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Ninsiima M, Wanyana MW, Kiggundu T, King P, Lubwama B, Migisha R, Bulage L, Kadobera D, Ario AR. Syndromic surveillance during 2022 Uganda Martyrs' commemoration. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002068. [PMID: 38271379 PMCID: PMC10810525 DOI: 10.1371/journal.pgph.0002068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/29/2023] [Indexed: 01/27/2024]
Abstract
Mass gatherings frequently include close, prolonged interactions between people, which presents opportunities for infectious disease transmission. Over 20,000 pilgrims gathered at Namugongo Catholic and Protestant shrines to commemorate 2022 Uganda Martyr's Day. We described syndromes suggestive of key priority diseases particularly COVID-19 and viral hemorrhagic fever (VHF) among visiting pilgrims during May 25-June 5, 2022. We conducted a survey among pilgrims at the catholic and protestant shrines based on signs and symptoms for key priority diseases: COVID-19 and VHF. A suspected COVID-19 case was defined as acute respiratory illness (temperature greater 37.5°C and at least one sign/symptom of respiratory infection such as cough or shortness of breath) whereas a suspected VHF case was defined as fever >37.5°C and unexplained bleeding among pilgrims who visited Namugongo Catholic and Protestant shrines from May 25 to June 5, 2022. Pilgrims were sampled systematically at entrances and demarcated zonal areas to participate in the survey. Additionally, we extracted secondary data on pilgrims who sought emergency medical services from Health Management Information System registers. Descriptive analysis was conducted to identify syndromes suggestive of key priority diseases. Among 1,350 pilgrims interviewed, 767 (57%) were female. The mean age was 37.9 (±17.9) years. Nearly all pilgrims 1,331 (98.6%) were Ugandans. A total of 236 (18%) reported ≥1 case definition symptom and 42 (3%) reported ≥2 symptoms. Thirty-nine (2.9%) were suspected COVID-19 cases and three (0.2%) were suspected VHF cases from different regions of Uganda. Among 5,582 pilgrims who sought medical care from tents, 628 (11.3%) had suspected COVID-19 and one had suspected VHF. Almost one in fifty pilgrims at the 2022 Uganda Martyrs' commemoration had at least one symptom of COVID-19 or VHF. Intensified syndromic surveillance and planned laboratory testing capacity at mass gatherings is important for early detection of public health emergencies that could stem from such events.
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Affiliation(s)
- Mackline Ninsiima
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Mercy W. Wanyana
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Thomas Kiggundu
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Patrick King
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Bernard Lubwama
- Division of Integrated Epidemiology and Surveillance, Ministry of Health, Kampala, Uganda
| | - Richard Migisha
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Daniel Kadobera
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Uganda National Institute of Public Health, Kampala, Uganda
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Naseralallah L, Isleem N, Aboelbaha S, Pallivalapila A, Alnaimi S, Al Hail M. Emergency pharmacy workforce views and experience related to the provision of pharmaceutical care during mass gathering events: the FIFA World Cup Qatar 2022™ experience. Front Public Health 2023; 11:1286637. [PMID: 38145068 PMCID: PMC10748417 DOI: 10.3389/fpubh.2023.1286637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose This study aimed to explore emergency pharmacy workforce perspectives and experiences in providing pharmaceutical care during mass gathering events (i.e., FIFA World Cup Qatar 2022™). Methods A qualitative methodology was employed using focus groups discussions. Emergency pharmacists across Hamad Medical Corporation were invited to participate using a combination of purposive and snowball sampling. Focus groups were audio-recorded, transcribed verbatim, and validated. Inductive thematic analysis was undertaken to generate key themes and subthemes. Results Four focus groups were conducted which included 21 participants and generated five major themes. Whilst participants had mixed opinions in relation to their preparedness to practice during the World Cup, they perceived their experience as successful and smooth. The primary perceived facilitators were management support, mobile medical units, and high public health awareness. The main highlighted barriers were related to staff insufficiency, medications availability, and cultural and language challenges. Participants recommended pharmacist's role identification in mass gatherings, development of pharmacy action plan, and offering simulation training and pharmacy-specific training. Conclusion Despite the perceived barriers, pharmacists reported positive views in relation to their experience in providing pharmaceutical care during mass gatherings. Future research should focus on the development of theory-driven action framework for pharmacy departments to adopt during mass gatherings.
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Affiliation(s)
- Lina Naseralallah
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Nour Isleem
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Shaikha Alnaimi
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al Hail
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
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Taheri M, Eshrati B, Bahadorimonfared A, Sohrabi MR. The Association of Acute Watery Diarrhea in Iranian Pilgrims of Iraq with Cholera Cases in Iranians. Med J Islam Repub Iran 2023; 37:52. [PMID: 37426475 PMCID: PMC10329509 DOI: 10.47176/mjiri.37.52] [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: 11/22/2022] [Indexed: 07/11/2023] Open
Abstract
Background Despite the advances in the control of infectious diseases like cholera, they can potentially cause epidemics, especially in mass gathering events. One of the most important countries on the walking way of the Arbaeen religious event is Iran, which requires health system preparedness. The aim of this study was to predict the cholera epidemic in Iran by using the syndromic surveillance system of Iranian pilgrims in Iraq. Methods The data of the Iranian pilgrims with acute watery diarrhea in Iraq during the Arbaeen religious event and the confirmed cholera cases of pilgrims after returning to Iran were analyzed. We used the Poisson regression model of the relationship between the numbers of cases to evaluate acute watery diarrhea and cholera. Spatial statistics and hot spot analysis were used to identify the provinces with the highest incidence. SPSS software Version 24 was used for statistical analysis. Results The frequency of acute watery diarrhea cases was 2232 and the frequency of cholera in pilgrims after returning to Iran was 641. The results of spatial analysis for acute watery diarrhea cases showed a high number of acute watery diarrhea cases in the Khuzestan and Isfahan provinces, located in hot spots. Using Poisson regression, the relationship between the number of acute watery diarrhea reported in the syndromic surveillance system and the number of cholera cases was confirmed. Conclusion The syndromic surveillance system is useful to predict the outbreak of infectious diseases in large religious mass gatherings.
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Affiliation(s)
- Mahbobeh Taheri
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
| | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of
Medical Sciences, Tehran, Iran
| | - Ayad Bahadorimonfared
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Sohrabi
- Department of Community Medicine, School of Medicine, Shahid Beheshti University
of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Centre, Shahid Beheshti University of
Medical Science, Tehran, Iran
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Maddah N, Verma A, Almashmoum M, Ainsworth J. Effectiveness of Public Health Digital Surveillance Systems for Infectious Disease Prevention and Control at Mass Gatherings: A Systematic Review (Preprint). J Med Internet Res 2022; 25:e44649. [DOI: 10.2196/44649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/07/2023] [Accepted: 02/28/2023] [Indexed: 03/04/2023] Open
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Spector E, Zhang Y, Guo Y, Bost S, Yang X, Prosperi M, Wu Y, Shao H, Bian J. Syndromic Surveillance Systems for Mass Gatherings: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084673. [PMID: 35457541 PMCID: PMC9026395 DOI: 10.3390/ijerph19084673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/02/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022]
Abstract
Syndromic surveillance involves the near-real-time collection of data from a potential multitude of sources to detect outbreaks of disease or adverse health events earlier than traditional forms of public health surveillance. The purpose of the present study is to elucidate the role of syndromic surveillance during mass gathering scenarios. In the present review, the use of syndromic surveillance for mass gathering scenarios is described, including characteristics such as methodologies of data collection and analysis, degree of preparation and collaboration, and the degree to which prior surveillance infrastructure is utilized. Nineteen publications were included for data extraction. The most common data source for the included syndromic surveillance systems was emergency departments, with first aid stations and event-based clinics also present. Data were often collected using custom reporting forms. While syndromic surveillance can potentially serve as a method of informing public health policy regarding specific mass gatherings based on the profile of syndromes ascertained, the present review does not indicate that this form of surveillance is a reliable method of detecting potentially critical public health events during mass gathering scenarios.
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Affiliation(s)
- Eliot Spector
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
| | - Yahan Zhang
- Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL 32610, USA; (Y.Z.); (H.S.)
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
| | - Sarah Bost
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
| | - Xi Yang
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
| | - Mattia Prosperi
- Department of Epidemiology, University of Florida, Gainesville, FL 32610, USA;
| | - Yonghui Wu
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
| | - Hui Shao
- Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL 32610, USA; (Y.Z.); (H.S.)
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL 32610, USA; (E.S.); (Y.G.); (S.B.); (X.Y.); (Y.W.)
- Correspondence:
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Heese H, Marquis A, Diercke M, Markus I, Böhm S, Metz J, Katz K, Wildner M, Liebl B. Results of the enhanced COVID-19 surveillance during UEFA EURO 2020 in Germany. Epidemiol Infect 2022; 150:1-18. [PMID: 35236530 PMCID: PMC8924559 DOI: 10.1017/s0950268822000449] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/11/2022] [Accepted: 02/25/2022] [Indexed: 11/06/2022] Open
Abstract
In general, mass gatherings might pose a risk to the public health (PH). The UEFA EURO 2020 tournament (EURO 2020) was one of the first mass gathering events since the start of the coronavirus disease 2019 (COVID-19) pandemic in Germany. To allow early detection and response to any EURO 2020-associated impact on the COVID-19-related epidemiological situation, we initiated enhanced surveillance activities using the routine surveillance system in collaboration with the regional PH authority of Bavaria. Several preventive measures regarding the attendance of football matches and public viewing were implemented according to state regulations. We describe the results from the enhanced surveillance during the EURO 2020. In total, five cases who had attended a football match in the stadium of Munich, nine cases, who attended a football match in a stadium outside of Germany, and 123 cases in association with public viewing events were identified by enhanced surveillance. Concluding, the EURO 2020 seems to not have had a major impact on the COVID-19 pandemic development in Germany. Health measures for stadium visitors and the restriction of large public viewing events may have potentially contributed to the low case numbers detected, emphasising the need of appropriate PH surveillance and regulations to limit the potential risk to PH during mass gathering events.
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Affiliation(s)
- Helena Heese
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Adine Marquis
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Michaela Diercke
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Inessa Markus
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Stefanie Böhm
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Jasmin Metz
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Katharina Katz
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Manfred Wildner
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
| | - Bernhard Liebl
- Bavarian Health and Food Safety Authority (LGL), Oberschleißheim, Germany
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Bouchouar E, Hetman BM, Hanley B. Development and validation of an automated emergency department-based syndromic surveillance system to enhance public health surveillance in Yukon: a lower-resourced and remote setting. BMC Public Health 2021; 21:1247. [PMID: 34187423 PMCID: PMC8240073 DOI: 10.1186/s12889-021-11132-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Automated Emergency Department syndromic surveillance systems (ED-SyS) are useful tools in routine surveillance activities and during mass gathering events to rapidly detect public health threats. To improve the existing surveillance infrastructure in a lower-resourced rural/remote setting and enhance monitoring during an upcoming mass gathering event, an automated low-cost and low-resources ED-SyS was developed and validated in Yukon, Canada. METHODS Syndromes of interest were identified in consultation with the local public health authorities. For each syndrome, case definitions were developed using published resources and expert elicitation. Natural language processing algorithms were then written using Stata LP 15.1 (Texas, USA) to detect syndromic cases from three different fields (e.g., triage notes; chief complaint; discharge diagnosis), comprising of free-text and standardized codes. Validation was conducted using data from 19,082 visits between October 1, 2018 to April 30, 2019. The National Ambulatory Care Reporting System (NACRS) records were used as a reference for the inclusion of International Classification of Disease, 10th edition (ICD-10) diagnosis codes. The automatic identification of cases was then manually validated by two raters and results were used to calculate positive predicted values for each syndrome and identify improvements to the detection algorithms. RESULTS A daily secure file transfer of Yukon's Meditech ED-Tracker system data and an aberration detection plan was set up. A total of six syndromes were originally identified for the syndromic surveillance system (e.g., Gastrointestinal, Influenza-like-Illness, Mumps, Neurological Infections, Rash, Respiratory), with an additional syndrome added to assist in detecting potential cases of COVID-19. The positive predictive value for the automated detection of each syndrome ranged from 48.8-89.5% to 62.5-94.1% after implementing improvements identified during validation. As expected, no records were flagged for COVID-19 from our validation dataset. CONCLUSIONS The development and validation of automated ED-SyS in lower-resourced settings can be achieved without sophisticated platforms, intensive resources, time or costs. Validation is an important step for measuring the accuracy of syndromic surveillance, and ensuring it performs adequately in a local context. The use of three different fields and integration of both free-text and structured fields improved case detection.
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Affiliation(s)
- Etran Bouchouar
- Department of Health and Social Services, Government of Yukon, Whitehorse, Canada.
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Benjamin M Hetman
- Canadian Field Epidemiology Program, Public Health Agency of Canada, Ottawa, ON, Canada
- Department of Population Medicine, University of Guelph, Guelph, ON, Canada
| | - Brendan Hanley
- Department of Health and Social Services, Government of Yukon, Whitehorse, Canada
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Aggrawal V, Dikid T, Jain SK, Pandey A, Khasnobis P, Choudhary S, Chandra R, Patil A, Maramraj KK, Talyan A, Singh A, Babu BS, Kumar A, Kumar D, Raveesh PM, Singh J, Kumar R, Qadri SS, Madan P, Vardan V, Dzeyie KA, Gupta G, Mishra A, Vaisakh TP, Patel P, Jainul A, Kaur S, Shrivastava A, Dhuria M, Chauhan R, Singh SK. Disease surveillance during a large religious mass gathering in India: The Prayagraj Kumbh 2019 experience. Int J Infect Dis 2020; 101:167-173. [PMID: 32979588 PMCID: PMC7513824 DOI: 10.1016/j.ijid.2020.09.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 12/02/2022] Open
Abstract
At Kumbh Mela 2019, disease surveillance was established for 22 acute diseases and syndromes. Among the reported illnesses, 95% were communicable diseases such as acute respiratory illness (35%), acute fever (28%), and skin infections (18%). The incident command centre generated 12 early warning signals from indicator-based and event-based surveillance: acute diarrheal diseases (n = 8, 66%), vector-borne diseases (n = 2, 16%), vaccine-preventable disease (n = 1, 8%), and thermal event (n = 1, 8%). There were two outbreaks (acute gastroenteritis and chickenpox) that were investigated and controlled. Implementation of disease surveillance facilitated early outbreak detection and response.
Background Mass gathering (MG) events are associated with public health risks. During the period January 14 to March 4, 2019, Kumbh Mela in Prayagraj, India was attended by an estimated 120 million visitors. An onsite disease surveillance was established to identify and respond to disease outbreaks. Methods A health coordination committee was established for planning. Disease surveillance was prioritized and risk assessment was done to identify diseases/conditions based on epidemic potential, severity of illness, and reporting requirement under the International Health Regulations (IHR) of 2005. A daily indicator and event-based disease surveillance was planned. The indicator-based surveillance (IBS) manually and electronically recorded data from patient hospital visits and collected MG area water testing data to assess trends. The event-based surveillance (EBS) helped identify outbreak signals based on pre-identified event triggers from the media, private health facilities, and the food safety department. Epidemic intelligence was used to analyse the data and events to detect signals, verify alerts, and initiate the response. Results At Kumbh Mela, disease surveillance was established for 22 acute diseases/syndromes. Sixty-five health facilities reported 156 154 illnesses (21% of a total 738 526 hospital encounters). Among the reported illnesses, 95% (n = 148 834) were communicable diseases such as acute respiratory illness (n = 52 504, 5%), acute fever (n = 41 957, 28%), and skin infections (n = 27 094, 18%). The remaining 5% (n = 7300) were non-communicable diseases (injuries n = 6601, 90%; hypothermia n = 224, 3%; burns n = 210, 3%). Water samples tested inadequate for residual chlorine in 20% of samples (102/521). The incident command centre generated 12 early warning signals from IBS and EBS: acute diarrheal disease (n = 8, 66%), vector-borne disease (n = 2, 16%), vaccine-preventable disease (n = 1, 8%), and thermal event (n = 1, 8%). There were two outbreaks (acute gastroenteritis and chickenpox) that were investigated and controlled. Conclusions This onsite disease surveillance imparted a public health legacy by successfully implementing an epidemic intelligence enabled system for early disease detection and response to monitor public health risks. Acute respiratory illnesses emerged as a leading cause of morbidity among visitors. Future MG events should include disease surveillance as part of planning and augment capacity for acute respiratory illness diagnosis and management.
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Affiliation(s)
- Vikasendu Aggrawal
- State Surveillance Office, Uttar Pradesh Department of Health, Lucknow, India.
| | - Tanzin Dikid
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - S K Jain
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Ashu Pandey
- State Surveillance Office, Uttar Pradesh Department of Health, Lucknow, India.
| | - Pradeep Khasnobis
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Sushma Choudhary
- South Asia Field Epidemiology and Technology Network, Delhi, India.
| | - Ramesh Chandra
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Amol Patil
- South Asia Field Epidemiology and Technology Network, Delhi, India.
| | | | - Ashok Talyan
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Akhileshwar Singh
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Binoy S Babu
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Akshay Kumar
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Davendra Kumar
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - P M Raveesh
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Jayanti Singh
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Rakesh Kumar
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - S S Qadri
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Preeti Madan
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Vaishali Vardan
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | | | - Ginisha Gupta
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Abhishek Mishra
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - T P Vaisakh
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Purvi Patel
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Azar Jainul
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Suneet Kaur
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | | | - Meera Dhuria
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
| | - Ritu Chauhan
- World Health Organization India Office, Delhi, India.
| | - S K Singh
- Epidemiology Division, National Centre for Disease Control, Delhi, India.
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Huot C, Paradis A, Hammond-Collins K, Bélair MA, Villeneuve J, Brousseau N, Goupil-Sormany I, Riffon J. A public health enhanced surveillance system for a mass gathering event. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2019; 45. [PMID: 31355825 PMCID: PMC6615436 DOI: 10.45745/ccdr.v45i78a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health. OBJECTIVE To assess three additional monitoring strategies to detect public health threats during a mass gathering event. INTERVENTION In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues. RESULTS Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period. CONCLUSION The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.
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Affiliation(s)
- C Huot
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC,Correspondence:
| | - A Paradis
- Département de médecine sociale et préventive, Université Laval, Québec, QC
| | - K Hammond-Collins
- Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Ottawa, ON
| | - MA Bélair
- Centre for Emergency Preparedness and Response, Public Health Agency of Canada, Whitehorse, YK
| | - J Villeneuve
- Institut national de santé publique du Québec, Québec, QC
| | - N Brousseau
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC
| | - I Goupil-Sormany
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC,Département de médecine sociale et préventive, Université Laval, Québec, QC
| | - J Riffon
- Direction de santé publique du Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC
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A public health enhanced surveillance system for a mass gathering event. ACTA ACUST UNITED AC 2019; 45:212-224. [PMID: 31355825 DOI: 10.14745/ccdr.v45i78a05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background From June 7 to June 9, 2018, a G7 Summit was held in the Canadian province of Quebec. This international political mass gathering event posed a number of potential risks to public health. Objective To assess three additional monitoring strategies to detect public health threats during a mass gathering event. Intervention In addition to routine public health monitoring, a partnership was created and three monitoring strategies were put in place three days before, during and six days after the G7 event: the analysis of data on the presenting complaint and discharge diagnosis from 11 emergency departments in the area using the logical Early Aberration Reporting System; the daily polling of key health partners with an online questionnaire; and the analysis of calls to Info-Santé, a government-run telephone consultation service for the public regarding health and social issues. Results Emergency room data produced 78 alerts from the presenting complaints and 39 alerts from the discharge diagnoses. Of these 117 alerts, two were investigated (one in the respiratory and one in the neurological-muscular categories) and no other interventions were required. With a few exceptions, all of the health partners completed the online survey each day and no signal of concern was generated. Compared with historical data, no increase or differences in calls to Info-Santé were detected during the monitoring period. Conclusion The three additional monitoring strategies developed to detect events of public health importance during the 2018 G7 Summit in Quebec were successful in gathering timely data for analysis. Close collaboration and good participation from the different partners were essential to this project. However, because no public health event occurred, it was not possible to determine whether the enhanced surveillance system had sufficient speed and sensitivity for timely detection and response.
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Sharma U, Desikachari BR, Sarma S. Protocol for development of a risk assessment tool for planning and management of religious mass-gathering events of India-a health system-strengthening initiative. Pilot Feasibility Stud 2019; 5:83. [PMID: 31293791 PMCID: PMC6591856 DOI: 10.1186/s40814-019-0464-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 06/05/2019] [Indexed: 12/02/2022] Open
Abstract
Background Religious mass gatherings (MGs) have always been an integral part of our society. At the outset, mass-gathering events provide challenging settings to plan a suitable emergency public health response. Published studies basically talk about retrospective reviews, case studies of the public health preparedness, or health care provided at individual events. Developing an understanding of the variables associated with MGs is the first step for public health managers. Risk assessment (RA) is a crucial part of pre-event planning as it helps foresee potential risks. Based on RA, one can develop preventive measures and ensure that the infrastructure to control the potential problems is in place. This study is an attempt to systemize RA process during MG events in a country that is culturally rich but with poor resources to handle such events. A RA tool will be developed for planning and management of religious MG events of India. Methods/design Various strategies will be used to develop the risk assessment tool (RA tool). Extensive review of literature clubbed with key informant interviews will be done in order to identify the risk variables and decide the domains and items of the tool. Further, this tool will be developed as a mobile-based application. The feasibility of the mobile-based RA tool will be tested in real-time MG event in one part of the country. Concurrently in the same event, a community survey of residents and visitors will be done in order to assess public perceptions of public health and environmental risks associated with MG events. Discussion The findings of this study will provide insights into the public health and environmental concerns that need to be considered if preventive strategies and intervention programs are to be designed for MG events. A “RA Tool,” which can be used in the planning and management of MG events by the public health managers will strengthen the existing health systems preparedness plans for MGs.
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Affiliation(s)
- Upasana Sharma
- 1Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum, 695011 Kerala India
| | - B R Desikachari
- 2Senior Public Health Consultant, Formerly with Department of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, India
| | - Sankara Sarma
- 1Achutha Menon Centre for Health Science Studies (AMCHSS), Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum, 695011 Kerala India
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El-Khatib Z, Taus K, Richter L, Allerberger F, Schmid D. A Syndrome-Based Surveillance System for Infectious Diseases Among Asylum Seekers in Austrian Reception Centers, 2015-2018: Analysis of Reported Data. JMIR Public Health Surveill 2019; 5:e11465. [PMID: 30810535 PMCID: PMC6414818 DOI: 10.2196/11465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/08/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022] Open
Abstract
Background Austria has been among the main European countries hosting incoming asylum seekers since 2015. Consequently, there was an urgent need to predict any public health threats associated with the arriving asylum seekers. The Department of Surveillance and Infectious Disease Epidemiology at the Austrian Agency for Health and Food Safety (AGES) was mandated to implement a national syndrome-based surveillance system in the 7 reception centers by the Austrian Ministry of Interior and Ministry of Health. Objective We aimed to analyze the occurrence and spread of infectious diseases among asylum seekers using data reported by reception centers through the syndrome-based surveillance system from September 2015 through February 2018. Methods We deployed a daily data collection system for 13 syndromes: rash with fever; rash without fever; acute upper respiratory tract infection; acute lower respiratory tract infection; meningitis or encephalitis; fever and bleeding; nonbloody gastroenteritis or watery diarrhea; bloody diarrhea; acute jaundice; skin, soft tissue, or bone abnormalities; acute flaccid paralysis; high fever with no other signs; and unexplained death. General practitioners, the first professionals to consult for health problems at reception centers in Austria, sent the tally sheets on identified syndromes daily to the AGES. Results We identified a total of 2914 cases, presenting 8 of the 13 syndromes. A total of 405 signals were triggered, and 6.4% (26/405) of them generated alerts. Suspected acute upper respiratory tract infection (1470/2914, 50.45% of cases), rash without fever (1174/2914, 40.29% of cases), suspected acute lower respiratory tract infection (159/2914, 5.46% of cases), watery diarrhea (73/2914, 2.51% of cases), and skin, soft tissue, or bone abnormalities (32/2914, 1.10% of cases) were the top 5 syndromes. Conclusions The cooperation of the AGES with reception center health care staff, supported by the 2 involved ministries, was shown to be useful for syndromic surveillance of infectious diseases among asylum seekers. None of the identified alerts escalated to an outbreak.
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Affiliation(s)
- Ziad El-Khatib
- Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Karin Taus
- Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Lukas Richter
- Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Franz Allerberger
- Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Department of Surveillance and Infectious Disease Epidemiology, Institute of Medical Microbiology and Hygiene, Austrian Agency for Health and Food Safety, Vienna, Austria
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Sharma U, Desikachari BR, Sarma S. Content validity of the newly developed risk assessment tool for religious mass gathering events in an Indian setting (Mass Gathering Risk Assessment Tool-MGRAT). J Family Med Prim Care 2019; 8:2207-2211. [PMID: 31463231 PMCID: PMC6691416 DOI: 10.4103/jfmpc.jfmpc_380_19] [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] [Indexed: 11/04/2022] Open
Abstract
Background Risk assessment (RA) for mass gathering events is crucial to identify potential health hazards. It aids in planning and response activities specific to the event but is often overlooked by the event organizers. This paper reports the content validity process of a newly developed tool called Mass Gathering Risk Assessment Tool (MGRAT), which intends to assess the risks associated with religious mass gathering events in Indian settings. Methods Qualitative approach was followed to identify the risks associated with mass gathering events and to identify the domains and items to be included in the RA tool. The draft tool was shared with six experts who were selected by the convenient method; selected experts were requested to assess the tool and give their comments about the domains, items, relevant responses, and overall presentation of the tool using content validity questionnaire. Content validity index and Fleiss kappa statistics were calculated to assess the agreement between multiple raters. Results Agreement proportion expressed as scale-level content validity index (S-CVI) calculated by the averaging method is 0.92. S-CVI; calculated by universal agreement is 0.78. Fleiss kappa statistics to measure the agreement between multiple experts after adjusting the component of the chance agreement is 0.522 (95% CI: 0.417, 0.628, P value: 0.001). Conclusion MGRAT is a valid tool, which has an appropriate level of content validity. As the number of raters increases, there will be difficulty in achieving consensus among all the items, which is the reason for lower Content Validity Index/Universal Average (CVI/UA) when compared with Content Validity Index/Average (CVI/Ave). Fleiss kappa statistics also indicated moderate agreement among the raters beyond the chance agreement, which also supports the appropriate content validity of MGRAT.
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Affiliation(s)
- Upasana Sharma
- AMCHSS (Achutha Menon Centre for Health Science Studies), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, Kerala, India
| | - B R Desikachari
- Ex-Department of Public Health and Preventive Medicine, Government of Tamil Nadu, Chennai, Tamil Nadu, India
| | - Sankara Sarma
- AMCHSS (Achutha Menon Centre for Health Science Studies), Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum, Kerala, India
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Yoon PW, Ising AI, Gunn JE. Using Syndromic Surveillance for All-Hazards Public Health Surveillance: Successes, Challenges, and the Future. Public Health Rep 2018; 132:3S-6S. [PMID: 28692397 PMCID: PMC5676514 DOI: 10.1177/0033354917708995] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Paula W Yoon
- 1 Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy I Ising
- 2 Carolina Center for Health Informatics, Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julia E Gunn
- 3 Communicable Disease Control Division, Infectious Disease Bureau, Boston Public Health Commission, Boston, MA, USA
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