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Germani F, Spitale G, Machiri SV, Ho CWL, Ballalai I, Biller-Andorno N, Reis AA. Ethical Considerations in Infodemic Management: Systematic Scoping Review. JMIR INFODEMIOLOGY 2024; 4:e56307. [PMID: 39208420 PMCID: PMC11393515 DOI: 10.2196/56307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/28/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND During health emergencies, effective infodemic management has become a paramount challenge. A new era marked by a rapidly changing information ecosystem, combined with the widespread dissemination of misinformation and disinformation, has magnified the complexity of the issue. For infodemic management measures to be effective, acceptable, and trustworthy, a robust framework of ethical considerations is needed. OBJECTIVE This systematic scoping review aims to identify and analyze ethical considerations and procedural principles relevant to infodemic management, ultimately enhancing the effectiveness of these practices and increasing trust in stakeholders performing infodemic management practices with the goal of safeguarding public health. METHODS The review involved a comprehensive examination of the literature related to ethical considerations in infodemic management from 2002 to 2022, drawing from publications in PubMed, Scopus, and Web of Science. Policy documents and relevant material were included in the search strategy. Papers were screened against inclusion and exclusion criteria, and core thematic areas were systematically identified and categorized following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We analyzed the literature to identify substantive ethical principles that were crucial for guiding actions in the realms of infodemic management and social listening, as well as related procedural ethical principles. In this review, we consider ethical principles that are extensively deliberated upon in the literature, such as equity, justice, or respect for autonomy. However, we acknowledge the existence and relevance of procedural practices, which we also consider as ethical principles or practices that, when implemented, enhance the efficacy of infodemic management while ensuring the respect of substantive ethical principles. RESULTS Drawing from 103 publications, the review yielded several key findings related to ethical principles, approaches, and guidelines for practice in the context of infodemic management. Community engagement, empowerment through education, and inclusivity emerged as procedural principles and practices that enhance the quality and effectiveness of communication and social listening efforts, fostering trust, a key emerging theme and crucial ethical principle. The review also emphasized the significance of transparency, privacy, and cybersecurity in data collection. CONCLUSIONS This review underscores the pivotal role of ethics in bolstering the efficacy of infodemic management. From the analyzed body of literature, it becomes evident that ethical considerations serve as essential instruments for cultivating trust and credibility while also facilitating the medium-term and long-term viability of infodemic management approaches.
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Affiliation(s)
- Federico Germani
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Giovanni Spitale
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Sandra Varaidzo Machiri
- Unit for High Impact Events Preparedness, Department of Epidemic and Pandemic Preparedness and Prevention, World Health Organization, Genève, Switzerland
| | | | | | - Nikola Biller-Andorno
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland
| | - Andreas Alois Reis
- Health Ethics and Governance Unit, Department of Research for Health, World Health Organization, Genève, Switzerland
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Mwangi LW, Macharia W, Wachira BW, Kimeu J, Mativa B, Atwoli L. Role of hospital leadership in pandemic preparedness: experience at a tertiary hospital in Kenya during the COVID-19 pandemic. BMJ LEADER 2024; 8:111-118. [PMID: 37567757 DOI: 10.1136/leader-2023-000833] [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: 04/17/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Pandemic preparedness refers to being ready for, responding to and recovering from public health crises, and is integral for health security. Hospital leadership is a critical building block of an effective healthcare system, providing policy, accountability and stewardship in a health crisis. OBJECTIVES AND METHODS We aimed to describe the leadership and governance structures put in place at the Aga Khan University Hospital, Nairobi, a private not-for-profit tertiary healthcare facility, following the COVID-19 pandemic. We reviewed over 200 hospital documents archived in the COVID-19 repository including those received from the Kenya Ministry of Health, emails, memos, bulletins, meeting minutes, protocols, brochures and flyers. We evaluated and described pandemic preparedness at the hospital under four main themes: (a) leadership, governance and incident management structures; (b) coordination and partnerships; (c) communication strategies; and (d) framework to resolve ethical dilemmas. RESULTS The hospital expeditiously established three emergency governance structures, namely a task force, an operations team and an implementation team, to direct and implement evidence-based preparedness strategies. Leveraging on partners, the hospital ensured that risk analyses and decisions made: (1) were based on evidence and in line with the national and global guidelines, (2) were supported by community leaders and (3) expedite financing for urgent hospital activities. Communication strategies were put in place to ensure harmonised COVID-19 messaging to the hospital staff, patients, visitors and the public to minimise misinformation or disinformation. An ethical framework was also established to build trust and transparency among the hospital leadership, staff and patients. CONCLUSION The establishment of a hospital leadership structure is crucial for efficient and effective implementation of pandemic preparedness and response strategies which are evidence based, well resourced and ethical. The role of leadership discussed is applicable to healthcare facilities across low and middle-income countries to develop contextualised pandemic preparedness plans.
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Affiliation(s)
- Lucy W Mwangi
- Research Division, The Aga Khan University Medical College East Africa, Nairobi, Kenya
| | - William Macharia
- Research Division, The Aga Khan University Medical College East Africa, Nairobi, Kenya
- Paediatrics and Child Health, The Aga Khan University Medical College East Africa, Nairobi, Kenya
| | - Benjamin W Wachira
- Accident & Emergency Department, The Aga Khan University Hospital, Nairobi, Nairobi, Kenya
- Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya
| | - Jemimah Kimeu
- Department of Nursing, The Aga Khan University Hospital, Nairobi, Nairobi, Kenya
| | - Boniface Mativa
- Quality and Patient Safety, The Aga Khan University Hospital, Nairobi, Nairobi, Kenya
- Family Medicine, The Aga Khan University Medical College East Africa, Nairobi, Kenya
| | - Lukoye Atwoli
- Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya
- Department of Medicine, The Aga Khan University Medical College East Africa, Nairobi, Kenya
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Owusu D, Ndegwa LK, Ayugi J, Kinuthia P, Kalani R, Okeyo M, Otieno NA, Kikwai G, Juma B, Munyua P, Kuria F, Okunga E, Moen AC, Emukule GO. Use of Sentinel Surveillance Platforms for Monitoring SARS-CoV-2 Activity: Evidence From Analysis of Kenya Influenza Sentinel Surveillance Data. JMIR Public Health Surveill 2024; 10:e50799. [PMID: 38526537 PMCID: PMC11002741 DOI: 10.2196/50799] [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: 07/19/2023] [Revised: 12/19/2023] [Accepted: 02/02/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Little is known about the cocirculation of influenza and SARS-CoV-2 viruses during the COVID-19 pandemic and the use of respiratory disease sentinel surveillance platforms for monitoring SARS-CoV-2 activity in sub-Saharan Africa. OBJECTIVE We aimed to describe influenza and SARS-CoV-2 cocirculation in Kenya and how the SARS-CoV-2 data from influenza sentinel surveillance correlated with that of universal national surveillance. METHODS From April 2020 to March 2022, we enrolled 7349 patients with severe acute respiratory illness or influenza-like illness at 8 sentinel influenza surveillance sites in Kenya and collected demographic, clinical, underlying medical condition, vaccination, and exposure information, as well as respiratory specimens, from them. Respiratory specimens were tested for influenza and SARS-CoV-2 by real-time reverse transcription polymerase chain reaction. The universal national-level SARS-CoV-2 data were also obtained from the Kenya Ministry of Health. The universal national-level SARS-CoV-2 data were collected from all health facilities nationally, border entry points, and contact tracing in Kenya. Epidemic curves and Pearson r were used to describe the correlation between SARS-CoV-2 positivity in data from the 8 influenza sentinel sites in Kenya and that of the universal national SARS-CoV-2 surveillance data. A logistic regression model was used to assess the association between influenza and SARS-CoV-2 coinfection with severe clinical illness. We defined severe clinical illness as any of oxygen saturation <90%, in-hospital death, admission to intensive care unit or high dependence unit, mechanical ventilation, or a report of any danger sign (ie, inability to drink or eat, severe vomiting, grunting, stridor, or unconsciousness in children younger than 5 years) among patients with severe acute respiratory illness. RESULTS Of the 7349 patients from the influenza sentinel surveillance sites, 76.3% (n=5606) were younger than 5 years. We detected any influenza (A or B) in 8.7% (629/7224), SARS-CoV-2 in 10.7% (768/7199), and coinfection in 0.9% (63/7165) of samples tested. Although the number of samples tested for SARS-CoV-2 from the sentinel surveillance was only 0.2% (60 per week vs 36,000 per week) of the number tested in the universal national surveillance, SARS-CoV-2 positivity in the sentinel surveillance data significantly correlated with that of the universal national surveillance (Pearson r=0.58; P<.001). The adjusted odds ratios (aOR) of clinical severe illness among participants with coinfection were similar to those of patients with influenza only (aOR 0.91, 95% CI 0.47-1.79) and SARS-CoV-2 only (aOR 0.92, 95% CI 0.47-1.82). CONCLUSIONS Influenza substantially cocirculated with SARS-CoV-2 in Kenya. We found a significant correlation of SARS-CoV-2 positivity in the data from 8 influenza sentinel surveillance sites with that of the universal national SARS-CoV-2 surveillance data. Our findings indicate that the influenza sentinel surveillance system can be used as a sustainable platform for monitoring respiratory pathogens of pandemic potential or public health importance.
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Affiliation(s)
- Daniel Owusu
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Linus K Ndegwa
- Global Influenza Branch, Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Jorim Ayugi
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | | | - Rosalia Kalani
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi, Kenya
| | - Mary Okeyo
- National Influenza Centre Laboratory, National Public Health Laboratories, Ministry of Health, Nairobi, Kenya
| | - Nancy A Otieno
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Gilbert Kikwai
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Bonventure Juma
- Global Influenza Branch, Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Peninah Munyua
- Global Influenza Branch, Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Francis Kuria
- Directorate of Public Health, Ministry of Health, Nairobi, Kenya
| | - Emmanuel Okunga
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi, Kenya
| | - Ann C Moen
- Influenza Division, US Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Gideon O Emukule
- Global Influenza Branch, Influenza Division, US Centers for Disease Control and Prevention, Nairobi, Kenya
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Hidayat M, Muljono P, Maarif S, Saleh A. Indigenous Village-Based Disaster Communication in COVID-19 Management. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Communication should always take the role to connect the community to disaster risk reduction actions. Communication aspects that must be mainly prepared are the knowledge of disaster signs, elements involved in disasters, disaster communication media, resources, the sources of basic needs of affected communities, the means of aid distribution, and human resources. Communication activities should always be carried out between the community and various stakeholders to ensure their readiness in the face of possible disaster. This study aimed to determine the Indigenous Village-based disaster communication strategy in Bali Province. Methods: This study used a qualitative descriptive method. The data analysis techniques used were data reduction, data presentation and conclusion drawing at pre-research, during research, and post-research. Data collection was done by observing, interviewing and documenting. Results: The results of this study found that the communication model carried out by Bali Province in handling COVID-19 was by utilizing the role of Indigenous Villages and service villages to communicate with the community. The uniqueness of the Bali Province which still adheres to social, cultural and religious aspects becomes its strength in COVID-19 management
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Lin CP, Boufkhed S, Kizawa Y, Mori M, Hamzah E, Aggarwal G, Namisango E, Higginson IJ, Goh C, Harding R. Preparedness to Face the COVID-19 Pandemic in Hospice and Palliative Care Services in the Asia-Pacific Region: A Rapid Online Survey. Am J Hosp Palliat Care 2021; 38:861-868. [PMID: 33789503 DOI: 10.1177/10499091211002797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Hospice and palliative care services provision for COVID-19 patients is crucial to improve their life quality. There is limited evidence on COVID-19 preparedness of such services in the Asia-Pacific region. AIM To evaluate the preparedness and capacity of hospice and palliative care services in the Asia-Pacific region to respond to the COVID-19 pandemic. METHOD An online cross-sectional survey was developed based on methodology guidance. Asia-Pacific Hospice and Palliative Care Network subscribers (n = 1551) and organizational members (n = 185) were emailed. Descriptive analysis was undertaken. RESULTS Ninety-seven respondents completed the survey. Around half of services were hospital-based (n = 47, 48%), and public-funded (n = 46, 47%). Half of services reported to have confirmed cases (n = 47, 49%) and the majority of the confirmed cases were patients (n = 28, 61%). Staff perceived moderate risk of being infected by COVID-19 (median: 7/10). > 85% of respondents reported they had up-to-date contact list for staff and patients, one-third revealed challenges to keep record of relatives who visited the services (n = 30, 31%), and of patients visited in communities (n = 29, 30%). Majority of services (60%) obtained adequate resources for infection control except face mask. More than half had no guidance on Do Not Resuscitate orders (n = 59, 66%) or on bereavement care for family members (n = 44, 51%). CONCLUSION Recommendations to strengthen the preparedness of palliative care services include: 1) improving the access to face mask; 2) acquiring stress management protocols for staff when unavailable; 3) reinforcing the contact tracing system for relatives and visits in the community and 4) developing guidance on patient and family care during patient's dying trajectory.
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Affiliation(s)
- Cheng-Pei Lin
- Institute of Community Health Care, School of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan.,Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, 12885Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | | | - Eve Namisango
- 108118African Palliative Care Association, Kampala, Uganda
| | - Irene J Higginson
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Cynthia Goh
- Division of Supportive and Palliative Care, 68751National Cancer Centre, Singapore, Singapore Cheng-Pei Lin and Sabah Boufkhed are joint first authors
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
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The Preparedness of Primary Health Care Network in terms of Emergency Risk Communication: A Study in Iran. Disaster Med Public Health Prep 2021; 16:1466-1475. [PMID: 34103122 DOI: 10.1017/dmp.2021.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Emergency Risk Communication (ERC) is known as 1 of the important components of an effective response to public health emergencies. In this study, we aimed to investigate the preparedness of the Primary Health Care Network (PHCN) of Iran in terms of the ERC. METHODS This study was conducted in 136 Primary Health Care Facilities (PHCFs) affilated to Shahrekord University of Medical Sciences, Chaharmahal and Bakhtiari Province, Iran. Data in terms of ERC were collected using a checklist developed by the Center of Disease Control and Prevention (CDC). RESULTS The findings of the study revealed that 65.9% of the PHCFs had low preparedness in terms of the ERC, 33.3% had a moderate level and 0.8% had high preparedness in this regard. There was a significant difference between the level of ERC and the history of crisis in the past year, PHCF type, and the education level of the responsible employees in the crisis unit in the PHCF. CONCLUSIONS The results showed that the PHCFs studied need to increase their capacity and capability in the field of ERC. Further efforts to provide ERC components may increase the preparedness of PHCN in Iran in terms of the ERC.
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Wachira BW, Mwai M. A baseline review of the ability of hospitals in Kenya to provide emergency and critical care services for COVID-19 patients. Afr J Emerg Med 2021; 11:213-217. [PMID: 33495726 PMCID: PMC7816953 DOI: 10.1016/j.afjem.2021.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/23/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction As the Coronavirus Disease 2019 (COVID-19) cases in Kenya begin to rise, the number of severe and critical COVID-19 patients has the potential to quickly overload the local healthcare system beyond its capacity to treat people. Objective The purpose of this study was to gather information about the ability of hospitals in Kenya to provide emergency and critical care services and to identify priority actions for use by policymakers and other stakeholders as a roadmap toward strengthening the COVID-19 response in the country. Methods This was a comprehensive review of the published and grey literature on emergency and critical care services in Kenya published in the last three years through April 2020. Screening of articles was conducted independently by the authors and the final decision for inclusion was made collaboratively. A total of 15 papers and documents were included in the review. Key recommendations There is an urgent need to strengthen prehospital emergency care in Kenya by establishing a single toll-free ambulance access number and an integrated public Emergency Medical Services (EMS) system to respond to severe and critical COVID-19 patients in the community and other emergency cases. Functional 24-h emergency centres (ECs) need to be established in all the level 4, 5 and 6 hospitals in the country to ensure these patients receive immediate lifesaving emergency care when they arrive at the hospitals. The ECs should be equipped with pulse oximeters and functioning oxygen systems and have the necessary resources and skills to perform endotracheal intubation to manage COVID-19-induced respiratory distress and hypoxia. Additional intensive care unit (ICU) beds and ventilators are also needed to ensure continuity of care for the critically ill patients seen in the EC. Appropriate practical interventions should be instituted to limit the spread of COVID-19 to healthcare personnel and other patients within the healthcare system. Further research with individual facility levels of assessment around infrastructure and service provision is necessary to more narrowly define areas with significant shortfalls in emergency and critical care services as the number of COVID-19 cases in the country increase.
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Baral P. Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 51:474-493. [DOI: 10.1177/0020731421997088] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This rapid scoping review has informed the development of the November 2020 United Nations Research Roadmap for the COVID-19 Recovery, by providing a synthesis of available evidence on the impact of pandemics and epidemics on (1) essential services and (2) health systems preparedness and strengthening. Emerging findings point to existing disparities in health systems and services being further exacerbated, with marginalized populations and low- and middle-income countries burdened disproportionately. More broadly, there is a need to further understand short- and long-term impacts of bypassed essential services, quality assurance of services, the role of primary health care in the frontline, and the need for additional mechanisms for effective vaccine messaging and uptake during epidemics. The review also highlights how trust—of institutions, of science, and between communities and health systems—remains central to a successful pandemic response. Finally, previous crises had repeatedly foreshadowed the inability of health systems to handle upcoming pandemics, yet the reactive nature of policies and practices compounded by lack of resources, infrastructure, and political will have resulted in the current failed response to COVID-19. There is therefore an urgent need for investments in implementation science and for strategies to bridge this persistent research–practice gap.
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Affiliation(s)
- Prativa Baral
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Salentijn W, Antony J, Douglas J. Six Sigma to distinguish patterns in COVID-19 approaches. TQM JOURNAL 2021. [DOI: 10.1108/tqm-11-2020-0271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeCOVID-19 has changed life as we know. Data are scarce and necessary for making decisions on fighting COVID-19. The purpose of this paper is to apply Six Sigma techniques on the current COVID-19 pandemic to distinguish between special cause and common cause variation. In the DMAIC structure, different approaches applied in three countries are compared.Design/methodology/approachFor three countries the mortality is compared to the population to distinguish between special cause variation and common cause variation. This variation and the patterns in it are assessed to the countries' different approaches to COVID-19.FindingsIn the DMAIC problem-solving approach, patterns in the data are distinguished. The special cause variation is assessed to the special causes and approaches. The moment on which measures were taken has been essential, as well as policies on testing and distancing.Research limitations/implicationsCross-national data comparisons are a challenge as countries have different moments on which they register data on their population. Furthermore, different intervals are taken, varying from registering weekly to registering yearly. For the research, three countries with similar data registration and different approaches in fighting COVID-19 were taken.Originality/valueThis is the first study with Master Black Belts from different countries on the application of Six Sigma techniques and the DMAIC from the viewpoint of special cause variation on COVID-19.
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Boufkhed S, Harding R, Kutluk T, Husseini A, Pourghazian N, Shamieh O. What Is the Preparedness and Capacity of Palliative Care Services in Middle-Eastern and North African Countries to Respond to COVID-19? A Rapid Survey. J Pain Symptom Manage 2021; 61:e13-e50. [PMID: 33227380 PMCID: PMC7679234 DOI: 10.1016/j.jpainsymman.2020.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 01/10/2023]
Abstract
CONTEXT Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. OBJECTIVE To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. METHODS A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. RESULTS Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives' details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1-10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). CONCLUSION Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
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Affiliation(s)
- Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Tezer Kutluk
- Department of Pediatric Oncology Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Nasim Pourghazian
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict, Department of Palliative Care, King Hussein Cancer Center, Amman, Jordan; College of Medicine, The University of Jordan, Amman, Jordan
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Boufkhed S, Namisango E, Luyirika E, Sleeman KE, Costantini M, Peruselli C, Normand C, Higginson IJ, Harding R. Preparedness of African Palliative Care Services to Respond to the COVID-19 Pandemic: A Rapid Assessment. J Pain Symptom Manage 2020; 60:e10-e26. [PMID: 32949761 PMCID: PMC7493734 DOI: 10.1016/j.jpainsymman.2020.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/29/2022]
Abstract
CONTEXT Palliative care is an essential component of the coronavirus disease 2019 (COVID-19) pandemic response but is overlooked in national and international preparedness plans. The preparedness and capacity of African palliative care services to respond to COVID-19 is unknown. OBJECTIVES To evaluate the preparedness and capacity of African palliative care services to respond to the COVID-19 pandemic. METHODS We developed, piloted, and conducted a cross-sectional online survey guided by the 2005 International Health Regulations. It was electronically mailed to the 166 African Palliative Care Association's members and partners. Descriptive analyses were conducted. RESULTS About 83 participants from 21 countries completed the survey. Most services had at least one procedure for the case management of COVID-19 or another infectious disease (63%). Respondents reported concerns over accessing running water, soap, and disinfectant products (43%, 42%, and 59%, respectively) and security concerns for themselves or their staff (52%). Two in five services (41%) did not have any or make available additional personal protective equipment. Most services (80%) reported having the capacity to use technology instead of face-to-face appointment, and half (52%) reported having palliative care protocols for symptom management and psychological support that could be shared with nonspecialist staff in other health care settings. CONCLUSION Our survey suggests that African palliative care services could support the wider health system's response to the COVID-19 pandemic with greater resources such as basic infection control materials. It identified specific and systemic weaknesses impeding their preparedness to respond to outbreaks. The findings call for urgent measures to ensure staff and patient safety.
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Affiliation(s)
- Sabah Boufkhed
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Eve Namisango
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom; African Palliative Care Association, Kampala, Uganda
| | | | - Katherine E Sleeman
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | | | | | - Charles Normand
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Irene J Higginson
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Richard Harding
- Cicely Saunders Institute for Palliative Care and Rehabilitation, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
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Collins T, Akselrod S, Bloomfield A, Gamkrelidze A, Jakab Z, Placella E. Rethinking the COVID-19 Pandemic: Back to Public Health. Ann Glob Health 2020; 86:133. [PMID: 33102153 PMCID: PMC7546103 DOI: 10.5334/aogh.3084] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 pandemic has highlighted vast differences across countries in their responses to the emergency and their capacities to implement public health measures that could slow the progression of the disease. As public health systems are the first line of defense during pandemics, it has become clear that sustained investment in strengthening public health infrastructure is a major need in all countries, irrespective of income levels. Drawing on the successful experiences of Switzerland, Georgia, and New Zealand in dealing with COVID-19, we suggest prioritizing core public health capacities with links to the International Health Regulations, improving international cooperation, coordination, and multisectoral action, addressing health inequities by targeting vulnerable groups, and enhancing health literacy, including through sophisticated and sustained communication campaigns to build resilience. These measures will ensure that health systems and communities will be better prepared for the disruptions that future disease outbreaks will inevitably bring.
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Badu K, Thorn JP, Goonoo N, Dukhi N, Fagbamigbe AF, Kulohoma BW, Oyebola K, Abdelsalam SI, Doorsamy W, Awe O, Sylverken AA, Egeru A, Gitaka J. Africa’s response to the COVID-19 pandemic: A review of the nature of the virus, impacts and implications for preparedness. AAS Open Res 2020. [DOI: 10.12688/aasopenres.13060.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: COVID-19 continues to wreak havoc in different countries across the world, claiming thousands of lives, increasing morbidity and disrupting lifestyles. The global scientific community is in urgent need of relevant evidence, to understand the challenges and knowledge gaps, as well as the opportunities to contain the spread of the virus. Considering the unique socio-economic, demographic, political, ecological and climatic contexts in Africa, the responses which may prove to be successful in other regions may not be appropriate on the continent. This paper aims to provide insight for scientists, policy makers and international agencies to contain the virus and to mitigate its impact at all levels. Methods: The Affiliates of the African Academy of Sciences (AAS), came together to synthesize the current evidence, identify the challenges and opportunities to enhance the understanding of the disease. We assess the potential impact of this pandemic and the unique challenges of the disease on African nations. We examine the state of Africa’s preparedness and make recommendations for steps needed to win the war against this pandemic and combat potential resurgence. Results: We identified gaps and opportunities among cross-cutting issues which is recommended to be addressed or harnessed in this pandemic. Factors such as the nature of the virus and the opportunities for drug targeting, point of care diagnostics, health surveillance systems, food security, mental health, xenophobia and gender-based violence, shelter for the homeless, water and sanitation, telecommunications challenges, domestic regional coordination and financing. Conclusion: Based on our synthesis of the current evidence, while there are plans for preparedness in several African countries, there are significant limitations. Multi-sectoral efforts from the science, education, medical, technological, communication, business and industry sectors as well as local communities is required in order to win this fight.
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15
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020. [PMID: 32087820 DOI: 10.1016/s0140‐6736(20)30411‐6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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16
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020; 395:871-877. [PMID: 32087820 PMCID: PMC7159277 DOI: 10.1016/s0140-6736(20)30411-6] [Citation(s) in RCA: 620] [Impact Index Per Article: 155.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/13/2020] [Accepted: 02/15/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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17
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Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle PY, D'Ortenzio E, Yazdanpanah Y, Eholie SP, Altmann M, Gutierrez B, Kraemer MUG, Colizza V. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020. [PMID: 32087820 DOI: 10.1016/s0140-6736-20-30411-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.
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Affiliation(s)
- Marius Gilbert
- Spatial Epidemiology Laboratory, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifiques, Brussels, Belgium
| | - Giulia Pullano
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France; Sociology and Economics of Networks and Services Laboratory at Orange Experience Design Laboratory Chatillion, Paris, France
| | - Francesco Pinotti
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eugenio Valdano
- Center for Biomedical Modeling, The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, LA, USA
| | - Chiara Poletto
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Pierre-Yves Boëlle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Eric D'Ortenzio
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Yazdan Yazdanpanah
- Infection, Antimicrobials, Modelling, Evolution, INSERM, Université de Paris, Paris, France; Bichat Claude Bernard Hospital, Assistance publique-Hôpitaux de Paris, Paris, France
| | - Serge Paul Eholie
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire; Département de Dermatologie-Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouet-Boigny, Abidjan, Côte d'Ivoire
| | - Mathias Altmann
- IDLIC-Maladies Infectieuses Dans Les Pays à Ressources Limitées, INSERM U1219, Bordeaux, France; Bordeaux Population Health, University of Bordeaux, Bordeaux, France
| | | | - Moritz U G Kraemer
- Department of Zoology, University of Oxford, Oxford, UK; Harvard Medical School, Harvard University, Boston, MA, USA; Computational Epidemiology Group, Boston Children's Hospital, Boston, MA, USA
| | - Vittoria Colizza
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.
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18
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Purcell LN, Charles AG. An Invited Commentary on "World Health Organization declares global emergency: A review of the 2019 novel Coronavirus (COVID-19)": Emergency or new reality? Int J Surg 2020; 76:111. [PMID: 32169565 PMCID: PMC7129518 DOI: 10.1016/j.ijsu.2020.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/05/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Laura N Purcell
- Department of Surgery, University of North Carolina at Chapel Hill, UNC School of Medicine, 4008 Burnett Womack Building, CB 7228, USA
| | - Anthony G Charles
- Department of Surgery, University of North Carolina at Chapel Hill, UNC School of Medicine, 4008 Burnett Womack Building, CB 7228, USA.
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19
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Warsame A, Blanchet K, Checchi F. Towards systematic evaluation of epidemic responses during humanitarian crises: a scoping review of existing public health evaluation frameworks. BMJ Glob Health 2020; 5:e002109. [PMID: 32133177 PMCID: PMC7042582 DOI: 10.1136/bmjgh-2019-002109] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/11/2019] [Accepted: 12/22/2019] [Indexed: 11/04/2022] Open
Abstract
Epidemics continue to pose a significant public health threat to populations in low and middle-income countries. However, little is known about the appropriateness and performance of response interventions in such settings. We undertook a rapid scoping review of public health evaluation frameworks for emergency settings in order to judge their suitability for assessing epidemic response. Our search identified a large variety of frameworks. However, very few are suitable for framing the response to an epidemic, or its evaluation. We propose a generic epidemic framework that draws on elements of existing frameworks. We believe that this framework may potentially be of use in closing the gap between increasing global epidemic risk and the ability to respond effectively.
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Affiliation(s)
- Abdihamid Warsame
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Karl Blanchet
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Francesco Checchi
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
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20
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Tialla D, Sausy A, Cissé A, Sagna T, Ilboudo AK, Ouédraogo GA, Hübschen JM, Tarnagda Z, Snoeck CJ. Serological evidence of swine exposure to pandemic H1N1/2009 influenza A virus in Burkina Faso. Vet Microbiol 2019; 241:108572. [PMID: 31928706 DOI: 10.1016/j.vetmic.2019.108572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/29/2019] [Accepted: 12/30/2019] [Indexed: 12/25/2022]
Abstract
Despite improvement of human and avian influenza surveillance, swine influenza surveillance in sub-Saharan Africa is scarce and pandemic preparedness is still deemed inadequate, including in Burkina Faso. This cross-sectional study therefore aimed to investigate the (past) exposure of pigs to influenza A viruses. Practices of people with occupational contacts with pigs and their knowledge on influenza A were investigated in order to formulate future prevention guidelines. In 2016-2017, pig nasopharyngeal swabs and sera were collected and screened for the presence of influenza virus by RT-PCR or of anti-influenza antibodies by competitive ELISA. Seropositive samples were further characterized in virus microneutralization assays against human and swine H1N1 virus strains. Nasopharyngeal swabs were obtained from people with occupational contact with pigs and screened similarly. Demographic data as well as practices related to their profession were recorded. No influenza A virus was detected in nasopharyngeal swabs in humans (n = 358) or in pigs (n = 600). Seroprevalence in pigs reached 6.8 % (41/600) and seropositive animals were found in 50.0 % of extensive settings (10/20) and 19.0 % of (semi-)intensive farms (4/21). All positive sera reacted against the pandemic H1N1/2009 strain, while seropositivity against two Eurasian avian-like and one American swine H1N1 strains and individual titers were lower. These results suggested exposure to pandemic H1N1/2009 virus and cross-reactivity to other H1N1 strains. Farmers with higher frequency of contact to pigs, absence of protective equipment and lack of knowledge on zoonoses are likely key players in driving human-to-swine virus transmission.
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Affiliation(s)
- Dieudonné Tialla
- Unité des Maladies à potentiel Epidémique, Maladies Emergentes et Zoonoses (UMEMEZ), Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), 399, Avenue de la Liberté 01, BP 545, Bobo-Dioulasso, Burkina Faso; Ecole Nationale de l'Elevage et de la Santé Animale (ENESA), Secteur 28, Ouagadougou, Burkina Faso.
| | - Aurélie Sausy
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354, Esch-sur-Alzette, Luxembourg.
| | - Assana Cissé
- Unité des Maladies à potentiel Epidémique, Maladies Emergentes et Zoonoses (UMEMEZ), Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), 399, Avenue de la Liberté 01, BP 545, Bobo-Dioulasso, Burkina Faso.
| | - Tani Sagna
- Unité des Maladies à potentiel Epidémique, Maladies Emergentes et Zoonoses (UMEMEZ), Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), 399, Avenue de la Liberté 01, BP 545, Bobo-Dioulasso, Burkina Faso.
| | - Abdoul Kader Ilboudo
- Unité des Maladies à potentiel Epidémique, Maladies Emergentes et Zoonoses (UMEMEZ), Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), 399, Avenue de la Liberté 01, BP 545, Bobo-Dioulasso, Burkina Faso.
| | - Georges Anicet Ouédraogo
- Laboratoire de Recherche et d'Enseignement en Santé et Biotechnologies Animales (LARESBA), Université Nazi Boni, 01 BP 109, Bobo-Dioulasso, Burkina Faso.
| | - Judith M Hübschen
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354, Esch-sur-Alzette, Luxembourg.
| | - Zékiba Tarnagda
- Unité des Maladies à potentiel Epidémique, Maladies Emergentes et Zoonoses (UMEMEZ), Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), 399, Avenue de la Liberté 01, BP 545, Bobo-Dioulasso, Burkina Faso.
| | - Chantal J Snoeck
- Infectious Diseases Research Unit, Department of Infection and Immunity, Luxembourg Institute of Health (LIH), 29 rue Henri Koch, L-4354, Esch-sur-Alzette, Luxembourg.
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