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Lim C, Klaytong P, Hantrakun V, Rangsiwutisak C, Phiancharoen C, Tangwangvivat R, Kripattanapong S, Jitpeera C, Poldech W, Jiramahasan P, Laosatiankit B, Photivet O, Sukbut P, Thongsri W, Kosasaeng K, Chiwehanyon B, Leesahud N, Ritthong P, Linreung W, Aramrueang P, Bhunyakitikorn W, Iamsirithaworn S, Limmathurotsakul D. Automating the Generation of Notifiable Bacterial Disease Reports: Proof-of-Concept Study and Implementation in Six Hospitals in Thailand. Am J Trop Med Hyg 2024; 111:151-155. [PMID: 38806021 PMCID: PMC11229635 DOI: 10.4269/ajtmh.23-0848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/23/2024] [Indexed: 05/30/2024] Open
Abstract
Information on notifiable bacterial diseases (NBD) in low- and middle-income countries (LMICs) is frequently incomplete. We developed the AutoMated tool for the Antimicrobial resistance Surveillance System plus (AMASSplus), which can support hospitals to analyze their microbiology and hospital data files automatically (in CSV or Excel format) and promptly generate antimicrobial resistance surveillance and NBD reports (in PDF and CSV formats). The NBD reports included the total number of cases and deaths after Brucella spp., Burkholderia pseudomallei, Corynebacterium diphtheriae, Neisseria gonorrhoeae, Neisseria meningitidis, nontyphoidal Salmonella spp., Salmonella enterica serovar Paratyphi, Salmonella enterica serovar Typhi, Shigella spp., Streptococcus suis, and Vibrio spp. infections. We tested the tool in six hospitals in Thailand in 2022. The total number of deaths identified by the AMASSplus was higher than those reported to the national notifiable disease surveillance system (NNDSS); particularly for B. pseudomallei infection (134 versus 2 deaths). This tool could support the NNDSS in LMICs.
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Affiliation(s)
- Cherry Lim
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Preeyarach Klaytong
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Viriya Hantrakun
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Chalida Rangsiwutisak
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
| | - Chadaporn Phiancharoen
- Division of Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Ratanaporn Tangwangvivat
- Division of Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Somkid Kripattanapong
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Charuttaporn Jitpeera
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | | | | | | | | | | | | | | | | | | | | | - Wichan Bhunyakitikorn
- Division of Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Sopon Iamsirithaworn
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Li X, Tang K. The Effects of Online Health Information-Seeking Behavior on Sexually Transmitted Disease in China: Infodemiology Study of the Internet Search Queries. J Med Internet Res 2023; 25:e43046. [PMID: 37171864 DOI: 10.2196/43046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/11/2023] [Accepted: 03/30/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Sexually transmitted diseases (STDs) are a serious issue worldwide. With the popularity of the internet, online health information-seeking behavior (OHISB) has been widely adopted to improve health and prevent disease. OBJECTIVE This study aimed to investigate the short-term and long-term effects of different types of OHISBs on STDs, including syphilis, gonorrhea, and AIDS due to HIV, based on the Baidu index. METHODS Multisource big data were collected, including case numbers of STDs, search queries based on the Baidu index, provincial total population, male-female ratio, the proportion of the population older than 65 years, gross regional domestic product (GRDP), and health institution number data in 2011-2018 in mainland China. We categorized OHISBs into 4 types: concept, symptoms, treatment, and prevention. Before and after controlling for socioeconomic and medical conditions, we applied multiple linear regression to analyze associations between the Baidu search index (BSI) and Baidu search rate (BSR) and STD case numbers. In addition, we compared the effects of 4 types of OHISBs and performed time lag cross-correlation analyses to investigate the long-term effect of OHISB. RESULTS The distributions of both STD case numbers and OHISBs presented variability. For case number, syphilis, and gonorrhea, cases were mainly distributed in southeastern and northwestern areas of China, while HIV/AIDS cases were mostly distributed in southwestern areas. For the search query, the eastern region had the highest BSI and BSR, while the western region had the lowest ones. For 4 types of OHISB for 3 diseases, the BSI was positively related to the case number, while the BSR was significantly negatively related to the case number (P<.05). Different categories of OHISB have different effects on STD case numbers. Searches for prevention tended to have a larger impact, while searches for treatment tended to have a smaller impact. Besides, due to the time lag effect, those impacts would increase over time. CONCLUSIONS Our study validated the significant associations between 4 types of OHISBs and STD case numbers, and the impact of OHISBs on STDs became stronger over time. It may provide insights into how to use internet big data to better achieve disease surveillance and prevention goals.
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Affiliation(s)
- Xuan Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Sun H, Zhang Y, Gao G, Wu D. Internet search data with spatiotemporal analysis in infectious disease surveillance: Challenges and perspectives. Front Public Health 2022; 10:958835. [PMID: 36544794 PMCID: PMC9760721 DOI: 10.3389/fpubh.2022.958835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
With the rapid development of the internet, the application of internet search data has been seen as a novel data source to offer timely infectious disease surveillance intelligence. Moreover, the advancements in internet search data, which include rich information at both space and time scales, enable investigators to sufficiently consider the spatiotemporal uncertainty, which can benefit researchers to better monitor infectious diseases and epidemics. In the present study, we present the necessary groundwork and critical appraisal of the use of internet search data and spatiotemporal analysis approaches in infectious disease surveillance by updating the current stage of knowledge on them. The study also provides future directions for researchers to investigate the combination of internet search data with the spatiotemporal analysis in infectious disease surveillance. Internet search data demonstrate a promising potential to offer timely epidemic intelligence, which can be seen as the prerequisite for improving infectious disease surveillance.
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Affiliation(s)
- Hua Sun
- Popsmart Technology (Zhejiang) Co., Ltd, Ningbo, China
| | - Yuzhou Zhang
- Popsmart Technology (Zhejiang) Co., Ltd, Ningbo, China,College of Computer Science and Technology, Zhejiang University, Hangzhou, China,*Correspondence: Yuzhou Zhang
| | - Guang Gao
- Popsmart Technology (Zhejiang) Co., Ltd, Ningbo, China
| | - Dun Wu
- Popsmart Technology (Zhejiang) Co., Ltd, Ningbo, China
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Zhu Z, Zhu X, Zhan Y, Gu L, Chen L, Li X. Development and comparison of predictive models for sexually transmitted diseases-AIDS, gonorrhea, and syphilis in China, 2011-2021. Front Public Health 2022; 10:966813. [PMID: 36091532 PMCID: PMC9450018 DOI: 10.3389/fpubh.2022.966813] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/25/2022] [Indexed: 01/24/2023] Open
Abstract
Background Accurate incidence prediction of sexually transmitted diseases (STDs) is critical for early prevention and better government strategic planning. In this paper, four different forecasting models were presented to predict the incidence of AIDS, gonorrhea, and syphilis. Methods The annual percentage changes in the incidence of AIDS, gonorrhea, and syphilis were estimated by using joinpoint regression. The performance of four methods, namely, the autoregressive integrated moving average (ARIMA) model, Elman neural network (ERNN) model, ARIMA-ERNN hybrid model and long short-term memory (LSTM) model, were assessed and compared. For 1-year prediction, the collected data from 2011 to 2020 were used for modeling to predict the incidence in 2021. For 5-year prediction, the collected data from 2011 to 2016 were used for modeling to predict the incidence from 2017 to 2021. The performance was evaluated based on four indices: mean square error (MSE), mean absolute error (MAE), and mean absolute percentage error (MAPE). Results The morbidities of AIDS and syphilis are on the rise, and the morbidity of gonorrhea has declined in recent years. The optimal ARIMA models were determined: ARIMA(2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(3,1,2)(1,1,2)12 for AIDS, gonorrhea, and syphilis 1-year prediction, respectively; ARIMA (2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(2,1,1)(0,1,0)12 for AIDS, gonorrhea and syphilis 5-year prediction, respectively. For 1-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 23.26, 20.24, 18.34, and 18.63, respectively; For gonorrhea, the MAPEs are 19.44, 18.03, 17.77, and 5.09, respectively; For syphilis, the MAPEs are 9.80, 9.55, 8.67, and 5.79, respectively. For 5-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 12.86, 23.54, 14.74, and 25.43, respectively; For gonorrhea, the MAPEs are 17.07, 17.95, 16.46, and 15.13, respectively; For syphilis, the MAPEs are 21.88, 24.00, 20.18 and 11.20, respectively. In general, the performance ranking of the four models from high to low is LSTM, ARIMA-ERNN, ERNN, and ARIMA. Conclusion The time series predictive models show their powerful performance in forecasting STDs incidence and can be applied by relevant authorities in the prevention and control of STDs.
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Affiliation(s)
| | | | | | | | | | - Xiuyang Li
- Department of Epidemiology & Biostatistics, and Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Comparing Vector-Borne Disease Surveillance and Response in Beijing and the Netherlands. Ann Glob Health 2022; 88:59. [PMID: 35974985 PMCID: PMC9336689 DOI: 10.5334/aogh.3672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Objective(s): Methods: Findings: Conclusions:
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The Presence of Opportunistic Premise Plumbing Pathogens in Residential Buildings: A Literature Review. WATER 2022. [DOI: 10.3390/w14071129] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Opportunistic premise plumbing pathogens (OPPP) are microorganisms that are native to the plumbing environment and that present an emerging infectious disease problem. They share characteristics, such as disinfectant resistance, thermal tolerance, and biofilm formation. The colonisation of domestic water systems presents an elevated health risk for immune-compromised individuals who receive healthcare at home. The literature that has identified the previously described OPPPs (Aeromonas spp., Acinetobacter spp., Helicobacter spp., Legionella spp., Methylobacterium spp., Mycobacteria spp., Pseudomonas spp., and Stenotrophomonas spp.) in residential drinking water systems were systematically reviewed. By applying the Preferred reporting items for systematic reviews and meta-analyses guidelines, 214 studies were identified from the Scopus and Web of Science databases, which included 30 clinical case investigations. Tap components and showerheads were the most frequently identified sources of OPPPs. Sixty-four of these studies detected additional clinically relevant pathogens that are not classified as OPPPs in these reservoirs. There was considerable variation in the detection methods, which included traditional culturing and molecular approaches. These identified studies demonstrate that the current drinking water treatment methods are ineffective against many waterborne pathogens. It is critical that, as at-home healthcare services continue to be promoted, we understand the emergent risks that are posed by OPPPs in residential drinking water. Future research is needed in order to provide consistent data on the prevalence of OPPPs in residential water, and on the incidence of waterborne homecare-associated infections. This will enable the identification of the contributing risk factors, and the development of effective controls.
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Hardhantyo M, Djasri H, Nursetyo AA, Yulianti A, Adipradipta BR, Hawley W, Mika J, Praptiningsih CY, Mangiri A, Prasetyowati EB, Brye L. Quality of National Disease Surveillance Reporting before and during COVID-19: A Mixed-Method Study in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052728. [PMID: 35270431 PMCID: PMC8910184 DOI: 10.3390/ijerph19052728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/12/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023]
Abstract
Background: Global COVID-19 outbreaks in early 2020 have burdened health workers, among them surveillance workers who have the responsibility to undertake routine disease surveillance activities. The aim of this study was to describe the quality of the implementation of Indonesia’s Early Warning and Response Alert System (EWARS) for disease surveillance and to measure the burden of disease surveillance reporting quality before and during the COVID-19 epidemic in Indonesia. Methods: A mixed-method approach was used. A total of 38 informants from regional health offices participated in Focus Group Discussion (FGD) and In-Depth Interview (IDI) for informants from Ministry of Health. The FGD and IDI were conducted using online video communication. Yearly completeness and timeliness of reporting of 34 provinces were collected from the application. Qualitative data were analyzed thematically, and quantitative data were analyzed descriptively. Results: Major implementation gaps were found in poorly distributed human resources and regional infrastructure inequity. National reporting from 2017–2019 showed an increasing trend of completeness (55%, 64%, and 75%, respectively) and timeliness (55%, 64%, and 75%, respectively). However, the quality of the reporting dropped to 53% and 34% in 2020 concomitant with the SARS-CoV2 epidemic. Conclusions: Report completeness and timeliness are likely related to regional infrastructure inequity and the COVID-19 epidemic. It is recommended to increase report capacities with an automatic EWARS application linked systems in hospitals and laboratories.
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Affiliation(s)
- Muhammad Hardhantyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
- Faculty of Health Science, Universitas Respati Yogyakarta, Yogyakarta 55281, Indonesia
- Correspondence:
| | - Hanevi Djasri
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Aldilas Achmad Nursetyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Andriani Yulianti
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - Bernadeta Rachela Adipradipta
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia; (H.D.); (A.A.N.); (A.Y.); (B.R.A.)
| | - William Hawley
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Jennifer Mika
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Catharina Yekti Praptiningsih
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
| | - Amalya Mangiri
- Centers for Disease Control and Prevention, Division of Global Health Protection, Atlanta, GA 30329, USA; (W.H.); (J.M.); (C.Y.P.); (A.M.)
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Du H, Zhu Y, Chen Y, Zhou S, Tong J, Deng Y, Zhang D. The current situation and influencing factors of reporting of Pneumonia of Unknown Etiology (PUE) cases in PUE Surveillance System by clinicians in China: A cross-sectional study. ASIAN PAC J TROP MED 2022. [DOI: 10.4103/1995-7645.340569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhao IY, Ma YX, Yu MWC, Liu J, Dong WN, Pang Q, Lu XQ, Molassiotis A, Holroyd E, Wong CWW. Ethics, Integrity, and Retributions of Digital Detection Surveillance Systems for Infectious Diseases: Systematic Literature Review. J Med Internet Res 2021; 23:e32328. [PMID: 34543228 PMCID: PMC8530254 DOI: 10.2196/32328] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background The COVID-19 pandemic has increased the importance of the deployment of digital detection surveillance systems to support early warning and monitoring of infectious diseases. These opportunities create a “double-edge sword,” as the ethical governance of such approaches often lags behind technological achievements. Objective The aim was to investigate ethical issues identified from utilizing artificial intelligence–augmented surveillance or early warning systems to monitor and detect common or novel infectious disease outbreaks. Methods In a number of databases, we searched relevant articles that addressed ethical issues of using artificial intelligence, digital surveillance systems, early warning systems, and/or big data analytics technology for detecting, monitoring, or tracing infectious diseases according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and further identified and analyzed them with a theoretical framework. Results This systematic review identified 29 articles presented in 6 major themes clustered under individual, organizational, and societal levels, including awareness of implementing digital surveillance, digital integrity, trust, privacy and confidentiality, civil rights, and governance. While these measures were understandable during a pandemic, the public had concerns about receiving inadequate information; unclear governance frameworks; and lack of privacy protection, data integrity, and autonomy when utilizing infectious disease digital surveillance. The barriers to engagement could widen existing health care disparities or digital divides by underrepresenting vulnerable and at-risk populations, and patients’ highly sensitive data, such as their movements and contacts, could be exposed to outside sources, impinging significantly upon basic human and civil rights. Conclusions Our findings inform ethical considerations for service delivery models for medical practitioners and policymakers involved in the use of digital surveillance for infectious disease spread, and provide a basis for a global governance structure. Trial Registration PROSPERO CRD42021259180; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259180
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Affiliation(s)
- Ivy Y Zhao
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ye Xuan Ma
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Man Wai Cecilia Yu
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jia Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wei Nan Dong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Qin Pang
- Department of Information Technology, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xiao Qin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Alex Molassiotis
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Eleanor Holroyd
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Chi Wai William Wong
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Department of Family Medicine and Primary Care, University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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Hu X, Zhou W, Zhang L, Lv J, Yan B, Zhou Y, Hu W, Dong Y, Chen B, Liu M, Cao J, Xu F, Li L. Implementing sequencing-based surveillance in developing countries: findings from a pilot rollout for hepatitis A in China. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1119. [PMID: 34430560 PMCID: PMC8350710 DOI: 10.21037/atm-21-1193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/10/2021] [Indexed: 01/15/2023]
Abstract
Background The emergence of SARS-Cov2 variants has highlighted the need to implement sequencing-based surveillance in developing countries for early response to mutant viruses of concern. However, limited information on how to implement sequencing-based surveillance is available, and the feasibility and performance of this new type of surveillance are still in question. Methods To understand the challenges with the implementation and to promote sequencing-based surveillance, we reported findings from a pilot for hepatitis A (HepA) in five sentinel provinces in China as an example of sequencing-based surveillance implementation. The performance of the surveillance system was evaluated by indicators related to acceptability, data quality, simplicity, utility, and timeliness. We use a scale from 1 to 3 was used to provide a score for each aspect. Results During the pilot, 306 cases of HepA were reported, and 49.79% of samples were available for sequencing. Eleven genomic clusters were found, of which seven clusters were potentially related to a foodborne outbreak oyster based on identical viral sequence and epidemiologic investigations. The greatest strength of the system was its simplicity (Score: 2.63). The acceptability (Score: 2.0) and utility (Score: 2.33) were modest, but data quality (Score: 1.75) and timeliness (Score: 1.75) were the main challenges. Conclusions Overall, the system performed satisfactorily and proved to be useful for virological characterization of cases and early outbreak detection, with a great potential for scale-up. Further efforts are required to address financial and human resource constraints and inadequate support among physicians. Education should be given to health care professionals to improve the data quality. The establishment of decentralized surveillance networks can be an approach to improve timeliness for emerging infections.
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Affiliation(s)
- Xiaotong Hu
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wenting Zhou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Zhang
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jingjing Lv
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Bingyu Yan
- Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yang Zhou
- Zhejiang Provincial Center for Disease Control and Prevention, Dept. of Immunization Program, Division of Immunization Surveillance & Evaluation, Hangzhou, China
| | - Weijun Hu
- Immunization Program Department, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Yuanyuan Dong
- Immunization Program Department, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Biyu Chen
- Hainan Center for Disease Control and Prevention, Haikou, China
| | - Man Liu
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Jingyuan Cao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fujie Xu
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China.,China Country Office, Bill& Melinda Gates Foundation, Beijing, China
| | - Lanjuan Li
- The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China
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Gontariuk M, Krafft T, Rehbock C, Townend D, Van der Auwermeulen L, Pilot E. The European Union and Public Health Emergencies: Expert Opinions on the Management of the First Wave of the COVID-19 Pandemic and Suggestions for Future Emergencies. Front Public Health 2021; 9:698995. [PMID: 34490183 PMCID: PMC8417533 DOI: 10.3389/fpubh.2021.698995] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The first wave of the coronavirus SARS-COV-2 pandemic has revealed a fragmented governance within the European Union (EU) to tackle public health emergencies. This qualitative study aims: 1) to understand the current EU position within the field of public health emergencies taking the case of the COVID-19 as an example by comparing and contrasting experiences from EU institutions and experts from various EU Member States at the beginning of the pandemic; and, 2) to identify and to formulate future EU pandemic strategies and actions based on experts' opinions. Methods: Eighteen semi-structured interviews were conducted with public health experts from various European Member States and European Commission officials from May 2020 until August 2020. The transcripts were analyzed by Thematic Content Analysis (TCA), mainly a manifest content analysis. Results: This study demonstrated that the limited EU mandate in health hinders proper actions to prevent and tackle infectious disease outbreaks, such as the COVID-19 pandemic. The results showed that this limitation significantly impacted the ECDC, as the Member States' competence did not allow the agency to have more capacity. The European Commission has fulfilled its role of coordinating and supporting the Member States by facilitating networks and information exchange. However, EU intra- and inter-communication need further improvement. Although diverse EU instruments and mechanisms were found valid, their implementation needed to be faster and more efficient. The results pointed out that underlying political challenges in EU decision-making regarding health emergencies hinder the aligned response. It was stated that the Member States were not prepared, and due to the restriction of their mandate, EU institutions could not enforce binding guidelines. Additionally, the study explored future EU pandemic strategies and actions. Both, EU institutions and national experts suggested similar and clear recommendations regarding the ECDC, the investment, and future harmonized preparedness tools. Conclusion: The complex politics of public health at the EU level have led to the fragmentation of its governance for effective pandemic responses. This ongoing pandemic has shed light on the fragility of the political and structural systems in Europe in public health emergencies. Health should be of high importance in the political agenda, and robust health reforms at the local, regional, national, and EU levels are highly recommended.
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Affiliation(s)
- Marie Gontariuk
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Thomas Krafft
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Cassandra Rehbock
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - David Townend
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Eva Pilot
- Department of Health, Ethics and Society, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Zeng W, Li G, Turbat V, Hu G, Ahn H, Shen J. Optimizing preventive medicine to bridge the gap between clinical medicine and public health for disease control in China: A lesson from COVID-19. Prev Med 2021; 143:106324. [PMID: 33186625 PMCID: PMC7654361 DOI: 10.1016/j.ypmed.2020.106324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/05/2020] [Accepted: 11/07/2020] [Indexed: 10/25/2022]
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) highlights the importance of early detection of disease outbreaks, taking swift and decisive public health actions, and strengthening public health systems. Preventive medicine, as a specialty of medicine, trains students on both clinical medicine and public health and is of a particular need in battling against this pandemic. In China, preventive medicine plays a unique role in the disease control system where preventive medicine graduates represent a large share of the workforce. However, there is a shortage of qualified staff in the Chinese disease control system. The reasons for such a shortage are multifaceted. From the human resource perspective, the undergraduate preventive medicine curricula and exclusive public health training for preventive medicine postgraduates limit their clinical capacities. A series of disease control and public health education reforms may further incapacitate preventive medicine graduates' clinical skills, unintentionally widening the gap between public health and clinical medicine and thus posing threats to effective disease detection and control. The authors call for reforming and optimizing preventive medicine to bridge the gap between clinical medicine and public health by strengthening curricula on clinical medicine, diversifying curricula on public health, enhancing preventive medicine residency programs, and rectifying regulations that restrict preventive medicine graduates from practicing curative medicine.
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Affiliation(s)
- Wu Zeng
- Department of International Health, School of Nursing & Health Studies, Georgetown University, Washington, DC, USA.
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China; China Hospital Development Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Vincent Turbat
- Department of International Health, School of Nursing & Health Studies, Georgetown University, Washington, DC, USA
| | - Guoqing Hu
- XiangYa School of Public Health, Central South University, Changsha, China
| | - Haksoon Ahn
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Jie Shen
- China Hospital Development Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Exploring Vector-Borne Disease Surveillance and Response Systems in Beijing, China: A Qualitative Study from the Health System Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228512. [PMID: 33212908 PMCID: PMC7698447 DOI: 10.3390/ijerph17228512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022]
Abstract
Background: Climate change may contribute to higher incidence and wider geographic spread of vector borne diseases (VBDs). Effective monitoring and surveillance of VBDs is of paramount importance for the prevention of and timely response to outbreaks. Although international regulations exist to support this, barriers and operational challenges within countries hamper efficient monitoring. As a first step to optimise VBD surveillance and monitoring, it is important to gain a deeper understanding of system characteristics and experiences in to date non-endemic regions at risk of becoming endemic in the future. Therefore, this study qualitatively analyses the nature and flexibility of VBD surveillance and response in Beijing. Methods: In this qualitative study, eleven experts working in Beijing’s vector-borne diseases surveillance and response system were interviewed about vector-borne disease surveillance, early warning, response, and strengths and weaknesses of the current approach. Results: Vector-borne disease surveillance occurs using passive syndromic surveillance and separate vector surveillance. Public health authorities use internet reporting networks to determine vector-borne disease risk across Beijing. Response toward a vector-borne disease outbreak is uncommon in this setting due to the currently low occurrence of outbreaks. Conclusions: A robust network of centralised institutions provides the continuity and flexibility needed to adapt and manage possible vector-borne disease threats. Opportunities exist for population-based health promotion and the integration of environment and climate monitoring in vector-borne disease surveillance.
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Li Y, Lu C, Liu Y. Medical Insurance Information Systems in China: Mixed Methods Study. JMIR Med Inform 2020; 8:e18780. [PMID: 32673209 PMCID: PMC7492979 DOI: 10.2196/18780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/06/2020] [Accepted: 06/03/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Since the People's Republic of China (PRC), or China, established the basic medical insurance system (MIS) in 1998, the medical insurance information systems (MIISs) in China have effectively supported the operation of the MIS through several phases of development; the phases included a stand-alone version, the internet, and big data. In 2018, China's national medical security systems were integrated, while MIISs were facing reconstruction. We summarized China's experience in medical insurance informatization over the past 20 years, aiming to provide a reference for the building of a new basic MIS for China and for developing countries. OBJECTIVE This paper aims to sort out medical insurance informatization policies throughout the years, use questionnaires to determine the status quo of provincial MIIS-building in China and the relevant policies, provide references and suggestions for the top-level design and implementation of the information systems in the transitional period of China's MIS reform, and provide a reference for the building of MIISs in developing countries. METHODS We conducted policy analysis by collecting the laws, regulations, and policy documents-issued from 1998 to 2020-on China's medical insurance and its informatization; we also analyzed the US Health Insurance Portability and Accountability Act and other relevant policies. We conducted a questionnaire survey by sending out questionnaires to 31 Chinese, provincial, medical security bureaus to collect information about network links, system functions, data exchange, standards and specifications, and building modes, among other items. We conducted a literature review by searching for documents about relevant laws and policies, building methods, application results, and other documents related to MIISs; we conducted searches using PubMed, Elsevier, China National Knowledge Infrastructure, and other major literature databases. We conducted telephone interviews to verify the results of questionnaires and to understand the focus issues concerning the building of China's national MIISs during the period of integration and transition of China's MIS. RESULTS In 74% (23/31) of the regions in China, MIISs were networked through dedicated fiber optic lines. In 65% (20/31) of the regions in China, MIISs supported identity recognition based on both ID cards and social security cards. In 55% (17/31) of the regions in China, MIISs at provincial and municipal levels were networked and have gathered basic medical insurance data, whereas MIISs were connected to health insurance companies in 35% (11/31) of the regions in China. China's MIISs are comprised of 11 basic functional modules, among which the modules of business operation, transregional referral, reimbursement, and monitoring systems are widely applied. MIISs in 83% (20/24) of Chinese provinces have stored data on coverage, payment, and settlement compensation of medical insurance. However, in terms of data security and privacy protection, pertinent policies are absent and data utilization is not in-depth enough. Respondents to telephone interviews universally reflected on the following issues and suggestions: in the period of integration and transition of MISs, close attention should be paid to the top-level design, and repeated investment should be avoided for the building of MIISs; MIISs should be adapted to the health care reform, and efforts should be made to strengthen the informatization support for the reform of payment methods; and MIISs should be adapted for the widespread application of mobile phones and should provide insured persons with more self-service functions. CONCLUSIONS In the future, the building of China's basic MIISs should be deployed at the national, provincial, prefectural, and municipal levels on a unified basis. Efforts should be made to strengthen the development of standard codes, data exchange, and data utilization. Work should be done to formulate the rules and regulations for security and privacy protection and to balance the right to be informed with the mining and utilization of big data. Efforts should be made to intensify the interconnectivity between MISs and other health systems and to strengthen the application of medical insurance information in public health monitoring and early warning systems; this would ultimately improve the degree of trust from stakeholders, including individuals, medical service providers, and public health institutions, in the basic MIISs.
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Affiliation(s)
- Yazi Li
- The Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Chunji Lu
- The Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Liu
- The Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
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15
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Cao Y, Shan J, Gong Z, Kuang J, Gao Y. Status and Challenges of Public Health Emergency Management in China Related to COVID-19. Front Public Health 2020; 8:250. [PMID: 32574311 PMCID: PMC7273973 DOI: 10.3389/fpubh.2020.00250] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/20/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed at exploring the current development status and problems of health emergency management in China and provides a reference for improving, constructing, and implementing a public health emergency management system. Methods: Cases of major and severe public health emergencies in China were analyzed along with the relevant health emergency management literature from the last decade. Results: China's health emergency system gradually improved during the study period. Monitoring and early warning systems were significantly strengthened. Material reserves and transfer management systems were constantly improved. However, the operational efficiency of command and decision systems was low, versatile talent accounted for a relatively small proportion, and emergency fund investment was insufficient. Conclusion: Constructing a sound and scientific emergency management mechanism is a lengthy and challenging process. To establish an emergency management mode for public health emergencies that is appropriate for China, it is necessary to solve existing problems and learn from the models and experiences of developed foreign countries.
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Affiliation(s)
- Yulong Cao
- Department of Hospital-Acquired Infection Control, Peking University People's Hospital, Beijing, China
| | - Jiao Shan
- Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, Beijing, China
| | - Zhizhong Gong
- School of Public Policy & Management, Tsinghua University, Beijing, China
| | - Jiqiu Kuang
- Department of Hospital-Acquired Infection Control, Peking University People's Hospital, Beijing, China
| | - Yan Gao
- Department of Hospital-Acquired Infection Control, Peking University People's Hospital, Beijing, China
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16
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Affiliation(s)
- Gabriel M Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Admistrative Region, China.
| | - Kathy Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Admistrative Region, China
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17
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Hantrakun V, Kongyu S, Klaytong P, Rongsumlee S, Day NPJ, Peacock SJ, Hinjoy S, Limmathurotsakul D. Clinical Epidemiology of 7126 Melioidosis Patients in Thailand and the Implications for a National Notifiable Diseases Surveillance System. Open Forum Infect Dis 2019; 6:ofz498. [PMID: 32083145 PMCID: PMC7020769 DOI: 10.1093/ofid/ofz498] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/17/2019] [Indexed: 12/14/2022] Open
Abstract
Background National notifiable diseases surveillance system (NNDSS) data in developing countries are usually incomplete, yet the total number of fatal cases reported is commonly used in national priority-setting. Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is largely underrecognized by policy-makers due to the underreporting of fatal cases via the NNDSS. Methods Collaborating with the Epidemiology Division (ED), Ministry of Public Health (MoPH), we conducted a retrospective study to determine the incidence and mortality of melioidosis cases already identified by clinical microbiology laboratories nationwide. A case of melioidosis was defined as a patient with any clinical specimen culture positive for B. pseudomallei. Routinely available microbiology and hospital databases of secondary care and tertiary care hospitals, the national death registry, and NNDSS data were obtained for analysis. Results A total of 7126 culture-confirmed melioidosis patients were identified from 2012 to 2015 in 60 hospitals countrywide. The total number of cases diagnosed in Northeast, Central, South, East, North, and West Thailand were 5475, 536, 374, 364, 358, and 19 cases, respectively. The overall 30-day mortality was 39% (2805/7126). Only 126 (4%) deaths were reported to the NNDSS. Age, presentation with bacteremia and pneumonia, prevalence of diabetes, and 30-day mortality differed by geographical region (all P < .001). The ED at MoPH has agreed to include the findings of our study in the next annual report of the NNDSS. Conclusions Melioidosis is an important cause of death in Thailand nationwide, and its clinical epidemiology may be different by region. In developing countries, NNDSS data can be supplemented by integrating information from readily available routine data sets.
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Affiliation(s)
- Viriya Hantrakun
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Somkid Kongyu
- Epidemiology Division, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Preeyarach Klaytong
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sittikorn Rongsumlee
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nicholas P J Day
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom
| | - Sharon J Peacock
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Soawapak Hinjoy
- Epidemiology Division, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.,Office of International Cooperation, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, Old Road Campus, University of Oxford, Oxford, United Kingdom.,Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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18
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Ye X, Liu J, Yi Z. Trends in the Epidemiology of Sexually Transmitted Disease, Acquired Immune Deficiency Syndrome (AIDS), Gonorrhea, and Syphilis, in the 31 Provinces of Mainland China. Med Sci Monit 2019; 25:5657-5665. [PMID: 31361737 PMCID: PMC6685330 DOI: 10.12659/msm.915732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 03/21/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND This study aimed to investigate trends in the epidemiology of the leading sexually transmitted diseases (STDs), acquired immune deficiency syndrome (AIDS), gonorrhea, and syphilis, in the 31 provinces of mainland China. MATERIAL AND METHODS This retrospective study analyzed the incidence data of STDs from official reports in China between 2004 and 2016. The grey model first order one variable, or GM (1,1), time series forecasting model for epidemiological studies predicted the incidence of STDs based on the annual incidence reports from 31 Chinese mainland provinces. Hierarchical cluster analysis was used to group the prevalence of STDs within each province. RESULTS The prediction accuracy of the GM (1,1) model was high, based on data during the 13 years between 2004 and 2016. The model predicted that the incidence rates of AIDS and syphilis would continue to increase over the next two years. Cluster analysis showed that 31 provinces could be classified into four clusters according to similarities in the incidence of STDs. Group A (Sinkiang Province) had the highest reported prevalence of syphilis. Group B included provinces with a higher incidence of gonorrhea, mainly in the southeast coast of China. Group C consisted of southwest provinces with a higher incidence of AIDS. CONCLUSIONS The GM (1,1) model was predictive for the incidence of STDs in 31 provinces in China. The predicted incidence rates of AIDS and syphilis showed an upward trend. Regional distribution of the major STDs highlights the need for targeted prevention and control programs.
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Affiliation(s)
- Xuechen Ye
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China
| | - Jie Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China
| | - Zhe Yi
- Department of Prothodontics, School of Stomatology, China Medical University, Shenyang, Liaoning, P.R. China
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19
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Miao N, Zheng H, Sun X, Shen L, Wang F, Cui F, Yin Z, Zhang G, Wang F. Enhanced sentinel surveillance for hepatitis B infection in 200 counties in China, 2013-2016. PLoS One 2019; 14:e0215580. [PMID: 31013293 PMCID: PMC6478295 DOI: 10.1371/journal.pone.0215580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 04/05/2019] [Indexed: 11/30/2022] Open
Abstract
Hepatitis B infection is a major public health challenge in China. Clinicians report hepatitis B cases to the National Notifiable Disease Reporting System. A 2007 study found that only 35% of hepatitis B cases that had been reported as acute infections met a rigorous case definition of acute hepatitis B, implying overreporting of new-onset infections. To increase the accuracy of reported acute hepatitis B infections, in 2013, we initiated enhanced hepatitis B surveillance in 200 sentinel counties. We compared incidences and proportions of different stages of hepatitis B infection before and after implementation of enhanced surveillance. We checked the accuracy of reported data and re-diagnosed hepatitis B cases reported as acute infection according to the enhanced diagnostic criteria and calculated positive predictive value(PPV) of acute hepatitis B reports. Compared to previous surveillance, with enhanced surveillance, the incidence of reported acute hepatitis B infection decreased by 53.7% and the proportion of unclassified hepatitis B infection was reduced by 79.4%. From 2013 to 2016, the PPV of acute hepatitis B increased (55.8% to 71.0%); PPV rates in western and rural areas were lower than in other areas. We recommend enhancing hepatitis B surveillance nationwide using these new standards, and raising western and rural areas clinicians’ diagnostic and reporting capacity, and ensuring sufficient resources for IgM anti-HBc testing.
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Affiliation(s)
- Ning Miao
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Hui Zheng
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Xiaojin Sun
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Liping Shen
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Feng Wang
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Fuqiang Cui
- School of Public Health, Peking University, Beijing, China
| | - Zundong Yin
- Chinese Center for Disease Control and Prevention, Beijing,China
| | - Guomin Zhang
- Chinese Center for Disease Control and Prevention, Beijing,China
- * E-mail: , (GZ); (FW)
| | - Fuzhen Wang
- Chinese Center for Disease Control and Prevention, Beijing,China
- * E-mail: , (GZ); (FW)
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20
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Gous NM, Onyebujoh PC, Abimiku A, Macek C, Takle J. The role of connected diagnostics in strengthening regional, national and continental African disease surveillance. Afr J Lab Med 2018; 7:775. [PMID: 30568899 PMCID: PMC6295790 DOI: 10.4102/ajlm.v7i2.775] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/22/2018] [Indexed: 11/01/2022] Open
Affiliation(s)
- Natasha M Gous
- SystemOne, LLC, Johannesburg, South Africa.,SystemOne, LLC, Springfield, Massachusetts, United States
| | - Philip C Onyebujoh
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | - Alash'le Abimiku
- International Research Center of Excellence, Institute of Human Virology, Abuja, Nigeria
| | | | - Jeff Takle
- SystemOne, LLC, Johannesburg, South Africa
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21
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Dhewantara PW, Mamun AA, Zhang WY, Yin WW, Ding F, Guo D, Hu W, Costa F, Ko AI, Soares Magalhães RJ. Epidemiological shift and geographical heterogeneity in the burden of leptospirosis in China. Infect Dis Poverty 2018; 7:57. [PMID: 29866175 PMCID: PMC5985562 DOI: 10.1186/s40249-018-0435-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/27/2018] [Indexed: 01/16/2023] Open
Abstract
Background Leptospirosis morbidity and mortality rates in China have decreased since the 2000s. Further analyses of the spatiotemporal and demographic changes occurring in the last decade and its implication on estimates of disease burden are required to inform intervention strategies. In this study, we quantified the epidemiological shift and geographical heterogeneity in the burden of leptospirosis during 2005–2015 in China. Methods We used reported leptospirosis case data from 1st January 2005 to 31st of December 2015 that routinely collected by the China Information System for Disease Control and Prevention (CISDCP) to analyze the epidemiological trend and estimate the burden in terms of disability-adjusted life-years (DALYs) over space, time, and demographical groups. Results A total of 7763 cases were reported during 2005–2015. Of which, 2403 (31%) cases were the laboratory-confirmed case. Since 2005, the notified incidence rate was gradually decreased (P < 0.05) and it was relatively stable during 2011–2015 (P > 0.05). During 2005–2015, we estimated a total of 10 313 DALYs were lost due to leptospirosis comprising a total of 1804 years-lived with disability (YLDs) and 8509 years-life lost (YLLs). Males had the highest burden of disease (7149 DALYs) compared to females (3164 DALYs). The highest burden estimate was attributed to younger individuals aged 10–19 years who lived in southern provinces of China. During 2005–2015, this age group contributed to approximately 3078 DALYs corresponding to 30% of the total DALYs lost in China. Yet, our analysis indicated a declining trend in burden estimates (P < 0.001) since 2005 and remained relatively low during 2011–2015. Low burden estimates have been identified in the endemic regions where infections principally distributed. Most of the changes in DALY estimates were driven by changes in YLLs. Conclusions In the last 11-years, the burden estimates of leptospirosis have shown a declining trend across the country; however, leptospirosis should not be neglected as it remains an important zoonotic disease and potentially affecting the young and productive population in economically less-developed provinces in southern of China. In addition, while in the last five years the incidence has been reported at very low-level, this might not reflect the true incidence of leptospirosis. Strengthened surveillance in the endemic regions is, hence, substantially required to capture the actual prevalence to better control leptospirosis in China. Electronic supplementary material The online version of this article (10.1186/s40249-018-0435-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pandji Wibawa Dhewantara
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia. .,National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, Unit of Vector-borne Diseases Control, Pangandaran, West Java, 46396, Indonesia.
| | - Abdullah A Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, 4068, Australia
| | - Wen-Yi Zhang
- Center for Disease Surveillance and Research, Institute of Disease Control and Prevention of PLA, Beijing, 100071, People's Republic of China.
| | - Wen-Wu Yin
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Fan Ding
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Danhuai Guo
- Scientific Data Center, Computer Network Information Center, Chinese Academy of Sciences, Beijing, 100190, People's Republic of China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
| | - Federico Costa
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, 40296-710, Brazil.,Instituto da Saúde Coletiva, Federal University of Bahia (UFBA), Salvador, BA, 40110-040, Brazil.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA
| | - Albert Icksang Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA
| | - Ricardo J Soares Magalhães
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia.,Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, 4101, Australia
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22
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Hinjoy S, Hantrakun V, Kongyu S, Kaewrakmuk J, Wangrangsimakul T, Jitsuronk S, Saengchun W, Bhengsri S, Akarachotpong T, Thamthitiwat S, Sangwichian O, Anunnatsiri S, Sermswan RW, Lertmemongkolchai G, Sitthidet Tharinjaroen C, Preechasuth K, Udpaun R, Chuensombut P, Waranyasirikul N, Anudit C, Narenpitak S, Jutrakul Y, Teparrukkul P, Teerawattanasook N, Thanvisej K, Suphan A, Sukbut P, Ploddi K, Sirichotirat P, Chiewchanyon B, Rukseree K, Hongsuwan M, Wongsuwan G, Sunthornsut P, Wuthiekanun V, Sachaphimukh S, Wannapinij P, Chierakul W, Chewapreecha C, Thaipadungpanit J, Chantratita N, Korbsrisate S, Taunyok A, Dunachie S, Palittapongarnpim P, Sirisinha S, Kitphati R, Iamsirithaworn S, Chaowagul W, Chetchotisak P, Whistler T, Wongratanacheewin S, Limmathurotsakul D. Melioidosis in Thailand: Present and Future. Trop Med Infect Dis 2018; 3:38. [PMID: 29725623 PMCID: PMC5928800 DOI: 10.3390/tropicalmed3020038] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/21/2018] [Indexed: 12/29/2022] Open
Abstract
A recent modelling study estimated that there are 2800 deaths due to melioidosis in Thailand yearly. The Thailand Melioidosis Network (formed in 2012) has been working closely with the Ministry of Public Health (MoPH) to investigate and reduce the burden of this disease. Based on updated data, the incidence of melioidosis is still high in Northeast Thailand. More than 2000 culture-confirmed cases of melioidosis are diagnosed in general hospitals with microbiology laboratories in this region each year. The mortality rate is around 35%. Melioidosis is endemic throughout Thailand, but it is still not uncommon that microbiological facilities misidentify Burkholderia pseudomallei as a contaminant or another organism. Disease awareness is low, and people in rural areas neither wear boots nor boil water before drinking to protect themselves from acquiring B. pseudomallei. Previously, about 10 melioidosis deaths were formally reported to the National Notifiable Disease Surveillance System (Report 506) each year, thus limiting priority setting by the MoPH. In 2015, the formally reported number of melioidosis deaths rose to 112, solely because Sunpasithiprasong Hospital, Ubon Ratchathani province, reported its own data (n = 107). Melioidosis is truly an important cause of death in Thailand, and currently reported cases (Report 506) and cases diagnosed at research centers reflect the tip of the iceberg. Laboratory training and communication between clinicians and laboratory personnel are required to improve diagnosis and treatment of melioidosis countrywide. Implementation of rapid diagnostic tests, such as a lateral flow antigen detection assay, with high accuracy even in melioidosis-endemic countries such as Thailand, is critically needed. Reporting of all culture-confirmed melioidosis cases from every hospital with a microbiology laboratory, together with final outcome data, is mandated under the Communicable Diseases Act B.E.2558. By enforcing this legislation, the MoPH could raise the priority of this disease, and should consider implementing a campaign to raise awareness and melioidosis prevention countrywide.
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Affiliation(s)
- Soawapak Hinjoy
- Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.H.); (S.K.)
| | - Viriya Hantrakun
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Somkid Kongyu
- Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand; (S.H.); (S.K.)
| | - Jedsada Kaewrakmuk
- Faculty of Science, Prince of Songkla University, Songkla 90110, Thailand;
| | - Tri Wangrangsimakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK;
| | - Siroj Jitsuronk
- Faculty of Medicine, Prince of Songkla University, Songkla, 90110, Thailand;
| | - Weerawut Saengchun
- Department of Clinical Pathology, Chiang Rai Prachanukroh Hospital, Chiang Rai 57000, Thailand;
| | - Saithip Bhengsri
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand; (S.B.); (T.A.); (S.T.); (O.S.); (T.W.)
| | - Thantapat Akarachotpong
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand; (S.B.); (T.A.); (S.T.); (O.S.); (T.W.)
| | - Somsak Thamthitiwat
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand; (S.B.); (T.A.); (S.T.); (O.S.); (T.W.)
| | - Ornuma Sangwichian
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand; (S.B.); (T.A.); (S.T.); (O.S.); (T.W.)
| | - Siriluck Anunnatsiri
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (S.A.); (R.W.S.); (P.C.); (S.W.)
| | - Rasana W Sermswan
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (S.A.); (R.W.S.); (P.C.); (S.W.)
| | - Ganjana Lertmemongkolchai
- The Centre for Research & Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Chayada Sitthidet Tharinjaroen
- Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (C.S.T.); (K.P.); (R.U.)
| | - Kanya Preechasuth
- Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (C.S.T.); (K.P.); (R.U.)
| | - Ratchadaporn Udpaun
- Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand; (C.S.T.); (K.P.); (R.U.)
| | - Poomin Chuensombut
- Department of Clinical Pathology, Chiangkham Hospital, Phayao, 56110 Thailand;
| | - Nisarat Waranyasirikul
- Department of Clinical Pathology, Somdejphrajaotaksin Maharaj Hospital, Tak 63000, Thailand;
| | - Chanihcha Anudit
- Department of Clinical Pathology, Uthai Thani Hospital, Uthai Thani 61000, Thailand;
| | - Surapong Narenpitak
- Department of Internal Medicine, Udon Thani Hospital, Udon Thani 41000, Thailand;
| | - Yaowaruk Jutrakul
- Department of Clinical Pathology, Udon Thani Hospital, Udon Thani 41000, Thailand;
| | - Prapit Teparrukkul
- Department of Internal Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand; (P.T.); (W.C)
| | - Nittaya Teerawattanasook
- Department of Clinical Pathology, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand;
| | - Kittisak Thanvisej
- Department of Internal Medicine, Nakhon Panom Hospital, Nakhon Panom 48000, Thailand;
| | - Alisa Suphan
- Ubon Ratchathani Provincial Public Health Office, Ubon Ratchathani 34000, Thailand;
| | - Punchawee Sukbut
- Mukdahan Provincial Public Health Office, Mukdahan 49000, Thailand;
| | - Kritchavat Ploddi
- The Office of Disease Prevention and Control 8, Udon Thani 41000, Thailand;
| | - Poolsri Sirichotirat
- The Office of Disease Prevention and Control 10, Ubon Ratchathani 34000, Thailand;
| | | | | | - Maliwan Hongsuwan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Gumphol Wongsuwan
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Pornpan Sunthornsut
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Vanaporn Wuthiekanun
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Sandy Sachaphimukh
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Prapass Wannapinij
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Wirongrong Chierakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Claire Chewapreecha
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Janjira Thaipadungpanit
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
| | - Narisara Chantratita
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Sunee Korbsrisate
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Apichai Taunyok
- Department of Infectious Diseases & Immunology, Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA;
| | - Susanna Dunachie
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK;
| | - Prasit Palittapongarnpim
- National Science and Technology Development Agency (NSTDA), Pathum Thani 12120, Thailand;
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand;
| | - Stitaya Sirisinha
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand;
| | - Rungrueng Kitphati
- Institute for Urban Disease Control and Prevention, Department of Disease Control, Ministry of Public Health, Bangkok 10220, Thailand;
| | - Sopon Iamsirithaworn
- Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand;
| | - Wipada Chaowagul
- Department of Internal Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand; (P.T.); (W.C)
| | - Ploenchan Chetchotisak
- Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (S.A.); (R.W.S.); (P.C.); (S.W.)
| | - Toni Whistler
- Division of Global Health Protection, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi 11000, Thailand; (S.B.); (T.A.); (S.T.); (O.S.); (T.W.)
| | | | - Direk Limmathurotsakul
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand; (V.H.); (T.W.); (M.H.); (G.W.); (P.S.); (V.W.); (S.S.); (P.W.); (W.C.); (C.C.); (J.T.); (N.C)
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ, UK;
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