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Talwar A, Katz R, Kirk MD, Housen T. Investigating the barriers and enablers to outbreak reporting in the Asia-Pacific region: A mixed-methods study protocol. PLoS One 2024; 19:e0300077. [PMID: 39208161 PMCID: PMC11361561 DOI: 10.1371/journal.pone.0300077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has raised concerns about the global capacity for timely outbreak reporting. However, gaps remain in our understanding of barriers and enablers to outbreak reporting, particularly at the local level. Field epidemiology training program (FETP) fellows often participate in the outbreak reporting process as part of both their training and the public health roles they assume after graduating; they therefore represent a potentially valuable source of information for better understanding these barriers and enablers. This study will investigate the barriers and enablers to outbreak reporting through a mixed methods approach that will encompass a review of the existing literature as well as surveying and interviewing FETP trainees and graduates from the Asia-Pacific region. METHODS This study will begin with a scoping review of the literature to identify existing evidence of barriers and enablers to outbreak reporting. Based on our findings from the scoping review, we will administer a survey to FETP trainees and graduates from the World Health Organization Western Pacific and South-East Asian Regions and conduct interviews with a subset of survey respondents to investigate the survey findings in more detail. We will summarise and compare the survey results according to various country-level economic and political indicators, and we will employ thematic analysis to evaluate the interview responses. Based on the findings from the scoping review, survey, and interviews, we will construct a model to comprehensively describe the various barriers and enablers to outbreak reporting. CONCLUSION This study will contribute to our understanding of the determinants of outbreak reporting across several geographic, political, and economic contexts by eliciting the viewpoints and experiences of persons involved with outbreak reporting, particularly at the local level. This information will help improve the outbreak reporting process, allowing for more timely reporting and helping prevent future outbreaks from becoming pandemics.
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Affiliation(s)
- Amish Talwar
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rebecca Katz
- Center for Global Health Science and Security, Georgetown University, Washington, DC, United States of America
| | - Martyn D. Kirk
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Tambri Housen
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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Saretzki CEB, Dobler G, Iro E, Heussen N, Küpper T. Dengue Virus and Zika Virus Seroprevalence in the South Pacific Populations of the Cook Islands and Vanuatu. Viruses 2024; 16:807. [PMID: 38793688 PMCID: PMC11125989 DOI: 10.3390/v16050807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Arboviral diseases are serious threats to global health with increasing prevalence and potentially severe complications. Significant arthropod-borne viruses are the dengue viruses (DENV 1-4), the Zika virus (ZIKV), and the chikungunya virus (CHIKV). Among the areas most affected is the South Pacific Region (SPR). Here, arboviruses not only cause a high local burden of disease, but the region has also proven to contribute to their global spread. Outpatient serum samples collected between 08/2016 and 04/2017 on three islands of the island states of Vanuatu and the Cook Islands were tested for anti-DENV- and anti-ZIKV-specific antibodies (IgG) using enzyme-linked immunosorbent assays (ELISA). ELISA test results showed 89% of all test sera from the Cook Islands and 85% of the Vanuatu samples to be positive for anti-DENV-specific antibodies. Anti-ZIKV antibodies were identified in 66% and 52%, respectively, of the test populations. Statistically significant differences in standardized immunity levels were found only at the intranational level. Our results show that in both the Cook Islands and Vanuatu, residents were exposed to significant Flavivirus transmission. Compared to other seroprevalence studies, the marked difference between ZIKV immunity levels and previously published CHIKV seroprevalence rates in our study populations is surprising. We propose the timing of ZIKV and CHIKV emergence in relation to recurrent DENV outbreaks and the impact of seasonality as explanatory external factors for this observation. Our data add to the knowledge of arboviral epidemics in the SPR and contribute to a better understanding of virus spread, including external conditions with potential influence on outbreak dynamics. These data may support preventive and rapid response measures in the affected areas, travel-related risk assessment, and infection identification in locals and returning travelers.
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Affiliation(s)
- Charlotte E. B. Saretzki
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany;
| | - Gerhard Dobler
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany;
| | - Elizabeth Iro
- Cook Islands Ministry of Health, Rarotonga P.O. Box 109, Cook Islands;
| | - Nicole Heussen
- Department of Medical Statistics, RWTH Aachen Technical University, 52074 Aachen, Germany;
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria
| | - Thomas Küpper
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany;
- Faculty for Travel Medicine, Royal College of Physicians and Surgeons of Glasgow, Glasgow G2 5RJ, UK
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Donadel M, Scobie HM, Pastore R, Grabovac V, Batmunkh N, O’Connor S, Dahl BA, Murrill CS. Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000-2021. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:GHSP-D-22-00017. [PMID: 36316133 PMCID: PMC9622275 DOI: 10.9745/ghsp-d-22-00017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION A strategic framework for 2021-2030 developed by the World Health Organization (WHO) Regional Office for the Western Pacific emphasizes the need for high-quality and integrated vaccine-preventable disease (VPD) surveillance. We conducted a literature review to document the barriers, enabling factors, and innovations for integrating surveillance functions for VPDs and other communicable diseases in Western Pacific Region (WPR) countries. METHODS We searched published and gray literature on integrated VPD surveillance from 2000 to 2021. Articles in English, Spanish, or French were screened to identify those relating to VPD surveillance in a WPR country and not meeting defined exclusion criteria. We categorized articles using the 8 WHO surveillance support functions and abstracted data on the country; type of surveillance; and reported barriers, enabling factors, and best practices for integration. RESULTS Of the 3,137 references screened, 87 met the eligibility criteria. Of the 8 surveillance support functions, the proportion of references that reported integration related to the laboratory was 56%, followed by workforce capacity (54%), governance (51%), data management and use (47%), field logistics and communication (47%), coordination (15%), program management (13%), and supervision (9%). Several references noted fragmented systems and a lack of coordination between units as barriers to integration, highlighting the importance of engagement across public health units and between the public and private sectors. The literature also indicated a need for interoperable information systems and revealed the use of promising new technologies for data reporting and laboratory testing. In some WPR countries, workforce capacity was strengthened at all administrative levels by the implementation of integrated trainings on data monitoring and use and on laboratory techniques applicable to multiple VPDs. CONCLUSION This literature review supports integrating VPDs into broader communicable disease surveillance systems in WPR countries while ensuring that the minimal WHO-recommended standards for VPD surveillance are met.
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Affiliation(s)
- Morgane Donadel
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.,Correspondence to Morgane Donadel ()
| | - Heather M. Scobie
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Roberta Pastore
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Varja Grabovac
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Nyambat Batmunkh
- World Health Organization, Western Pacific Regional Office, Manila, the Philippines
| | - Stephanie O’Connor
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin A. Dahl
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher S. Murrill
- Global Immunization Division, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
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Universal Health Coverage and the Pacific Islands: An Overview of Senior Leaders' Discussions, Challenges, Priorities and Solutions, 2015-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074108. [PMID: 35409794 PMCID: PMC8998582 DOI: 10.3390/ijerph19074108] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 02/05/2023]
Abstract
In 1995, Pacific Health Ministers articulated their vision of a healthy Pacific as ‘a place where children are nurtured in body and mind; environments invite learning and leisure; people work and age with dignity; where ecological balance is a source of pride; and where the ocean is protected.’ Central to this vision is the achievement of universal health coverage (UHC). To provide an indication of the UHC-related priorities of Pacific health authorities and promote alignment of domestic and international investments in health sector development, we thematically analyzed the discussion, resolutions, and recommendations from 5 years (2015–2020) of senior-level Pacific health meetings. Five main themes emerged: (i) the Healthy Islands vision has (and continues to have) a unifying influence on action for UHC; (ii) adoption of appropriate service delivery models that support integrated primary health care at the community level are needed; (iii) human resources for health are critical if efforts to achieve UHC are to be successful; (iv) access to reliable health information is core to health sector improvement; and (v) while not a panacea for all challenges, digital health offers many opportunities. Small and isolated populations, chronic workforce limitations, weak governance arrangements, ageing and inadequate health facilities, and supply chain and logistics difficulties (among other issues) interact to challenge primary health care delivery across the Pacific Islands. We found evidence that the Healthy Islands vision is a tool that garners support for UHC; however, to realize the vision, a realistic understanding of needed political, human resource, and economic investments is required. The significant disruptive effect of COVID-19 and the uncertainty it brings for implementation of the medium- to long-term health development agenda raises concern that progress may stagnate or retreat.
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Matthews RJ, Kaluthotage I, Russell TL, Knox TB, Horwood PF, Craig AT. Arboviral Disease Outbreaks in the Pacific Islands Countries and Areas, 2014 to 2020: A Systematic Literature and Document Review. Pathogens 2022; 11:74. [PMID: 35056022 PMCID: PMC8779081 DOI: 10.3390/pathogens11010074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/19/2021] [Accepted: 12/23/2021] [Indexed: 12/10/2022] Open
Abstract
Arthropod-borne diseases pose a significant public health threat, accounting for greater than 17% of infectious disease cases and 1 million deaths annually. Across Pacific Island countries and areas (PICs), outbreaks of dengue, chikungunya, and Zika are increasing in frequency and scale. Data about arbovirus outbreaks are incomplete, with reports sporadic, delayed, and often based solely on syndromic surveillance. We undertook a systematic review of published and grey literature and contacted relevant regional authorities to collect information about arboviral activity affecting PICs between October 2014 and June 2020. Our literature search identified 1176 unique peer-reviewed articles that were reduced to 25 relevant publications when screened. Our grey literature search identified 873 sources. Collectively, these data reported 104 unique outbreaks, including 72 dengue outbreaks affecting 19 (out of 22) PICs, 14 chikungunya outbreaks affecting 11 PICs, and 18 Zika outbreaks affecting 14 PICs. Our review is the most complete account of arboviral outbreaks to affect PICs since comparable work was published in 2014. It highlights the continued elevated level of arboviral activity across the Pacific and inconsistencies in how information about outbreaks is reported and recorded. It demonstrates the importance of a One-Health approach and the role that improved communication and reporting between different governments and sectors play in understanding the emergence, circulation, and transboundary risks posed by arboviral diseases.
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Affiliation(s)
- Rosie J. Matthews
- Department of Medicine, Cairns Hospital, Cairns, QID 4870, Australia
| | - Ishani Kaluthotage
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QID 4870, Australia; (I.K.); (T.L.R.)
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QID 4870, Australia
| | - Tanya L. Russell
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QID 4870, Australia; (I.K.); (T.L.R.)
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QID 4870, Australia
| | - Tessa B. Knox
- Vanuatu Country Liaison Office, World Health Organization, Port Vila, Vanuatu;
| | - Paul F. Horwood
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QID 4811, Australia;
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QID 4811, Australia
| | - Adam T. Craig
- School of Population Health, University of New South Wales, Sydney, NSW 1466, Australia
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Salvacion AR. COVID-19 susceptibility mapping: a case study for Marinduque Island, Philippines. SPATIAL INFORMATION RESEARCH 2022; 30:563-570. [PMCID: PMC9136557 DOI: 10.1007/s41324-022-00444-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/02/2022] [Accepted: 03/06/2022] [Indexed: 06/16/2023]
Abstract
Small islands are highly susceptible to infectious disease outbreak and other health emergencies because of their remoteness, small physical size, and poorly developed infrastructure. These are true in the case of Marinduque, an island province around 200 km south of the National Capital Region (NCR), which is the “epidemiological epicenter” of the COVID-19 pandemic in the Philippines. This study utilized GIS and Principal Component Analysis (PCA) using demographic, socio-economic, and geographic indicators to map susceptibility of different villages in the island province of Marinduque, the Philippines. Based on the results, the northwestern and northeastern portion of Marinduque has a higher susceptibility score. Also, villages in the town centers have relatively high susceptibility scores compared to other villages in each municipality.
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Affiliation(s)
- Arnold R. Salvacion
- Department of Community and Environmental Resource Planning, College of Human Ecology, University of the Philippines Los Baños, 4031 College, Laguna, Philippines
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Nelson S, Drabarek D, Jenkins A, Negin J, Abimbola S. How community participation in water and sanitation interventions impacts human health, WASH infrastructure and service longevity in low-income and middle-income countries: a realist review. BMJ Open 2021; 11:e053320. [PMID: 34857572 PMCID: PMC8640661 DOI: 10.1136/bmjopen-2021-053320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 11/14/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To understand how, and under what circumstances community participation in water and sanitation interventions impacts the availability of safe water and sanitation, a change in health status or behaviour and the longevity of water, sanitation and hygiene (WASH) resources and services. DESIGN Realist review. DATA SOURCES PubMed, Web of Science and Scopus databases were used to identify papers from low-income and middle-income countries from 2010 to 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Criteria were developed for papers to be included. The contribution of each paper was assessed based on its relevance and rigour (eg, can it contribute to context, mechanism or outcome, and is the method used to generate that information credible). ANALYSIS Inductive and deductive coding was used to generate context-mechanism-outcome configurations. RESULTS 73 studies conducted in 29 countries were included. We identified five mechanisms that explained the availability, change and longevity outcomes: (1) accountability (policies and procedures to hold communities responsible for their actions and outcomes of an intervention), (2) diffusion (spread of an idea or behaviour by innovators over time through communication among members of a community), (3) market (the interplay between demand and supply of a WASH service or resource), (4) ownership (a sense of possession and control of the WASH service or resource) and (5) shame (a feeling of disgust in one's behaviour or actions). Contextual elements identified included community leadership and communication, technical skills and knowledge, resource access and dependency, committee activity such as the rules and management plans, location and the level of community participation. CONCLUSIONS The findings highlight five key mechanisms impacted by 19 contextual factors that explain the outcomes of community water and sanitation interventions. Policymakers, programme implementers and institutions should consider community dynamics, location, resources, committee activity and practices and nature of community participation, before introducing community water and sanitation interventions.
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Affiliation(s)
- Sarah Nelson
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dorothy Drabarek
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Aaron Jenkins
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Joel Negin
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Seye Abimbola
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Craig AT, Kama N, Fafale G, Bugoro H. Citizen science as a tool for arboviral vector surveillance in a resourced-constrained setting: results of a pilot study in Honiara, Solomon Islands, 2019. BMC Public Health 2021; 21:509. [PMID: 33726697 PMCID: PMC7962342 DOI: 10.1186/s12889-021-10493-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background Recent arboviral disease outbreaks highlight the value a better understanding of the spread of disease-carrying mosquitoes across spatial-temporal scales can provide. Traditional surveillance tools are limited by jurisdictional boundaries, workforce constraints, logistics, and cost; factors that in low- and middle-income countries often conspire to undermine public health protection efforts. To overcome these, we undertake a pilot study designed to explore if citizen science provides a feasible strategy for arboviral vector surveillance in small developing Pacific island contexts. Methods We recruited, trained, and equipped community volunteers to trap and type mosquitos within their household settings, and to report count data to a central authority by short-message-service. Mosquito catches were independently assessed to measure participants’ mosquito identification accuracy. Other data were collected to measure the frequency and stability of reporting, and volunteers’ experiences. Results Participants collected data for 78.3% of the study period, and agreement between the volunteer citizen scientists’ and the reviewing entomologist’s mosquito identification was 94%. Opportunity to contribute to a project of social benefit, the chance to learn new skills, and the frequency of engagement with project staff were prime motivators for participation. Unstable electricity supply (required to run the trap’s fan), insufficient personal finances (to buy electricity and phone credit), and inconvenience were identified as barriers to sustained participation. Conclusions While there are challenges to address, our findings suggest that citizen science offers an opportunity to overcome the human resource constraints that conspire to limit health authorities’ capacity to monitor arboviral vectors across populations. We note that the success of citizen science-based surveillance is dependent on the appropriate selection of equipment and participants, and the quality of engagement and support provided. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10493-6.
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Affiliation(s)
- Adam T Craig
- University of New South Wales (Sydney), Sydney, New South Wales, Australia
| | - Nathan Kama
- Vector-borne Disease Unit, Solomon Islands Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - George Fafale
- Environmental Health Unit, Honiara City Council, Honiara, Solomon Islands
| | - Hugo Bugoro
- Solomon Islands National University, Honiara, Solomon Islands.
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