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Thystrup C, Hald T, Belina D, Gobena T. Outbreak detection in Harar town and Kersa district, Ethiopia using phylogenetic analysis and source attribution. BMC Infect Dis 2024; 24:864. [PMID: 39187763 PMCID: PMC11348558 DOI: 10.1186/s12879-024-09800-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/22/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Foodborne diseases (FBDs) represent a significant risk to public health, with nearly one in ten people falling ill every year globally. The large incidence of foodborne diseases in African low- and middle-income countries (LMIC) shows the immediate need for action, but there is still far to a robust and efficient outbreak detection system. The detection of outbreak heavily relies on clinical diagnosis, which are often delayed or ignored due to resource limitations and inadequate surveillance systems. METHODS In total, 68 samples of non-typhoidal Salmonella isolates from human, animal and environmental sources collected between November 2021 and January 2023 were analyzed using sequencing methods to infer phylogenetic relationships between the samples. A source attribution model using a machine-learning logit-boost that predicted the likely source of infection for 20 cases of human salmonellosis was also run and compared with the results of the cluster detection. RESULTS Three clusters of samples with close relation (SNP difference < 30) were identified as non-typhoidal Salmonella in Harar town and Kersa district, Ethiopia. These three clusters were comprised of isolates from different sources, including at least two human isolates. The isolates within each cluster showed identical serovar and sequence type (ST), with few exceptions in cluster 3. The close proximity of the samples suggested the occurrence of three potential outbreaks of non-typhoidal Salmonella in the region. The results of the source attribution model found that human cases of salmonellosis could primarily be attributed to bovine meat, which the results of the phylogenetic analysis corroborated. CONCLUSIONS The findings of this study suggested the occurrence of three possible outbreaks of non-typhoidal Salmonella in eastern Ethiopia, emphasizing the importance of targeted intervention of food safety protocols in LMICs. It also highlighted the potential of integrated surveillance for detecting outbreak and identifying the most probable source. Source attribution models in combination with other epidemiological methods is recommended as part of a more robust and integrated surveillance system for foodborne diseases.
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Affiliation(s)
- Cecilie Thystrup
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Tine Hald
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Dinaol Belina
- School of Biological Sciences and Biotechnology, Haramaya University, Dire Dawa, Ethiopia
- College of Veterinary Medicine, Haramaya University, Dire Dawa, Ethiopia
| | - Tesfaye Gobena
- School of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
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Sasie SD, Ayano G, Mamo F, Azage M, Spigt M. Assessing the performance of the integrated disease surveillance and response systems: a systematic review of global evidence. Public Health 2024; 231:71-79. [PMID: 38636279 DOI: 10.1016/j.puhe.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Public health surveillance systems are critical for detecting and responding to health threats. This review aims to analyze international literature on the performance of these systems in terms of core, support, and attributes of surveillance system. STUDY DESIGN Systematic review. METHODS Following the preregistered protocol (PROSPERO: CRD42022366051), a systematic search was conducted on PubMed/MEDLINE, CINHAL, CABI, Web of Science, and Google Scholar for articles evaluating Public Health Surveillance System performance from inception to July 21, 2023. Various study designs were included, and quality assessment was performed. Thematic analysis categorized findings into key surveillance system functions. RESULTS Nine studies from different countries assessed core and supportive functions, as well as surveillance attributes. Performance varied among countries, with some excelling overall and others showing poor performance in specific areas. Many countries' surveillance systems had inadequate performance in key measures in terms of the core and supportive functions, as well as the attributes of the surveillance system. CONCLUSION This review shows significant variations in the performance of public health surveillance systems across countries. Further research is needed to understand underperformance reasons and inform global policymaking for strengthening surveillance systems.
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Affiliation(s)
- S D Sasie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
| | - G Ayano
- School of Population Health, Curtin University, Australia.
| | - F Mamo
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - M Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - M Spigt
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; General Practice Research Unit, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
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Kallay R, Mbuyi G, Eggers C, Coulibaly S, Kangoye DT, Kubuya J, Soke GN, Mossoko M, Kazambu D, Magazani A, Fonjungo P, Luce R, Aruna A. Assessment of the integrated disease surveillance and response system implementation in health zones at risk for viral hemorrhagic fever outbreaks in North Kivu, Democratic Republic of the Congo, following a major Ebola outbreak, 2021. BMC Public Health 2024; 24:1150. [PMID: 38658902 PMCID: PMC11044341 DOI: 10.1186/s12889-024-18642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/17/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND The Democratic Republic of the Congo (DRC) experienced its largest Ebola Virus Disease Outbreak in 2018-2020. As a result of the outbreak, significant funding and international support were provided to Eastern DRC to improve disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy has been used in the DRC as a framework to strengthen public health surveillance, and full implementation could be critical as the DRC continues to face threats of various epidemic-prone diseases. In 2021, the DRC initiated an IDSR assessment in North Kivu province to assess the capabilities of the public health system to detect and respond to new public health threats. METHODS The study utilized a mixed-methods design consisting of quantitative and qualitative methods. Quantitative assessment of the performance in IDSR core functions was conducted at multiple levels of the tiered health system through a standardized questionnaire and analysis of health data. Qualitative data were also collected through observations, focus groups and open-ended questions. Data were collected at the North Kivu provincial public health office, five health zones, 66 healthcare facilities, and from community health workers in 15 health areas. RESULTS Thirty-six percent of health facilities had no case definition documents and 53% had no blank case reporting forms, limiting identification and reporting. Data completeness and timeliness among health facilities were 53% and 75% overall but varied widely by health zone. While these indicators seemingly improved at the health zone level at 100% and 97% respectively, the health facility data feeding into the reporting structure were inconsistent. The use of electronic Integrated Disease Surveillance and Response is not widely implemented. Rapid response teams were generally available, but functionality was low with lack of guidance documents and long response times. CONCLUSION Support is needed at the lower levels of the public health system and to address specific zones with low performance. Limitations in materials, resources for communication and transportation, and workforce training continue to be challenges. This assessment highlights the need to move from outbreak-focused support and funding to building systems that can improve the long-term functionality of the routine disease surveillance system.
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Affiliation(s)
- Ruth Kallay
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
| | - Gisèle Mbuyi
- National Epidemiology Surveillance Direction, DRC Ministry of Health, Hygiene and Prevention Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Carrie Eggers
- Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Soumaila Coulibaly
- Division of Global Health Protection, Centers for Disease Control and Prevention, Bizzell US, Kinshasa, Democratic Republic of the Congo
| | - David Tiga Kangoye
- Division of Global Health Protection, Centers for Disease Control and Prevention, Bizzell US, Kinshasa, Democratic Republic of the Congo
| | - Janvier Kubuya
- North Kivu Provincial Health Direction, DRC Ministry of Health, Hygiene and Prevention, Goma, Democratic Republic of the Congo
| | - Gnakub Norbert Soke
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Mathias Mossoko
- National Epidemiology Surveillance Direction, DRC Ministry of Health, Hygiene and Prevention Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ditu Kazambu
- African Field Epidemiology Network, Kinshasa, Democratic Republic of the Congo
| | - Alain Magazani
- African Field Epidemiology Network, Kinshasa, Democratic Republic of the Congo
| | - Peter Fonjungo
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Richard Luce
- Division of Global Health Protection, Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Aaron Aruna
- National Epidemiology Surveillance Direction, DRC Ministry of Health, Hygiene and Prevention Kinshasa, Kinshasa, Democratic Republic of the Congo
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Nyenswah TG, Skrip L, Stone M, Schue JL, Peters DH, Brieger WR. Documenting the development, adoption and pre-ebola implementation of Liberia's integrated disease surveillance and response (IDSR) strategy. BMC Public Health 2023; 23:2093. [PMID: 37880607 PMCID: PMC10601278 DOI: 10.1186/s12889-023-17006-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND In the immediate aftermath of a 14-year civil conflict that disrupted the health system, Liberia adopted the internationally recommended integrated disease surveillance and response (IDSR) strategy in 2004. Despite this, Liberia was among the three West African countries ravaged by the worst Ebola epidemic in history from 2014 to 2016. This paper describes successes, failures, strengths, and weaknesses in the development, adoption, and implementation of IDSR following the civil war and up until the outbreak of Ebola, from 2004 to early 2014. METHODS We reviewed 112 official Government documents and peer-reviewed articles and conducted 29 in-depth interviews with key informants from December 2021 to March 2022 to gain perspectives on IDSR in the post-conflict and pre-Ebola era in Liberia. We assessed the core and supportive functions of IDSR, such as notification of priority diseases, confirmation, reporting, analysis, investigation, response, feedback, monitoring, staff training, supervision, communication, and financial resources. Data were triangulated and presented via emerging themes and in-depth accounts to describe the context of IDSR introduction and implementation, and the barriers surrounding it. RESULTS Despite the adoption of the IDSR framework, Liberia failed to secure the resources-human, logistical, and financial-to support effective implementation over the 10-year period. Documents and interview reports demonstrate numerous challenges prior to Ebola: the surveillance system lacked key components of IDSR including laboratory testing capacity, disease reporting, risk communication, community engagement, and staff supervision systems. Insufficient financial support and an abundance of vertical programs further impeded progress. In-depth accounts by donors and key governmental informants demonstrate that although the system had a role in detecting Ebola in Liberia, it could not respond effectively to control the disease. CONCLUSION Our findings suggest that post-war, Liberia's health system intended to prioritize epidemic preparedness and response with the adoption of IDSR. However, insufficient investment and systems development meant IDSR was not well implemented, leaving the country vulnerable to the devastating impact of the Ebola epidemic.
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Affiliation(s)
- Tolbert G Nyenswah
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Laura Skrip
- School of Public Health, University of Liberia, Monrovia, Liberia
| | - Mardia Stone
- Division of Global Psychiatry, Boston University School of Medicine, Boston Medical Center, Boston, USA
| | - Jessica L Schue
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - William R Brieger
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Ssendagire S, Karanja MJ, Abdi A, Lubogo M, Azad Al A, Mzava K, Osman AY, Abdikarim AM, Abdi MA, Abdullahi AM, Mohamed A, Ahmed HS, Hassan NY, Hussein A, Ibrahim AD, Mohamed AY, Nur IM, Muhamed MB, Mohamed MA, Nur FA, Mohamed HSA, Derow MM, Diriye AA, Malik SMMR. Progress and experiences of implementing an integrated disease surveillance and response system in Somalia; 2016-2023. Front Public Health 2023; 11:1204165. [PMID: 37780418 PMCID: PMC10539911 DOI: 10.3389/fpubh.2023.1204165] [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: 05/16/2023] [Accepted: 08/21/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction In 2021, a regional strategy for integrated disease surveillance was adopted by member states of the World Health Organization Eastern Mediterranean Region. But before then, member states including Somalia had made progress in integration of their disease surveillance systems. We report on the progress and experiences of implementing an integrated disease surveillance and response system in Somalia between 2016 and 2023. Methods We reviewed 20 operational documents and identified key integrated disease surveillance and response system (IDSRS) actions/processes implemented between 2016 and 2023. We verified these through an anonymized online survey. The survey respondents also assessed Somalia's IDSRS implementation progress using a standard IDS monitoring framework Finally, we interviewed 8 key informants to explore factors to which the current IDSRS implementation progress is attributed. Results Between 2016 and 2023, 7 key IDSRS actions/processes were implemented including: establishment of high-level commitment; development of a 3-year operational plan; development of a coordination mechanism; configuring the District Health Information Software to support implementation among others. IDSRS implementation progress ranged from 15% for financing to 78% for tools. Reasons for the progress were summarized under 6 thematic areas; understanding frustrations with the current surveillance system; the opportunity occasioned by COVID-19; mainstreaming IDSRS in strategic documents; establishment of an oversight mechanism; staggering implementation of key activities over a reasonable length of time and being flexible about pre-determined timelines. Discussion From 2016 to 2023, Somalia registered significant progress towards implementation of IDSRS. The 15 years of EWARN implementation in Somalia (since 2008) provided a strong foundation for IDSRS implementation. If implemented comprehensively, IDSRS will accelerate country progress toward establishment of IHR core capacities. Sustainable funding is the major challenge towards IDSRS implementation in Somalia. Government and its partners need to exploit feasible options for sustainable investment in integrated disease surveillance and response.
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Affiliation(s)
| | | | | | - Mutaawe Lubogo
- World Health Organization Country Office, Mogadishu, Somalia
| | | | - Khadija Mzava
- Health Information Strengthening Project, Dar es Salaam, Tanzania
| | - Abdinasir Yusuf Osman
- Federal Ministry of Health, Mogadishu, Somalia
- The Royal Veterinary College, University of London, Hatfield, United Kingdom
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Mercy K, Balajee A, Numbere TW, Ngere P, Simwaba D, Kebede Y. Africa CDC's blueprint to enhance early warning surveillance: accelerating implementation of event-based surveillance in Africa. J Public Health Afr 2023; 14:2827. [PMID: 37753431 PMCID: PMC10519113 DOI: 10.4081/jphia.2023.2827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/08/2023] [Indexed: 09/28/2023] Open
Abstract
Event-based surveillance (EBS) is a core component of early warning surveillance. In 2018, Africa CDC developed the first edition of an event-based surveillance framework to guide African Union Member States in implementing EBS. Country experiences during the COVID-19 pandemic demonstrated the value of data from non-traditional sources for real time situational awareness; at the same time revealed the huge gaps in strengthening this arm of surveillance. Learning from these lessons and to begin to close those gaps, Africa CDC convened subject matter experts from African Union Member States and technical partners to develop the second edition of the EBS framework, 2023 and its training materials. The revised version includes additional sections such as, the multi-sectoral one health collaboration in EBS, monitoring and evaluation, cross border EBS, and use of event management systems. The current manuscript provides an overview of the 2023 Africa CDC EBS framework and highlights experience in two countries that have successfully employed this resource in their implementation efforts.
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Affiliation(s)
- Kyeng Mercy
- Africa Centres for Disease Control and Prevention (Africa CDC), Division of Surveillance and Disease Intelligence, Addis Ababa, Ethiopia
| | - Arunmozhi Balajee
- The Global Fund to fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Tamuno-Wari Numbere
- Africa Centres for Disease Control and Prevention (Africa CDC), Division of Surveillance and Disease Intelligence, Addis Ababa, Ethiopia
| | | | - Davie Simwaba
- Zambia National Public Health Institute, Lusaka, Zambia
| | - Yenew Kebede
- Africa Centres for Disease Control and Prevention (Africa CDC), Division of Surveillance and Disease Intelligence, Addis Ababa, Ethiopia
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Seck O, Loko Roka J, Ndiaye M, Namageyo-Funa A, Abdoulaye S, Mangane A, Dieye NL, Ndoye B, Diop B, Ting J, Pasi O. SARS-CoV-2 case detection using community event-based surveillance system-February-September 2020: lessons learned from Senegal. BMJ Glob Health 2023; 8:e012300. [PMID: 37353236 PMCID: PMC10314499 DOI: 10.1136/bmjgh-2023-012300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/05/2023] [Indexed: 06/25/2023] Open
Abstract
The COVID-19 pandemic necessitated the rapid development and implementation of effective surveillance systems to detect and respond to the outbreak in Senegal. In this documentation, we describe the design and implementation of the Community Event-Based Surveillance (CEBS) system in Senegal to strengthen the existing Integrated Disease Surveillance and Response system. The CEBS system used a hotline and toll-free number to collect and triage COVID-19-related calls from the community. Data from the CEBS system were integrated with the national system for further investigation and laboratory testing. From February to September 2020, a total of 10 760 calls were received by the CEBS system, with 10 751 calls related to COVID-19. The majority of calls came from the Dakar region, which was the epicentre of the outbreak in Senegal. Of the COVID-19 calls, 50.2% were validated and referred to health districts for further investigation, and 25% of validated calls were laboratory-confirmed cases of SARS-CoV-2. The implementation of the CEBS system allowed for timely detection and response to potential COVID-19 cases, contributing to the overall surveillance efforts in the country. Lessons learned from this experience include the importance of decentralised CEBS, population sensitisation on hotlines and toll-free usage, and the potential role of Community Health Workers in triaging alerts that needs further analysis. This experience highlights the contribution of a CEBS system in Senegal and provides insights into the design and operation of such a system. The findings can inform other countries in strengthening their surveillance systems and response strategies.
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Affiliation(s)
- Oumy Seck
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | | | - Mamadou Ndiaye
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | | | - Sam Abdoulaye
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | - Abdoulaye Mangane
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | - Ndeye Licka Dieye
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | | | - Boly Diop
- Surveillance Division, Prevention Department, Government of Senegal Ministry of Health and Social Action, Dakar, Senegal
| | - Jim Ting
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Omer Pasi
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Mboussou F, Farham B, Nsasiirwe S, Atagbaza A, Oyaole D, Atuhebwe PL, Alegana V, Osei-sarpong F, Bwaka A, Paluku G, Petu A, Efe-Aluta O, Kalu A, Bagayoko MM, Impouma B. COVID-19 Vaccination in the WHO African Region: Progress Made in 2022 and Factors Associated. Vaccines (Basel) 2023; 11:1010. [PMID: 37243114 PMCID: PMC10223522 DOI: 10.3390/vaccines11051010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 05/28/2023] Open
Abstract
This study summarizes progress made in rolling out COVID-19 vaccinations in the African region in 2022, and analyzes factors associated with vaccination coverage. Data on vaccine uptake reported to the World Health Organization (WHO) Regional Office for Africa by Member States between January 2021 and December 2022, as well as publicly available health and socio-economic data, were used. A negative binomial regression was performed to analyze factors associated with vaccination coverage in 2022. As of the end of 2022, 308.1 million people had completed the primary vaccination series, representing 26.4% of the region's population, compared to 6.3% at the end of 2021. The percentage of health workers with complete primary series was 40.9%. Having carried out at least one high volume mass vaccination campaign in 2022 was associated with high vaccination coverage (β = 0.91, p < 0.0001), while higher WHO funding spent per person vaccinated in 2022 was correlated with lower vaccination coverage (β = -0.26, p < 0.03). All countries should expand efforts to integrate COVID-19 vaccinations into routine immunization and primary health care, and increase investment in vaccine demand generation during the transition period that follows the acute phase of the pandemic.
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Affiliation(s)
- Franck Mboussou
- World Health Organization, Regional Office for Africa, Brazzaville P.O. Box 06, Congo
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Yusuf A, Oljira L, Mehadi A, Ayele BH. Integrated Disease Surveillance Response Practice and Associated Factors Among Health Professionals Working in Public Hospitals in West Hararghe Zone, Eastern Oromia, Ethiopia: Multi-Center Cross-Sectional Study. J Multidiscip Healthc 2023; 16:1111-1126. [PMID: 37131935 PMCID: PMC10149072 DOI: 10.2147/jmdh.s411191] [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: 03/21/2023] [Accepted: 04/14/2023] [Indexed: 05/04/2023] Open
Abstract
Background Health workforces across all levels of the healthcare system are the main modulators in the effective implementation of disease surveillance system. However, their level of integrated disease surveillance response (IDSR) practice and determinant factors was hardly investigated in Ethiopia. This study determined the level of IDSR practice and associated factors among health professionals in the west Hararghe zone, eastern Oromia, Ethiopia. Methodology A multicenter facility-based cross-sectional study design was conducted between December 20, 2021, and January 10, 2022, among 297 systematically selected health professionals. Trained data collectors collected data using structured pretested self-administered questionnaires. The level of IDSR practice was assessed using six questions where each acceptable practice was given "1" and unacceptable "0", with a total score of 0 to 6. Hence, a score above or equal to the median was categorized as good practice. Epi-data and STATA were used for data entry and analysis. A binary logistic regression analysis model with an adjusted odds ratio was used to determine the effects of independent variables on the outcome variable. Results The magnitude of good practice of IDSR was 50.17% (95% CI: 45.17, 55.17). Being married (AOR = 1.76; 95% CI: 1.01, 3.06), perceived organizational support (AOR = 2.14, 95% CI: 1.16, 3.94), good knowledge (AOR = 2.77, 95% CI: 1.61, 4.78), positive attitude (AOR = 3.30, 95% CI: 1.82, 5.98) and working in an emergency (AOR = 0.37, 95% CI: 0.14, 0.98) were significantly associated with the level of practice. Conclusion Only half of the health professionals had a good level of practice in integrated disease surveillance response. Marital status, working department, perceived organizational support, knowledge level, and attitude toward integrated disease surveillance were significantly associated with health professionals' practice of disease surveillance. Thus, organizational and provider-targeted interventions should be considered to improve the knowledge and attitude of health professionals that improve integrated disease surveillance response practice.
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Affiliation(s)
- Ahmednajash Yusuf
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Ame Mehadi
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Behailu Hawulte Ayele
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Nansikombi HT, Kwesiga B, Aceng FL, Ario AR, Bulage L, Arinaitwe ES. Timeliness and completeness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020-2021. BMC Public Health 2023; 23:647. [PMID: 37016380 PMCID: PMC10072024 DOI: 10.1186/s12889-023-15534-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/27/2023] [Indexed: 04/06/2023] Open
Abstract
INTRODUCTION Disease surveillance provides vital data for disease prevention and control programs. Incomplete and untimely data are common challenges in planning, monitoring, and evaluation of health sector performance, and health service delivery. Weekly surveillance data are sent from health facilities using mobile tracking (mTRAC) program, and synchronized into the District Health Information Software version 2 (DHIS2). The data are then merged into district, regional, and national level datasets. We described the completeness and timeliness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020-2021. METHODS We abstracted data on completeness and timeliness of weekly reporting of epidemic-prone diseases from 146 districts of Uganda from the DHIS2.Timeliness is the proportion of all expected weekly reports that were submitted to DHIS2 by 12:00pm Monday of the following week. Completeness is the proportion of all expected weekly reports that were completely filled and submitted to DHIS2 by 12:00pm Wednesday of the following week. We determined the proportions and trends of completeness and timeliness of reporting at national level by year, health region, district, health facility level, and facility ownership. RESULTS National average reporting timeliness and completeness was 44% and 70% in 2020, and 49% and 75% in 2021. Eight of the 15 health regions achieved the target for completeness of ≥ 80%; Lango attained the highest (93%) in 2020, and Karamoja attained 96% in 2021. None of the regions achieved the timeliness target of ≥ 80% in either 2020 or 2021. Kampala District had the lowest completeness (38% and 32% in 2020 and 2021, respectively) and the lowest timeliness (19% in both 2020 and 2021). Referral hospitals and private owned health facilities did not attain any of the targets, and had the poorest reporting rates throughout 2020 and 2021. CONCLUSION Weekly surveillance reporting on epidemic prone diseases improved modestly over time, but timeliness of reporting was poor. Further investigations to identify barriers to reporting timeliness for surveillance data are needed to address the variations in reporting.
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Affiliation(s)
- Hildah Tendo Nansikombi
- Uganda Public Health Fellowship Program, National Institute of Public Health, Kampala, Uganda.
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, National Institute of Public Health, Kampala, Uganda
| | | | - Alex R Ario
- Uganda Public Health Fellowship Program, National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, National Institute of Public Health, Kampala, Uganda
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Rumunu J, Wamala JF, Konga SB, Igale AL, Adut AA, Lonyik SK, Lasu RM, Kaya RD, Guracha G, Nsubuga P, Ndenzako F, Olu OO. Integrated disease surveillance and response in humanitarian context: South Sudan experience. Pan Afr Med J 2022; 42:13. [PMID: 36158932 PMCID: PMC9474851 DOI: 10.11604/pamj.supp.2022.42.1.33779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION decades of instability continue to impact the implementation of the Integrated Disease Surveillance and Response (IDSR) strategy. The study reviewed the progress and outcomes of rolling out IDSR in South Sudan. METHODS this descriptive cross-sectional study used epidemiological data for 2019, 2020, and other program data to assess indicators for the five surveillance components including surveillance priorities, core and support functions, and surveillance system structure and quality. RESULTS South Sudan expanded the priority disease scope from 26 to 59 to align with national and regional epidemiological trends and the International Health Regulations (IHR) 2005. Completing the countrywide rollout of electronic Early Warning Alert and Response (EWARS) reporting has improved both the timeliness and completeness of weekly reporting to 78% and 90%, respectively, by week 39 of 2020 in comparison to a baseline of 54% on both timeliness and completeness of reporting in 2019. The National Public Health Laboratory confirmatory testing capacities have been expanded to include cholera, measles, HIV, tuberculosis (TB), influenza, Ebola, yellow fever, and Severe Acute Respiratory Syndrome 2 (SARS-COV-2). Rapid response teams have been established to respond to epidemics and pandemics. CONCLUSION since 2006, South Sudan has registered progress towards using indicator and event-based surveillance and continues to strengthen IHR (2005) capacities. Following the adoption of third edition IDSR guidelines, the current emphasis entails maintaining earlier gains and strengthening community and event-based surveillance, formalizing cross-sectoral one-health engagement, optimal EWARS and District Health Information Systems (DHIS2) use, and strengthening cross-border surveillance. It is also critical that optimal government, and donors' resources are dedicated to supporting health system strengthening and disease surveillance.
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Affiliation(s)
- John Rumunu
- Directorate of Preventive Health Services, South Sudan Ministry of Health, Joint Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan,,Corresponding author John Rumunu, Directorate of Preventive Health Services, South Sudan Ministry of Health, Joint Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan.
| | | | | | | | | | | | | | | | - Guyo Guracha
- World Health Organization Country office, Juba, South Sudan
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Guyo AG, Berta KK, Ramadan OP, Gai M, Lado AI, Loi GT, Kol MT, Obat MD, Maleghemi S, Ndenzako F, Olu OO. Joint external evaluation of the international health regulations (2005) capacity in South Sudan: assessing the country´s capacity for health security. Pan Afr Med J 2022; 42:7. [PMID: 36158933 PMCID: PMC9475044 DOI: 10.11604/pamj.supp.2022.42.1.33842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/05/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION joint external evaluation is a voluntary and collaborative process to assess a country´s capacity under International Health Regulations (2005) to prevent, detect, and respond to public health threats. The main objective is to measure a country´s status in building the necessary capacities to prevent, detect, and respond to infectious disease threats and establish a baseline measurement of capacities and capabilities. The Republic of South Sudan conducted the Joint External Evaluation from 16-20 October 2017, where its capacities were assessed to public health threats per the International Health Regulation (2005). METHODS cross-sectional descriptive study of the Joint External Evaluation process and the findings are described along with major findings and recommendations for the country. RESULTS South Sudan's overall mean score across 48 indicators was 1.5 (min= 1, max= 4) and 42/48 indicators (87.5%) scored < 2 on a 1 to 5 scale. Technical areas in the prevent category with the lowest score were antimicrobial resistance, biosafety and biosecurity, and National legislation, policy, and financing. In the detect category, the mean score was 2. Technical areas with the lowest mean scores were workforce development and the National Laboratory System. Preparedness, medical countermeasures, personnel deployment, linking public health, and security authorities had the lowest scores in the respond category. Chemical events, radiation emergencies, and points of entry had a score of 1 in the other IHR-related hazards and points of entry category. CONCLUSION South Sudan's mean score of 1.5 can be attributed to several civil conflicts experienced, which have impacted negatively on the health system. Recommendations from the Joint External Evaluation need to be implemented and these must be aligned with the costed National Action Plan for Health Security.
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Affiliation(s)
- Argata Guracha Guyo
- World Health Organization, WHO Country Office, Juba, South Sudan,,Corresponding author Argata Guracha Guyo, World Health Organization, WHO Country Office, Juba, South Sudan.
| | | | - Otim Patrick Ramadan
- World Health Organization, East and South Africa, Sub-Regional Office, Nairobi, Kenya
| | - Malick Gai
- World Health Organization, WHO Country Office, Juba, South Sudan
| | - Alice Igale Lado
- World Health Organization, WHO Country Office, Juba, South Sudan
| | | | | | | | | | - Fabian Ndenzako
- World Health Organization, WHO Country Office, Juba, South Sudan
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Rumunu J, Wamala JF, Sakaya R, Konga SB, Igale AL, Adut AA, Lonyik SK, Lasu RM, Kaya RD, Guracha G, Nsubuga P, Ndenzako F, Talisuna AO. Evaluation of integrated disease surveillance and response (IDSR) and early warning and response network (EWARN) in South Sudan 2021. Pan Afr Med J 2022; 42:6. [PMID: 36158929 PMCID: PMC9474832 DOI: 10.11604/pamj.supp.2022.42.1.33780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/05/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction South Sudan has been implementing the Integrated Disease Surveillance and Response (IDSR) strategy since 2006, along with Early Warning and Alert Response and Network (EWARN). The IDSR/EWARN stakeholders commissioned an independent evaluation to establish performance at national, state, county, health facility, and community levels in the first half of 2021. Methods the evaluation was conducted between June and September 2021 (during the COVID-19 pandemic) and was based on the World Health Organization (WHO) protocols for monitoring and evaluating communicable disease surveillance and response systems and the guidelines for evaluating EWARN. Results integrated disease surveillance and response/early warning and alert response and network indicator data showed improving timeliness and completeness from the beginning of 2021 to week 16 and then a slight depression of timeliness by week 32, while completeness remained high. Event-based surveillance was active at the beginning of 2021 and in week 32. However, there was inadequate sample collection to investigate acute watery diarrhea, bloody diarrhea, and acute jaundice syndrome alerts. Respondents in all cadres had substantial experience working in IDSR/EWARN. All respondents performed the various IDSR/EWARN tasks and duties as expected, but needed more resources and training. Conclusion while IDSR/EWARN is performing relatively well, confirmation of priority diseases by the laboratories needs to be strengthened. Health facilities need more regular supervision from the higher levels. Community health workers need more training on IDSR/EWARN. The whole IDSR/EWARN system needs more resources, particularly for communication and transport and to confirm priority diseases. Staff at all levels requested more training in IDSR/EWARN.
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Affiliation(s)
- John Rumunu
- Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan,Corresponding author John Rumunu, Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan.
| | | | | | - Sheila Baya Konga
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Alice Lado Igale
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | | | | | - Robert Martin Lasu
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Rose Dagama Kaya
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Guyo Guracha
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | | | - Fabian Ndenzako
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Ambrose Otau Talisuna
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Tagurum YO, Dogo MJ, Adah GA, Maimagani IC, Sodipo OO, Adeniji T, Daboer JC, Banwat ME, Lar LA, Akosu TJ, Chingle MP. Comparative Assessment of the Implementation of Integrated Disease Surveillance and Response in Public and Private Health Facilities in Jos North Local Government Area of Plateau State, Nigeria. Ann Afr Med 2022; 21:146-152. [PMID: 35848647 PMCID: PMC9383018 DOI: 10.4103/1596-3519.349974] [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] [Indexed: 11/04/2022] Open
Abstract
Background Due to the continuous increase in the spread of epidemic-prone diseases and the associated morbidity and mortality, integrated disease surveillance and response (IDSR) was introduced as the main strategy in resource-poor settings for the detection and notification of these diseases. Integrated disease surveillance is a combination of active and passive systems using a single infrastructure that gathers information about multiple diseases or behaviors of interest. Methods : A comparative cross-sectional study was conducted between March and July 2018 among selected public and private health facilities in Jos North Local Government Area (LGA), Plateau State. Quantitative data were collected with the aid of a semi-structured interviewer-administered questionnaire and facility-based checklist. Data were analyzed using SPSS version 23. Statistical significance level was set at P ≤ 0.05 at a 95% confidence level. Results A. total of 126 health workers were studied. IDSR-trained health personnel was found in 52.7% of the public health facilities compared with only 16.7% of the private health facilities studied (P < 0.001). Awareness of IDSR was higher in the public health facilities than in the private ones (P < 0.001). IDSR implementation was poorer in the private health facilities 40.7% compared with 76.4% in public health facilities (P < 0.001). Evidence of previous disease notification and reporting was seen only in 33.3% and 16.7% of public and private health facilities, respectively (P < 0.001). Conclusion This study revealed that awareness and attitude of health workers in public health facilities in Jos North were higher than that of those in private health facilities and there is the sub-optimal implementation of IDSR among the health workers in Jos North LGA, especially among the private health facilities.
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Affiliation(s)
- Yetunde Olubusayo Tagurum
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - M Joy Dogo
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - G A Adah
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - I C Maimagani
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - O O Sodipo
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - T Adeniji
- Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - J C Daboer
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - M E Banwat
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - L A Lar
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - T J Akosu
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
| | - M P Chingle
- Department of Community Medicine, College of Health Sciences, University of Jos; Department of Community Medicine, Jos University Teaching Hospital, Jos, Nigeria
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Keita M, Lucaccioni H, Ilumbulumbu MK, Polonsky J, Nsio-Mbeta J, Panda GT, Adikey PC, Ngwama JK, Tosalisana MK, Diallo B, Subissi L, Dakissaga A, Finci I, de Almeida MM, Guha-Sapir D, Talisuna A, Delamou A, Dagron S, Keiser O, Ahuka-Mundeke S. Evaluation of Early Warning, Alert and Response System for Ebola Virus Disease, Democratic Republic of the Congo, 2018-2020. Emerg Infect Dis 2021; 27:2988-2998. [PMID: 34808084 PMCID: PMC8632192 DOI: 10.3201/eid2712.210290] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The 10th and largest Ebola virus disease epidemic in the Democratic Republic of the Congo (DRC) was declared in North Kivu Province in August 2018 and ended in June 2020. We describe and evaluate an Early Warning, Alert and Response System (EWARS) implemented in the Beni health zone of DRC during August 5, 2018–June 30, 2020. During this period, 194,768 alerts were received, of which 30,728 (15.8%) were validated as suspected cases. From these, 801 confirmed and 3 probable cases were detected. EWARS showed an overall good performance: sensitivity and specificity >80%, nearly all (97%) of alerts investigated within 2 hours of notification, and good demographic representativeness. The average cost of the system was US $438/case detected and US $1.8/alert received. The system was stable, despite occasional disruptions caused by political insecurity. Our results demonstrate that EWARS was a cost-effective component of the Ebola surveillance strategy in this setting.
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Mremi IR, George J, Rumisha SF, Sindato C, Kimera SI, Mboera LEG. Twenty years of integrated disease surveillance and response in Sub-Saharan Africa: challenges and opportunities for effective management of infectious disease epidemics. ONE HEALTH OUTLOOK 2021; 3:22. [PMID: 34749835 PMCID: PMC8575546 DOI: 10.1186/s42522-021-00052-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/18/2021] [Indexed: 05/15/2023]
Abstract
INTRODUCTION This systematic review aimed to analyse the performance of the Integrated Disease Surveillance and Response (IDSR) strategy in Sub-Saharan Africa (SSA) and how its implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources. METHODS HINARI, PubMed, and advanced Google Scholar databases were searched for eligible articles. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. RESULTS A total of 1,809 articles were identified and screened at two stages. Forty-five studies met the inclusion criteria, of which 35 were country-specific, seven covered the SSA region, and three covered 3-4 countries. Twenty-six studies assessed the IDSR core functions, 43 the support functions, while 24 addressed both functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The routine Health Management Information System (HMIS), which collects data from health care facilities, has remained the primary source of IDSR data. However, the system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation, and lack of integration of data from other sources. Under-use of advanced and big data analytical technologies in performing disease surveillance and relating multiple indicators minimises the optimisation of clinical and practice evidence-based decision-making. CONCLUSIONS This review indicates that most countries in SSA rely mainly on traditional indicator-based disease surveillance utilising data from healthcare facilities with limited use of data from other sources. It is high time that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate other sources of health information to provide support to effective detection and prompt response to public health threats.
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Affiliation(s)
- Irene R Mremi
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania.
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania.
- National Institute for Medical Research, Dar es Salaam, Tanzania.
| | - Janeth George
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Susan F Rumisha
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Malaria Atlas Project, Geospatial Health and Development, Telethon Kids Institute, West Perth, Australia
| | - Calvin Sindato
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
- National Institute for Medical Research, Tabora Research Centre, Tabora, Tanzania
| | - Sharadhuli I Kimera
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Leonard E G Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
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The COVID-19 pandemic in the WHO African region: the first year (February 2020 to February 2021). Epidemiol Infect 2021; 149:e263. [PMID: 34732270 PMCID: PMC8712926 DOI: 10.1017/s0950268821002429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The World Health Organization African region recorded its first laboratory-confirmed coronavirus disease-2019 (COVID-19) cases on 25 February 2020. Two months later, all the 47 countries of the region were affected. The first anniversary of the pandemic occurred in a changed context with the emergence of new variants of concern (VOC) and growing COVID-19 fatigue. This study describes the epidemiological trajectory of COVID-19 in the region, summarises public health and social measures (PHSM) implemented and discusses their impact on the pandemic trajectory. As of 24 February 2021, the African region accounted for 2.5% of cases and 2.9% of deaths reported globally. Of the 13 countries that submitted detailed line listing of cases, the proportion of cases with at least one co-morbid condition was estimated at 3.3% of all cases. Hypertension, diabetes and human immunodeficiency virus (HIV) infection were the most common comorbid conditions, accounting for 11.1%, 7.1% and 5.0% of cases with comorbidities, respectively. Overall, the case fatality ratio (CFR) in patients with comorbid conditions was higher than in patients without comorbid conditions: 5.5% vs. 1.0% (P < 0.0001). Countries started to implement lockdown measures in early March 2020. This contributed to slow the spread of the pandemic at the early stage while the gradual ease of lockdowns from 20 April 2020 resulted in an upsurge. The second wave of the pandemic, which started in November 2020, coincided with the emergence of the new variants of concern. Only 0.08% of the population from six countries received at least one dose of the COVID-19 vaccine. It is critical to not only learn from the past 12 months to improve the effectiveness of the current response but also to start preparing the health systems for subsequent waves of the current pandemic and future pandemics.
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Onwe FI, Okedo-Alex IN, Akamike IC, Igwe-Okomiso DO. Vertical disease programs and their effect on integrated disease surveillance and response: perspectives of epidemiologists and surveillance officers in Nigeria. Trop Dis Travel Med Vaccines 2021; 7:28. [PMID: 34593034 PMCID: PMC8483794 DOI: 10.1186/s40794-021-00152-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrated Disease Surveillance and Response (IDSR) is a cost-effective surveillance system designed to curb the inefficiency associated with vertical (disease-specific) programs. The study determined the existence and effect of vertical programs on disease surveillance and response in Nigeria. METHODS A cross-sectional study involving 14 State epidemiologists and Disease Notification Surveillance Officers (DSNOs) in 12 states located within the 6 geopolitical zones in Nigeria. Data was collected using mailed electronic semi-structured self-administered questionnaires. Response rate was 33.3%. The data was analyzed using SPSS version 20. RESULTS Half of the respondents were males (50.0%) and State epidemiologists (50.0%). Malaria, HIV/AIDS, tuberculosis, and other diseases were ongoing vertical programs in the States surveyed. In over 90% of cases, vertical programs had different personnel, communication channels and supportive supervision processes different from the IDSR system. Although less than 50% acknowledged the existence of a forum for data harmonization, this forum was ineffectively utilized in 83.3% of cases. Specific disease funding was higher than that of IDSR (92.9%) and only 42.9% reported funding for IDSR activities from development partners in the State. Poor data management, low priority on IDSR priority diseases, and donor-driven programming were major negative effects of vertical programs. Improved funding, political ownership, and integration were major recommendations preferred by the respondents. CONCLUSION We found that vertical programs in the surveyed States in the Nigerian health system led to duplication of efforts, inequitable funding, and inefficiencies in surveillance. We recommend integration of existing vertical programs into the IDSR system, increased resource allocation, and political support to improve IDSR.
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Affiliation(s)
- Francis Idenyi Onwe
- Ebonyi State Ministry of Health, Abakaliki, Nigeria
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Ijeoma Nkem Okedo-Alex
- Ebonyi State Ministry of Health, Abakaliki, Nigeria.
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria.
| | - Ifeyinwa Chizoba Akamike
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
- African Institute for Health Policy and Health Systems, Ebonyi State University, Abakaliki, Nigeria
| | - Dorothy Ogechi Igwe-Okomiso
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
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Mboussou F, Impouma B, Farham B, Wolfe CM, Williams GS, Ngom R, Nzingou M, Merzouki A, Orel E, Ahmed YA, Keiser O, Moeti MR. Analysing the reported incidence of COVID-19 and factors associated in the World Health Organization African region as of 31 December 2020. Epidemiol Infect 2021; 149:e256. [PMID: 34392872 PMCID: PMC8712961 DOI: 10.1017/s095026882100193x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/10/2021] [Accepted: 08/05/2021] [Indexed: 11/07/2022] Open
Abstract
This study analysed the reported incidence of COVID-19 and associated epidemiological and socio-economic factors in the WHO African region. Data from COVID-19 confirmed cases and SARS-CoV-2 tests reported to the WHO by Member States between 25 February and 31 December 2020 and publicly available health and socio-economic data were analysed using univariate and multivariate binomial regression models. The overall cumulative incidence was 1846 cases per million population. Cape Verde (21 350 per million), South Africa (18 060 per million), Namibia (9840 per million), Eswatini (8151 per million) and Botswana (6044 per million) recorded the highest cumulative incidence, while Benin (260 per million), Democratic Republic of Congo (203 per million), Niger (141 cases per million), Chad (133 per million) and Burundi (62 per million) recorded the lowest. Increasing percentage of urban population (β = -0.011, P = 0.04) was associated with low cumulative incidence, while increasing number of cumulative SARS-CoV-2 tests performed per 10 000 population (β = 0.0006, P = 0.006) and the proportion of population aged 15-64 years (adjusted β = 0.174, P < 0.0001) were associated with high COVID-19 cumulative incidence. With limited testing capacities and overwhelmed health systems, these findings highlight the need for countries to increase and decentralise testing capacities and adjust testing strategies to target most at-risk populations.
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Affiliation(s)
- Franck Mboussou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Bridget Farham
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Caitlin M. Wolfe
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Roland Ngom
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Milse Nzingou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Aziza Merzouki
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Erol Orel
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Yahaya Ali Ahmed
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Olivia Keiser
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Matshidiso R Moeti
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Implementing epidemic intelligence in the WHO African region for early detection and response to acute public health events. Epidemiol Infect 2021; 149:e261. [PMID: 33985609 PMCID: PMC8727712 DOI: 10.1017/s095026882100114x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Epidemic intelligence activities are undertaken by the WHO Regional Office for Africa to support member states in early detection and response to outbreaks to prevent the international spread of diseases. We reviewed epidemic intelligence activities conducted by the organisation from 2017 to 2020, processes used, key results and how lessons learned can be used to strengthen preparedness, early detection and rapid response to outbreaks that may constitute a public health event of international concern. A total of 415 outbreaks were detected and notified to WHO, using both indicator-based and event-based surveillance. Media monitoring contributed to the initial detection of a quarter of all events reported. The most frequent outbreaks detected were vaccine-preventable diseases, followed by food-and-water-borne diseases, vector-borne diseases and viral haemorrhagic fevers. Rapid risk assessments generated evidence and provided the basis for WHO to trigger operational processes to provide rapid support to member states to respond to outbreaks with a potential for international spread. This is crucial in assisting member states in their obligations under the International Health Regulations (IHR) (2005). Member states in the region require scaled-up support, particularly in preventing recurrent outbreaks of infectious diseases and enhancing their event-based surveillance capacities with automated tools and processes.
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Ng’etich AKS, Voyi K, Kirinyet RC, Mutero CM. A systematic review on improving implementation of the revitalised integrated disease surveillance and response system in the African region: A health workers' perspective. PLoS One 2021; 16:e0248998. [PMID: 33740021 PMCID: PMC7978283 DOI: 10.1371/journal.pone.0248998] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/09/2021] [Indexed: 12/01/2022] Open
Abstract
Background The revised integrated disease surveillance and response (IDSR) guidelines adopted by African member states in 2010 aimed at strengthening surveillance systems critical capacities. Milestones achieved through IDSR strategy implementation prior to adopting the revised guidelines are well documented; however, there is a dearth of knowledge on the progress made post-adoption. This study aimed to review key recommendations resulting from surveillance assessment studies to improve implementation of the revitalised IDSR system in the African region based on health workers’ perspectives. The review focused on literature published between 2010 and 2019 post-adopting the revised IDSR guidelines in the African region. Methods A systematic literature search in PubMed, Web of Science and Cumulative Index for Nursing and Allied Health Literature was conducted. In addition, manual reference searches and grey literature searches using World Health Organisation Library and Information Networks for Knowledge databases were undertaken. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement checklist for systematic reviews was utilised for the review process. Results Thirty assessment studies met the inclusion criteria. IDSR implementation under the revised guidelines could be improved considerably bearing in mind critical findings and recommendations emanating from the reviewed surveillance assessment studies. Key recommendations alluded to provision of laboratory facilities and improved specimen handling, provision of reporting forms and improved reporting quality, surveillance data accuracy and quality, improved knowledge and surveillance system performance, utilisation of up-to-date information and surveillance system strengthening, provision of resources, enhanced reporting timeliness and completeness, adopting alternative surveillance strategies and conducting further research to improve surveillance functions. Conclusion Recommendations on strengthening IDSR implementation in the African region post-adopting the revised guidelines mainly identify surveillance functions focused on reporting, feedback, training, supervision, timeliness and completeness of the surveillance system as aspects requiring policy refinement. Systematic review registration PROSPERO registration number CRD42019124108.
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Affiliation(s)
- Arthur K. S. Ng’etich
- School of Health Systems and Public Health (SHSPH), University of Pretoria, Pretoria, South Africa
- * E-mail:
| | - Kuku Voyi
- School of Health Systems and Public Health (SHSPH), University of Pretoria, Pretoria, South Africa
| | - Ruth C. Kirinyet
- Department of Environmental and Occupational Health, School of Public Health, Kenyatta University, Nairobi, Kenya
| | - Clifford M. Mutero
- School of Health Systems and Public Health (SHSPH), University of Pretoria, Pretoria, South Africa
- University of Pretoria Institute for Sustainable Malaria Control (UP ISMC), University of Pretoria, Pretoria, South Africa
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
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Wolfe CM, Hamblion EL, Dzotsi EK, Mboussou F, Eckerle I, Flahault A, Codeço CT, Corvin J, Zgibor JC, Keiser O, Impouma B. Systematic review of Integrated Disease Surveillance and Response (IDSR) implementation in the African region. PLoS One 2021; 16:e0245457. [PMID: 33630890 PMCID: PMC7906422 DOI: 10.1371/journal.pone.0245457] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 12/30/2020] [Indexed: 01/02/2023] Open
Abstract
Background The WHO African region frequently experiences outbreaks and epidemics of infectious diseases often exacerbated by weak health systems and infrastructure, late detection, and ineffective outbreak response. To address this, the WHO Regional Office for Africa developed and began implementing the Integrated Disease Surveillance and Response strategy in 1998. Objectives This systematic review aims to document the identified successes and challenges surrounding the implementation of IDSR in the region available in published literature to highlight areas for prioritization, further research, and to inform further strengthening of IDSR implementation. Methods A systematic review of peer-reviewed literature published in English and French from 1 July 2012 to 13 November 2019 was conducted using PubMed and Web of Science. Included articles focused on the WHO African region and discussed the use of IDSR strategies and implementation, assessment of IDSR strategies, or surveillance of diseases covered in the IDSR framework. Data were analyzed descriptively using Microsoft Excel and Tableau Desktop 2019. Results The number of peer-reviewed articles discussing IDSR remained low, with 47 included articles focused on 17 countries and regional level systems. Most commonly discussed topics were data reporting (n = 39) and challenges with IDSR implementation (n = 38). Barriers to effective implementation were identified across all IDSR core and support functions assessed in this review: priority disease detection; data reporting, management, and analysis; information dissemination; laboratory functionality; and staff training. Successful implementation was noted where existing surveillance systems and infrastructure were utilized and streamlined with efforts to increase access to healthcare. Conclusions and implications of findings These findings highlighted areas where IDSR is performing well and where implementation remains weak. While challenges related to IDSR implementation since the first edition of the technical guidelines were released are not novel, adequately addressing them requires sustained investments in stronger national public health capabilities, infrastructure, and surveillance processes.
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Affiliation(s)
- Caitlin M. Wolfe
- Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
- University of South Florida College of Public Health, Tampa, Florida, United States of America
- * E-mail:
| | - Esther L. Hamblion
- Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Emmanuel K. Dzotsi
- Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Franck Mboussou
- Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Isabelle Eckerle
- Division of Infectious Diseases, Geneva Centre for Emerging Viral Diseases, University Hospital of Geneva, Geneva, Switzerland
| | - Antoine Flahault
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Claudia T. Codeço
- National School of Public Health (ENSP/Fiocruz), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Jaime Corvin
- University of South Florida College of Public Health, Tampa, Florida, United States of America
| | - Janice C. Zgibor
- University of South Florida College of Public Health, Tampa, Florida, United States of America
| | - Olivia Keiser
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Benido Impouma
- Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
- Institute of Global Health, University of Geneva, Geneva, Switzerland
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Balinandi S, von Brömssen C, Tumusiime A, Kyondo J, Kwon H, Monteil VM, Mirazimi A, Lutwama J, Mugisha L, Malmberg M. Serological and molecular study of Crimean-Congo Hemorrhagic Fever Virus in cattle from selected districts in Uganda. J Virol Methods 2021; 290:114075. [PMID: 33515661 DOI: 10.1016/j.jviromet.2021.114075] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Crimean-Congo Hemorrhagic Fever (CCHF) is a severe tick-borne viral hemorrhagic disease caused by Crimean-Congo Hemorrhagic Fever Virus (CCHFV) that poses serious public health challenges in many parts of Africa, Europe and Asia. METHODS We examined 500 cattle sera samples from five districts for CCHFV antibodies using in-house and commercially available (IDVet) ELISA, Immunofluorescent assay (IFA) and Real-time polymerase chain reaction (RT-PCR). RESULTS 500 cattle (73.8 % females) were analyzed; CCHFV seropositivity was 12.6 % (n = 63) and 75.0 % (n = 375) with the in-house and IDVet ELISAs, respectively. Seropositivity was associated with geographical location, increasing age, being female, and having a higher tick burden. Twenty four out of the 37 (64.8 %) were seropositive for CCHFV using IFA and all were negative for virus on RT-PCR. The IFA results were more comparable to IDVet (κcoefficient = 0.88, p = <0.01) than to in-house (κcoefficient = 0.32, p = 0.02). CONCLUSIONS Our study confirmed the presence and high prevalence of anti-CCHF antibodies in cattle based on three methods from all the five study districts, confirming presence and exposure of CCHFV. Given the zoonotic potential for CCHFV, we recommend a multidisciplinary public health surveillance and epidemiology of CCHFV in both animals and humans throughout the country.
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Affiliation(s)
- Stephen Balinandi
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - Claudia von Brömssen
- Division of Applied Statistics and Mathematics, Department of Engergy and Technology, Swedish University of Agricultural Sciences, Box 7013, Uppsala, 750 07, Sweden.
| | - Alex Tumusiime
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Jackson Kyondo
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Hyesoo Kwon
- National Veterinary Institute, Uppsala, 751 89, Sweden.
| | - Vanessa M Monteil
- Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden.
| | - Ali Mirazimi
- National Veterinary Institute, Uppsala, 751 89, Sweden; Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden; Public Health Agency of Sweden, Stockholm, 171 82, Sweden.
| | - Julius Lutwama
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Lawrence Mugisha
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda; Ecohealth Research Group, Conservation & Ecosystem Health Alliance (CEHA), Box 34153, Kampala, Uganda.
| | - Maja Malmberg
- Section of Virology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Box 7028, Uppsala, 750 07, Sweden; SLU Global Bioinformatics Centre, Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Box 7023, Uppsala, 750 07, Sweden.
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Ismail K, Maiga G, Ssebuggwawo D, Nabende P, Mansourian A. Spatio-temporal trends and distribution patterns of typhoid disease in Uganda from 2012 to 2017. GEOSPATIAL HEALTH 2021; 15. [PMID: 33461278 DOI: 10.4081/gh.2020.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/18/2020] [Indexed: 06/12/2023]
Abstract
Typhoid disease continues to be a global public health burden. Uganda is one of the African countries characterized by high incidences of typhoid disease. Over 80% of the Ugandan districts are endemic for typhoid, largely attributable to lack of reliable knowledge to support disease surveillance. Spatial-temporal studies exploring major characteristics of the disease within the local population have remained limited in Uganda. The main goal of the study was to reveal spatial-temporal trends and distribution patterns of typhoid disease in Uganda for the period 2012 to 2017. Spatial-temporal statistics revealed monthly and annual trends of the disease at both regional and national levels. Results show that outbreaks occurred during 2015 and 2017 in central and eastern regions, respectively. Spatial scan statistic using the discrete Poisson model revealed spatial clusters of the disease for each of the years from 2012 to 2017, together with populations at risk. Most of the disease clustering was in the central region, followed by western and eastern regions (P <0.01). The northern region was the safest throughout the study period. This knowledge helps surveillance teams to i) plan and enforce preventive measures; ii) effectively prepare for outbreaks; iii) make targeted interventions for resource optimization; and iv) evaluate effectiveness of the intervention methods in the study period. This exploratory research forms a foundation of using Geographical Information Systems (GIS) in other related subsequent research studies to discover hidden spatial patterns that are difficult to discover with conventional methods.
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Affiliation(s)
- Kamukama Ismail
- Department of Information Systems, Makerere University, Kampala; Department of Computer Science, Kyambogo University, Kyambogo.
| | - Gilbert Maiga
- Department of Information Systems, Makerere University, Kampala.
| | | | - Peter Nabende
- Department of Information Systems, Makerere University, Kampala.
| | - Ali Mansourian
- Department of Physical Geography, Lund University, Lund.
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25
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Clara A, Ndiaye SM, Joseph B, Nzogu MA, Coulibaly D, Alroy KA, Gourmanon DC, Diarrassouba M, Toure-Adechoubou R, Houngbedji KA, Attiey HB, Balajee SA. Community-Based Surveillance in Côte d'Ivoire. Health Secur 2020; 18:S23-S33. [PMID: 32004127 DOI: 10.1089/hs.2019.0062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Community-based surveillance can be an important component of early warning systems. In 2016, the Côte d'Ivoire Ministry of Health launched a community-based surveillance project in 3 districts along the Guinea border. Community health workers were trained in detection and immediate reporting of diseases and events using a text-messaging platform. In December 2017, surveillance data from before and after implementation of community-based surveillance were analyzed in intervention and control districts. A total of 3,734 signals of priority diseases and 4,918 unusual health events were reported, of which 420 were investigated as suspect diseases and none were investigated as unusual health events. Of the 420 suspected cases reported, 23 (6%) were laboratory confirmed for a specific pathogen. Following implementation of community-based surveillance, 5-fold and 8-fold increases in reporting of suspected measles and yellow fever clusters, respectively, were documented. Reporting incidence rates in intervention districts for suspected measles, yellow fever, and acute flaccid paralysis were significantly higher after implementation, with a difference of 29.2, 19.0, and 2.5 cases per 100,000 person-years, respectively. All rate differences were significantly higher in intervention districts (p < 0.05); no significant increase in reporting was noted in control districts. These findings suggest that community-based surveillance strengthened detection and reporting capacity for several suspect priority diseases and events. However, the surveillance program was very sensitive, resulting in numerous false-positives. Learning from the community-based surveillance implementation experience, the ministry of health is revising signal definitions to reduce sensitivity and increase specificity, reviewing training materials, considering scaling up sustainable reporting platforms, and standardizing community health worker roles.
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Affiliation(s)
- Alexey Clara
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Serigne M Ndiaye
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Benie Joseph
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Maurice A Nzogu
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Daouda Coulibaly
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Karen A Alroy
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Djebo C Gourmanon
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Mamadou Diarrassouba
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Ramatou Toure-Adechoubou
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Koffi Ange Houngbedji
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Henry Banny Attiey
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - S Arunmozhi Balajee
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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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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Clemente J, Rhee S, Miller B, Bronner E, Whitney E, Bratton S, Carnevale C. Reading between the lines: A qualitative case study of national public health institute functions and attributes in the Joint External Evaluation. J Public Health Afr 2020; 11:1329. [PMID: 33209238 PMCID: PMC7649726 DOI: 10.4081/jphia.2020.1329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/23/2020] [Indexed: 11/23/2022] Open
Abstract
National Public Health Institutes (NPHIs) are national-level institutions that can lead and coordinate a country’s public health system. The Africa Centres for Disease Control and Prevention (Africa CDC) considers NPHI development critical to strengthening public health systems in Africa. This paper describes how Joint External Evaluation (JEE) reports demonstrate the role NPHIs can play in supporting the goals of IHR compliance and global health security. This study is a secondary document-based qualitative analysis of JEE reports from 11 countries in the WHO AFRO region (Botswana, Ethiopia, Liberia, Mozambique, Namibia, Nigeria, Rwanda, Sierra Leone, South Africa, Uganda, and Zambia). Researchers found three distinct thematic areas: i) core public health functions, ii) governance, and iii) coordination, collaboration, and communication. These themes and their interlinkages, both in pairs and all three, were of importance in displaying the roles that NPHIs could play in the strengthening of health systems. The data suggests that NPHIs, though not always explicitly mentioned in the data, may have a vital role in strengthening health systems across Africa and their governments’ goals of achieving IHR compliance.
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Affiliation(s)
- Jacob Clemente
- US Centers for Disease Control and Prevention, Atlanta, GA
| | - Shelby Rhee
- US Centers for Disease Control and Prevention, Atlanta, GA
| | - Bridget Miller
- US Centers for Disease Control and Prevention, Atlanta, GA
| | - Elisha Bronner
- International Association of National Public Health Institutes, Atlanta, GA, USA
| | - Ellen Whitney
- International Association of National Public Health Institutes, Atlanta, GA, USA
| | - Shelly Bratton
- US Centers for Disease Control and Prevention, Atlanta, GA
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Makinde OA, Odimegwu CO. Compliance with disease surveillance and notification by private health providers in South-West Nigeria. Pan Afr Med J 2020; 35:114. [PMID: 32637012 PMCID: PMC7320761 DOI: 10.11604/pamj.2020.35.114.21188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/19/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Private health facilities are important contributors to health service delivery across several low and middle income countries. In Nigeria, they make up 33% of the health facilities, account for more than 70% of healthcare spending and over 60% of healthcare contacts are estimated to take place within them However, their level of participation in the disease surveillance system has been questioned. Methods We conducted a cross-sectional survey of 507 private health facilities in South-West Nigeria to investigate the level of compliance with disease surveillance reporting and the factors that affect their participation. Results We found only 40% of the private health facilities to be complying with routine disease surveillance reporting which ranged from 17% to 60% across the six states in the region. Thirty-four percent of the private health facilities had the requisite data collection tools, 49% had designated professionals assigned to health records management and only 7% of the clinicians could properly identify the three data collection tools for disease surveillance. Some important factors such as awareness of a law on disease surveillance (OR=1.55 95% CI=1.08-2.24), availability of reporting tools (OR=13.69, 95% CI=8.85-21.62), availability of a designated health records officer (OR=3.9, 95% CI=2.68-5.73), and health records officers (OR=10.51, 95%CI=2.86-67.70) and clinicians (OR=2.49, 95% CI=1.22-5.25) with knowledge of disease surveillance system were important predictive factors to compliance with disease surveillance participation. Conclusion Private health facilities are poorly compliant with disease surveillance in Nigeria resulting in missed opportunities for prompt identification and response to threats of infectious disease outbreaks.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Viable Knowledge Masters, Plot C114 (Platinum Plaza), First Avenue, Gwarinpa, Abuja, Nigeria
| | - Clifford Obby Odimegwu
- Demography and Population Studies Program, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Standley CJ, MacDonald PDM, Attal-Juncqua A, Barry AM, Bile EC, Collins DL, Corvil S, Ibrahima DB, Hemingway-Foday JJ, Katz R, Middleton KJ, Reynolds EM, Sorrell EM, Lamine SM, Wone A, Martel LD. Leveraging Partnerships to Maximize Global Health Security Improvements in Guinea, 2015-2019. Health Secur 2020; 18:S34-S42. [PMID: 32004131 PMCID: PMC11323542 DOI: 10.1089/hs.2019.0089] [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: 11/13/2022] Open
Abstract
In response to the 2014-2016 West Africa Ebola virus disease (EVD) outbreak, a US congressional appropriation provided funds to the US Centers for Disease Control and Prevention (CDC) to support global health security capacity building in 17 partner countries, including Guinea. The 2014 funding enabled CDC to provide more than 300 deployments of personnel to Guinea during the Ebola response, establish a country office, and fund 11 implementing partners through cooperative agreements to support global health security engagement efforts in 4 core technical areas: workforce development, surveillance systems, laboratory systems, and emergency management. This article reflects on almost 4 years of collaboration between CDC and its implementing partners in Guinea during the Ebola outbreak response and the recovery period. We highlight examples of collaborative synergies between cooperative agreement partners and local Guinean partners and discuss the impact of these collaborations in strengthening the above 4 core capacities. Finally, we identify the key elements of the successful collaborations, including communication and information sharing as a core cooperative agreement activity, a flexible funding mechanism, and willingness to adapt to local needs. We hope these observations can serve as guidance for future endeavors seeking to establish strong and effective partnerships between government and nongovernment organizations providing technical and operational assistance.
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Affiliation(s)
- Claire J Standley
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Pia D M MacDonald
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Aurelia Attal-Juncqua
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Alpha Mahmoud Barry
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Ebi Celestin Bile
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Doreen L Collins
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Salomon Corvil
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Diallo Boubabar Ibrahima
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Jennifer J Hemingway-Foday
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Rebecca Katz
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Kathy J Middleton
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Eileen M Reynolds
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Erin M Sorrell
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Soumah Mohamed Lamine
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Abdoulaye Wone
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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
| | - Lise D Martel
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. 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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Olu O, Drameh-Avognon P, Asamoah-Odei E, Kasolo F, Valdez T, Kabaniha G, Karamagi H, Good S, O'Malley H, Yoti Z, Razakazoa N, Minkoulou E, Dangou JM, Mbola Mbassi S, Castellon MS, Cabore J, Moeti M. Community participation and private sector engagement are fundamental to achieving universal health coverage and health security in Africa: reflections from the second Africa health forum. BMC Proc 2019; 13:7. [PMID: 31737089 PMCID: PMC6849158 DOI: 10.1186/s12919-019-0170-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Inadequate access to quality health care services due to weak health systems and recurrent public health emergencies are impediments to the attainment of Universal Health Coverage and health security in Africa. To discuss these challenges and deliberate on plausible solutions, the World Health Organization Regional Office for Africa, in collaboration with the Government of Cabo Verde, convened the second Africa Health Forum in Praia, Cabo Verde on 26–28 March 2019, under the theme Achieving Universal Health Coverage and Health Security: The Africa We Want to See. Methods The Forum was conducted through technical sessions consisting of high-level, moderated panel discussions on specific themes, some of them preceded by keynote addresses. There were booth exhibitions by Member States, World Health Organization and other organizations to facilitate information exchanges. A Communiqué highlighting the recommendations of the Forum was issued during the closing ceremony. More than 750 participants attended. Relevant information from the report of the Forum and notes by the authors were extracted and synthesized into these proceedings. Conclusions The Forum participants agreed that the role of community engagement and participation in the attainment of Universal Health Coverage, health security and ultimately the Sustainable Development Goals cannot be overemphasized. The public sector of Africa alone cannot achieve these three interrelated goals; other partners, such as the private sector, must be engaged. Technological innovations will be a key driver of the attainment of these goals; hence, there is need to harness the comparative advantages that they offer. Attainment of the three goals is also intertwined – achieving one paves the way for achieving the others. Thus, there is need for integrated public health approaches in the planning and implementation of interventions aimed at achieving them. Recommendations To ensure that the recommendations of this Forum are translated into concrete actions in a sustainable manner, we call on African Ministers of Health to ensure their integration into national health sector policies and strategic documents and to provide the necessary leadership required for their implementation. We also call on partners to mainstream these recommendations into their ongoing support to World Health Organization African Member States.
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Affiliation(s)
- Olushayo Olu
- WHO Country Office, Juba, Republic of South Sudan
| | | | - Emil Asamoah-Odei
- 3Consultant, Regional Director's Office, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francis Kasolo
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | | | - Grace Kabaniha
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | | | - Suvajee Good
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Helena O'Malley
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Zabulon Yoti
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Nirina Razakazoa
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | | | | | | | | | - Joseph Cabore
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Matshidiso Moeti
- 2WHO Regional Office for Africa, Brazzaville, Republic of the Congo
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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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Nsubuga P, Masiira B, Ibrahim L, Ndakala N, Dongmo N. The contribution of the polio eradication initiative on the operations and outcomes of non-polio public health programs: a survey of programs in the African region. Pan Afr Med J 2019; 31:207. [PMID: 31447967 PMCID: PMC6691281 DOI: 10.11604/pamj.2018.31.207.17666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction The effect of the Global polio eradication initiative (PEI) on public health programs beyond polio is widely debated. PEI contribution to other health programs has been assessed from the perspective of polio-funded personnel, which may introduce bias as PEI staff are probably more likely to show that they have benefited of other programs. We set out to identify and document how public health programs have benefited from the public health capacity that was provided at the country level as part of the PEI program in a systematic and standardized manner. Methods Between July and November 2017, we conducted a mixed-methods cross-sectional study, which combined two methods: a multi-country quantitative survey and a qualitative study. We created a self-administered electronic multi-lingual questionnaire in English, French and Portuguese. The qualitative study, which followed an interim analysis of the quantitative survey, comprised interviews with national and subnational level staff in a few countries. Results A total of 127 public health workers from 43 of the 47 countries in the African WHO Region responded online. Most of the respondents 56/127 (42.7%) belonged to the immunization sector and 51/127 (38.9%) belonged to the emergencies and outbreaks sector. Respondents who identified themselves with the immunization (50/64 (78%)) and maternal health program (64/82 (78%)) reported the highest level of greatly benefiting from PEI resources. A total of 78/103 (76%) respondents rated PEI's contribution data management system to their program very high and high. Of the 127 respondents, the majority 91 (71.6%) reported that the withdrawal of PEI resources would result in a weakening of surveillance for other diseases; 88 (62.9%) reported that there would be inadequate resources to carry out planned activities and 80 (62.9%) reported that there would be poor logistics and transport for implementation of activities. Cameroon, DRC, Nigeria and Uganda participated in the qualitative study. Each country had between 7-8 key informants from the national and sub-national level for a total of 31 key informants. Polio funds and other PEI resources have supported various activities in the ministries of health of the four countries especially IDSR, data management, laboratories and development of the public health workforce. Respondents believed that the infrastructure and processes that PEI has created need to be maintained, along with the workforce and they believed that this was an essential role of their governments with support from the partners. Conclusion There is a high awareness of the PEI program in all the countries and at all levels which should be leveraged into improving other child survival activities for example routine immunizations. Future large-scale programs of this nature should be designed to benefit other public health programs beyond the specific program. The public health workforce, surveillance development, data management and laboratory strengthening that have been developed by PEI need to be maintained.
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Affiliation(s)
- Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Ben Masiira
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Luka Ibrahim
- Global Public Health Solutions, Atlanta, Georgia, USA
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Cholera surveillance and estimation of burden of cholera. Vaccine 2019; 38 Suppl 1:A13-A17. [PMID: 31326254 DOI: 10.1016/j.vaccine.2019.07.036] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 06/13/2019] [Accepted: 07/08/2019] [Indexed: 11/22/2022]
Abstract
Cholera continues to be poorly controlled in multiple epidemic and endemic areas across the globe, with estimated annual incidence of 1.3-4.0 million cases, resulting in 21,000 to 143,000 deaths worldwide in 2015. The usual approach for patient diagnosis and cholera surveillance is clinical examination of cases of acute watery diarrhea (AWD), confirmed by positive culture or polymerase chain reaction tests. Rapid diagnostic tests (RDTs) are used in regions with limited laboratory capacities but have been found to demonstrate large variations in performance, ranging in sensitivity from 58% to 100% and in specificity from 60% to 100%. Most countries rely on hospital-based surveillance of diarrheal disease to compute the cholera burden. The World Health Organization (WHO) recommends that countries assess public health events involving cholera against the International Health Regulations 2005 criteria and determine need for official notification using the standard case definition. Cholera is an often under-recognized and under reported problem because of differences in case definitions, reluctance by authorities to acknowledge and report cholera, inadequacies in hospital surveillance systems, lack of effective diagnostic tests and commonalities in clinical presentation of cholera with other AWD etiologies. The resulting gap in burden data impairs economic analysis of disease impact and identification of areas for targeted control interventions. There is an urgent need to strengthen surveillance data by supplementing reported numbers with estimates from literature reviews and data from modelling studies, developing better-performing RDTs, enhancing monitoring and evaluation processes of in-country surveillance systems, and encouraging countries to report cholera cases by "rewarding" better reporting with technical support and improved access to vaccines. It is imperative that immediate steps are taken towards strengthening surveillance and reporting systems globally, especially in cholera-prone and resource-limited areas, where it will enable countries to articulate their demand for resources more accurately.
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Fall IS, Rajatonirina S, Yahaya AA, Zabulon Y, Nsubuga P, Nanyunja M, Wamala J, Njuguna C, Lukoya CO, Alemu W, Kasolo FC, Talisuna AO. Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa. BMJ Glob Health 2019; 4:e001427. [PMID: 31354972 PMCID: PMC6615866 DOI: 10.1136/bmjgh-2019-001427] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/13/2019] [Accepted: 05/18/2019] [Indexed: 11/04/2022] Open
Abstract
In 1998, the WHO African region adopted a strategy called Integrated Disease Surveillance and Response (IDSR). Here, we present the current status of IDSR implementation; and provide some future perspectives for enhancing the IDSR strategy in Africa. In 2017, we used two data sources to compile information on the status of IDSR implementation: a pretested rapid assessment questionnaire sent out biannually to all countries and quarterly compilation of data for two IDSR key performance indicators (KPI). The first KPI measures country IDSR performance and the second KPI tracks the number of countries that the WHO secretariat supports to scale up IDSR. The KPI data for 2017 were compared with a retrospective baseline for 2014. By December 2017, 44 of 47 African countries (94%) were implementing IDSR. Of the 44 countries implementing IDSR, 40 (85%) had initiated IDSR training at subnational level; 32 (68%) had commenced community-based surveillance; 35 (74%) had event-based surveillance; 33 (70%) had electronic IDSR; and 32 (68%) had a weekly/monthly bulletin for sharing IDSR data. Thirty-two countries (68%) had achieved the timeliness and completeness threshold of at least 80% of the reporting units. However, only 12 countries (26%) had the desired target of at least 90% IDSR implementation coverage at the peripheral level. After 20 years of implementing IDSR, there are major achievements in the indicator-based surveillance systems. However, major gaps were identified in event-based surveillance. All African countries should enhance IDSR everywhere.
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Affiliation(s)
- Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Soatiana Rajatonirina
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Yoti Zabulon
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | | | - Joseph Wamala
- World Health Organization, Country Office, Juba, South Sudan
| | - Charles Njuguna
- World Health Organization, Country Office, Free Town, Sierra Leone
| | - Charles Okot Lukoya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Francis Chisaka Kasolo
- World Health Organization, Regional Office for Africa, Country Support, Brazzaville, Congo
| | - Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
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Nagbe T, Naiene JD, Rude JM, Mahmoud N, Kromah M, Sesay J, Chukwudi OJ, Stephen M, Talisuna A, Yahaya AA, Rajatonirina S, Fallah M, Nyenswah T, Dahn B, Gasasira A, Fall IS. The implementation of integrated disease surveillance and response in Liberia after Ebola virus disease outbreak 2015-2017. Pan Afr Med J 2019; 33:3. [PMID: 31404272 PMCID: PMC6675929 DOI: 10.11604/pamj.supp.2019.33.2.16820] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/22/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Although Liberia adapted the integrated diseases surveillance and response (IDSR) in 2004 as a platform for implementation of International Health Regulation (IHR (2005)), IDSR was not actively implemented until 2015. Some innovations and best practices were observed during the implementation of IDSR in Liberia after Ebola virus disease outbreak. This paper describes the different approaches used for implementation of IDSR in Liberia from 2015 to 2017. METHODS We conducted a cross-sectional study using the findings from IDSR supervisions conducted from September to November 2017 and perused the outbreaks linelists submitted by the counties to the national level from January to December 2017 and key documents available at the national level. RESULTS In 2017, the country piloted the use of mobile phones application to store and send data from the health facilities to the national level. In addition, an electronic platform for acute flaccid paralysis (AFP) surveillance called Auto-Visual AFP Detection and Reporting (AVADAR) was piloted in Montserrado County during the first semester of 2017. The timeliness and completeness of reports submitted from the counties to national level were above the target of 80% stable despite the challenges like insufficient resources, including skilled staff. CONCLUSION IDSR is being actively implemented in Liberia since 2015. Although the country is facing the same challenges as other countries during the early stages of implementation of IDSR, the several innovations were implemented in a short time. The surveillance system reveled to be resilient, despite the challenges.
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Affiliation(s)
- Thomas Nagbe
- National Public Health Institute, Monrovia, Liberia
| | | | | | | | | | | | | | - Mary Stephen
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ambrose Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | - Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Nakiire L, Masiira B, Kihembo C, Katushabe E, Natseri N, Nabukenya I, Komakech I, Makumbi I, Charles O, Adatu F, Nanyunja M, Nsubuga P, Woldetsadik SF, Tusiime P, Yahaya AA, Fall IS, Wondimagegnehu A. Healthcare workers' experiences regarding scaling up of training on integrated disease surveillance and response (IDSR) in Uganda, 2016: cross sectional qualitative study. BMC Health Serv Res 2019; 19:117. [PMID: 30760259 PMCID: PMC6374884 DOI: 10.1186/s12913-019-3923-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 01/22/2019] [Indexed: 11/24/2022] Open
Abstract
Background The Integrated Disease Surveillance and Response (IDSR) strategy was adopted as the framework for implementation of International Health Regulation (2005) in the African region of World Health Organisation (WHO AFRO). While earlier studies documented gains in performance of core IDSR functions, Uganda still faces challenges due to infectious diseases. IDSR revitalisation programme aimed to improve prevention, early detection, and prompt response to disease outbreaks. However, little is known about health worker’s perception of the revitalised IDSR training. Methods We conducted focus group discussions of health workers who were trained between 2015 and 2016. Discussions on benefits, challenges and possible solutions for improvement of IDSR training were recorded, transcribed, translated and coded using grounded theory. Results In total, 22/26 FGDs were conducted. Participants cited improved completeness and timeliness of reporting, case detection and data analysis and better response to disease outbreaks as key achievements after the training. Programme challenges included an inadequate number of trained staff, funding, irregular supervision, high turnover of trained health workers, and lack of key logistics. Suggestions to improve IDSR included pre-service and community training, mentorship, regular supervision and improving funding at the district level. Conclusion Health workers perceived that scaling up revitalized IDSR training in Uganda improved public health surveillance. However, they acknowledge encountering challenges that hinder their performance after the training. Ministry of Health should have a mentorship plan, integrate IDSR training in pre-service curricula and advocate for funding IDSR activities to address some of the gaps highlighted in this study.
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Affiliation(s)
- Lydia Nakiire
- Public Health Emergency Operation Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda.
| | - Ben Masiira
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | - Christine Kihembo
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | | | - Nasan Natseri
- World Health Organization, Country Office, Kampala, Uganda
| | - Immaculate Nabukenya
- Epidemiology and Surveillance Division, Ministry of Health Kampala, Kampala, Uganda
| | | | - Issa Makumbi
- Public Health Emergency Operation Centre, Ministry of Health, P.O BOX 7072, Kampala, Uganda
| | - Okot Charles
- World Health Organization, Country Office, Kampala, Uganda
| | | | | | - Peter Nsubuga
- Global Public Health Solutions Inc, Atlanta, Georgia, USA
| | | | - Patrick Tusiime
- National Disease Control, Ministry of Health, Kampala, Uganda
| | - Ali Ahmed Yahaya
- World Health Organization Africa Regional Office, Brazzaville, Congo
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Masiira B, Nakiire L, Kihembo C, Katushabe E, Natseri N, Nabukenya I, Komakech I, Makumbi I, Charles O, Adatu F, Nanyunja M, Woldetsadik SF, Fall IS, Tusiime P, Wondimagegnehu A, Nsubuga P. Evaluation of integrated disease surveillance and response (IDSR) core and support functions after the revitalisation of IDSR in Uganda from 2012 to 2016. BMC Public Health 2019; 19:46. [PMID: 30626358 PMCID: PMC6327465 DOI: 10.1186/s12889-018-6336-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 12/17/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Uganda is a low income country that continues to experience disease outbreaks caused by emerging and re-emerging diseases such as cholera, meningococcal meningitis, typhoid and viral haemorrhagic fevers. The Integrated Disease Surveillance and Response (IDSR) strategy was adopted by WHO-AFRO in 1998 as a comprehensive strategy to improve disease surveillance and response in WHO Member States in Africa and was adopted in Uganda in 2000. To address persistent inconsistencies and inadequacies in the core and support functions of IDSR, Uganda initiated an IDSR revitalisation programme in 2012. The objective of this evaluation was to assess IDSR core and support functions after implementation of the revitalised IDSR programme. METHODS The evaluation was a cross-sectional survey that employed mixed quantitative and qualitative methods. We assessed IDSR performance indicators, knowledge acquisition, knowledge retention and level of confidence in performing IDSR tasks among health workers who underwent IDSR training. Qualitative data was collected to guide the interpretation of quantitative findings and to establish a range of views related to IDSR implementation. RESULTS Between 2012 and 2016, there was an improvement in completeness of monthly reporting (69 to 100%) and weekly reporting (56 to 78%) and an improvement in timeliness of monthly reporting (59 to 93%) and weekly reporting (40 to 68%) at the national level. The annualised non-polio AFP rate increased from 2.8 in 2012 to 3.7 cases per 100,000 population < 15 years in 2016. The case fatality rate for cholera decreased from 3.2% in 2012 to 2.1% in 2016. All districts received IDSR feedback from the national level. Key IDSR programme challenges included inadequate numbers of trained staff, inadequate funding, irregular supervision and high turnover of trained staff. Recommendations to improve IDSR performance included: improving funding, incorporating IDSR training into pre-service curricula for health workers and strengthening support supervision. CONCLUSION The revitalised IDSR programme in Uganda was associated with improvements in performance. However in 2016, the programme still faced significant challenges and some performance indicators were still below the target. It is important that the documented gains are consolidated and challenges are continuously identified and addressed as they emerge.
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Affiliation(s)
- Ben Masiira
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Lydia Nakiire
- Public Health Emergency Operation Centre, Ministry of Health, Kampala, Uganda
| | - Christine Kihembo
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Edson Katushabe
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Nasan Natseri
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Immaculate Nabukenya
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | | | - Issa Makumbi
- Public Health Emergency Operation Centre, Ministry of Health, Kampala, Uganda
| | - Okot Charles
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | - Francis Adatu
- Epidemiology and Surveillance Division, Ministry of Health, P.O Box 7072, Kampala, Uganda
| | - Miriam Nanyunja
- World Health Organization, Uganda Country Office, Kampala, Uganda
| | | | | | - Patrick Tusiime
- National Disease Control, Ministry of Health, Kampala, Uganda
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Joseph Wu TS, Kagoli M, Kaasbøll JJ, Bjune GA. Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert. PLoS One 2018; 13:e0200858. [PMID: 30496177 PMCID: PMC6264833 DOI: 10.1371/journal.pone.0200858] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/13/2018] [Indexed: 11/30/2022] Open
Abstract
Objective The recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon global efforts to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening. Methods This was a mixed-method research study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2) during October 2014 to September 2016. Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and 7 key informants of the IDSR system implementation and administration at district and national levels. Findings The current IDSR system showed relatively good completeness (73.1%) but poor timeliness (40.2%) of total expected monthly reports nationwide and zero weekly reports during the study period. Major implementation gaps were lack of weekly report and trainings. The challenges of IDSR implementation revealed through qualitative data included case identification, compiling reports for timely submission and inadequate resources. Conclusions The differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.
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Affiliation(s)
- Tsung-Shu Joseph Wu
- Department of Informatics, University of Oslo, Oslo City, Norway
- Research Department, Luke International, Mzuzu City, Malawi
- Overseas Mission Department, Pingtung Christian Hospital, Pingtung County, Taiwan
- Department of Public Health, National Taiwan University, Taipei City, Taiwan
- * E-mail: ,
| | - Matthew Kagoli
- Department of Epidemiology, Ministry of Health, Lilongwe City, Malawi
- Public Health Institute of Malawi, Lilongwe, Malawi
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Makinde OA, Odimegwu CO. A qualitative inquiry on the status and adequacy of legal instruments establishing infectious disease surveillance in Nigeria. Pan Afr Med J 2018; 31:22. [PMID: 30918549 PMCID: PMC6430840 DOI: 10.11604/pamj.2018.31.22.14119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 08/03/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The threat of devastating disease outbreaks is on the rise with several outbreaks recorded across the world in the last five years. The intractable Ebola Virus Disease outbreak in West Africa which spread to Nigeria was a reawakening point. This study aims to review the status and adequacy of the legal framework for disease surveillance in Nigeria. Methods: a mixed methods approach comprising of document reviews and key informant interviews was used in data collection. METHODS A mixed methods approach comprising of document reviews and key informant interviews was used in data collection. RESULTS Fourteen key informants from the federal ministry of health (FMOH) and six States were interviewed. Five legal instruments were identified and reviewed. The Quarantine Act of 1926 remains the active National Law on disease surveillance in Nigeria. An Integrated Disease Surveillance and Response Policy (IDSR) was developed in 2005 as the means for achieving the International Health Regulations (IHR). All six states claimed to have adopted the national IDSR policy though none could present a domesticated version of the policy. Key informants were concerned that Nigeria does not yet have an adequate legal framework for disease surveillance. CONCLUSION The legal instruments establishing disease surveillance in Nigeria require strengthening and possibly enactment as a National Law in order to address emerging disease threats.
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Affiliation(s)
- Olusesan Ayodeji Makinde
- Demography And Population Studies Program, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg, South Africa
- Managing Partner, Viable Knowledge Masters, 22 Olusegun Obasanjo Street, Peace Court Estate, Lokogoma, Abuja Federal Capital Territory Nigeria
| | - Clifford Obby Odimegwu
- Demography And Population Studies Program, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg, South Africa
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Diaz T, Rasanathan K, Meribole E, Maina I, Nsona H, Aung KM, Nemser B, O'Neill KP. Framework and strategy for integrated monitoring and evaluation of child health programmes for responsive programming, accountability, and impact. BMJ 2018; 362:k2785. [PMID: 30061104 PMCID: PMC6283362 DOI: 10.1136/bmj.k2785] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Theresa Diaz
- Epidemiology and Monitoring and Evaluation Team, Maternal Newborn and Child Adolescent Health Department, World Health Organization, Geneva, Switzerland
| | - Kumanan Rasanathan
- Knowledge Management and Implementation Research Unit, Health Section, Unicef, New York, USA
| | - Emmanuel Meribole
- Monitoring and Evaluation, Nigeria Ministry of Health, Abuja, Nigeria
| | - Isabella Maina
- Health Sector Monitoring and Evaluation Unit-MOH;,Nairobi, Kenya
| | - Humphreys Nsona
- Integrated Management of Childhood Illnesses, Ministry of Health, Malawi
| | | | - Bennett Nemser
- Epidemiology and Monitoring and Evaluation Team, Maternal Newborn and Child Adolescent Health Department, World Health Organization, Geneva, Switzerland
| | - Kathryn Patricia O'Neill
- Global Platform on Measurement and Accountability, Department of Information, Evidence and Research, Health Systems and Innovation, World Health Organization, Geneva, Switzerland
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André AM, Lopez A, Perkins S, Lambert S, Chace L, Noudeke N, Fall A, Pedalino B. Frontline Field Epidemiology Training Programs as a Strategy to Improve Disease Surveillance and Response. Emerg Infect Dis 2018; 23. [PMID: 29155657 PMCID: PMC5711307 DOI: 10.3201/eid2313.170803] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Since 1980, Field Epidemiology Training Programs (FETPs) have trained highly qualified field epidemiologists to work for ministries of health (MOH) around the world. However, the 2013–2015 Ebola epidemic in West Africa, which primarily affected Guinea, Liberia, and Sierra Leone, demonstrated a lack of field epidemiologists at the local levels. Trained epidemiologists at these levels could have detected the Ebola outbreak earlier. In 2015, the US Centers for Disease Control and Prevention (CDC) launched FETP-Frontline, a 3-month field training program targeting local MOH staff in 24 countries to augment local public health capacity. As of December 2016, FETP-Frontline has trained 1,354 graduates in 24 countries. FETP-Frontline enhances global health security by training local public health staff to improve surveillance quality in their jurisdictions, which can be a valuable strategy to strengthen the capacity of countries to more rapidly detect, respond to, and contain public health emergencies at the source.
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Lehman MW, Craig AS, Malama C, Kapina-Kany’anga M, Malenga P, Munsaka F, Muwowo S, Shadomy S, Marx MA. Role of Food Insecurity in Outbreak of Anthrax Infections among Humans and Hippopotamuses Living in a Game Reserve Area, Rural Zambia. Emerg Infect Dis 2018; 23:1471-1477. [PMID: 28820129 PMCID: PMC5572886 DOI: 10.3201/eid2309.161597] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In September 2011, a total of 511 human cases of anthrax (Bacillus anthracis) infection and 5 deaths were reported in a game management area in the district of Chama, Zambia, near where 85 hippopotamuses (Hippopotamus amphibious) had recently died of suspected anthrax. The human infections generally responded to antibiotics. To clarify transmission, we conducted a cross-sectional, interviewer-administered household survey in villages where human anthrax cases and hippopotamus deaths were reported. Among 284 respondents, 84% ate hippopotamus meat before the outbreak. Eating, carrying, and preparing meat were associated with anthrax infection. Despite the risk, 23% of respondents reported they would eat meat from hippopotamuses found dead again because of food shortage (73%), lack of meat (12%), hunger (7%), and protein shortage (5%). Chronic food insecurity can lead to consumption of unsafe foods, leaving communities susceptible to zoonotic infection. Interagency cooperation is necessary to prevent outbreaks by addressing the root cause of exposure, such as food insecurity.
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Randriamiarana R, Raminosoa G, Vonjitsara N, Randrianasolo R, Rasamoelina H, Razafimandimby H, Rakotonjanabelo AL, Lepec R, Flachet L, Halm A. Evaluation of the reinforced integrated disease surveillance and response strategy using short message service data transmission in two southern regions of Madagascar, 2014-15. BMC Health Serv Res 2018; 18:265. [PMID: 29631631 PMCID: PMC5891931 DOI: 10.1186/s12913-018-3081-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/28/2018] [Indexed: 01/17/2023] Open
Abstract
Background The Integrated Disease Surveillance and Response (IDSR) strategy was introduced in Madagascar in 2007. Information was collected by Healthcare structures (HS) on paper forms and transferred to the central level by post or email. Completeness of data reporting was around 20% in 2009–10. From 2011, in two southern regions data were transmitted through short messages service using one telephone provider. We evaluated the system in 2014–15 to determine its performance before changing or expanding it. Methods We randomly selected 80 HS and interviewed their representatives face-to-face (42) or by telephone (38). We evaluated knowledge of surveillance activities and selected case definitions, number of SMS with erroneous or missing information among the last ten transferred SMS, proportion of weekly reports received in the last 4 weeks and of the last four health alerts notified within 48 h, as well as mobile phone network coverage. Results Sixty-four percent of 80 interviewed HS representatives didn’t know their terms of reference, 83% were familiar with the malaria case definition and 32% with that of dengue. Ninety percent (37/41) of visited HS had five or more errors and 47% had missing data in the last ten SMS they transferred. The average time needed for weekly IDSR data compilation was 24 min in the Southern and 47 in the South-eastern region. Of 320 expected SMS 232 (73%) were received, 136 (43%) of them in time. Out of 38 alerts detected, four were notified on time. Nine percent (7/80) of HS had no telephone network with the current provider. Conclusions SMS transfer has improved IDSR data completeness, but timeliness and data quality remain a problem. Healthcare staff needs training on guidelines and case definitions. From 2016, data are collected and managed electronically to reduce errors and improve the system’s performance.
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Affiliation(s)
- Rado Randriamiarana
- Indian Ocean Field Epidemiology Training Programme, SEGA One Health Network, Indian Ocean Commission, Ebène, Mauritius.,Epidemiological Surveillance Department, Ministry of Health, Antananarivo, Madagascar
| | - Grégoire Raminosoa
- Epidemiological Surveillance Department, Ministry of Health, Antananarivo, Madagascar
| | - Nikaria Vonjitsara
- Epidemiological Surveillance Department, Ministry of Health, Antananarivo, Madagascar
| | - Rivo Randrianasolo
- Epidemiological Surveillance Department, Ministry of Health, Antananarivo, Madagascar
| | - Harena Rasamoelina
- Health Surveillance Unit, SEGA One Health Network, Indian Ocean Commission, Ebène, Mauritius
| | | | | | - Richard Lepec
- Health Surveillance Unit, SEGA One Health Network, Indian Ocean Commission, Ebène, Mauritius
| | - Loïc Flachet
- Health Surveillance Unit, SEGA One Health Network, Indian Ocean Commission, Ebène, Mauritius
| | - Ariane Halm
- Health Surveillance Unit, SEGA One Health Network, Indian Ocean Commission, Ebène, Mauritius.
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Mitsakakis K, Hin S, Müller P, Wipf N, Thomsen E, Coleman M, Zengerle R, Vontas J, Mavridis K. Converging Human and Malaria Vector Diagnostics with Data Management towards an Integrated Holistic One Health Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E259. [PMID: 29401670 PMCID: PMC5858328 DOI: 10.3390/ijerph15020259] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/27/2018] [Accepted: 01/31/2018] [Indexed: 01/22/2023]
Abstract
Monitoring malaria prevalence in humans, as well as vector populations, for the presence of Plasmodium, is an integral component of effective malaria control, and eventually, elimination. In the field of human diagnostics, a major challenge is the ability to define, precisely, the causative agent of fever, thereby differentiating among several candidate (also non-malaria) febrile diseases. This requires genetic-based pathogen identification and multiplexed analysis, which, in combination, are hardly provided by the current gold standard diagnostic tools. In the field of vectors, an essential component of control programs is the detection of Plasmodium species within its mosquito vectors, particularly in the salivary glands, where the infective sporozoites reside. In addition, the identification of species composition and insecticide resistance alleles within vector populations is a primary task in routine monitoring activities, aiming to support control efforts. In this context, the use of converging diagnostics is highly desirable for providing comprehensive information, including differential fever diagnosis in humans, and mosquito species composition, infection status, and resistance to insecticides of vectors. Nevertheless, the two fields of human diagnostics and vector control are rarely combined, both at the diagnostic and at the data management end, resulting in fragmented data and mis- or non-communication between various stakeholders. To this direction, molecular technologies, their integration in automated platforms, and the co-assessment of data from multiple diagnostic sources through information and communication technologies are possible pathways towards a unified human vector approach.
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Affiliation(s)
- Konstantinos Mitsakakis
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - Sebastian Hin
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - Pie Müller
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, PO Box, 4002 Basel, Switzerland.
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
| | - Nadja Wipf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, PO Box, 4002 Basel, Switzerland.
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
| | - Edward Thomsen
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Michael Coleman
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany.
| | - John Vontas
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, 70013 Heraklion, Greece.
- Pesticide Science Laboratory, Department of Crop Science, Agricultural University of Athens, 11855 Athens, Greece.
| | - Konstantinos Mavridis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, 70013 Heraklion, Greece.
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Toda M, Zurovac D, Njeru I, Kareko D, Mwau M, Morita K. Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya. BMC Public Health 2018; 18:146. [PMID: 29343225 PMCID: PMC5772726 DOI: 10.1186/s12889-018-5028-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 01/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. However, surveillance evaluations commonly assume this prerequisite. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya. METHODS A cross-sectional survey including 131 health workers and their 11 supervisors was undertaken in two counties in Kenya. Descriptive analysis was conducted to classify the correctness of knowledge into four categories for three tracer diseases (dysentery, measles, and dengue). We conducted a univariate and multivariable logistic regression analyses to explore factors influencing knowledge of the case definition for dysentery. RESULTS Among supervisors, 81.8% knew the correct definition for dysentery, 27.3% for measles, and no correct responses were provided for dengue. Correct knowledge was observed for 50.4% of the health workers for dysentery, only 12.2% for measles, and none for dengue. Of 10 examined factors, the following were significantly associated with health workers' correct knowledge of the case definition for dysentery: health workers' cadre (aOR 2.71; 95% CI 1.20-6.12; p = 0.017), and display of case definition poster (aOR 2.24; 95% CI 1.01-4.98; p = 0.048). Health workers' exposure to the surveillance refresher training, supportive supervision and guidelines were not significantly associated with the knowledge. CONCLUSION The correct knowledge of standard case definitions was sub-optimal among health workers and their supervisors, which is likely to impact the reliability of routine surveillance reports generated from health facilities.
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Affiliation(s)
- Mitsuru Toda
- Nagasaki University Institute of Tropical Medicine, KEMRI-NUITM, Kenyatta Hospital Grounds, Nairobi, Kenya.
| | - Dejan Zurovac
- Oxford University, Oxford, UK.,Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Ian Njeru
- Kenya Ministry of Health Disease Surveillance and Response Unit, Nairobi, Kenya
| | - David Kareko
- Kenya Ministry of Health Disease Surveillance and Response Unit, Nairobi, Kenya
| | - Matilu Mwau
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Kouichi Morita
- Nagasaki University Institute of Tropical Medicine, Nagasaki, Japan
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Suthar AB, Allen LG, Cifuentes S, Dye C, Nagata JM. Lessons learnt from implementation of the International Health Regulations: a systematic review. Bull World Health Organ 2017; 96:110-121E. [PMID: 29403114 PMCID: PMC5791773 DOI: 10.2471/blt.16.189100] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 10/26/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022] Open
Abstract
Objective To respond to the World Health Assembly call for dissemination of lessons learnt from countries that have begun implementing the International Health Regulations, 2005 revision; IHR (2005). Methods In November 2015, we conducted a systematic search of the following online databases and sources: PubMed®, Embase®, Global Health, Scopus, World Health Organization (WHO) Global Index Medicus, WHO Bulletin on IHR Implementation and the International Society for Disease Surveillance. We included identified studies and reports summarizing national experience in implementing any of the IHR (2005) core capacities or their components. We excluded studies that were theoretical or referred to IHR (1969). Qualitative systematic review methodology, including meta-ethnography, was used for qualitative synthesis. Findings We analysed 51 articles from 77 countries representing all WHO Regions. The meta-syntheses identified a total of 44 lessons learnt across the eight core capacities of IHR (2005). Major themes included the need to mobilize and sustain political commitment; to adapt global requirements based on local sociocultural, epidemiological, health system and economic contexts; and to conduct baseline and follow-up assessments to monitor the status of IHR (2005) implementation. Conclusion Although experiences of IHR (2005) implementation covered a wide global range, more documentation from Africa and Eastern Europe is needed. We did not find specific areas of weakness in monitoring IHR (2005); sustained monitoring of all core capacities is required to ensure effective systems. These lessons learnt could be adapted by countries in the process of meeting IHR (2005) requirements.
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Affiliation(s)
- Amitabh B Suthar
- South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Private Bag X1, Matieland, Stellenbosch, 7602, South Africa
| | - Lisa G Allen
- TMF Health Quality Institute, Austin, United States of America (USA)
| | - Sara Cifuentes
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, USA
| | - Christopher Dye
- Department of Strategy, Policy and Information, World Health Organization, Geneva, Switzerland
| | - Jason M Nagata
- Department of Pediatrics, University of California San Francisco, San Francisco, USA
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Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks. BMC Infect Dis 2017; 17:726. [PMID: 29157211 PMCID: PMC5696767 DOI: 10.1186/s12879-017-2824-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/12/2017] [Indexed: 01/22/2023] Open
Abstract
Background Detection, confirmation and monitoring of cholera outbreaks in many developing countries including Uganda is a big challenge due to lack of the required resources and the time the test takes. Culture method which takes 24–48 h to get the feedback and requires highly skilled laboratory staff plus other complex resources is the standard test. This study evaluated the new cholera rapid detection method that relies on Crystal VC dipsticks after enrichment with alkaline peptone water (APW) against the culture method for monitoring the progress of cholera outbreaks in rural setting. Methods We conducted the study between March and June 2015. Fresh stool samples and rectal swabs were incubated in 1% APW for 6 h at room temperature before testing with RDT following the manufacturer’s instruction. The same stool sample was cultured to isolate V. cholerae in the standard manner. We also reviewed patient registers to epidemiologically describe the cholera epidemic. Results We tested stool from 102 consenting suspected cholera patients reporting during daytime at Bwera Hospital (n = 69), Kilembe Mines Hospital (n = 4) and Kinyabwama Health Centre (n = 29). Ninety one (91) samples were positive and nine samples were negative according to both methods. One (1) sample was positive only by dipstick and one sample was positive only by culture (sensitivity of 99%, specificity of 90%, Positive Predictive Value of 99% and Negative Predictive Value of 90%). Overall, 146 suspected cholera cases and two deaths, (case fatality rate of 1.36%) were recorded during the study period. Among the cases aged 1–9 years, 63% (50/79) were males while in those aged 20–49 years, 76% (34/45) were females. Conclusions Our findings showed that the modified dipstick test after enrichment with 1% APW had high level of accuracy in detection of V. cholerae and is quick, affordable alternative cholera outbreak monitoring tool in resource constrained settings. However, culture method should remain for cholera epidemic confirmation, for monitoring of antibiotic sensitivity and for production of pure isolates for molecular characterization. Further studies should be done to better understand the observed age and sex case distribution, in Kasese district.
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Mwakapeje ER, Assenga JA, Kunda JS, Mjingo EE, Makondo ZE, Nonga HE, Mdegela RH, Skjerve E. Prevention, detection, and response to anthrax outbreak in Northern Tanzania using one health approach: A case study of Selela ward in Monduli district. INTERNATIONAL JOURNAL OF ONE HEALTH 2017. [DOI: 10.14202/ijoh.2017.66-76] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Doedeh J, Frimpong JA, Yealue KD, Wilson HW, Konway Y, Wiah SQ, Doedeh V, Bao U, Seneh G, Gorwor L, Toe S, Ghartey E, Larway L, Gweh D, Gonotee P, Paasewe T, Tamatai G, Yarkeh J, Smith S, Brima-Davis A, Dauda G, Monger T, Gornor-Pewu LW, Lombeh S, Naiene J, Dovillie N, Korvayan M, George G, Kerwillain G, Jetoh R, Friesen S, Kinkade C, Katawera V, Amo-Addae M, George RN, Gbanya MZ, Dokubo EK. Rapid Field Response to a Cluster of Illnesses and Deaths - Sinoe County, Liberia, April-May, 2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:1140-1143. [PMID: 29072886 PMCID: PMC5689099 DOI: 10.15585/mmwr.mm6642a4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Ashbaugh HR, Kuang B, Gadoth A, Alfonso VH, Mukadi P, Doshi RH, Hoff NA, Sinai C, Mossoko M, Kebela BI, Muyembe JJ, Wemakoy EO, Rimoin AW. Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system. Trop Med Int Health 2017; 22:1141-1153. [PMID: 28653456 DOI: 10.1111/tmi.12917] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. METHODS Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. RESULTS Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. CONCLUSION Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities.
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Affiliation(s)
- Hayley R Ashbaugh
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Brandon Kuang
- David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - Adva Gadoth
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Vivian H Alfonso
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Patrick Mukadi
- School of Medicine, Kinshasa University, Kinshasa, Democratic Republic of Congo
| | - Reena H Doshi
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Nicole A Hoff
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Cyrus Sinai
- Fielding School of Public Health, University of California, Los Angeles, USA
| | - Mathias Mossoko
- Direction for Disease Control, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | - Benoit Ilunga Kebela
- Direction for Disease Control, Ministry of Health, Kinshasa, Democratic Republic of Congo
| | - Jean-Jacques Muyembe
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of Congo
| | | | - Anne W Rimoin
- Fielding School of Public Health, University of California, Los Angeles, USA
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