1
|
Geteri F, Dawa J, Gachohi J, Kadivane S, Humwa F, Okunga E. A recent history of disease outbreaks in Kenya, 2007-2022: Findings from routine surveillance data. BMC Res Notes 2024; 17:309. [PMID: 39407228 PMCID: PMC11481684 DOI: 10.1186/s13104-024-06930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 09/02/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Africa reports the highest number of outbreaks globally, accounting for 39% of all outbreaks in 2022. The Integrated Disease Surveillance and Response strategy in Kenya ensures the reporting of outbreaks up to the national level. We present a summary of the burden of reported disease outbreaks in Kenya, 2007-2022. METHODS We reviewed historical surveillance data, 2007-2022, summarized the annual caseload and deaths of reported outbreaks, and classified the outbreaks into 3 categories, that is high, moderate, and low burden. A nested Poisson regression model was fit to determine whether there was a significant increase in the number of diseases and counties reporting outbreaks over time. RESULTS Twenty-three diseases were reported. COVID-19, cholera, epidemic malaria, kala-azar, and measles were associated with a high disease burden. The highest number of diseases reported in a single year was 10. We observed an increase in the number of outbreaks over time (IRR = 1.26, 95% CI [1.22-1.29], p < 0.001), and an increase in the number of counties reporting outbreaks over time (r = 0.97, p < 0.001). CONCLUSION There was an increase in the frequency and geographic occurrence of outbreaks. The differences in outbreak occurrence between counties necessitate targeted and enhanced preventive, preparedness, and response interventions at the sub-national level to reduce the burden of outbreaks.
Collapse
Affiliation(s)
- Farida Geteri
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi City, Kenya.
| | - Jeanette Dawa
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi City, Kenya
| | - John Gachohi
- Washington State University - Global Health Programs, Nairobi City, Kenya
| | - Samuel Kadivane
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi City, Kenya
| | - Felix Humwa
- Africa Society for Laboratory Science, Addis Ababa, Ethiopia
| | - Emmanuel Okunga
- Disease Surveillance and Response Unit, Ministry of Health, Nairobi City, Kenya
| |
Collapse
|
2
|
Kaburi BB, Harries M, Hauri AM, Kenu E, Wyss K, Silenou BC, Klett-Tammen CJ, Ressing C, Awolin J, Lange B, Krause G. Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review. BMC Public Health 2024; 24:1731. [PMID: 38943132 PMCID: PMC11214246 DOI: 10.1186/s12889-024-19205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.
Collapse
Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- PhD Programme "Epidemiology" Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bernard Chawo Silenou
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Cordula Ressing
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Jannis Awolin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| |
Collapse
|
3
|
Conteddu K, English HM, Byrne AW, Amin B, Griffin LL, Kaur P, Morera-Pujol V, Murphy KJ, Salter-Townshend M, Smith AF, Ciuti S. A scoping review on bovine tuberculosis highlights the need for novel data streams and analytical approaches to curb zoonotic diseases. Vet Res 2024; 55:64. [PMID: 38773649 PMCID: PMC11110237 DOI: 10.1186/s13567-024-01314-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 03/20/2024] [Indexed: 05/24/2024] Open
Abstract
Zoonotic diseases represent a significant societal challenge in terms of their health and economic impacts. One Health approaches to managing zoonotic diseases are becoming more prevalent, but require novel thinking, tools and cross-disciplinary collaboration. Bovine tuberculosis (bTB) is one example of a costly One Health challenge with a complex epidemiology involving humans, domestic animals, wildlife and environmental factors, which require sophisticated collaborative approaches. We undertook a scoping review of multi-host bTB epidemiology to identify trends in species publication focus, methodologies, and One Health approaches. We aimed to identify knowledge gaps where novel research could provide insights to inform control policy, for bTB and other zoonoses. The review included 532 articles. We found different levels of research attention across episystems, with a significant proportion of the literature focusing on the badger-cattle-TB episystem, with far less attention given to tropical multi-host episystems. We found a limited number of studies focusing on management solutions and their efficacy, with very few studies looking at modelling exit strategies. Only a small number of studies looked at the effect of human disturbances on the spread of bTB involving wildlife hosts. Most of the studies we reviewed focused on the effect of badger vaccination and culling on bTB dynamics with few looking at how roads, human perturbations and habitat change may affect wildlife movement and disease spread. Finally, we observed a lack of studies considering the effect of weather variables on bTB spread, which is particularly relevant when studying zoonoses under climate change scenarios. Significant technological and methodological advances have been applied to bTB episystems, providing explicit insights into its spread and maintenance across populations. We identified a prominent bias towards certain species and locations. Generating more high-quality empirical data on wildlife host distribution and abundance, high-resolution individual behaviours and greater use of mathematical models and simulations are key areas for future research. Integrating data sources across disciplines, and a "virtuous cycle" of well-designed empirical data collection linked with mathematical and simulation modelling could provide additional gains for policy-makers and managers, enabling optimised bTB management with broader insights for other zoonoses.
Collapse
Affiliation(s)
- Kimberly Conteddu
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland.
| | - Holly M English
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Andrew W Byrne
- Department of Agriculture, Food and the Marine, One Health Scientific Support Unit, Dublin, Ireland
| | - Bawan Amin
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Laura L Griffin
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Prabhleen Kaur
- School of Mathematics and Statistics, University College Dublin, Dublin, Ireland
| | - Virginia Morera-Pujol
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - Kilian J Murphy
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | | | - Adam F Smith
- Department of Wildlife Ecology and Management, Faculty of Environment and Natural Resources, University of Freiburg, Freiburg, Germany
- The Frankfurt Zoological Society, Frankfurt, Germany
- Department of National Park Monitoring and Animal Management, Bavarian Forest National Park, Grafenau, Germany
| | - Simone Ciuti
- Laboratory of Wildlife Ecology and Behaviour, School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| |
Collapse
|
4
|
Arcos González P, Cabria Fernández J, Gan RK, Fernández Camporro Á, Cernuda Martínez JA. The epidemiological profile of incidence and mortality from epidemics in complex humanitarian emergencies from 1990 to 2022 - A scoping review. Trop Med Int Health 2024; 29:343-353. [PMID: 38481292 DOI: 10.1111/tmi.13982] [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] [Indexed: 05/07/2024]
Abstract
AIM This study aimed to investigate the impact of communicable diseases with epidemic potential in complex emergency (CE) situations, focusing on the epidemiological profile of incidence and mortality and exploring underlying factors contributing to increased epidemic risks. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines, we conducted a scoping review of articles published between 1990 and 2022. The search included terms related to complex emergencies, communicable diseases, outbreaks, and epidemics. We identified 92 epidemics related to CE occurring in 32 different countries. RESULTS Communicable diseases like Shigellosis, Cholera, Measles, Meningococcal meningitis, Yellow Fever, and Malaria caused significant morbidity and mortality. Diarrhoeal diseases, particularly Cholera and Shigellosis, had the highest incidence rates. Shigella specifically had an incidence of 241.0 per 1000 (people at risk), with a mortality rate of 11.7 per 1000, while Cholera's incidence was 13.0 per 1000, with a mortality rate of 0.22 per 1000. Measles followed, with an incidence of 25.0 per 1000 and a mortality rate of 0.76 per 1000. Meningococcal Meningitis had an incidence rate of 1.3 per 1000 and a mortality rate of 0.13 per 1000. Despite their lower incidences, yellow fever at 0.8 per 1000 and malaria at 0.4 per 1000, their high case fatality rates of 20.1% and 0.4% remained concerning in CE. The qualitative synthesis reveals that factors such as water, sanitation, and hygiene, shelter and settlements, food and nutrition, and public health and healthcare in complex emergencies affect the risk of epidemics. CONCLUSION Epidemics during complex emergencies could potentially lead to a public health crisis. Between 1990 and 2022, there have been no statistically significant changes in the trend of incidence, mortality, or fatality rates of epidemic diseases in CE. It is crucial to understand that all epidemics identified in CE are fundamentally preventable.
Collapse
Affiliation(s)
- Pedro Arcos González
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Julián Cabria Fernández
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Rick Kye Gan
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | - Ángel Fernández Camporro
- Unit for Research in Emergency and Disaster, Department of Medicine, University of Oviedo, Oviedo, Spain
| | | |
Collapse
|
5
|
Bessler AL, Hoet AE, Nigatu S, Swisher S, Fentie T, Admassu B, Molla A, Brown M, Berrian AM. Advancing One Health through veterinary education: a mixed methods needs assessment for implementing a WOAH-harmonized national veterinary medicine curriculum in Ethiopia. Front Vet Sci 2024; 11:1357855. [PMID: 38601911 PMCID: PMC11005791 DOI: 10.3389/fvets.2024.1357855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/01/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction International organizations now actively promote and implement One Health collaborative approaches to prevent, detect, and control diseases in humans and animals, recognizing the critical importance of the veterinary and agricultural sectors. Moreover, Veterinary Services are chronically under-resourced, especially in low- and middle-income countries. Given the importance of National Veterinary Services to food security, nutrition, poverty alleviation, and global health security, strengthening veterinary capacity is a priority for the international community. The World Organisation for Animal Health (WOAH) outlines a set of minimum competencies veterinarians need to support National Veterinary Services effectively. To improve the quality of veterinary education, Ethiopia has developed a new 2020 national curriculum that is harmonized with the WOAH competencies. Methods A mixed methods needs assessment was conducted to identify barriers and challenges that Ethiopian veterinary medicine programs have faced in implementing the new WOAH-harmonized national curriculum. Representatives from active veterinary programs granting a Doctor of Veterinary Medicine (DVM) degree were invited to share their experiences via an online survey and follow-up focus group discussion. Results Fourteen veterinary programs, representing 93% of eligible programs nationwide, participated in the needs assessment. Quantitative analysis indicated that the most difficult topics associated with the new curriculum included Organization of Veterinary Services (Competency 3.1), Inspection and Certification Procedures (3.2), and practical applications of the regulatory framework for disease prevention and control (multiple competencies). Challenges associated with specific instructional methodologies, particularly the facilitation of off-site (private and public sector) student training, were also perceived as barriers to implementation. Focus group discussions elucidated reasons for these challenges and included limitations in faculty expertise, resource constraints (e.g., supplies, infrastructure), and access to off-site facilities for hands-on teaching. Conclusion The results of this needs assessment will be used to identify and prioritize solutions to implementation challenges, helping Ethiopian veterinary medicine programs move the new WOAH-harmonized curriculum from theory to practice. As veterinarians are integral partners in advancing One Health, strengthening the capacity of Veterinary Services can ultimately safeguard animal and human health, grow economies, and improve lives.
Collapse
Affiliation(s)
- Andrea L. Bessler
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Armando E. Hoet
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Shimelis Nigatu
- College of Veterinary Medicine and Animal Science, University of Gondar, Gondar, Ethiopia
| | - Samantha Swisher
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Tsegaw Fentie
- College of Veterinary Medicine and Animal Science, University of Gondar, Gondar, Ethiopia
| | - Bemrew Admassu
- College of Veterinary Medicine and Animal Science, University of Gondar, Gondar, Ethiopia
| | - Adugna Molla
- College of Veterinary Medicine and Animal Science, University of Gondar, Gondar, Ethiopia
| | - Manon Brown
- College of Public Health, The Ohio State University, Columbus, OH, United States
| | - Amanda M. Berrian
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
- College of Public Health, The Ohio State University, Columbus, OH, United States
| |
Collapse
|
6
|
Simegn GL, Degu MZ, Gebeyehu WB, Senay AB, Krishnamoorthy J, Tegenaw GS. Spatiotemporal distribution of climate-sensitive disease incidences in ethiopia: a longitudinal retrospective analysis of Malaria, Meningitis, Cholera, Dysentery, Leishmaniasis and Dengue fever between 2010 and 2022/2023. BMC Public Health 2024; 24:697. [PMID: 38439016 PMCID: PMC10913215 DOI: 10.1186/s12889-024-18054-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/09/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Understanding the temporal and geographic distribution of disease incidences is crucial for effective public health planning and intervention strategies. This study presents a comprehensive analysis of the spatiotemporal distribution of disease incidences in Ethiopia, focusing on six major diseases: Malaria, Meningitis, Cholera and Dysentery, over the period from 2010 to 2022, whereas Dengue Fever and Leishmaniasis from 2018 to 2023. METHODS Using data from Ethiopian public health institute: public health emergency management (PHEM), and Ministry of Health, we examined the occurrence and spread of each disease across different regions of Ethiopia. Spatial mapping and time series analysis were employed to identify hotspots, trends, and seasonal variations in disease incidence. RESULTS The findings reveal distinct patterns for each disease, with varying cases and temporal dynamics. Monthly wise, Malaria exhibits a cyclical pattern with a peak during the rainy and humid season, while Dysentery, Meningitis and Cholera displays intermittent incidences. Dysentery cases show a consistent presence throughout the years, while Meningitis remains relatively low in frequency but poses a potential threat due to its severity. Dengue fever predominantly occurs in the eastern parts of Ethiopia. A significant surge in reported incident cases occurred during the years 2010 to 2013, primarily concentrated in the Amhara, Sidama, Oromia, Dire Dawa, and Benishangul-Gumuz regions. CONCLUSIONS This study helps to a better understanding of disease epidemiology in Ethiopia and can serve as a foundation for evidence-based decision-making in disease prevention and control. By recognizing the patterns and seasonal changes associated with each disease, health authorities can implement proactive measures to mitigate the impact of outbreaks and safeguard public health in the region.
Collapse
Affiliation(s)
- Gizeaddis Lamesgin Simegn
- Biomedical Imaging Unit, School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia.
- Artificial Intelligence & Biomedical Imaging Research Lab, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia.
| | - Mizanu Zelalem Degu
- Artificial Intelligence & Biomedical Imaging Research Lab, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
- Faculty of Computing, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
| | | | - Asaye Birhanu Senay
- Department of Health Policy and management, Jimma Institute of Health, Jimma University, Jimma, Ethiopia
| | - Janarthanan Krishnamoorthy
- Biomedical Imaging Unit, School of Biomedical Engineering, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
- Artificial Intelligence & Biomedical Imaging Research Lab, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
| | - Geletaw Sahle Tegenaw
- Artificial Intelligence & Biomedical Imaging Research Lab, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
- Faculty of Computing, Jimma Institute of Technology, Jimma University, Jimma, Ethiopia
| |
Collapse
|
7
|
Arushothy R, Mohd Ali MR, Zambri HF, Muthu V, Hashim R, Chieng S, Nathan S. Assessing the national antibiotic surveillance data to identify burden for melioidosis in Malaysia. IJID REGIONS 2024; 10:94-99. [PMID: 38179416 PMCID: PMC10764260 DOI: 10.1016/j.ijregi.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 01/06/2024]
Abstract
Objectives A leading cause of morbidity and mortality in Southeast Asia, the epidemiological data on melioidosis disease occurrence and mortality in Malaysia is not comprehensive. The aim of this study is to determine the burden of melioidosis and assess the National Surveillance for Antibiotic Resistance (NSAR) data as a potential tool melioidosis surveilance in Malaysia. Methods We performed a retrospective analysis on the B. pseudomallei reposited data submitted to the NSAR network between January 2014 and December 2020. The data were screened for information on patient demographics and specimen types. Additional patient comorbidities and outcomes were drawn from parallel surveillance for bacteremic melioidosis. Results The average annual incidence rate of melioidosis between 2014-2020 was 3.41 per 100,000 population and was significantly different between states (P <0.001). The highest incidence was observed in Pahang at 11.33 per 100,000 population. Individuals of Malay ethnicity, from the states of Pahang, Johor, Perak, and Negeri Sembilan aged 40-49, who were diabetic and working in agriculture-related sectors had a higher risk of succumbing to the infection. Conclusion Assessing the NSAR data proved to be a useful tool for the determination of the incidence and socio-demographic risk factors attributed to melioidosis in Malaysia.
Collapse
Affiliation(s)
- Revathy Arushothy
- Institute for Medical Research, National Institutes of Health, Shah Alam, Malaysia
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Hana Farizah Zambri
- Institute for Medical Research, National Institutes of Health, Shah Alam, Malaysia
| | - Vickneshwaran Muthu
- Disease Control Division, Ministry of Health Malaysia, Federal Government Administrative Centre, Putrajaya, Malaysia
| | - Rohaidah Hashim
- Institute for Medical Research, National Institutes of Health, Shah Alam, Malaysia
| | - Sylvia Chieng
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Sheila Nathan
- Department of Biological Sciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| |
Collapse
|
8
|
Fallah MP, Raji T, Ngongo AN, Ndembi N, Ogwell A, Abdulaziz M, Aragaw M, Sembuche S, Gonese E, Dereje N, Materu P, Kaseya J. The role of Africa Centres for Disease Control and Prevention during response to COVID-19 pandemic in Africa: lessons learnt for future pandemics preparedness, prevention, and response. BMJ Glob Health 2024; 9:e014872. [PMID: 38413103 PMCID: PMC10900438 DOI: 10.1136/bmjgh-2023-014872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Mosoka Papa Fallah
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Tajudeen Raji
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Nicaise Ndembi
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Ahmed Ogwell
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Mohammed Abdulaziz
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Merawi Aragaw
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Senga Sembuche
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Elizabeth Gonese
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Nebiyu Dereje
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | | | - Jean Kaseya
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| |
Collapse
|
9
|
Kowalcyk M, Dorevitch S. A Framework for Evaluating Local Adaptive Capacity to Health Impacts of Climate Change: Use of Kenya's County-Level Integrated Development Plans. Ann Glob Health 2024; 90:15. [PMID: 38370864 PMCID: PMC10870949 DOI: 10.5334/aogh.4266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/20/2024] [Indexed: 02/20/2024] Open
Abstract
Background Health National Adaptation Plans were developed to increase the capacity of low- and middle-income countries (LMICs) to adapt to the impacts of climate change on the health sector. Climate and its health impacts vary locally, yet frameworks for evaluating the adaptive capacity of health systems on the subnational scale are lacking. In Kenya, counties prepare county integrated development plans (CIDPs), which contain information that might support evaluations of the extent to which counties are planning climate change adaptation for health. Objectives To develop and apply a framework for evaluating CIDPs to assess the extent to which Kenya's counties are addressing the health sector's adaptive capacity to climate change. Methods CIDPs were analyzed based on the extent to which they addressed climate change in their description of county health status, whether health is noted in their descriptions of climate change, and whether they mention plans for developing climate and health programs. Based on these and other data points, composite climate and health adaptation (CHA) scores were calculated. Associations between CHA scores and poverty rates were analyzed. Findings CHA scores varied widely and were not associated with county-level poverty. Nearly all CIDPs noted climate change, approximately half mentioned health in the context of climate change and only 16 (34%) noted one or more specific climate-sensitive health conditions. Twelve (25%) had plans for a sub-program in both adaptive capacity and environmental health. Among the 24 counties with plans to develop climate-related programs in health programs, all specified capacity building, and 20% specified integrating health into disaster risk reduction. Conclusion Analyses of county planning documents provide insights into the extent to which the impacts of climate change on health are being addressed at the subnational level in Kenya. This approach may support governments elsewhere in evaluating climate change adaptation for health by subnational governments.
Collapse
Affiliation(s)
- Megan Kowalcyk
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago, School of Public Health, Chicago IL, US
| | - Samuel Dorevitch
- Division of Environmental and Occupational Health Sciences, University of Illinois Chicago, School of Public Health, Chicago IL, US
| |
Collapse
|
10
|
Accoe K, Criel B, Ag Ahmed MA, Buitrago VT, Marchal B. Conditions for health system resilience in the response to the COVID-19 pandemic in Mauritania. BMJ Glob Health 2023; 8:e013943. [PMID: 38050409 PMCID: PMC10693853 DOI: 10.1136/bmjgh-2023-013943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION A country's ability to manage a crisis depends on its level of resilience. Efforts are made to clarify the concept of health system resilience, but its operationalisation remains little studied. In the present research, we described the capacity of the local healthcare system in the Islamic Republic of Mauritania, in West Africa, to cope with the COVID-19 pandemic. METHODS We used a single case study with two health districts as units of analysis. A context analysis, a literature review and 33 semi-structured interviews were conducted. The data were analysed using a resilience conceptual framework. RESULTS The analysis indicates a certain capacity to manage the crisis, but significant gaps and challenges remain. The management of many uncertainties is largely dependent on the quality of the alignment of decision-makers at district level with the national level. Local management of COVID-19 in the context of Mauritania's fragile healthcare system has been skewed to awareness-raising and a surveillance system. Three other elements appear to be particularly important in building a resilient healthcare system: leadership capacity, community dynamics and the existence of a learning culture. CONCLUSION The COVID-19 pandemic has put a great deal of pressure on healthcare systems. Our study has shown the relevance of an in-depth contextual analysis to better identify the enabling environment and the capacities required to develop a certain level of resilience. The translation into practice of the skills required to build a resilient healthcare system remains to be further developed.
Collapse
Affiliation(s)
- Kirsten Accoe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | | | - Bruno Marchal
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|
11
|
Owusu I, Adu C, Aboagye RG, Mpangah RA, Acheampong GK, Akyereko E, Bonsu EO, Peprah P. Preparing for future outbreaks in Ghana: An overview of current COVID-19, monkeypox, and Marburg disease outbreaks. Health Promot Perspect 2023; 13:202-211. [PMID: 37808942 PMCID: PMC10558975 DOI: 10.34172/hpp.2023.25] [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: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 10/10/2023] Open
Abstract
Amidst the ongoing COVID-19 pandemic, Ghana is currently grappling with simultaneous outbreaks of Marburg virus disease and human monkeypox virus. The coexistence of these outbreaks emphasizes the imperative for a collaborative and global approach to enhance surveillance and expedite case detection. While Ghana has made efforts to respond to these outbreaks, this paper outlines the lessons learned and proposes recommendations in this regard. It is crucial to intensify response efforts at the local, regional, and national levels to effectively contain the spread of these infectious diseases. Therefore, this paper suggests prioritizing the following recommendations as crucial for assisting Ghana in adequately preparing for future outbreaks and safeguarding global public health: strengthening surveillance system through digitization, rapid and effective response; risk communication and community engagement; healthcare system readiness; and research and collaboration. Also, prioritizing building healthy public policies and developing personal skills of health personnel across the country is key for future outbreak response.
Collapse
Affiliation(s)
- Isaac Owusu
- Ghana Health Service, Headquarters, Accra, Ghana
| | - Collins Adu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland 4811, Australia
| | - Richard Gyan Aboagye
- Fred Newton Binka School of Public Health, University of Health, and Allied Sciences, Hohoe, Ghana
| | | | | | - Ernest Akyereko
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Peprah
- Centre for Primary Health Care and Equity/Social Policy Research Centre, University of New South Wales, Sydney, Australia
| |
Collapse
|
12
|
Fekadu ST, Gebrewahid AL, Mankoula W, Eteng W, Lokossou V, Kawe Y, Abdullah A, Jian L, Kol MTM, Wilton MC, Rosenfeld E, Bemo VN, Collard E, McGinley L, Halm A, Aragaw M, Conteh IN, Braka F, Gueye AS. Public health emergency operations centres in Africa: a cross-sectional study assessing the implementation status of core components and areas for improvement, December 2021. BMJ Open 2023; 13:e068934. [PMID: 37339838 PMCID: PMC10314583 DOI: 10.1136/bmjopen-2022-068934] [Citation(s) in RCA: 2] [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: 10/07/2022] [Accepted: 02/17/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE To assess implementation status of public health emergency operations centres (PHEOCs) in all countries in Africa. DESIGN Cross-sectional. SETTING Fifty-four national PHEOC focal points in Africa responded to an online survey between May and November 2021. Included variables aimed to assess capacities for each of the four PHEOC core components. To assess the PHEOCs' functionality, criteria were defined from among the collected variables by expert consensus based on PHEOC operations' prioritisation. We report results of the descriptive analysis, including frequencies of proportions. RESULTS A total of 51 (93%) African countries responded to the survey. Among these, 41 (80%) have established a PHEOC. Twelve (29%) of these met 80% or more of the minimum requirements and were classified as fully functional. Twelve (29%) and 17 (41%) PHEOCs that met 60%-79% and below 60% the minimum requirements were classified as functional and partially functional, respectively. CONCLUSIONS Countries in Africa made considerable progress in setting up and improving functioning of PHEOCs. One-third of the responding countries with a PHEOC have one fulfilling at least 80% of the minimum requirements to operate the critical emergency functions. There are still several African countries that either do not have a PHEOC or whose PHEOCs only partially meet these minimal requirements. This calls for significant collaboration across all stakeholders to establish functional PHEOCs in Africa.
Collapse
Affiliation(s)
- Senait Tekeste Fekadu
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Abrham Lilay Gebrewahid
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Wessam Mankoula
- Division of Emergency Preparedness and Response, African Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | - Womi Eteng
- Division of Emergency Preparedness and Response, African Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | - Virgil Lokossou
- ECOWAS Regional Center for Surveillance and Disease Control, West African Health Organisation, Abuja, Nigeria
| | - Yan Kawe
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ali Abdullah
- WHO Health Emergencies Programme, World Health Organisation Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - L Jian
- WHO Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Mathew Tut M Kol
- Division of Emergency Preparedness and Response, African Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | | | - Emily Rosenfeld
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Emily Collard
- Global Public Health Directorate, UK Health Security Agency, London, UK
| | - Liz McGinley
- Global Public Health Directorate, UK Health Security Agency, London, UK
| | - Ariane Halm
- Department of infectious disease epidemiology, Robert Koch Institute, Berlin, Germany
| | - Merawi Aragaw
- Division of Emergency Preparedness and Response, African Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia
| | - Ishata Nannie Conteh
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Fiona Braka
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Abdou Salam Gueye
- Emergency Preparedness and Response cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo
| |
Collapse
|
13
|
McKevitt S, White M, Petticrew M, Summerbell C, Vasiljevic M, Boyland E, Cummins S, Laverty AA, Junghans C, Millett C, De Vocht F, Hrobonova E, Vamos EP. Typology of how 'harmful commodity industries' interact with local governments in England: a critical interpretive synthesis. BMJ Glob Health 2023; 8:e010216. [PMID: 36690378 PMCID: PMC9872461 DOI: 10.1136/bmjgh-2022-010216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/20/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Industries that produce and market potentially harmful commodities or services (eg, tobacco, alcohol, gambling, less healthy foods and beverages) are a major influence on the drivers of behavioural risk factors for non-communicable diseases. The nature and impact of interactions between public bodies and 'harmful commodity industries' (HCIs) has been widely recognised and discussed at national and international levels, but to date little is known about such interactions at local or regional government levels. This study aimed to identify and characterise actual and potential interactions and proposes a typology of interactions between HCIs and English local authorities (LAs). METHODS Five electronic databases covering international literature (PubMed, EBSCO, OVID, Scopus and Web of Science) were searched up to June 2021. We also performed online searches for publicly available, web-based grey literature and documented examples of interactions in an English LA context. We conducted a critical interpretive synthesis of the published and grey literature to integrate and conceptualise the data in the context of English LAs. RESULTS We included 47 published papers to provide the frame for the typology, which was refined and contextualised for English LAs through the available grey literature. Three categories were developed, describing the medium through which interactions occur: (1) direct involvement with LAs, (2) involvement through intermediaries and (3) involvement through the local knowledge space. Within these, we grouped interactions into 10 themes defining their nature and identified illustrative examples. CONCLUSION Our typology identifies complex inter-relationships and characterises interactions between HCIs and LAs, with illustrative examples from English LAs. Drawn from well-established theories and frameworks in combination with contextual information on English LAs, this typology explores the LA perspective and could help local decision-makers to maximise population health while minimising negative impacts of HCIs. PROSPERO REGISTRATION NUMBER CRD42021257311.
Collapse
Affiliation(s)
- Sarah McKevitt
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Petticrew
- PHP, London School of Hygiene and Tropical Medicine, London, UK
| | - Carolyn Summerbell
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Milica Vasiljevic
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Durham University, Durham, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Cornelia Junghans
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank De Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, Bristol, UK
| | | | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
14
|
Rinsky-Halivni L, Brammli-Greenberg S, Christiani DC. Ageing workers' mental health during COVID-19: a multilevel observational study on the association with the work environment, perceived workplace safety and individual factors. BMJ Open 2022; 12:e064590. [PMID: 36572502 PMCID: PMC9805828 DOI: 10.1136/bmjopen-2022-064590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The stress and anxiety associated with the predisposition of ageing workers to severe COVID-19 illness, once occupationally infected, jeopardise their mental health. This study aimed to investigate the association between individual level, work environment exposure factors and perceived workplace safety with a decline in mental health of ageing workers from different industry sectors. DESIGN Observational study, prevalence assessment of survey added to longitudinal cohort data. SETTING The Survey of Health, Ageing and Retirement in Europe (SHARE) from 27 countries in Europe and Israel participating in the COVID-19 survey (summer 2020) and having prepandemic waves' SHARE data. PARTICIPANTS Workers aged 50-70 (n=6449) who attended their workplaces at least partially after the pandemic broke out. PRIMARY OUTCOME MEASURE Perceived decline in mental health compared with preoutbreak status. RESULTS Multilevel analyses demonstrated that 24.5% (95% CI 23.5% to 25.5%) of ageing workers in Europe experienced mental health decline associated with national-level self-reported COVID-19 burden. Workplace safety perception was the strongest predictor, as each one-point increase in unsafe perception was associated with 60% of mental health decline (OR=1.6, 95% CI 1.47 to 1.74), explaining 30% of increased reported mental health symptoms of ageing workers. Safety perception mediates the mental health outcomes of the work environment, such as workplace contagion risk and work location. Female gender (OR=1.77, 95% CI 1.55 to 2.02), financial difficulties (OR=1.19, 95% CI 1.1 to 1.28), higher vulnerability index (comorbidities, age >60) (OR=1.11, 95% CI 1.05 to 1.18), pre-existing mental problems (OR=1.78, 95% CI 1.55 to 2.04) and increased national burden of COVID-19 (OR=1.01, 95% CI 1.0 to 1.02) were associated with declines in mental health, whereas exclusively working on-site was protective. CONCLUSION Vulnerable subgroups for mental health declines among ageing workers were revealed, which warrant their screening and employers' evaluation of workplace conditions of ageing workers to prevent mental health-related implications. Workplace interventions should aim to reduce work environment influences on infection risk and mental distress.
Collapse
Affiliation(s)
- Lilah Rinsky-Halivni
- Takemi Program in International Health, Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - David C Christiani
- Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| |
Collapse
|
15
|
Kouladoum JC. Inclusive Education and Health Performance in Sub Saharan Africa. SOCIAL INDICATORS RESEARCH 2022; 165:879-900. [PMID: 36536614 PMCID: PMC9750046 DOI: 10.1007/s11205-022-03046-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The study assesses the effect of inclusive education on health performance in 48 Sub Saharan African countries from 2000 to 2020. The study adopted the Driscoll/Kraay technique to address cross-sectional dependence and the GMM strategy to address potential endogeneity. The study employed three indicators of health performance which are the total life expectancy, the female life expectancy and the male life expectancy. Three gender parity index of educational enrolments are employed: primary education, secondary and the tertiary education as indicators of inclusive education. The findings of the study reveal that inclusive education enhances the health situation of individuals in Sub Saharan Africa. The findings further show that the health situation of both the male and the female are improved by inclusive education. The study recommends policymakers in this region to invest more in the education and the health sector so as to enhance the health performance of the citizens.
Collapse
|
16
|
Ward MC, Crinall K, McDonald R, Crinall W, Aridas J, Leung C, Quittner D, Hodges RJ, Rolnik DL. The kindness COVID-19 toolkit: a mixed-methods evaluation of a programme designed by doctors in training for doctors in training. BMJ Open 2022; 12:e060575. [PMID: 36414290 PMCID: PMC9684278 DOI: 10.1136/bmjopen-2021-060575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 10/10/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The impact of a coronavirus disease (COVID-19)-specific professional development programme on the well-being of obstetrics and gynaecology (O&G) doctors in training (DiT) working during the pandemic. DESIGN A mixed-method evaluation of a single group pre-post test design study. SETTING Melbourne, Australia between September 2020 and April 2021. PARTICIPANTS 55 O&G DiT working across four healthcare sites of a major tertiary hospital in Victoria, Australia, were included in the programme. INTERVENTIONS The delivery of a codesigned peer-to-peer programme, which identified and addressed the well-being goals of O&G DiT. Seven interactive workshops were run alongside the implementation of a number of participant-led wellness initiatives. MAIN OUTCOME MEASURES Repeated-measures analysis of WHO Well-being Index (WHO-5) and Copenhagen Burnout Innovatory (CBI) scores across three time points during the programme. Multilevel generalised linear mixed-effects models with random intercept were fit to the data, both in the entire population (intention-to-treat) and restricted to those who attended the workshop ('per-protocol' analysis). Participatory experiences and programme learning were captured using the Most Significant Change (MSC) technique, which included inductive thematic analysis. RESULTS We demonstrated an overall 31.9% improvement in well-being scores (p=0.006). The MSC evaluation captured a shift in workplace culture as a result of the programme, with improvement across the domains of connection, caring, communication, confidence and cooperation. CONCLUSIONS We have successfully used a mixed-method approach to contextualise a productive programme to improve the well-being of COVID-19 front-line healthcare workers.
Collapse
Affiliation(s)
- Madeleine C Ward
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - Rebecca McDonald
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - James Aridas
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Cheryl Leung
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | | | - Ryan J Hodges
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| | - Daniel L Rolnik
- Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
- Women's & Newborn, Monash Health, Clayton, Victoria, Australia
| |
Collapse
|
17
|
Torres Munguía JA, Badarau FC, Díaz Pavez LR, Martínez-Zarzoso I, Wacker KM. A global dataset of pandemic- and epidemic-prone disease outbreaks. Sci Data 2022; 9:683. [PMID: 36357405 PMCID: PMC9648436 DOI: 10.1038/s41597-022-01797-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/20/2022] [Indexed: 11/12/2022] Open
Abstract
This paper presents a new dataset of infectious disease outbreaks collected from the Disease Outbreak News and the Coronavirus Dashboard produced by the World Health Organization. The dataset contains information on 70 infectious diseases and 2227 public health events that occurred over the period from January 1996 to March 2022 in 233 countries and territories around the world. We illustrate the potential use of this dataset to the research community by analysing the spatial distribution of disease outbreaks. We find evidence of spatial clusters of high incidences ("hot spots") in Africa, America, and Asia. This spatial analysis enables policymakers to identify the regions with the greatest likelihood of suffering from disease outbreaks and, taking into account their degree of preparedness and vulnerability, to develop policies that may help contain the spreading of future outbreaks. Further applications could focus on combining our data with other information sources to study, for instance, the link between environmental, globalization, and/or socioeconomic factors with disease outbreaks.
Collapse
Affiliation(s)
| | | | | | - Inmaculada Martínez-Zarzoso
- Faculty of Economic Sciences, Georg-August-Universität Göttingen, Göttingen, Germany
- Department of Economics, University Jaume I, Castelló de la Plana, Spain
| | - Konstantin M Wacker
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
18
|
Silva C, Fonseca C, Ferreira R, Pinho L, Schneider BC, Weidner A, Morgado B, Lopes MJ. Depression in older adults during the COVID-19 pandemic: a systematic review protocol. BMJ Open 2022; 12:e065610. [PMID: 36288844 PMCID: PMC9615176 DOI: 10.1136/bmjopen-2022-065610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/15/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Depression is a common mental disorder and is a major cause of years lived with disability. The COVID-19 pandemic has caused an increase in the prevalence of depression worldwide. Our aim is to identify and synthesise the determinants of depression, the diagnostic assessment tools used to evaluate depression, and the interventions carried out since the beginning of the COVID-19 pandemic in the population aged 60 and older. METHODS AND ANALYSIS A systematic review of the literature will be conducted. The following databases will be searched: CINAHL Plus with Full Text, MedicLatina, MEDLINE with Full Text, and Psychology and Behavioural Sciences Collection. The search strategy will include the following Medical Subject Headings or similar terms: "Depression", "Depressive Disorder", "Depressive Symptoms", "Older Adults", "Aging", "Elderly", Pandemic" and "COVID-19". Two independent reviewers will ascertain whether the resulting articles meet inclusion and exclusion criteria, and perform the analysis of data quality. Disagreements will be resolved by a third reviewer. All studies reported between December 2019 and March 2022 meeting the following criteria will be included: studies in adults aged 60 and over, and articles written in English, Portuguese, Spanish or German. Information on determinants of depression, assessment instruments used to assess depressive symptoms and/or interventions to decrease depression are reported. Studies will not be excluded based on geographical area study context (eg, community, culture or specific environment). All studies related to diagnostic assessment, care planning and/or intervention strategies specifically for older adults with depression will be included. ETHICS AND DISSEMINATION As only secondary data will be analysed, no ethical approval is required for this study. This scientific article is a systematic review protocol for which data have not yet been extracted or analysed. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER CRD42022299775.
Collapse
Affiliation(s)
- Celso Silva
- Higher School of Health, Polytechnic Institute of Beja, Beja, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - César Fonseca
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
- Nursing Department, University of Évora, Évora, Portugal
| | - Rogério Ferreira
- Higher School of Health, Polytechnic Institute of Beja, Beja, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Lara Pinho
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
- Nursing Department, University of Évora, Évora, Portugal
| | - Brooke C Schneider
- MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Anna Weidner
- MSH Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Bruno Morgado
- Nursing Department, University of Évora, Évora, Portugal
- Garcia de Orta Hospital, Almada, Portugal
| | - Manuel José Lopes
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
- Nursing Department, University of Évora, Évora, Portugal
| |
Collapse
|
19
|
Ayenew T, Tassew SF, Workneh BS. Level of emergency and disaster preparedness of public hospitals in Northwest Ethiopia: A cross-sectional study. Afr J Emerg Med 2022; 12:246-251. [PMID: 35795819 PMCID: PMC9249593 DOI: 10.1016/j.afjem.2022.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/26/2022] [Accepted: 05/26/2022] [Indexed: 11/19/2022] Open
Abstract
Low- and middle-income countries like Sub Saharan Africa repeatedly experience natural and manmade disasters. Emergencies and disasters frequently have serious consequences for people's health, including the loss of many lives and significant disruptions in community functioning. Emergency and disaster preparedness, on the other hand, is still in its early stages in Africa. Personnel shortages, weakened health systems, mishandling of scarce resources, and political instability are among the challenges facing disaster management in Africa. This study is projected to fill an information gap about the state of hospitals’ emergency and disaster preparedness.
Background From time to time, the magnitude and type of health emergencies and disasters are increasing. Hospital emergency and disaster preparedness, on the other hand, is still in its early stages in many low- and middle-income countries. In Ethiopia, research on hospital disaster preparedness is severely limited. As a result, the purpose of this study was to determine the level of hospital emergency and disaster preparedness at public hospitals in the east Gojjam zone of Northwest Ethiopia. Methods A census method was used to include ten hospitals in the East Gojjam zone in a cross-sectional descriptive study. An adopted World Health Organization observation checklist was used to assess disaster and emergency preparedness. Each question was assigned a score out of three points, with one indicating low readiness and three indicating the highest level of preparation. Finally, the level of preparedness was classified as “low“ if the average percentage score ranged from 33.3% to 66.6 %, and as “high” if the percentage score ranged from 66.7 % to 100 %. The results were then presented in the form of texts, tables, and percentages. Results The evaluated hospitals' overall level of emergency and disaster preparedness falls into the low category, with an average calculated preparedness score of 54.75 %. The domain with the lowest preparedness is logistics and finance (43.33 %), while the domain with the highest preparedness is patient care and support services (60 %). Conclusion According to the findings of this study, the level of emergency and disaster preparedness in the hospitals studied is low. It is therefore recommended that the ministry of health, regional health bureaus, and hospital administrators collaborate to develop an appropriate intervention strategy to address this issue.
Collapse
Affiliation(s)
- Temesgen Ayenew
- Department of Emergency and critical care nursing, College of health sciences, Debremarkos Markos University, Po. Box: 269, Debre Markos, Amhara, Ethiopia
- Corresponding author.
| | - Sheganew Fetene Tassew
- Department of Emergency and critical care nursing, college of health science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care nursing, school of nursing, College of medicine and health sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
20
|
Cristaldi MA, Catry T, Pottier A, Herbreteau V, Roux E, Jacob P, Previtali MA. Determining the spatial distribution of environmental and socio-economic suitability for human leptospirosis in the face of limited epidemiological data. Infect Dis Poverty 2022; 11:86. [PMID: 35927739 PMCID: PMC9351081 DOI: 10.1186/s40249-022-01010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/19/2022] [Indexed: 12/03/2022] Open
Abstract
Background Leptospirosis is among the leading zoonotic causes of morbidity and mortality worldwide. Knowledge about spatial patterns of diseases and their underlying processes have the potential to guide intervention efforts. However, leptospirosis is often an underreported and misdiagnosed disease and consequently, spatial patterns of the disease remain unclear. In the absence of accurate epidemiological data in the urban agglomeration of Santa Fe, we used a knowledge-based index and cluster analysis to identify spatial patterns of environmental and socioeconomic suitability for the disease and potential underlying processes that shape them. Methods We geocoded human leptospirosis cases derived from the Argentinian surveillance system during the period 2010 to 2019. Environmental and socioeconomic databases were obtained from satellite images and publicly available platforms on the web. Two sets of human leptospirosis determinants were considered according to the level of their support by the literature and expert knowledge. We used the Zonation algorithm to build a knowledge-based index and a clustering approach to identify distinct potential sets of determinants. Spatial similarity and correlations between index, clusters, and incidence rates were evaluated. Results We were able to geocode 56.36% of the human leptospirosis cases reported in the national epidemiological database. The knowledge-based index showed the suitability for human leptospirosis in the UA Santa Fe increased from downtown areas of the largest cities towards peri-urban and suburban areas. Cluster analysis revealed downtown areas were characterized by higher levels of socioeconomic conditions. Peri-urban and suburban areas encompassed two clusters which differed in terms of environmental determinants. The highest incidence rates overlapped areas with the highest suitability scores, the strength of association was low though (CSc r = 0.21, P < 0.001 and ESc r = 0.19, P < 0.001). Conclusions We present a method to analyze the environmental and socioeconomic suitability for human leptospirosis based on literature and expert knowledge. The methodology can be thought as an evolutive and perfectible scheme as more studies are performed in the area and novel information regarding determinants of the disease become available. Our approach can be a valuable tool for decision-makers since it can serve as a baseline to plan intervention measures. Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-01010-x.
Collapse
Affiliation(s)
- Maximiliano A Cristaldi
- Department of Natural Sciences, College of Humanities and Sciences, National University of Litoral, Santa Fe, Argentina.
| | - Thibault Catry
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Auréa Pottier
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Vincent Herbreteau
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France
| | - Emmanuel Roux
- ESPACE-DEV, French National Research Institute for Sustainable Development (IRD), University of Montpellier, University of French West Indies, University of French Guiana, University of La Reunion, Montpellier, France.,Sentinela International Joint Laboratory, French National Research Institute for Sustainable Development (IRD), University of Brasilia (UnB), Oswaldo Cruz Foundation (Fiocruz), Brasília, Brazil.,Sentinela International Joint Laboratory, French National Research Institute for Sustainable Development (IRD), University of Brasilia (UnB), Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Paulina Jacob
- National Institute of Respiratory Diseases (INER) "Dr. E. Coni"/National Administration of Health Institutes (ANLIS "Dr. C.G. Malbrán"), Santa Fe, Argentina.,Leptospirosis Laboratory, College of Biochemistry and Biological Sciences, National University of Litoral, Santa Fe, Argentina
| | - M Andrea Previtali
- Department of Natural Sciences, College of Humanities and Sciences, National University of Litoral, Santa Fe, Argentina. .,National Scientific and Technical Research Council (CONICET), Santa Fe, Argentina.
| |
Collapse
|
21
|
Jain V, Clarke J, Beaney T. Association between democratic governance and excess mortality during the COVID-19 pandemic: an observational study. J Epidemiol Community Health 2022; 76:jech-2022-218920. [PMID: 35768188 PMCID: PMC9271843 DOI: 10.1136/jech-2022-218920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Excess mortality has been used to assess the overall health impact of COVID-19 across countries. Democracies aim to build trust in government and enable checks and balances on decision making, which may be useful in a pandemic. But during the pandemic, they have been criticised as being hesitant to enforce restrictive public health measures. METHODS Through linking open-access datasets we constructed univariable and multivariable linear regression models investigating the association between country V-Dem Liberal Democracy Indices (LDI), representing strength of democratic governance and excess mortality rates, from January 2020 to September 2021. We adjusted for several important confounders and conducted a range of sensitivity analyses to assess the robustness of our findings. RESULTS Across 78 countries, 4.19 million deaths million excess deaths were recorded. On multivariable regression, a one-point increase in V-Dem LDI was associated with a decrease in excess mortality of 2.18 per 100 000 (p=0.004), after accounting for age, gender, wealth and universal health coverage. This association was only partially attenuated by COVID-19 vaccination rates and remained robust in all sensitivity analyses. CONCLUSIONS Democratic governance may have played an important role in mitigating the overall health impact of COVID-19 across countries. This study strengthens the case to broaden the scope of traditional pandemic risk assessment and discussions on preparedness.
Collapse
Affiliation(s)
- Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Jonathan Clarke
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, London, UK
| |
Collapse
|
22
|
Phiri MM, MacPherson EE, Panulo M, Chidziwisano K, Kalua K, Chirambo CM, Kawalazira G, Gundah Z, Chunda P, Morse T. Preparedness for and impact of COVID-19 on primary health care delivery in urban and rural Malawi: a mixed methods study. BMJ Open 2022; 12:e051125. [PMID: 35688583 PMCID: PMC9189546 DOI: 10.1136/bmjopen-2021-051125] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Across Africa, the impact of COVID-19 continues to be acutely felt. This includes Malawi, where a key component of health service delivery to mitigate against COVID-19 are the primary healthcare facilities, strategically placed throughout districts to offer primary and maternal healthcare. These facilities have limited infrastructure and capacity but are the most accessible and play a crucial role in responding to the COVID-19 pandemic. This study assessed health facility preparedness for COVID-19 and the impact of the pandemic on health service delivery and frontline workers. SETTING Primary and maternal healthcare in Blantyre District, Malawi. PARTICIPANTS We conducted regular visits to 31 healthcare facilities and a series of telephone-based qualitative interviews with frontline workers (n=81 with 38 participants) between August 2020 and May 2021. RESULTS Despite significant financial and infrastructural constraints, health centres continued to remain open. The majority of frontline health workers received training and access to preventative COVID-19 materials. Nevertheless, we found disruptions to key services and a reduction in clients attending facilities. Key barriers to implementing COVID-19 prevention measures included periodic shortages of resources (soap, hand sanitiser, water, masks and staff). Frontline workers reported challenges in managing physical distancing and in handling suspected COVID-19 cases. We found discrepancies between reported behaviour and practice, particularly with consistent use of masks, despite being provided. Frontline workers felt COVID-19 had negatively impacted their lives. They experienced fatigue and stress due to heavy workloads, stigma in the community and worries about becoming infected with and transmitting COVID-19. CONCLUSION Resource (human and material) inadequacy shaped the health facility capacity for support and response to COVID-19, and frontline workers may require psychosocial support to manage the impacts of the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Eleanor Elizabeth MacPherson
- Social Science Department, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mindy Panulo
- Department of Enviromental Health and WASHTED Centre, Polytechnic, University of Malawi, Blantyre, Malawi
| | - Kondwani Chidziwisano
- Department of Environmental Health, Polytechnic, University of Malawi, Blantyre, Malawi
- Department of Civil and Environmental Engineering, University of Strathclyde, Glasgow, UK
| | - Khumbo Kalua
- Blantyre Institute for Community Outreach, Blantyre, Malawi
| | | | | | | | | | - Tracy Morse
- Civil and Environmental Engineering, University of Strathclyde, Glasgow, UK
- WASHTED Center, Polytechnic, University of Malawi, Blantyre, Malawi
| |
Collapse
|
23
|
Thabrew H, Boggiss AL, Lim D, Schache K, Morunga E, Cao N, Cavadino A, Serlachius AS. Well-being app to support young people during the COVID-19 pandemic: randomised controlled trial. BMJ Open 2022; 12:e058144. [PMID: 35589362 PMCID: PMC9121135 DOI: 10.1136/bmjopen-2021-058144] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy and acceptability of 'Whitu: seven ways in seven days', a well-being application (app) for young people. DESIGN Prospective randomised controlled trial of Whitu against waitlist control, with 45 participants in each arm. PARTICIPANTS 90 New Zealand young people aged 16-30 recruited via a social media advertising campaign. SETTING Participants' homes. INTERVENTIONS Developed during the COVID-19 pandemic, and refined from a prototype version that was evaluated during a smaller qualitative study, 'Whitu: seven ways in seven days' is a well-being app that, as its name suggests, contains seven modules to help young people (1) recognise and rate emotions, (2) learn relaxation and mindfulness, (3) practice self-compassion and (4) gratitude, (5) connect with others, (6) care for their physical health and (7) engage in goal-setting. It can be completed within a week or as desired. MAIN OUTCOME MEASURES Primary outcomes were changes in well-being on the WHO 5-item Well-Being Index and Short Warwick-Edinburgh Mental Well-Being Scale. Secondary outcomes were changes in depression on the Centre for Epidemiological Studies Depression Scale, anxiety on the Generalised Anxiety Disorder 7-item Scale, self-compassion on the Self Compassion Scale-Short Form, stress on the 10-item Perceived Stress Scale, sleep on the single-item Sleep Quality Scale and user engagement on the end-user version of the Mobile Application Rating Scale and via qualitative feedback during an online survey. Outcomes were evaluated at baseline, 4 weeks (primary study endpoint) and 3 months, and analysed using linear mixed models with group, time and a group-time interaction. RESULTS At 4 weeks, participants in the Whitu group experienced significantly higher emotional (Mean difference (md) 13.19 (3.96 to 22.42); p=0.005) and mental (md 2.44 (0.27 to 4.61); p=0.027) well-being, self-compassion (md 0.56 (0.28 to 0.83); p<0.001) and sleep (md 1.13 (0.24 to 2.02); p=0.018), and significantly lower stress (md -4.69 (-7.61 to -1.76); p=0.002) and depression (md -5.34 (-10.14 to -0.53); p=0.030), compared with the waitlist controls. Group differences remained statistically significant at 3 months for all outcomes. Symptoms of anxiety were also lower in the intervention group at 4 weeks (p=0.096), with statistically significant differences at 3 months (md -2.31 (-4.54 to -0.08); p=0.042). Usability of Whitu was high (subjective ratings of 4.45 (0.72) and 4.38 (0.79) out of 5 at 4 weeks and 3 months, respectively) and qualitative feedback indicated individual and cultural acceptability of the app. CONCLUSIONS Given the evolving psychological burden of the COVID-19 pandemic, Whitu could provide a clinically effective and scalable means of improving the well-being, mental health and resilience of young people. Replication of current findings with younger individuals and in other settings is planned. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12620000516987).
Collapse
Affiliation(s)
- Hiran Thabrew
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Anna Lynette Boggiss
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - David Lim
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Kiralee Schache
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Eva Morunga
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Nic Cao
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Alana Cavadino
- Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Anna Sofia Serlachius
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
24
|
Mwendera CA, Mzilahowa T, Njiokou F, N'falé S, Amegee Quach J, Thomsen E, Dabire R, Ranson H, Alhassan N, Oronje R, Worrall E. Knowledge translation and evidence generation to increase the impact of vector control in Burkina Faso, Cameroon and Malawi. BMJ Glob Health 2022; 7:e008378. [PMID: 35545288 PMCID: PMC9096501 DOI: 10.1136/bmjgh-2021-008378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/13/2022] [Indexed: 11/07/2022] Open
Abstract
Lack of context-specific evidence and inadequate evidence-use for decision-making contribute to poor health. This paper reports on our work aimed at addressing the knowledge translation (KT) gap between evidence generators and users. We present our experiences of strengthening KT via technical advisory groups (TAGs) in parallel with increasing evidence generation through research fellowships and operational research. Vectorborne diseases (VBDs) impose substantial health and economic burdens in sub-Saharan Africa despite being preventable with vector control. The Partnership for Increasing the Impact of Vector Control aimed to reduce the burden of VBDs in Burkina Faso, Cameroon, Malawi and at regional and global levels. TAGs can promote evidence-use in policy and practice by engaging relevant stakeholders in both research and policy processes. TAGs and related activities are best facilitated by a coordinator with skills in research and policy. Contextual factors should influence the design and governance of TAGs, which will likely evolve over time. Relevant national stakeholders should be included in TAGs and be actively involved in developing research agendas to increase the relevance and acceptability of research findings for decision-making. The countries present three differing contexts with longer-term research and evaluation necessary to draw lessons on impact.
Collapse
Affiliation(s)
| | - Themba Mzilahowa
- Malaria Alert Centre, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Flobert Njiokou
- Centre for Research in Infectious Diseases, Yaoundé, Cameroon
| | - Sagnon N'falé
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Jessica Amegee Quach
- Centre for Capacity Research, International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Edward Thomsen
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Roch Dabire
- Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Hilary Ranson
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rose Oronje
- African Institute for Development Policy, Nairobi, Kenya
| | - Eve Worrall
- Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|
25
|
Bardosh K, de Figueiredo A, Gur-Arie R, Jamrozik E, Doidge J, Lemmens T, Keshavjee S, Graham JE, Baral S. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health 2022; 7:e008684. [PMID: 35618306 PMCID: PMC9136690 DOI: 10.1136/bmjgh-2022-008684] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/05/2022] [Indexed: 11/04/2022] Open
Abstract
Vaccination policies have shifted dramatically during COVID-19 with the rapid emergence of population-wide vaccine mandates, domestic vaccine passports and differential restrictions based on vaccination status. While these policies have prompted ethical, scientific, practical, legal and political debate, there has been limited evaluation of their potential unintended consequences. Here, we outline a comprehensive set of hypotheses for why these policies may ultimately be counterproductive and harmful. Our framework considers four domains: (1) behavioural psychology, (2) politics and law, (3) socioeconomics, and (4) the integrity of science and public health. While current vaccines appear to have had a significant impact on decreasing COVID-19-related morbidity and mortality burdens, we argue that current mandatory vaccine policies are scientifically questionable and are likely to cause more societal harm than good. Restricting people's access to work, education, public transport and social life based on COVID-19 vaccination status impinges on human rights, promotes stigma and social polarisation, and adversely affects health and well-being. Current policies may lead to a widening of health and economic inequalities, detrimental long-term impacts on trust in government and scientific institutions, and reduce the uptake of future public health measures, including COVID-19 vaccines as well as routine immunisations. Mandating vaccination is one of the most powerful interventions in public health and should be used sparingly and carefully to uphold ethical norms and trust in institutions. We argue that current COVID-19 vaccine policies should be re-evaluated in light of the negative consequences that we outline. Leveraging empowering strategies based on trust and public consultation, and improving healthcare services and infrastructure, represent a more sustainable approach to optimising COVID-19 vaccination programmes and, more broadly, the health and well-being of the public.
Collapse
Affiliation(s)
- Kevin Bardosh
- School of Public Health, University of Washington, Seattle, Washington, USA
- Division of Infection Medicine, University of Edinburgh, Edinburgh, UK
| | - Alex de Figueiredo
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rachel Gur-Arie
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
- Oxford-Johns Hopkins Global Infectious Disease Collaborative (GLIDE), University of Oxford, Oxford, UK
| | - Euzebiusz Jamrozik
- Oxford-Johns Hopkins Global Infectious Disease Collaborative (GLIDE), University of Oxford, Oxford, UK
- Ethox and the Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - James Doidge
- Intensive Care National Audit and Research Centre (ICNARC), London, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Trudo Lemmens
- Faculty of Law and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Janice E Graham
- Department of Pediatrics (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
26
|
Okoroafor SC, Asamani JA, Kabego L, Ahmat A, Nyoni J, Millogo JJS, Illou MMA, Mwinga K. Preparing the health workforce for future public health emergencies in Africa. BMJ Glob Health 2022; 7:bmjgh-2021-008327. [PMID: 35414522 PMCID: PMC9006823 DOI: 10.1136/bmjgh-2021-008327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/06/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Sunny C Okoroafor
- Health Workforce Unit, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - James Avoka Asamani
- Health Workforce Unit, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Landry Kabego
- Infection Prevention and Control Unit, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Adam Ahmat
- Health Workforce Unit, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Jennifer Nyoni
- Health Workforce Unit, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | | | - Kasonde Mwinga
- Universal Health Coverage - Life Course, World Health Organization Regional Office for Africa, Brazzaville, Congo
| |
Collapse
|
27
|
Maruta T, Moyo S. Impact of pre-COVID-19 epidemic preparedness on the trajectory of the pandemic in African countries. Afr J Lab Med 2022; 11:1571. [PMID: 35402199 PMCID: PMC8991044 DOI: 10.4102/ajlm.v11i1.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 02/02/2022] [Indexed: 11/05/2022] Open
Abstract
Background The novel coronavirus disease 2019 (COVID-19), declared a pandemic by the World Health Organization (WHO) in March 2020, has taught us about the importance of epidemic preparedness. Objective We analysed the pre-COVID-19 preparedness of sub-Saharan African countries and how this may have influenced the trajectory of COVID-19 cases. Methods The WHO Joint External Evaluation (JEE) tool and the Global Health Security (GHS) Index were used to determine the epidemic preparedness of countries in the WHO African Region. The relationship between pre-COVID-19 preparedness and the reported number of cases per million people was evaluated over the first 120 days of the first reported case in each country, between February 2020 and September 2020. Results The overall performance of the 42 countries was 40% in the 19 JEE core capacities and 32% in the six GHS Index indicators. At Day 1, the mean number of cases per million population was significantly higher among countries rated as ‘prepared’ in the JEE legislation, policy and finance (p = 0.03), ports of entry (p = 0.001), and international health regulation coordination, communication and advocacy (p = 0.03) categories. At Day 90, countries rated as ‘prepared’ in the national laboratory systems (p = 0.05) and real-time surveillance (p = 0.04) JEE categories had statistically significantly fewer cases per million population. Conclusion This analysis highlights the importance of building capacity for pandemic preparedness in Africa. The WHO African Region was not adequately prepared for the COVID-19 pandemic as measured by the WHO JEE tool and the GHS Index.
Collapse
Affiliation(s)
- Talkmore Maruta
- Laboratory Department, African Centres for Disease Control and Prevention, Lusaka, Zambia
| | - Sikhulile Moyo
- Laboratory Department, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| |
Collapse
|
28
|
Lorenzoni G, Azzolina D, Maresio E, Gallipoli S, Ghidina M, Baldas S, Berchialla P, Giron MC, Silano M, Gregori D. Impact of the COVID-19 lockdown on psychological health and nutritional habits in Italy: results from the #PRESTOinsieme study. BMJ Open 2022; 12:e048916. [PMID: 35383054 PMCID: PMC8983406 DOI: 10.1136/bmjopen-2021-048916] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The present work aims to present the results of the 'PRESTOinsieme' (which is 'we will be together soon' in English). The web-based survey (www.prestoinsieme.com) describes changes in lifestyle habits and symptoms of psychological discomfort in the Italian population during the COVID-19 lockdown. DESIGN Cross-sectional online survey disseminated by messaging apps (ie, WhatsApp and Telegram) and social networks (ie, Instagram, Facebook and LinkedIn). SETTING Italy. PARTICIPANTS Italian population older than 16 years of age. EXPOSURE COVID-19 lockdown. MAIN OUTCOMES AND MEASURES Survey respondents filled out a set of validated questionnaires aimed at assessing lifestyle habits and psychological health, that is, the General Health Questionnaire (GHQ-12) to screen for psychological distress, the Impact of Event Scale-Revised (IES-R) to screen for post-traumatic stress and the Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS Survey respondents totalled 5008. Moderate or severe psychological distress was reported in 25.5% and 22% of survey respondents, respectively. Lower age, female gender, being unemployed (OR 1.57, 95% CI 1.22 to 2.02) or being a student (OR 1.73, 95% CI 1.31 to 2.28) were predictors of more severe depressive symptoms. CONCLUSIONS The present study is one of the largest population-based surveys conducted in Italy during the first COVID-19 lockdown, providing valuable data about the Italian population's psychological health. Further studies should be conducted to understand whether psychological distress persists after the end of the lockdown.
Collapse
Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | | | | | - Solidea Baldas
- University of Padova School of Medicine and Surgery, Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Maria Cecilia Giron
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Marco Silano
- Unit of Human Nutrition and Health, Department of Food Safety, Nutrition and Veterinary Public Health, Italian National Institute of Health, Rome, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| |
Collapse
|
29
|
Spurr L, Tan HL, Wakeman R, Chatwin M, Hughes Z, Simonds A. Psychosocial impact of the COVID-19 pandemic and shielding in adults and children with early-onset neuromuscular and neurological disorders and their families: a mixed-methods study. BMJ Open 2022; 12:e055430. [PMID: 35354630 PMCID: PMC8968110 DOI: 10.1136/bmjopen-2021-055430] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM To describe and evaluate the psychosocial impact of the COVID-19 pandemic and measures to reduce the risk of transmission on patients with early-onset neuromuscular and neurological disorders (NMDs) and their families. DESIGN A mixed-methods study in which data were collected between 17 September 2020 and 31 December 2020 using a semi-structured telephone questionnaire developed specifically to meet research aims, and were analysed using quantitative methods and qualitative inductive thematic analysis. PARTICIPANTS Forty questionnaires were completed by patients with NMDs (eg, muscular dystrophies, spinal muscular atrophy) or their parent. 70% (n=28) of patients were male, aged 2-48 years. 90% (n=36) were wheelchair users; 72.5% (n=29) required long-term non-invasive or tracheostomy ventilation. RESULTS Strict adherence to risk mitigation strategies, for example, shielding, were reported at the start of the pandemic. Over half continued some or all measures after official limitations were relaxed. 67.5% (n=27) reported changes to personal care assistance arrangements including temporary cessation of outside carers. Three themes were identified: (1) Concern regarding the health impact of COVID-19; (2) Perceptions of strategies to prevent SARS-CoV-2 transmission; (3) Psychological impact of the COVID-19 pandemic. The level and pervasiveness of frequently reported negative psychological effects, for example, anxiety and fear fluctuated, and were related to the perceived risk of COVID-19, concern about attending hospital, and perceived lack of access to intensive care management if severe COVID-19 infection occurred. Support, particularly from family and healthcare services, were considered to have positive psychosocial effects. CONCLUSIONS Measures to reduce transmission of COVID-19 have greatly affected patients with NMDs and their families. For most, negative psychosocial impacts have and will continue to improve, but this may depend on the incidence of further pandemic waves. Consistent, up-to-date and accessible information on clinical outcomes and risk mitigation must be provided to support patients' physical and mental well-being.
Collapse
Affiliation(s)
- Lydia Spurr
- Academic and Clinical Department of Sleep and Ventilation, Royal Brompton Hospital, London, UK
| | - Hui-Leng Tan
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Ruth Wakeman
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
| | - Michelle Chatwin
- Academic and Clinical Department of Sleep and Ventilation, Royal Brompton Hospital, London, UK
| | | | - Anita Simonds
- Academic and Clinical Department of Sleep and Ventilation, Royal Brompton Hospital, London, UK
| |
Collapse
|
30
|
D'Mello-Guyett L, Cumming O, Rogers E, D'hondt R, Mengitsu E, Mashako M, Van den Bergh R, Welo PO, Maes P, Checchi F. Identifying transferable lessons from cholera epidemic responses by Médecins Sans Frontières in Mozambique, Malawi and the Democratic Republic of Congo, 2015-2018: a scoping review. Confl Health 2022; 16:12. [PMID: 35351171 PMCID: PMC8966369 DOI: 10.1186/s13031-022-00445-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 03/16/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cholera epidemics occur frequently in low-income countries affected by concurrent humanitarian crises. Evaluations of these epidemic response remains largely unpublished and there is a need to generate evidence on response efforts to inform future programmes. This review of MSF cholera epidemic responses aimed to describe the main characteristics of the cholera epidemics and related responses in these three countries, to identify challenges to different intervention strategies based on available data; and to make recommendations for epidemic prevention and control practice and policy. METHODS Case studies from the Democratic Republic of Congo, Malawi and Mozambique were purposively selected by MSF for this review due to the documented burden of cholera in each country, frequency of cholera outbreaks, and risk of humanitarian crises. Data were extracted on the characteristics of the epidemics; time between alert and response; and, the delivery of health and water, sanitation and hygiene interventions. A Theory of Change for cholera response programmes was built to assess factors that affected implementation of the responses. RESULTS AND CONCLUSIONS 20 epidemic response reports were identified, 15 in DRC, one in Malawi and four in Mozambique. All contexts experienced concurrent humanitarian crises, either armed conflict or natural disasters. Across the settings, median time between the date of alert and date of the start of the response by MSF was 23 days (IQR 14-41). Almost all responses targeted interventions community-wide, and all responses implemented in-patient treatment of suspected cholera cases in either established health care facilities (HCFs) or temporary cholera treatment units (CTUs). In three responses, interventions were delivered as case-area targeted interventions (CATI) and four responses targeted households of admitted suspected cholera cases. CATI or delivery of interventions to households of admitted suspected cases occurred from 2017 onwards only. Overall, 74 factors affecting implementation were identified including delayed supplies of materials, insufficient quantities of materials and limited or lack of coordination with local government or other agencies. Based on this review, the following recommendations are made to improve cholera prevention and control efforts: explore improved models for epidemic preparedness, including rapid mobilisation of supplies and deployment of trained staff; invest in and strengthen partnerships with national and local government and other agencies; and to standardise reporting templates that allow for rigorous and structured evaluations within and across countries to provide consistent and accessible data.
Collapse
Affiliation(s)
- Lauren D'Mello-Guyett
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Environmental Health Unit, Médecins Sans Frontières, Brussels, Belgium.
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Elliot Rogers
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Rob D'hondt
- Environmental Health Unit, Médecins Sans Frontières, Brussels, Belgium
| | | | - Maria Mashako
- Médecins Sans Frontières, Kinshasa, Democratic Republic of Congo
| | - Rafael Van den Bergh
- LuxOR, Luxembourg Operational Research Unit, Médecins Sans Frontières, Luxembourg, Luxembourg
| | - Placide Okitayemba Welo
- Programme National d'Elimination du Choléra et de lutte contre les autres Maladies Diarrhéiques, Kinshasa, Democratic Republic of Congo
| | - Peter Maes
- WASH Section, UNICEF, Kinshasa, Democratic Republic of Congo
| | - Francesco Checchi
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
31
|
Ang KW, Koh YLE, Wang XF, Yusoff AM, Tan AM, Poh XYC, Zhang N, Tan NC. Pilot cross-sectional study of foreign domestic workers supporting the basic healthcare needs of older persons in the community. BMJ Open 2022; 12:e051877. [PMID: 35351699 PMCID: PMC8961118 DOI: 10.1136/bmjopen-2021-051877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This pilot study aimed to determine the proportions, level of knowledge, anxiety and confidence of foreign domestic workers (FDWs) who were involved in supporting the healthcare needs of older persons with long-term non-communicable diseases. DESIGN The pilot study used a cross-sectional and descriptive design.FDWs who accompanied the older adults attending a primary healthcare setting in Singapore. 100 eligible FDWs' demographic data, knowledge and confidence level of caregiving in food preparation, medication supervision, exercise, blood pressure (BP), blood glucose (BG) monitoring and anxiety level assessed by the Generalised Anxiety Disorder-7 scale were recorded. Descriptive statistics were performed and presented. Items on confidence were regrouped into two groups of 'very' versus 'no/a little/moderate'. Knowledge scores and caregiving tasks were assessed with items on confidence using Mann-Whitney U test and χ2 test, respectively. RESULTS The FDWs were from Indonesia (60%), Philippines (23%) and Myanmar (14%). Their mean age was 33 years with an average of 5.8 years working experience; 62% self-reported previous caregiver training for elderly. The mean age of care-recipients was 81 years. Knowledge of FDWs on BP and BG monitoring was low (<50% answered correctly). Among the 55 FDWs who were required to perform BP monitoring, 45.5% lack confidence. Similarly, 40% of the 30 FDWs were not confident in performing BG monitoring. Those with very high confidence levels had higher knowledge on BP and BG monitoring. Of those who were involved in medication supervision (n=86), 36% lacked confidence. The majority of the FDWs (96%) were not affected by anxiety in managing these healthcare tasks for older persons. CONCLUSION More than half of the FDWs supported healthcare needs of older persons but they had inadequate knowledge and lacked confidence in performing the healthcare-related tasks.
Collapse
Affiliation(s)
- Kim Wai Ang
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
| | | | | | | | | | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
| |
Collapse
|
32
|
Tsai J, Huang M, Rajan SS, Elbogen EB. Prospective association between receipt of the economic impact payment and mental health outcomes. J Epidemiol Community Health 2022; 76:285-292. [PMID: 34389662 PMCID: PMC8366281 DOI: 10.1136/jech-2021-216661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 08/05/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Coronavirus Aid, Relief, and Economic Security Act of 2020 provided 'economic impact payments' (EIPs) of $1200 to US adults with annual personal income of $75 000 or less. This study examined the prospective association between EIP receipt and mental health outcomes. METHODS A nationally representative sample of 3169 middle-income and low-income US adults completed a baseline assessment of their health and well-being in May-June 2020 and a 3-month follow-up assessment during the period of the COVID-19 pandemic when EIPs were distributed. RESULTS Controlling for sociodemographic characteristics, EIP recipients had higher odds of reporting a positive COVID-19 test, endorsing a history of post-traumatic stress disorder and reporting any illicit drug use in the past month than participants who did not receive EIP. Participants who did not receive EIP were more likely to report a history of anxiety disorder or alcohol use disorder and recent suicidal ideation than EIP recipients. There was no association between EIP receipt and financial distress, although over one-third to over half of EIP recipients were not employed at baseline. Between baseline and 3-month follow-up, receipt of EIP was significantly associated with reduced medical conditions and alcohol use problems, but increased depression, suicidal ideation and COVID-19 era-related stress. CONCLUSION The EIP provided a brief income stimulus to many adults in need but was not associated with improvements in financial distress or mental health among middle-income and low-income recipients. Long-term income security and employment may be more important to improving and sustaining positive mental health outcomes.
Collapse
Affiliation(s)
- Jack Tsai
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Minda Huang
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Suja S Rajan
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Eric B Elbogen
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, Florida, USA
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| |
Collapse
|
33
|
Nyaruaba R, Okoye CO, Akan OD, Mwaliko C, Ebido CC, Ayoola A, Ayeni EA, Odoh CK, Abi ME, Adebanjo O, Oyejobi GK. Socio-economic impacts of emerging infectious diseases in Africa. Infect Dis (Lond) 2022; 54:315-324. [PMID: 35007473 DOI: 10.1080/23744235.2021.2022195] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Raphael Nyaruaba
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Organization of African Academic Doctors, Nairobi, Kenya
| | - Charles Obinwanne Okoye
- Organization of African Academic Doctors, Nairobi, Kenya.,Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Nigeria
| | - Otobong Donald Akan
- Organization of African Academic Doctors, Nairobi, Kenya.,Department of Microbiology, Akwa-Ibom State University, Akwa-Ibom State, Nigeria
| | - Caroline Mwaliko
- Organization of African Academic Doctors, Nairobi, Kenya.,CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, China
| | - Chike Chukwuenyem Ebido
- Organization of African Academic Doctors, Nairobi, Kenya.,Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Nigeria
| | - Adeola Ayoola
- Organization of African Academic Doctors, Nairobi, Kenya.,State Key Laboratory of Genetic Resources and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, China
| | - Emmanuel Ayodeji Ayeni
- Organization of African Academic Doctors, Nairobi, Kenya.,The Research Unit, New Being Foundation, Abuja, FCT-Nigeria
| | - Chuks Kenneth Odoh
- Organization of African Academic Doctors, Nairobi, Kenya.,Dalian Institute of Chemical Physics, CAS, Dalian, China
| | - Manzama-Esso Abi
- Organization of African Academic Doctors, Nairobi, Kenya.,Yunnan Provincial Cancer Biotherapy and Chemotherapy Center, The third Affiliated Hospital of Kunming Medical University (Tumor Hospital of Yunnan Province), Kunming, China
| | - Omosalewa Adebanjo
- Organization of African Academic Doctors, Nairobi, Kenya.,MOE Laboratory of Biosystem Homeostasis and Protection, College of Life Sciences, Zhejiang University, Hangzhou, China
| | - Greater Kayode Oyejobi
- CAS Key Laboratory of Special Pathogens and Biosafety, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Organization of African Academic Doctors, Nairobi, Kenya.,Department of Microbiology, Faculty of Basic and Applied Sciences, Osun State University, Osogbo, Nigeria
| |
Collapse
|
34
|
Lenferink L, Mouthaan J, Fritz AM, Soydas S, Eidhof M, van Hoof MJ, Groen S, Mooren T. Predicting transitions between longitudinal classes of post-traumatic stress disorder, adjustment disorder and well-being during the COVID-19 pandemic: protocol of a latent transition model in a general Dutch sample. BMJ Open 2022; 12:e055696. [PMID: 34996798 PMCID: PMC8743835 DOI: 10.1136/bmjopen-2021-055696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A growing body of literature shows profound effects of the COVID-19 pandemic on mental health, among which increased rates of post-traumatic stress disorder (PTSD) and adjustment disorder (AD). However, current research efforts have largely been unilateral, focusing on psychopathology and not including well-being, and are dominated by examining average psychopathology levels or on disorder absence/presence, thereby ignoring individual differences in mental health. Knowledge on individual differences, as depicted by latent subgroups, in the full spectrum of mental health may provide valuable insights in how individuals transition between health states and factors that predict transitioning from resilient to symptomatic classes. Our aim is to (1) identify longitudinal classes (ie, subgroups of individuals) based on indicators of PTSD, AD and well-being in response to the pandemic and (2) examine predictors of transitioning between these subgroups. METHODS AND ANALYSIS We will conduct a three-wave longitudinal online survey study of n≥2000 adults from the general Dutch population. The first measurement occasion takes place 6 months after the start of the pandemic, followed by two follow-up measurements with 6 months of intervals. Latent transition analysis will be used for data analysis. ETHICS AND DISSEMINATION Ethical approval has been obtained from four Dutch universities. Longitudinal study designs are vital to monitor mental health (and predictors thereof) in the pandemic to develop preventive and curative mental health interventions. This study is carried out by researchers who are board members of the Dutch Society for Traumatic Stress Studies and is part of a pan-European study (initiated by the European Society for Traumatic Stress Studies) examining the impact of the pandemic in 11 countries. Results will be published in peer-reviewed journals and disseminated at conferences, via newsletters, and media appearance among (psychotrauma) professionals and the general public.
Collapse
Affiliation(s)
- Lonneke Lenferink
- Psychology, Health, and Technology, University of Twente, Enschede, The Netherlands
- Clinical Psychology and Experimental Psychopathology, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Joanne Mouthaan
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Anna M Fritz
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Suzan Soydas
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Marloes Eidhof
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, The Netherlands
- Reinier van Arkel Psychotraumacenter South Netherlands, Den Bosch, The Netherlands
| | - Marie-José van Hoof
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, locatie Meibergdreef, Amsterdam, The Netherlands
- Child and Adolescent Psychiatry, Curium-LUMC, Leiden, The Netherlands
| | - Simon Groen
- GGZ Drenthe Mental Health Care, De Evenaar Centrum Transculturele Psychiatrie, Beilen, The Netherlands
| | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
| |
Collapse
|
35
|
Bitanihirwe B, Ssewanyana D, Ddumba-Nyanzi I. Pacing Forward in the Face of Fragility: Lessons From African Institutions and Governments' Response to Public Health Emergencies. Front Public Health 2021; 9:714812. [PMID: 34900886 PMCID: PMC8655676 DOI: 10.3389/fpubh.2021.714812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Africa is home to 54 United Nation member states, each possessing a wealth of ethno-cultural, physiographic, and economic diversity. While Africa is credited as having the youngest population in the world, it also exhibits a unique set of “unfortunate realties” ranging from famine and poverty to volatile politics, conflicts, and diseases. These unfortunate realities all converge around social inequalities in health, that are compounded by fragile healthcare systems and a lack of political will by the continent's leaders to improve smart investment and infrastructure planning for the benefit of its people. Noteworthy are the disparities in responsive approaches to crises and emergencies that exist across African governments and institutions. In this context, the present article draws attention to 3 distinct public health emergencies (PHEs) that have occurred in Africa since 2010. We focus on the 2013–2016 Ebola outbreak in Western Africa, the ongoing COVID-19 pandemic which continues to spread throughout the continent, and the destructive locust swarms that ravaged crops across East Africa in 2020. Our aim is to provide an integrated perspective on how governments and institutions handled these PHEs and how scientific and technological innovation, along with educational response played a role in the decision-making process. We conclude by touching on public health policies and strategies to address the development of sustainable health care systems with the potential to improve the health and well-being of the African people.
Collapse
Affiliation(s)
- Byron Bitanihirwe
- Humanitarian and Conflict Response Institute, University of Manchester, Manchester, United Kingdom
| | - Derrick Ssewanyana
- Alliance for Health Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | | |
Collapse
|
36
|
|
37
|
Overton K, Fortané N, Broom A, Raymond S, Gradmann C, Orubu ESF, Podolsky SH, Rogers Van Katwyk S, Zaman MH, Kirchhelle C. Waves of attention: patterns and themes of international antimicrobial resistance reports, 1945-2020. BMJ Glob Health 2021; 6:e006909. [PMID: 34740914 PMCID: PMC8573652 DOI: 10.1136/bmjgh-2021-006909] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/17/2021] [Indexed: 11/04/2022] Open
Abstract
This article uses quantitative and qualitative approaches to review 75 years of international policy reports on antimicrobial resistance (AMR). Our review of 248 policy reports and expert consultation revealed waves of political attention and repeated reframings of AMR as a policy object. AMR emerged as an object of international policy-making during the 1990s. Until then, AMR was primarily defined as a challenge of human and agricultural domains within the Global North that could be overcome via 'rational' drug use and selective restrictions. While a growing number of reports jointly addressed human and agricultural AMR selection, international organisations (IOs) initially focused on whistleblowing and reviewing data. Since 2000, there has been a marked shift in the ecological and geographic focus of AMR risk scenarios. The Global South and One Health (OH) emerged as foci of AMR reports. Using the deterritorialised language of OH to frame AMR as a Southern risk made global stewardship meaningful to donors and legitimised pressure on low-income and middle-income countries to adopt Northern stewardship and surveillance frameworks. It also enabled IOs to move from whistleblowing to managing governance frameworks for antibiotic stewardship. Although the environmental OH domain remains neglected, realisation of the complexity of necessary interventions has increased the range of topics targeted by international action plans. Investment nonetheless continues to focus on biomedical innovation and tends to leave aside broader socioeconomic issues. Better knowledge of how AMR framings have evolved is key to broadening participation in international stewardship going forward.
Collapse
Affiliation(s)
- Kristen Overton
- Infectious Diseases Department, Prince of Wales Hospital Randwick, Sydney, New South Wales, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicolas Fortané
- IRISSO, CNRS, INRAE, Paris-Dauphine University, PSL, Paris, France
| | - Alex Broom
- School of Social and Political Sciences, Sydney Centre for Healthy Societies, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Raymond
- School of Social and Political Sciences, Sydney Centre for Healthy Societies, The University of Sydney, Sydney, New South Wales, Australia
| | - Christoph Gradmann
- Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Ebiowei Samuel F Orubu
- Institute for Health System Innovation and Policy, Boston University, Boston, Massachusetts, USA
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Scott H Podolsky
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Muhammad H Zaman
- Department of International Health, Boston University, Boston, Massachusetts, USA
| | | |
Collapse
|
38
|
Yates J, Gillespie S, Savona N, Deeney M, Kadiyala S. Trust and responsibility in food systems transformation. Engaging with Big Food: marriage or mirage? BMJ Glob Health 2021; 6:e007350. [PMID: 34819325 PMCID: PMC8614044 DOI: 10.1136/bmjgh-2021-007350] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
Concentration of power among transnational 'Big Food' companies has contributed to food systems that are unsustainable, unhealthy and inequitable for people and planet. Given these commercial determinants of health, if 'food systems transformation' is to be authentic-more than a passing narrative-then leveraging Big Food is paramount. To this end, researchers, practitioners and policy-makers are increasingly encouraged to engage with these powerful entities. However, given the conflicts of interest at stake, engagement relies on trust and transparency, that all stakeholders take responsibility for their actions and demonstrate commitment to do no harm. Given Big Food's track record in influencing policy, shifting costs and responsibility for their harms-and while profit primarily drives business decision making-we question whether it is logical to expect trust.This analysis explores concepts of responsibility and trust in relation to food systems transformation involving public-private partnerships. Through short cautionary case studies-looking at the United Nations Food Systems Summit, and Big Food's plastic burden-it argues that unless such companies take responsibility for their cross-cutting effects and earn authentic trust through demonstrably doing no harm, their participation in evidence generation and policy processes should be limited to responding to information requests and adhering to regulation. Any involvement in research agenda-setting or formulating policy solutions introduces conflicts of interest, legitimises corporate irresponsibility and jeopardises scientific integrity. Big Food has dynamism and power to address food system problems, but while it contributes to so many of these problems it should follow-not formulate-transformational evidence, policies and regulations.
Collapse
Affiliation(s)
- Joe Yates
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Stuart Gillespie
- International Food Policy Research Institute, Washington, District of Columbia, USA
| | - Natalie Savona
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Megan Deeney
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Suneetha Kadiyala
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
39
|
Ifeanyichi M, Aune E, Shrime M, Gajewski J, Pittalis C, Kachimba J, Borgstein E, Brugha R, Baltussen R, Bijlmakers L. Financing of surgery and anaesthesia in sub-Saharan Africa: a scoping review. BMJ Open 2021; 11:e051617. [PMID: 34667008 PMCID: PMC8527159 DOI: 10.1136/bmjopen-2021-051617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study aimed to provide an overview of current knowledge and situational analysis of financing of surgery and anaesthesia across sub-Saharan Africa (SSA). SETTING Surgical and anaesthesia services across all levels of care-primary, secondary and tertiary. DESIGN We performed a scoping review of scientific databases (PubMed, EMBASE, Global Health and African Index Medicus), grey literature and websites of development organisations. Screening and data extraction were conducted by two independent reviewers and abstracted data were summarised using thematic narrative synthesis per the financing domains: mobilisation, pooling and purchasing. RESULTS The search resulted in 5533 unique articles among which 149 met the inclusion criteria: 132 were related to mobilisation, 17 to pooling and 5 to purchasing. Neglect of surgery in national health priorities is widespread in SSA, and no report was found on national level surgical expenditures or budgetary allocations. Financial protection mechanisms are weak or non-existent; poor patients often forego care or face financial catastrophes in seeking care, even in the context of universal public financing (free care) initiatives. CONCLUSION Financing of surgical and anaesthesia care in SSA is as poor as it is underinvestigated, calling for increased national prioritisation and tracking of surgical funding. Improving availability, accessibility and affordability of surgical and anaesthesia care require comprehensive and inclusive policy formulations.
Collapse
Affiliation(s)
- Martilord Ifeanyichi
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
- EMAI Health Systems and Health Services Consulting, Nijmegen, The Netherlands
| | - Ellis Aune
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Mark Shrime
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jakub Gajewski
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Chiara Pittalis
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Kachimba
- Department of Surgery, University of Zambia University Teaching Hospital, Lusaka, Zambia
| | - Eric Borgstein
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Ruairi Brugha
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rob Baltussen
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Leon Bijlmakers
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
40
|
D'Mello-Guyett L, Cumming O, Bonneville S, D'hondt R, Mashako M, Nakoka B, Gorski A, Verheyen D, Van den Bergh R, Welo PO, Maes P, Checchi F. Effectiveness of hygiene kit distribution to reduce cholera transmission in Kasaï-Oriental, Democratic Republic of Congo, 2018: a prospective cohort study. BMJ Open 2021; 11:e050943. [PMID: 34649847 PMCID: PMC8522665 DOI: 10.1136/bmjopen-2021-050943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/24/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Household contacts of cholera cases are at a greater risk of Vibrio cholerae infection than the general population. There is currently no agreed standard of care for household contacts, despite their high risk of infection, in cholera response strategies. In 2018, hygiene kit distribution and health promotion was recommended by Médecins Sans Frontières for admitted patients and accompanying household members on admission to a cholera treatment unit in the Democratic Republic of Congo. METHODS To investigate the effectiveness of the intervention and risk factors for cholera infection, we conducted a prospective cohort study and followed household contacts for 7 days after patient admission. Clinical surveillance among household contacts was based on self-reported symptoms of cholera and diarrhoea, and environmental surveillance through the collection and analysis of food and water samples. RESULTS From 94 eligible households, 469 household contacts were enrolled and 444 completed follow-up. Multivariate analysis suggested evidence of a dose-response relationship with increased kit use associated with decreased relative risk of suspected cholera: household contacts in the high kit-use group had a 66% lower incidence of suspected cholera (adjusted risk ratio (aRR) 0.34, 95% CI 0.11 to 1.03, p=0.055), the mid-use group had a 53% lower incidence (aRR 0.47, 95% CI 0.17 to 1.29, p=1.44) and low-use group had 22% lower incidence (aRR 0.78, 95% CI 0.24 to 2.53, p=0.684), compared with household contacts without a kit. Drinking water contamination was significantly reduced among households in receipt of a kit. There was no significant effect on self-reported diarrhoea or food contamination. CONCLUSION The integration of a hygiene kit intervention to case-households may be effective in reducing cholera transmission among household contacts and environmental contamination within the household. Further work is required to evaluate whether other proactive localised distribution among patients and case-households or to households surrounding cholera cases can be used in future cholera response programmes in emergency contexts.
Collapse
Affiliation(s)
- Lauren D'Mello-Guyett
- London School of Hygiene & Tropical Medicine, London, UK
- Médecins Sans Frontières, Brussels, Belgium
| | - Oliver Cumming
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Restar A, Garrison-Desany HM, Baker KE, Adamson T, Howell S, Baral SD, Operario D, Beckham SW. Prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary individuals. BMJ Glob Health 2021; 6:e006808. [PMID: 34518208 PMCID: PMC8438577 DOI: 10.1136/bmjgh-2021-006808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/27/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Testing for COVID-19 and linkage to services is fundamental to successful containment and control of transmission. Yet, knowledge on COVID-19 testing among transgender and non-binary communities remains limited. METHODS Between October 2020 and November 2020, we examined the prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary people (n=536). Multivariable hierarchical logistic regression analyses examined associations between COVID-19 testing and participants' sociodemographic, mental health, substance use, gender affirmation, economic changes and healthcare experiences. RESULTS Prevalence of COVID-19 testing in this sample was 35.5% (n=190/536). In the final model, transgender and non-binary participants from upper socioeconomic income background and Europe, who reported having active alcohol use disorder, limited access to gender-affirming surgery, had more than 20% reduction in income, and experienced mistreatment in a health facility due to gender identity had significantly increased odds of COVID-19 testing (all p<0.05); those who reported recent tobacco use had significantly lower odds of COVID-19 testing (p=0.007). CONCLUSIONS These findings highlight structural disparities in COVID-19 testing and reinforce the importance of increasing testing strategies for transgender and non-binary populations.
Collapse
Affiliation(s)
- Arjee Restar
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Behavioral and Social Science, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Henri M Garrison-Desany
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kellan E Baker
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Tyler Adamson
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Stefan David Baral
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Don Operario
- Department of Behavioral and Social Science, Brown University School of Public Health, Providence, Rhode Island, USA
| | - S Wilson Beckham
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
42
|
Decouttere C, De Boeck K, Vandaele N. Advancing sustainable development goals through immunization: a literature review. Global Health 2021; 17:95. [PMID: 34446050 PMCID: PMC8390056 DOI: 10.1186/s12992-021-00745-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 07/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Immunization directly impacts health (SDG3) and brings a contribution to 14 out of the 17 Sustainable Development Goals (SDGs), such as ending poverty, reducing hunger, and reducing inequalities. Therefore, immunization is recognized to play a central role in reaching the SDGs, especially in low- and middle-income countries (LMICs). Despite continuous interventions to strengthen immunization systems and to adequately respond to emergency immunization during epidemics, the immunization-related indicators for SDG3 lag behind in sub-Saharan Africa. Especially taking into account the current Covid19 pandemic, the current performance on the connected SDGs is both a cause and a result of this. METHODS We conduct a literature review through a keyword search strategy complemented with handpicking and snowballing from earlier reviews. After title and abstract screening, we conducted a qualitative analysis of key insights and categorized them according to showing the impact of immunization on SDGs, sustainability challenges, and model-based solutions to these challenges. RESULTS We reveal the leveraging mechanisms triggered by immunization and position them vis-à-vis the SDGs, within the framework of Public Health and Planetary Health. Several challenges for sustainable control of vaccine-preventable diseases are identified: access to immunization services, global vaccine availability to LMICs, context-dependent vaccine effectiveness, safe and affordable vaccines, local/regional vaccine production, public-private partnerships, and immunization capacity/capability building. Model-based approaches that support SDG-promoting interventions concerning immunization systems are analyzed in light of the strategic priorities of the Immunization Agenda 2030. CONCLUSIONS In general terms, it can be concluded that relevant future research requires (i) design for system resilience, (ii) transdisciplinary modeling, (iii) connecting interventions in immunization with SDG outcomes, (iv) designing interventions and their implementation simultaneously, (v) offering tailored solutions, and (vi) model coordination and integration of services and partnerships. The research and health community is called upon to join forces to activate existing knowledge, generate new insights and develop decision-supporting tools for Low-and Middle-Income Countries' health authorities and communities to leverage immunization in its transformational role toward successfully meeting the SDGs in 2030.
Collapse
Affiliation(s)
- Catherine Decouttere
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
| | - Kim De Boeck
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
| | - Nico Vandaele
- KU Leuven, Access-To-Medicines research Center, Naamsestraat 69, Leuven, Belgium
| |
Collapse
|
43
|
Carter SE, Ahuka-Mundeke S, Pfaffmann Zambruni J, Navarro Colorado C, van Kleef E, Lissouba P, Meakin S, le Polain de Waroux O, Jombart T, Mossoko M, Bulemfu Nkakirande D, Esmail M, Earle-Richardson G, Degail MA, Umutoni C, Anoko JN, Gobat N. How to improve outbreak response: a case study of integrated outbreak analytics from Ebola in Eastern Democratic Republic of the Congo. BMJ Glob Health 2021; 6:bmjgh-2021-006736. [PMID: 34413078 PMCID: PMC8380808 DOI: 10.1136/bmjgh-2021-006736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
The emerging field of outbreak analytics calls attention to the need for data from multiple sources to inform evidence-based decision making in managing infectious diseases outbreaks. To date, these approaches have not systematically integrated evidence from social and behavioural sciences. During the 2018–2020 Ebola outbreak in Eastern Democratic Republic of the Congo, an innovative solution to systematic and timely generation of integrated and actionable social science evidence emerged in the form of the Cellulle d’Analyse en Sciences Sociales (Social Sciences Analytics Cell) (CASS), a social science analytical cell. CASS worked closely with data scientists and epidemiologists operating under the Epidemiological Cell to produce integrated outbreak analytics (IOA), where quantitative epidemiological analyses were complemented by behavioural field studies and social science analyses to help better explain and understand drivers and barriers to outbreak dynamics. The primary activity of the CASS was to conduct operational social science analyses that were useful to decision makers. This included ensuring that research questions were relevant, driven by epidemiological data from the field, that research could be conducted rapidly (ie, often within days), that findings were regularly and systematically presented to partners and that recommendations were co-developed with response actors. The implementation of the recommendations based on CASS analytics was also monitored over time, to measure their impact on response operations. This practice paper presents the CASS logic model, developed through a field-based externally led consultation, and documents key factors contributing to the usefulness and adaption of CASS and IOA to guide replication for future outbreaks.
Collapse
Affiliation(s)
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale, Kinshasa, The Democratic Republic of the Congo
| | | | | | - Esther van Kleef
- Public Health, Prince Leopold Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Sophie Meakin
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine Faculty of Epidemiology and Public Health, London, UK
| | | | | | - Mathias Mossoko
- Ministry of Health, Kinshasa, The Democratic Republic of the Congo
| | | | - Marjam Esmail
- Public Health Emergencies, UNICEF, New York, New York, USA
| | - Giulia Earle-Richardson
- National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marie-Amelie Degail
- Health Emergencies Programme, World Health Organization, Geneve, Switzerland
| | | | | | | |
Collapse
|
44
|
Shahil Feroz A, Pradhan NA, Hussain Ahmed Z, Shah MM, Asad N, Saleem S, Siddiqi S. Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study. BMJ Open 2021; 11:e048984. [PMID: 34344683 PMCID: PMC8338319 DOI: 10.1136/bmjopen-2021-048984] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To explore healthcare provider's perspectives and experiences of the barriers and facilitators to treat and manage COVID-19 cases. DESIGN AND SETTING We conducted an exploratory qualitative study using a purposive sampling approach, at a private tertiary care teaching hospital in Karachi, Pakistan. Study data were analysed manually using the conventional content analysis technique. PARTICIPANTS Key-informant interviews (KIIs) were conducted with senior management and hospital leadership and in-depth interviews (IDIs) were conducted with front-line healthcare providers. RESULTS A total of 31 interviews (KIIs=19; IDIs=12) were conducted, between April and May 2020. Three overarching themes emerged. The first was 'challenges faced by front-line healthcare providers working in COVID-19 wards. Healthcare workers experienced increased anxiety due to the fear of acquiring infection and transmitting it to their family members. They felt overwhelmed due to the exhaustive donning and doffing process, intense work and stigmatisation. The second theme was 'enablers supporting healthcare providers to deal with the COVID-19 pandemic'. Front liners pointed out several enabling factors that supported hospital staff including a safe hospital environment, adequate training, a strong system of information sharing and supportive management. The third theme was 'recommendations to support the healthcare workforce during the COVID-19 crisis'. Healthcare workers recommended measures to mitigate current challenges including providing risk allowance to front-line healthcare providers, preparing a backup health workforce, and establishing a platform to address the mental health needs of the healthcare providers. CONCLUSION This study provides an initial evidence base of healthcare providers' experiences of managing patients with COVID-19 in the early stage of the pandemic and highlights measures needed to address the encountered challenges. It offers lessons for hospitals in low-income and middle-income countries to ensure a safe working environment for front-line workers in their fight against COVID-19.
Collapse
Affiliation(s)
- Anam Shahil Feroz
- Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Zarak Hussain Ahmed
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Mashal Murad Shah
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Sindh, Pakistan
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| | - Sameen Siddiqi
- Department of Community Health Sciences, Aga Khan University, Karachi, Sindh, Pakistan
| |
Collapse
|
45
|
Osmann J, Selva M, Feinstein A. How have journalists been affected psychologically by their coverage of the COVID-19 pandemic? A descriptive study of two international news organisations. BMJ Open 2021; 11:e045675. [PMID: 34253664 PMCID: PMC8277489 DOI: 10.1136/bmjopen-2020-045675] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/08/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has presented unprecedented healthcare challenges. Journalists covering the pandemic at close quarters are working in ways akin to first responders, but nothing to date is known of the psychological distress this is potentially causing them. This study aims to determine whether journalists reporting on the COVID-19 crisis have been affected emotionally, and if so to assess the severity of their distress. It also investigates potential demographic and work-related predictors and whether news organisations had provided counselling to their journalists. PARTICIPANTS A total of 111 journalists working for two international news organisations were approached of which 73 (66%) participated in the study. PRIMARY AND SECONDARY OUTCOME MEASURES Symptoms of anxiety (Generalised Anxiety Disorder Scale-7 (GAD-7)), depression (Patient Health Questionnaire (PHQ-9)), posttraumatic stress disorder (PTSD; PTSD Checklist for DSM-5 (PCL-5)), overall psychological distress (12-item General Health Questionnaire (GHQ-12)), and treatment. RESULTS The percentages of journalists exceeding threshold scores for clinically significant anxiety, depression, PTSD and psychological distress were: GAD-7, 26%; PHQ-9, 20.5%; PCL-5, 9.6%; GHQ-12, 82.2%. Journalists assigned to cover the pandemic (n=54 (74%)) were significantly more anxious (p<0.05). Journalists who received counselling (n=38 (52%)) following the onset of the pandemic reported significantly fewer symptoms of anxiety (p<0.01), depression (p<0.01) and overall psychological distress (p<0.01). CONCLUSIONS Journalists covering the COVID-19 pandemic are experiencing levels of anxiety and depression similar to those seen in first responders. Psychological therapy provided in a timely manner can significantly alleviate emotional distress.
Collapse
Affiliation(s)
- Jonas Osmann
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Meera Selva
- Reuters Institute for the Study of Journalism, University of Oxford, Oxford, UK
| | - Anthony Feinstein
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
46
|
Rajabzadeh V, Burn E, Sajun SZ, Suzuki M, Bird VJ, Priebe S. Understanding global mental health: a conceptual review. BMJ Glob Health 2021; 6:bmjgh-2020-004631. [PMID: 33758013 PMCID: PMC7993328 DOI: 10.1136/bmjgh-2020-004631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/14/2022] Open
Abstract
Background Mental health disorders are viewed as a global concern requiring globally led approaches to address them. Since the publication of the 2007 Lancet series on global mental health (GMH), the term has become widespread. Over the last two decades, GMH has become increasingly affiliated with policy reform, academic courses, funding bodies and research. However, it is not always obvious how those working in the field of GMH are using the term, resulting in a lack of clarity. Therefore, work is needed to synthesise the current understanding(s) of GMH to help characterise its meaning. Aim To synthesise the literature and identify the different ways GMH is understood. Method A conceptual review, using a systematic search and a content analysis, was conducted to develop a conceptual framework of the different conceptual understandings of GMH. Results We developed a conceptual framework of four understandings of GMH. These understandings of GMH are as follows: an area of research generating findings to establish a GMH evidence-base; implementation of research into practice; improving the mental health environment; learning from and supporting low-and-middle-income countries (LMICs). Conclusion Our review proposes a simple framework, clarifying the key characteristics of the GMH landscape. The findings highlight the diversity of usage of the term in the literature, as well as present the wide scope that comprises the field of GMH. Referring to this framework may help those engaged with GMH to be more specific with which aspect of the field they are concerned with.
Collapse
Affiliation(s)
- Vian Rajabzadeh
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Erin Burn
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Sana Z Sajun
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Mimi Suzuki
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Victoria Jane Bird
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
| |
Collapse
|
47
|
Landrum K, Cotache-Condor CF, Liu Y, Truche P, Robinson J, Thompson N, Granzin R, Ameh E, Bickler S, Samad L, Meara J, Rice HE, Smith ER. Global and regional overview of the inclusion of paediatric surgery in the national health plans of 124 countries: an ecological study. BMJ Open 2021; 11:e045981. [PMID: 34135040 PMCID: PMC8211076 DOI: 10.1136/bmjopen-2020-045981] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study evaluates the priority given to surgical care for children within national health policies, strategies and plans (NHPSPs). PARTICIPANTS AND SETTING We reviewed the NHPSPs available in the WHO's Country Planning Cycle Database. Countries with NHPSPs in languages different from English, Spanish, French or Chinese were excluded. A total of 124 countries met the inclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES We searched for child-specific and surgery-specific terms in the NHPSPs' missions, goals and strategies using three analytic approaches: (1) count of the total number of mentions, (2) count of the number of policies with no mentions and (3) count of the number of policies with five or more mentions. Outcomes were compared across WHO regional and World Bank income-level classifications. RESULTS We found that the most frequently mentioned terms were 'child*', 'infant*' and 'immuniz*'. The most frequently mentioned surgery term was 'surg*'. Overall, 45% of NHPSPs discussed surgery and 7% discussed children's surgery. The majority (93%) of countries did not mention selected essential and cost-effective children's procedures. When stratified by WHO region and World Bank income level, the West Pacific region led the inclusion of 'pediatric surgery' in national health plans, with 17% of its countries mentioning this term. Likewise, low-income countries led the inclusion of surg* and 'pediatric surgery', with 63% and 11% of countries mentioning these terms, respectively. In both stratifications, paediatric surgery only equated to less than 1% of the total terms. CONCLUSION The low prevalence of children's surgical search terms in NHPSPs indicates that the influence of surgical care for this population remains low in the majority of countries. Increased awareness of children's surgical needs in national health plans might constitute a critical step to scale up surgical system in these countries.
Collapse
Affiliation(s)
- Kelsey Landrum
- Global Health Institute, Duke University, Durham, North Carolina, USA
| | | | - Yingling Liu
- Department of Sociology, Baylor University, Waco, Texas, USA
| | - Paul Truche
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
| | - Julia Robinson
- Department of Public Health, Baylor University, Waco, Texas, USA
| | - Nealey Thompson
- Department of Public Health, Baylor University, Waco, Texas, USA
| | - Ryann Granzin
- Department of Public Health, Baylor University, Waco, Texas, USA
| | - Emmanuel Ameh
- Division of Pediatric Surgery, Department of Surgery, National Hospital, Abuja, Nigeria
| | - Steve Bickler
- Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, California, USA
- Department of Surgery, University of California San Diego, La Jolla, California, USA
| | - Lubna Samad
- Department of Pediatric Surgery, Indus Hospital, Karachi, Pakistan
| | - John Meara
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
- Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Henry E Rice
- Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Emily R Smith
- Global Health Institute, Duke University, Durham, North Carolina, USA
- Department of Public Health, Baylor University, Waco, Texas, USA
| |
Collapse
|
48
|
Wang J, Zhu J, Yang H, Hu Y, Sun Y, Ying Z, Qu Y, Valdimarsdottir U, Fang F, Song H. Cardiovascular-related deaths at the beginning of the COVID-19 outbreak: a prospective analysis based on the UK Biobank. BMJ Open 2021; 11:e046931. [PMID: 34088708 PMCID: PMC8184350 DOI: 10.1136/bmjopen-2020-046931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To assess the impact of the COVID-19 outbreak on cardiovascular disease (CVD) related mortality and hospitalisation. DESIGN Community-based prospective cohort study. SETTING The UK Biobank. PARTICIPANTS 421 372 UK Biobank participants who were registered in England and alive as of 1 January 2020. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome of interest was CVD-related death, which was defined as death with CVD as a cause in the death register. We retrieved information on hospitalisations with CVD as the primary diagnosis from the UK Biobank hospital inpatient data. The study period was 1 January 2020 to June 30 2020, and we used the same calendar period of the three preceding years as the reference period. In order to control for seasonal variations and ageing of the study population, standardised mortality/incidence ratios (SMRs/SIRs) with 95% CIs were used to estimate the relative risk of CVD outcomes during the study period, compared with the reference period. RESULTS We observed a distinct increase in CVD-related deaths in March and April 2020, compared with the corresponding months of the three preceding years. The observed number of CVD-related deaths (n=218) was almost double in April, compared with the expected number (n=120) (SMR=1.82, 95% CI 1.58 to 2.07). In addition, we observed a significant decline in CVD-related hospitalisations from March onwards, with the lowest SIR observed in April (0.45, 95% CI 0.41 to 0.49). CONCLUSIONS There was a distinct increase in the number of CVD-related deaths in the UK Biobank population at the beginning of the COVID-19 outbreak. The shortage of medical resources for hospital care and stress reactions to the pandemic might have partially contributed to the excess CVD-related mortality, underscoring the need of sufficient healthcare resources and improved instructions to the public about seeking healthcare in a timely way.
Collapse
Affiliation(s)
- Junren Wang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Jianwei Zhu
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Huazhen Yang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Yao Hu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Yajing Sun
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Zhiye Ying
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan Qu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
| | - Unnur Valdimarsdottir
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Medical Big Data Center, Sichuan University, Chengdu, Sichuan, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
49
|
Africa needs to prioritize One Health approaches that focus on the environment, animal health and human health. Nat Med 2021; 27:943-946. [PMID: 34017135 DOI: 10.1038/s41591-021-01375-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
50
|
Amimo F, Lambert B, Magit A, Hashizume M. A review of prospective pathways and impacts of COVID-19 on the accessibility, safety, quality, and affordability of essential medicines and vaccines for universal health coverage in Africa. Global Health 2021; 17:42. [PMID: 33832487 PMCID: PMC8027968 DOI: 10.1186/s12992-021-00666-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 01/11/2021] [Indexed: 01/15/2023] Open
Abstract
Background The ongoing pandemic of coronavirus disease 2019 (COVID-19) has the potential to reverse progress towards global targets. This study examines the risks that the COVID-19 pandemic poses to equitable access to essential medicines and vaccines (EMV) for universal health coverage in Africa. Methods We searched medical databases and grey literature up to 2 October 2020 for studies reporting data on prospective pathways and innovative strategies relevant for the assessment and management of the emerging risks in accessibility, safety, quality, and affordability of EMV in the context of the COVID-19 pandemic. We used the resulting pool of evidence to support our analysis and to draw policy recommendations to mitigate the emerging risks and improve preparedness for future crises. Results Of the 310 records screened, 134 were included in the analysis. We found that the disruption of the international system affects more immediately the capability of low- and middle-income countries to acquire the basket of EMV. The COVID-19 pandemic may facilitate dishonesty and fraud, increasing the propensity of patients to take substandard and falsified drugs. Strategic regional cooperation in the form of joint tenders and contract awarding, joint price negotiation and supplier selection, as well as joint market research, monitoring, and evaluation could improve the supply, affordability, quality, and safety of EMV. Sustainable health financing along with international technology transfer and substantial investment in research and development are needed to minimize the vulnerability of African countries arising from their dependence on imported EMV. To ensure equitable access, community-based strategies such as mobile clinics as well as fees exemptions for vulnerable and under-served segments of society might need to be considered. Strategies such as task delegation and telephone triage could help reduce physician workload. This coupled with payments of risk allowance to frontline healthcare workers and health-literate healthcare organization might improve the appropriate use of EMV. Conclusions Innovative and sustainable strategies informed by comparative risk assessment are increasingly needed to ensure that local economic, social, demographic, and epidemiological risks and potentials are accounted for in the national COVID-19 responses. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00666-8.
Collapse
Affiliation(s)
- Floriano Amimo
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. .,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
| | - Ben Lambert
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Anthony Magit
- Human Research Protection Program, University of California San Diego School of Medicine, San Diego, California, USA
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|