL. Association of wild-type PRRSV detection patterns with mortality of MLV-vaccinated growing pig groups. Prev Vet Med 2021; 189:105270. [PMID: 33550121 DOI: 10.1016/j.prevetmed.2021.105270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/15/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
PRRS is a viral disease characterized by increasing reproduction losses in breeding herds and worsening performance of growing pigs, which leads to a considerable economic impact. A better understanding of the differences in the infection patterns of the virus in growing pig batches would help to develop cost-effective surveillance methods and disease control and elimination programs. Therefore, field studies documenting growing pig productivity according to the patterns of wild-type-PRRSV (wt-PRRSV) detection in the field are needed. This study was conducted with the objectives to (1) characterize patterns of wt-PRRSV-1 and wt-PRRSV-2 RNA detection over time in modified-live virus (MLV)-vaccinated batches of growing pigs raised in pig-dense regions of the USA; (2) compare wean-to-finish mortality among batches of growing pigs characterized with the different patterns of wt-PRRSV-1 and wt-PRRSV-2 detection; and (3) compare wean-to-finish mortality among batches of growing pigs characterized with the different patterns of wt-PRRSV-2 detection and vaccinated with two different doses of PRRS MLV vaccine. Eighty-one batches of growing pigs were originated from PRRSV positive-stable and unstable sow farms and vaccinated with two different doses of PRRS MLV vaccine. All batches were monitored for wt-PRRSV by testing six oral fluids every three weeks from weaning to marketing. Diagnostics were conducted to detect wt-PRRSV-1 and wt-PRRSV-2 by RT-qPCR testing and ORF-5 region sequencing. K-means clustering analysis was applied to identify batches sharing similar patterns of wt-PRRSV detection over time. Regression analyses were used to compare mortality among batches of growing pigs characterized with different patterns of wt-PRRSV detection over time. Thirty-eight percent of batches were detected with wt-PRRSV-1 during the growth phase, with three different patterns of detection. Detection of wt-PRRSV-1 was not associated with significant increase on mortality. Ninety-one percent of batches were detected with wt-PRRSV-2 during the growth phase, with four different patterns of detection. Batches originated from PRRSV positive-unstable farms had highest mortality rate (p < 0.0001) and were characterized as Unstable wt-PRRSV-2 detection pattern. Batches characterized with Early wt-PRRSV-2 detection pattern had higher mortality than batches characterized by Mid, Late and No wt-PRRSV-2 detection during the growth phase (p < 0.0001). Batches with Mid wt-PRRSV-2 detection had higher mortality than batches characterized with Late wt-PRRSV-2 detection (p < 0.0124). Mortality rate of batches characterized with Unstable and Early wt-PRRSV-2 detection patterns was lower when pigs were vaccinated with two doses of PRRS MLV vaccine, compared to batches that received only one dose. Results presented in this study suggested that early wt-PRRSV exposure on pig populations was associated with higher wean-to-finish mortality. Additionally, results suggested that vaccination with two PRRS MLV doses was associated with lower mortality rate, when growing pig populations had early wt-PRRSV exposure.
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Lokossou VK, Sombie I, Ahanhanzo CD, Brito C, Antara SN, Nguku PM, Balogun MS, Kenu E, Ouendo EM, Umeokonkwo CD, Okolo S. Strengthening Applied Epidemiology in West Africa: Progress, Gaps, and Advancing a Regional Strategy to Improve Health Security. Health Secur 2020; 19:88-99. [PMID: 33290155 DOI: 10.1089/hs.2019.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The ability to prevent, promptly detect, and appropriately respond to a public health threat is essential for health security. Field epidemiology training has helped increase the quality and quantity of the public health workforce to strengthen disease surveillance, outbreak preparedness and response, and general public health capacity. We conducted a desk review on the status of the Field Epidemiology and Laboratory Training Program model in 16 countries in West Africa. We also developed a questionnaire and shared it with West African Health Organization (WAHO) member states to document their experiences and the status of training in their countries. WAHO organized a regional 3-day consultative meeting with major stakeholders in the region to examine progress, gaps, and challenges, and outline a roadmap to strengthen the Field Epidemiology and Laboratory Training Program. Stakeholders shared their experiences, engaged in discussions to identify strengths and gaps, and made plans on a way forward. Member states are at different levels of implementing field epidemiology and laboratory training programs in their countries, and, therefore, major gaps remain in the number and distribution of trained epidemiologists throughout West Africa. Member states implement different variants of the program and in some instances the same cadre of health workers are trained in different but comparable programs with different funding streams. Two member states had not begun implementing the training program. Developing regional centers of excellence was recommended in the long term while collaboration among member states to train the required number of epidemiologists to fill the acute needs could be helpful in the short and medium term. Curriculum harmonization and expansion, deployment and use of trained epidemiologists, accreditation of training institutions, and generation of indigenous funding streams are recommended to improve the Field Epidemiology and Laboratory Training Program in West Africa.
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Affiliation(s)
- Virgil Kuassi Lokossou
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Issiaka Sombie
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Césaire Damien Ahanhanzo
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Carlos Brito
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Simon Nyovuura Antara
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Patrick Mboya Nguku
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Muhammad Shakir Balogun
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Ernest Kenu
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Edgard-Marius Ouendo
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Chukwuma David Umeokonkwo
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
| | - Stanley Okolo
- Virgil Kuassi Lokossou, MD, MPH, MBA, MSc, is Head of Division, Health Emergency and Disaster Management Department, ECOWAS Regional Center for Surveillance and Disease Control, Abuja, Nigeria. Issiaka Sombie, PhD, is Head of Research and Grant Division and Carlos Brito, MPH, is Director, Department of Public Health and Research; Césaire Damien Ahanhanzo, MSc, MPA, is General Coordinator of World Bank-Funded Projects, Department of Planning and Health Information; and Stanley Okolo, PhD, is Director General; all for the West African Health Organization, Bobo Dioulasso, Burkina Faso. Simon Nyovuura Antara, MPH, is Director, Africa Field Epidemiology Network, Kampala, Uganda. Patrick Mboya Nguku, MSc, is Senior Regional Technical Coordinator; Muhammad Shakir Balogun, FMCPath, is Resident Advisor; and Chukwuma David Umeokonkwo, MPH, FWACP, is a Scientific Writer and Field Coordinator; all for the Africa Field Epidemiology Network, Abuja, Nigeria. Chukwuma David Umeokonkwo is also a Consultant Community Physician and Epidemiologist, Community Medicine, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Abakaliki, Ebonyi State, Nigeria. Ernest Kenu, PhD, is a Professor, Ghana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Accra, Ghana. Edgard-Marius Ouendo, PhD, is a Professor of Public Health, Institut Regional de Santé Publique, Ouidah, Atlantique, Bénin
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Saad NJ, Muller N, Walter J, Murajda L. Scarlet fever outbreak in a primary and middle school in Germany: importance of case ascertainment and risk communication. Epidemiol Infect 2020; 148:e278. [PMID: 33143786 DOI: 10.1017/S0950268820002642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A cluster of 18 scarlet fever cases and large illness absenteeism (32%, 58/184) in a school prompted concern and further investigation. We conducted telephone interviews with parents to ascertain cases and better comprehend parents' views. We identified 19 cases, of which 13 reported scarlet fever diagnosis by a physician and only seven fulfilled the probable case definition. We concluded that the outbreak was far smaller than suspected and found that communication and reporting could be improved. Accurate information and communication is essential in an outbreak; the school's concern could have been alleviated sooner and response measures better targeted.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ario AR, Bulage L, Kadobera D, Kwesiga B, Kabwama SN, Tusiime P, Wanyenze RK. Uganda public health fellowship program's contribution to building a resilient and sustainable public health system in Uganda. Glob Health Action 2019; 12:1609825. [PMID: 31117889 PMCID: PMC6534252 DOI: 10.1080/16549716.2019.1609825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Low-income countries with relatively weak-health systems are highly vulnerable to public health threats. Effective public health system with a workforce to investigate outbreaks can reduce disease impact on livelihoods and economic development. Building effective public health partnerships is critical for sustainability of such a system. Uganda has made significant progress in responding to emergencies during the past quarter century, but its public health workforce is still inadequate in number and competency. Objectives: To reinforce implementation of priority public health programs in Uganda and cultivate core capacities for compliance with International Health Regulations. Methods: To develop a competent workforce to manage epidemics and improve disease surveillance, Uganda Ministry of Health (MoH) established an advanced-level Field Epidemiology Training Program, called Public Health Fellowship Program (PHFP); closely modelled after the US CDC’s Epidemic Intelligence Service. PHFP is a 2-year, full-time, non-degree granting program targeting mid-career public health professionals. Fellows spend 85% of their field time in MoH placements learning through service delivery and gaining competencies in major domains. Results: During 2015–2018, PHFP enrolled 41 fellows, and graduated 30. Fellows were placed in 19 priority areas at MoH and completed 235 projects (91 outbreaks, 12 refugee assessments, 50 surveillance, and 60 epidemiologic studies, 3 cost analysis and 18 quality improvement); made 194 conference presentations; prepared 63 manuscripts for peer-reviewed publications (27 published as of December 2018); produced MoH bulletins, and developed three case studies. Projects have resulted in public health interventions with improvements in surveillance systems and disease control. Conclusion: During the 4 years of existence, PHFP has contributed greatly to improving real-time disease surveillance and outbreak response core capacities. Enhanced focus on evidence-based targeted approaches has increased effectiveness in outbreak response and control, and integration of PHFP within MoH has contributed to building a resilient and sustainable health system in Uganda.
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Affiliation(s)
- Alex Riolexus Ario
- a Ministry of Health of Uganda , Kampala , Uganda.,b Uganda National Institute of Public Health , Kampala , Uganda.,c Uganda Public Health Fellowship Program , Ministry of Health , Kampala , Uganda
| | - Lilian Bulage
- c Uganda Public Health Fellowship Program , Ministry of Health , Kampala , Uganda.,d African Field Epidemiology Network , Kampala , Uganda
| | - Daniel Kadobera
- c Uganda Public Health Fellowship Program , Ministry of Health , Kampala , Uganda
| | - Benon Kwesiga
- c Uganda Public Health Fellowship Program , Ministry of Health , Kampala , Uganda
| | - Steven N Kabwama
- e Uganda Public Health Fellowship Program and Makerere University School of Public Health , Kampala , Uganda
| | - Patrick Tusiime
- a Ministry of Health of Uganda , Kampala , Uganda.,c Uganda Public Health Fellowship Program , Ministry of Health , Kampala , Uganda
| | - Rhoda K Wanyenze
- e Uganda Public Health Fellowship Program and Makerere University School of Public Health , Kampala , Uganda
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Vasiman A, Stothard JR, Bogoch II. Mobile Phone Devices and Handheld Microscopes as Diagnostic Platforms for Malaria and Neglected Tropical Diseases (NTDs) in Low-Resource Settings: A Systematic Review, Historical Perspective and Future Outlook. Adv Parasitol 2018; 103:151-173. [PMID: 30878057 DOI: 10.1016/bs.apar.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The accurate, rapid, and cost-effective diagnosis of malaria and neglected tropical diseases (NTDs) in low-resource settings may benefit by significant technological advances in handheld and mobile phone microscopy. We systematically review the available literature in this field and discuss the future directions in which these technologies may be applied. English-language studies from the PubMed, Embase, and Web of Sciences were searched through April 2018 for observational and interventional studies reporting diagnostic characteristics of handheld and mobile phone microscopy devices as compared to field-established gold standard reference tests. Seventeen studies were included in the analysis. Findings included the high performance of the Newton Nm1 microscope in the diagnosis of Plasmodium species, Schistosoma mansoni, and soil-transmitted helminths (STHs), exhibiting sensitivity and specificity values often greater than 90%. Similarly, the CellScope was shown to have excellent diagnostic characteristics in the detection of Loa loa and Schistosoma species. Fluorescent microscopy was found to have high specificity and sensitivity in the diagnosis of Plasmodium species. Mobile phone technologies and handheld microscopes hold significant promise in the rapid and effective diagnosis of malaria and NTDs in areas where accurate diagnosis is vital. Although many of these technologies have yet to be securely embedded within the health system and studied directly in this context, the foundations for significant healthcare advances and impact have already been laid by several studies conducted within the last decade.
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Affiliation(s)
- Alon Vasiman
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Isaac I Bogoch
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Divisions of General Internal Medicine and Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, ON, Canada
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Dietze K, Moritz T, Alexandrov T, Krstevski K, Schlottau K, Milovanovic M, Hoffmann D, Hoffmann B. Suitability of group-level oral fluid sampling in ruminant populations for lumpy skin disease virus detection. Vet Microbiol 2018; 221:44-48. [PMID: 29981707 DOI: 10.1016/j.vetmic.2018.05.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 12/23/2022]
Abstract
The geographic expansion of Lumpy skin disease (LSD) from the near East into the European Union highlighted again the need for appropriate disease detection tools applicable to animal host populations where access to individual animals is difficult. This is of particular importance considering that the clinical manifestation of LSD is often mild making early disease detection challenging under the above-mentioned conditions. Building on positive experiences of group-level oral fluid sampling for pathogen detection as it is known to work for swine herds and wild boar, the concept was transferred to ruminants. Two groups of six cattle were infected experimentally with Lumpy skin disease virus (LSDV) under controlled conditions. Blood as well as oropharyngeal and nasal swab samples were collected at regular intervals. Group samples were obtained by placing cotton gauze around a salt lick block provided commonly as dietary supplement. Pieces of the gauze with visible signs of manipulation were tested in parallel to samples obtained from individual animals. Genome load analysis by qPCR technology revealed LSDV detection window starting from day 2 post infection until day 28 post infection, the end of the animal trial. At the individual level, detection periods varied between animals and type of sample and included intermitted detection. The accumulative character of the alternative sampling method makes it suitable to detect LSDV DNA at group-level even at times of the infection where a selective sampling of individuals from a group - as normally done in LSD surveillance - would have most likely failed in the detection.
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Affiliation(s)
- K Dietze
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany.
| | - T Moritz
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - T Alexandrov
- Bulgarian Food Safety Agency, Pencho Slaveikov 15A, Sofia, 1606, Bulgaria
| | - K Krstevski
- University "Ss. Cyril and Methodius" Skopje, Faculty of Veterinary Medicine, Lazar Pop Trajkov 5-7, 1000, Skopje, Macedonia
| | - K Schlottau
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - M Milovanovic
- University of Belgrade, Faculty of Veterinary Medicine, Blvd. Oslobodjenja 18, 11000 Belgrade, Serbia
| | - D Hoffmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany
| | - B Hoffmann
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Südufer 10, 17493, Greifswald, Insel Riems, Germany
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16
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Roka ZG, Githuku J, Obonyo M, Boru W, Galgalo T, Amwayi S, Kioko J, Njoroge D, Ransom JA. Strengthening health systems in Africa: a case study of the Kenya field epidemiology training program for local frontline health workers. Public Health Rev 2017; 38:23. [PMID: 29450095 PMCID: PMC5809989 DOI: 10.1186/s40985-017-0070-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/12/2017] [Indexed: 11/10/2022] Open
Abstract
The logistical and operational challenges to improve public health practice capacity across Africa are well documented. This report describes Kenya's Field Epidemiology and Laboratory Training Program's (KFELTP) experience in implementing frontline public health worker training to transfer knowledge and practical skills that help strengthen their abilities to detect, document, respond to, and report unusual health events. Between May 2014 and May 2015, KFELTP hosted five training courses across the country to address practice gaps among local public health workers. Participants completed a 10-week process: two 1-week didactic courses, a 7-week field project, and a final 1-week course to present and defend the findings of their field project. The first year was a pilot period to determine whether the program could fit into the existing 2-year KFELTP model and whether this frontline-level training would have an impact on local practice. At the end of the first year, KFELTP certified 167 frontline health workers in field epidemiology and data management. This paper concludes that local, national, and international partnerships are critical for improving local public health response capacity and workforce development training in an African setting.
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Affiliation(s)
- Zeinab Gura Roka
- Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | - Jane Githuku
- Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | - Mark Obonyo
- Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | - Waqo Boru
- Field Epidemiology and Laboratory Training Program, Nairobi, Kenya
| | - Tura Galgalo
- African Field Epidemiology Network, Nairobi, Kenya
| | - Samuel Amwayi
- 3Disease Surveillance and Response Unit, Ministry of Health, Nairobi, Kenya
| | - Jackson Kioko
- 4Division of Preventive and Promotive Health, Ministry of Health, Nairobi, Kenya
| | - David Njoroge
- 5Human Resources Department, Ministry of Health, Nairobi, Kenya
| | - James Anthony Ransom
- Piret Partners Consulting, 611 Pennsylvania Avenue SE, Unit 358, Washington, DC 20003-4303 USA
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17
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Arvelo W, Gura Z, Amwayi S, Wiersma P, Omolo J, Becknell S, Jones D, Ongore D, Dicker R. Establishing a field epidemiology elective for medical students in Kenya: a strategy for increasing public health awareness and workforce capacity. J Epidemiol Glob Health 2015; 5:33-9. [PMID: 25700921 PMCID: PMC5497307 DOI: 10.1016/j.jegh.2014.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 08/04/2014] [Accepted: 10/04/2014] [Indexed: 11/19/2022] Open
Abstract
Medical students have limited exposure to field epidemiology, even though will assume public health roles after graduation. We established a 10-week elective in field epidemiology during medical school. Students attended one-week didactic sessions on epidemiology, and nine weeks in field placement sites. We administered pre- and post-tests to evaluate the training. We enrolled 34 students in 2011 and 2012. In 2011, we enrolled five of 24 applicants from a class of 280 medical students. In 2012, we enrolled 18 of 81 applicants from a class of 360 students; plus 11 who participated in the didactic sessions only. Among the 34 students who completed the didactic sessions, 74% were male, and their median age was 24 years (range: 22-26). The median pre-test score was 64% (range: 47-88%) and the median post-test score was 82% (range: 72-100%). Successful completion of the field projects was 100%. Six (30%) students were not aware of public health as a career option before this elective, 56% rated the field experience as outstanding, and 100% reported it increased their understanding of epidemiology. Implementing an elective in field epidemiology within the medical training is a highly acceptable strategy to increase awareness for public health among medical students.
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Affiliation(s)
- Wences Arvelo
- US Centers for Disease Control and Prevention, Atlanta, USA.
| | | | | | - Petra Wiersma
- CTS Global, Inc., Assigned to: US Centers for Disease Control Prevention, East Africa, USA
| | | | | | - Donna Jones
- US Centers for Disease Control and Prevention, Atlanta, USA
| | | | - Richard Dicker
- US Centers for Disease Control and Prevention, Atlanta, USA
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18
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Oyemakinde A, Nguku P, Babirye R, Gitta S, Nsubuga P, Nyager J, Nasidi A. Building a public health workforce in Nigeria through experiential training. Pan Afr Med J 2014; 18 Suppl 1:1. [PMID: 25328620 PMCID: PMC4199347 DOI: 10.11694/pamj.supp.2014.18.1.4920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 07/20/2014] [Indexed: 11/24/2022] Open
Affiliation(s)
- Akin Oyemakinde
- Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health, Abuja, Nigeria
| | - Patrick Nguku
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
| | | | - Sheba Gitta
- African Field Epidemiology Network (AFENET), Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Joseph Nyager
- Federal Ministry of Agriculture and Rural Development, Abuja Nigeria
| | - Abdulsalami Nasidi
- Nigeria Centre for Disease Control (NCDC), Federal Ministry of Health, Abuja, Nigeria
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19
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Nsubuga P, Johnson K, Tetteh C, Oundo J, Weathers A, Vaughan J, Elbon S, Tshimanga M, Ndugulile F, Ohuabunwo C, Evering-Watley M, Mosha F, Oleribe O, Nguku P, Davis L, Preacely N, Luce R, Antara S, Imara H, Ndjakani Y, Doyle T, Espinosa Y, Kazambu D, Delissaint D, Ngulefac J, Njenga K. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects. Pan Afr Med J 2011; 10:24. [PMID: 22187606 PMCID: PMC3224071 DOI: 10.4314/pamj.v10i0.72235] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 10/14/2011] [Indexed: 11/17/2022] Open
Abstract
As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.
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Affiliation(s)
- Peter Nsubuga
- Division of Public Health Systems and Workforce Development, Center for Global Health, US Centers for Disease Control and Prevention, USA
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