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Ponnaiah M, Virumbi V, Sharma U, Muthappan S, Parasuraman G, Balasubramanian P, Venkatachalam V, Karumanagoundar K. Public health preparedness, syndromic surveillance, and response during the largest religious gathering at the Catholic pilgrimage center of Velankanni in South India: 2016. J Family Med Prim Care 2024; 13:3135-3142. [PMID: 39228585 PMCID: PMC11368300 DOI: 10.4103/jfmpc.jfmpc_1815_23] [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: 11/11/2023] [Revised: 12/23/2023] [Accepted: 03/13/2024] [Indexed: 09/05/2024] Open
Abstract
Background The dynamicity and mobility of the population in a mass gathering setting pose a challenge to traditional disease surveillance methods and strain the local health services. Velankanni is one of the most sacred Christian pilgrimage places located in Nagapattinam, Tamil Nadu, India. We participated in the Velankanni festival to describe the public health preparedness, surveillance, and response activities carried out during the festival. Methods This was a cross-sectional study. We reviewed the national and international guidelines and published literature and discussed with the key stakeholders. We developed a checklist to observe public health preparedness activities. We facilitated the staff and monitored the activities by the implementers. We established the syndromic surveillance in the designated locations of the event and used tracker software to capture the data. Emergency medical teams were formed with trained health personnel to respond to medical emergencies. Results The team monitored all the public health activities. There are 59 primary care public health facilities and nine ambulatory Mobile Medical Units, with 160 medical officers available at the site. Of the 16,169 persons who attended the medical camps, 9863 (61%) were males and 8408 (52%) were aged 15-44. Acute diarrheal disease was the most frequent of the reported syndromes, followed by injuries, acute febrile illness, and animal bites. Conclusions There was no outbreak of any disease either identified or reported. Our findings suggest that risk assessments should be used, and establishing an Incident Command Center is vital for executing command and control mechanisms during mass gatherings.
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Affiliation(s)
- Manickam Ponnaiah
- Department of Online Courses, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Viduthalai Virumbi
- Department of Online Courses, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Upasana Sharma
- Department of Online Courses, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Sendhilkumar Muthappan
- Department of Online Courses, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Ganeshkumar Parasuraman
- Department of Online Courses, ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
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2
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Hardhantyo M, Djasri H, Nursetyo AA, Donna B, Ariani M, Pangaribuan H, Yogadhita GY, Yulianti A, Adipradipta BR. Evidence-Based Policy Recommendations for Public Health Emergency Operation Centers in Regional Settings: A Case Study in Indonesia. Public Health Rev 2023; 44:1604899. [PMID: 37601901 PMCID: PMC10435730 DOI: 10.3389/phrs.2023.1604899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background: Public health emergencies require integration between multiple stakeholders in different sectors to monitor the situation and carry out an appropriate response. As a country with a large land area consisting of thousands of islands, Indonesia's centralized Public Health Emergency Operation Center (PHEOC) system is currently unable to effectively contain diseases. A PHEOC system reform is required to accommodate Indonesia's circumstances, particularly at the regional level. We have outlined potential models at the sub-national level for PHEOC based on existing evidence. Policy Options and Recommendations: Based on existing evidence of PHEOC models internationally, we have formulated three policy models for regional-level PHEOC. These models (the ad hoc agency model, the independent agency model, and the Province Health Office (PHO)-based model) entail different chains of command, and each has its own benefits. Conclusion: We recommend that the Ministry of Health in Indonesia adopt the third PHEOC policy model, in which the chain of command lies under the PHO. This is the most practical approach, as the PHO has the authority to mobilize units and access resources in response to imminent public health emergencies. Further training and capacity-building are required to support the PHO as the commander of the regional PHEOC.
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Affiliation(s)
- Muhammad Hardhantyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Faculty of Health Science, Universitas Respati Yogyakarta, Yogyakarta, Indonesia
| | - Hanevi Djasri
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Aldilas Achmad Nursetyo
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bella Donna
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Madelina Ariani
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Happy Pangaribuan
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gde Yulian Yogadhita
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andriani Yulianti
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Bernadeta Rachela Adipradipta
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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3
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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: 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: 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.
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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
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4
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Tsukayama R, Wodniak N, Hinjoy S, Bunthi C, Akarasewi P, Jiaranairungroj W, Pueyo W, Masunglong W, Kleblumjeak P, MacArthur JR, Bloss E. Public health emergency operations center operations and coordination among Thailand, Cambodia, Lao PDR, and Malaysia during the COVID-19 pandemic. GLOBAL SECURITY: HEALTH, SCIENCE AND POLICY 2023; 8. [PMID: 39234412 PMCID: PMC11373493 DOI: 10.1080/23779497.2023.2216267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/17/2023] [Indexed: 09/06/2024] Open
Abstract
Public Health Emergency Operations Centers (PHEOCs) are the critical units to lead communications, information sharing, and resource mobilisation during national and international health emergencies, and are key components for maintaining global health security. This assessment sought to examine the coordination mechanisms between national and sub-national PHEOCs in Thailand, Cambodia, Lao People's Democratic Republic, and Malaysia (TCLM countries) during the COVID-19 pandemic. Information was collected on PHEOC structures, functions, and cross-border communications in three stages: a literature review of national PHEOC and emergency preparedness capacities; questionnaire responses from stakeholders to describe PHEOC activity at the national level; and meetings with emergency response staff in five border provinces of Thailand to assess communications between sub-national PHEOCs across country borders. The findings showed that each of the countries has demonstrated a commitment to strengthening their national PHEOCs and improving cross-border communication in the face of the COVID-19 pandemic. Strong existing relationships between TCLM countries assisted in activating a coordinated pandemic response, but gaps remain in efficient data sharing, workforce capacity, and the utilisation of consistent communication platforms among countries. Lessons learned from the pandemic can be used to further strengthen countries' preparedness for future health emergencies, in line with International Health Regulations (2005) and regional plans to build health security in the Southeast Asia region. This assessment provides TCLM countries with the opportunity to address weaknesses in national and international PHEOC capacities. It may be used alongside existing guidelines to prepare the region for a stronger response to future global and regional health emergencies.
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Affiliation(s)
- Royce Tsukayama
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Natalie Wodniak
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Bangkok, Thailand
| | - Soawapak Hinjoy
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Charatdao Bunthi
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Bangkok, Thailand
| | - Pasakorn Akarasewi
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Walaiporn Jiaranairungroj
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Wannaporn Pueyo
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Wattana Masunglong
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - Pitchapa Kleblumjeak
- Department of Disease Control, Ministry of Public Health, Office of International Cooperation, Nonthaburi, Thailand
| | - John R MacArthur
- Southeast Asia Regional Office, Office of the Director, Centers for Disease Control and Prevention, Hanoi, Vietnam
| | - Emily Bloss
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Bangkok, Thailand
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5
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Dokubo EK, Shang JD, N'Dir A, Ndongmo CB, Okpu G, Fadil YM, Takang LE, Angumua C, Lyonga E, Mayer M, Ayukotabe T, Nkwoh TK, Hedje J, Etoundi GA, Njock RL. Building on Capacity Established through US Centers for Disease Control and Prevention Global Health Programs to Respond to COVID-19, Cameroon. Emerg Infect Dis 2022; 28:S181-S190. [PMID: 36502395 DOI: 10.3201/eid2813.221193] [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: 12/12/2022] Open
Abstract
The COVID-19 pandemic has highlighted the need for resilient health systems with the capacity to effectively detect and respond to disease outbreaks and ensure continuity of health service delivery. The pandemic has disproportionately affected resource-limited settings with inadequate health capacity, resulting in disruptions in health service delivery and worsened outcomes for key health indicators. As part of the US government's goal of ensuring health security, the US Centers for Disease Control and Prevention has used its scientific and technical expertise to build health capacity and address health threats globally. We describe how capacity developed through global health programs of the US Centers for Disease Control and Prevention in Cameroon was leveraged to respond to coronavirus disease and maintain health service delivery. The health system strengthening efforts in Cameroon can be applied in similar settings to ensure preparedness for future global public health threats and improve health outcomes.
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6
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Krishnan S, Espinosa C, Podgornik MN, Haile S, Aponte JJ, Brown CK, Vagi SJ. COVID-19 Response Roles among CDC International Public Health Emergency Management Fellowship Graduates. Emerg Infect Dis 2022; 28:S145-S150. [PMID: 36502380 DOI: 10.3201/eid2813.220713] [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: 12/15/2022] Open
Abstract
Since 2013, the US Centers for Disease Control and Prevention has offered the Public Health Emergency Management Fellowship to health professionals from around the world. The goal of this program is to build an international workforce to establish public health emergency management programs and operations centers in participating countries. In March 2021, all 141 graduates of the fellowship program were invited to complete a web survey designed to examine their job roles and functions, assess their contributions to their country's COVID-19 response, and identify needs for technical assistance to strengthen national preparedness and response systems. Of 141 fellows, 89 successfully completed the survey. Findings showed that fellowship graduates served key roles in COVID-19 response in many countries, used skills they gained from the fellowship, and desired continuing engagement between the Centers for Disease Control and Prevention and fellowship alumni to strengthen the community of practice for international public health emergency management.
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7
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Wang H. Public health emergency decision-making and management system sound research using rough set attribute reduction and blockchain. Sci Rep 2022; 12:3600. [PMID: 35246582 PMCID: PMC8897403 DOI: 10.1038/s41598-022-07493-w] [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: 12/23/2021] [Accepted: 02/14/2022] [Indexed: 11/24/2022] Open
Abstract
Public health emergency decisions are explored to ensure the emergency response measures in an environment where various emergencies occur frequently. An emergency decision is essentially a multi-criteria risk decision-making problem. The feasibility of applying prospect theory to emergency decisions is analyzed, and how psychological behaviors of decision-makers impact decision-making results are quantified. On this basis, the cognitive process of public health emergencies is investigated based on the rough set theory. A Decision Rule Extraction Algorithm (denoted as A-DRE) that considers attribute costs is proposed, which is then applied for attribute reduction and rule extraction on emergency datasets. In this way, decision-makers can obtain reduced decision table attributes quickly. Considering that emergency decisions require the participation of multiple departments, a framework is constructed to solve multi-department emergency decisions. The technical characteristics of the blockchain are in line with the requirements of decentralization and multi-party participation in emergency management. The core framework of the public health emergency management system-plan, legal system, mechanism, and system can play an important role. When [Formula: see text], the classification accuracy under the K-Nearest Neighbor (KNN) classifier reaches 73.5%. When [Formula: see text], the classification accuracy under the Support Vector Machines (SVM) classifier reaches 86.4%. It can effectively improve China's public health emergency management system and improve the efficiency of emergency management. By taking Coronavirus Disease 2019 (COVID-19) as an example, the weight and prospect value functions of different decision-maker attributes are constructed based on prospect theory. The optimal rescue plan is finally determined. A-DRE can consider the cost of each attribute in the decision table and the ability to classify it correctly; moreover, it can reduce the attributes and extract the rules on the COVID-19 dataset, suitable for decision-makers' situation face once an emergency occurs. The emergency decision approach based on rough set attribute reduction and prospect theory can acquire practical decision-making rules while considering the different risk preferences of decision-makers facing different decision-making results, which is significant for the rapid development of public health emergency assistance and disaster relief.
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Affiliation(s)
- Hanyi Wang
- School of Economics and Management, Kunming University, Kunming, 650214, China.
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8
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Oyebanji O, Ibrahim Abba F, Akande OW, Aniaku EC, Abubakar A, Oladejo J, Aderinola O, Benyeogor E, Owoeye F, Nguku PM, Bemo VN, Ihekweazu C. Building local capacity for emergency coordination: establishment of subnational Public Health Emergency Operations Centres in Nigeria. BMJ Glob Health 2021; 6:bmjgh-2021-007203. [PMID: 34711580 PMCID: PMC8557245 DOI: 10.1136/bmjgh-2021-007203] [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: 08/18/2021] [Accepted: 10/08/2021] [Indexed: 11/23/2022] Open
Abstract
Public Health Emergency Operations Centres (PHEOCs) provide a platform for multisectoral coordination and collaboration, to enhance the efficiency of outbreak response activities and enable the control of disease outbreaks. Over the last decade, PHEOCs have been introduced to address the gaps in outbreak response coordination. With its tropical climate, high population density and poor socioeconomic indicators, Nigeria experiences large outbreaks of infectious diseases annually. These outbreaks have led to mortality and negative economic impact as a result of large disparities in healthcare and poor coordination systems. Nigeria is a federal republic with a presidential system of government and a separation of powers among the three tiers of government which are the federal, state and local governments. There are 36 states in Nigeria, and as with other countries with a federal system of governance, each state in Nigeria has its budgets, priorities and constitutional authority for health sector interventions including the response to disease outbreaks. Following the establishment of a National PHEOC in 2017 to improve the coordination of public health emergencies, the Nigeria Centre for Disease Control began the establishment of State PHEOCs. Using a defined process, the establishment of State PHEOCs has led to improved coordination, coherence of thoughts among public health officials, government ownership, commitment and collaboration. This paper aims to share the experience and importance of establishing PHEOCs at national and subnational levels in Nigeria and the lessons learnt which can be used by other countries considering the use of PHEOCs in managing complex emergencies.
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Affiliation(s)
- Oyeronke Oyebanji
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Fatima Ibrahim Abba
- Health Emergency Preparedness and Response, Public Health England, London, UK.,Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Oluwatosin Wuraola Akande
- Prevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Everistus Chijioke Aniaku
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Anwar Abubakar
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - John Oladejo
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Olaolu Aderinola
- Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Emmanuel Benyeogor
- Health Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Femi Owoeye
- Independent Consultant, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
| | - Patrick M Nguku
- Nigeria Field Epidemiology Training Programme, African Field Epidemiology Network, Abuja, Federal Capital Territory, Nigeria
| | | | - Chikwe Ihekweazu
- Office of the Director General, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, Nigeria
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9
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Thai PQ, Rabaa MA, Luong DH, Tan DQ, Quang TD, Quach HL, Hoang Thi NA, Dinh PC, Nghia ND, Tu TA, Quang LN, Phuc TM, Chau V, Khanh NC, Anh DD, Duong TN, Thwaites G, van Doorn HR, Choisy M. The First 100 Days of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Control in Vietnam. Clin Infect Dis 2021; 72:e334-e342. [PMID: 32738143 PMCID: PMC7454342 DOI: 10.1093/cid/ciaa1130] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Indexed: 12/17/2022] Open
Abstract
Background One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. Methods Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers. Results A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI, .·37–2.·36). No community transmission has been detected since 15 April. Conclusions Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission.
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Affiliation(s)
- Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maia A Rabaa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Duong Huy Luong
- Medical Services Administration, Ministry of Health, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Tran Dai Quang
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Ha-Linh Quach
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Ngoc-Anh Hoang Thi
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Phung Cong Dinh
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi, Vietnam
| | - Ngu Duy Nghia
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Anh Tu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Tran My Phuc
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Vinh Chau
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - H Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Marc Choisy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
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10
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Thai PQ, Rabaa MA, Luong DH, Tan DQ, Quang TD, Quach HL, Hoang Thi NA, Dinh PC, Nghia ND, Tu TA, Quang LN, Phuc TM, Chau V, Khanh NC, Anh DD, Duong TN, Thwaites G, van Doorn HR, Choisy M. The First 100 Days of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Control in Vietnam. Clin Infect Dis 2021. [PMID: 32738143 DOI: 10.1093/cid/ciaa1130/5879764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND One hundred days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Vietnam on 23 January, 270 cases were confirmed, with no deaths. We describe the control measures used by the government and their relationship with imported and domestically acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. METHODS Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of government control measures, including numbers of tests and quarantined individuals, were analyzed. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of presymptomatic transmission events and time-varying reproduction numbers. RESULTS A national lockdown was implemented between 1 and 22 April. Around 200 000 people were quarantined and 266 122 reverse transcription polymerase chain reaction (RT-PCR) tests conducted. Population mobility decreased progressively before lockdown. In total, 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. The serial interval was 3.24 days, and 27.5% (95% confidence interval [CI], 15.7%-40.0%) of transmissions occurred presymptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% CI, .·37-2.·36). No community transmission has been detected since 15 April. CONCLUSIONS Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial presymptomatic transmission.
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Affiliation(s)
- Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Maia A Rabaa
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Duong Huy Luong
- Medical Services Administration, Ministry of Health, Hanoi, Vietnam
| | - Dang Quang Tan
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Tran Dai Quang
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Ha-Linh Quach
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Ngoc-Anh Hoang Thi
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.,Research School of Population Health, Australian National University, Canberra, Australia
| | - Phung Cong Dinh
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi, Vietnam
| | - Ngu Duy Nghia
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Anh Tu
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Tran My Phuc
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Vinh Chau
- Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Guy Thwaites
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - H Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
| | - Marc Choisy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Oxford University Clinical Research Unit, Ho Chi Minh city, Vietnam
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11
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Clara A, Dao ATP, Tran Q, Tran PD, Dang TQ, Nguyen HT, Tran QD, Rzeszotarski P, Talbert K, Stehling-Ariza T, Veasey F, Clemens L, Mounts AW, Lofgren H, Balajee SA, Do TT. Testing early warning and response systems through a full-scale exercise in Vietnam. BMC Public Health 2021; 21:409. [PMID: 33637080 PMCID: PMC7907319 DOI: 10.1186/s12889-021-10402-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: 10/16/2020] [Accepted: 02/07/2021] [Indexed: 11/25/2022] Open
Abstract
Background Simulation exercises can functionally validate World Health Organization (WHO) International Health Regulations (IHR 2005) core capacities. In 2018, the Vietnam Ministry of Health (MOH) conducted a full-scale exercise (FSX) in response to cases of severe viral pneumonia with subsequent laboratory confirmation for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) to evaluate the country’s early warning and response capabilities for high-risk events. Methods An exercise planning team designed a complex fictitious scenario beginning with one case of severe viral pneumonia presenting at the hospital level and developed all the materials required for the exercise. Actors, controllers and evaluators were trained. In August 2018, a 3-day exercise was conducted in Quang Ninh province and Hanoi city, with participation of public health partners at the community, district, province, regional and national levels. Immediate debriefings and an after-action review were conducted after all exercise activities. Participants assessed overall exercise design, conduction and usefulness. Results FSX findings demonstrated that the event-based surveillance component of the MOH surveillance system worked optimally at different administrative levels. Detection and reporting of signals at the community and health facility levels were appropriate. Triage, verification and risk assessment were successfully implemented to identify a high-risk event and trigger timely response. The FSX identified infection control, coordination with internal and external response partners and process documentation as response challenges. Participants positively evaluated the exercise training and design. Conclusions This exercise documents the value of exercising surveillance capabilities as part of a real-time operational scenario before facing a true emergency. The timing of this exercise and choice of disease scenario was particularly fortuitous given the subsequent appearance of COVID-19. As a result of this exercise and subsequent improvements made by the MOH, the country may have been better able to deal with the emergence of SARS-CoV-2 and contain it. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10402-x.
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Affiliation(s)
- Alexey Clara
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anh T P Dao
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Quy Tran
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Phu D Tran
- General Department of Preventive Medicine, Under the Vietnam Ministry of Health, Hanoi, Vietnam
| | - Tan Q Dang
- General Department of Preventive Medicine, Under the Vietnam Ministry of Health, Hanoi, Vietnam
| | - Huong T Nguyen
- General Department of Preventive Medicine, Under the Vietnam Ministry of Health, Hanoi, Vietnam
| | - Quang D Tran
- General Department of Preventive Medicine, Under the Vietnam Ministry of Health, Hanoi, Vietnam
| | - Peter Rzeszotarski
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Karen Talbert
- Division of Emergency Operations, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, USA
| | - Tasha Stehling-Ariza
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | | | | | - Anthony W Mounts
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Hannah Lofgren
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Arunmozhi Balajee
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Trang T Do
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
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12
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Balajee SA, Salyer SJ, Greene-Cramer B, Sadek M, Mounts AW. The practice of event-based surveillance: concept and methods. GLOBAL SECURITY: HEALTH, SCIENCE AND POLICY 2021. [DOI: 10.1080/23779497.2020.1848444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- S. Arunmozhi Balajee
- Division of Viral Disease, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention (US CDC), Atlanta, Georgia
| | - Stephanie J. Salyer
- Division of Global Health Protection, Center for Global Health, US CDC, United States of America
- Africa Centres for Disease Control and Prevention, African Union, Addis Ababa, Ethiopia
| | | | - Mahmoud Sadek
- Health Emergency Information and Risk Assessment Unit, Eastern Mediterranean Region WHO Office, Egypt
| | - Anthony W. Mounts
- Office of Maternal and Child Health and Nutrition, Bureau for Global Health, U.S. Agency for International Development (USAID), United States of America
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13
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Ding F, Li Q, Jin LM. Experience and practice of the Emergency Operations Center, Chinese Center for Disease Control and Prevention: a case study of response to the H7N9 outbreak. Infect Dis Poverty 2021; 10:4. [PMID: 33407876 PMCID: PMC7787607 DOI: 10.1186/s40249-020-00789-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergency Operations Center (EOC) is a place to provide response to public health emergencies. Chinese Center for Disease Control and Prevention (China CDC)'s EOC was officially established in 2016, which has been the core department for the public health emergencies and risk response. In recent years, we have been continuously improving the function of EOC through many incidents. In the study, we hope to share the construction status, operation management experience of China CDC's EOC and the response process in the human avian influenza A (H7N9) outbreak. MAIN TEXT The China CDC's EOC mainly focus on building the five core elements including sites/places and facilities, information and data, plans and procedures, training and exercises, and logistics. Based on summarizing previous emergency response, the China CDC's EOC established its own incident management and the standardized response procedures. The event-specific data, context-specific data and event management data could be obtained through various source. The logistics department of the EOC also provides comprehensive support. The well-trained staff is another necessary conditions for its operation. Through sharing the response process of H7N9 outbreak, it further explains the EOC's functions in the five phases of outbreak response, such as the formulation of the incident response framework, monitoring, personnel dispatch and resource mobilization. CONCLUSIONS The EOC contributes to faster and more efficient responses during emergencies which enable a greater reduction in morbidity and mortality. Compared with the traditional incident response process, under the command and coordination of China CDC's EOC, each group involved in the response has a clearer goal, responsibilities and tasks at each stage. Meanwhile, each group also gave full play to its own expertise and advantages. As a whole, incident response tended to be more specialized and precise, which generally improves the efficiency of incident response. However, different countries and regions have different response processes to the events. We still suggested that appropriate emergency operation plan should be made according to the complexity of incident response in the region when constructing response mechanism, through our experience. And the China CDC's EOC is still at growing and groping phase.
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Affiliation(s)
- Fan Ding
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qun Li
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lian-Mei Jin
- Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China.
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14
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Ma J, Huang Y, Zheng ZJ. Leveraging the Public Health Emergency Operation Center (PHEOC) for pandemic response: opportunities and challenges. ACTA ACUST UNITED AC 2020; 4:118-120. [PMID: 33251032 PMCID: PMC7680508 DOI: 10.1016/j.glohj.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinating information and resources towards goal-oriented response in large scale public health emergency. Yet, the activities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario. This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified the opportunities and challenges in compliance with standards and framework, demonstrated the accountability of PHEOC network, thereby promoted best practice guidance for global public health emergency preparedness and response. This review will help navigate emergency response complexities leveraging PHEOC partnerships and advance the ability to detect and respond to public health emergencies in low resource settings. The review shows that the information on how to adapt best practice guidance to local circumstances could incentivize the full implementation of prevention, early detection and response to outbreaks. Identifying and correcting deficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With the gradually reopening economies and public services in some countries, there is an urgent need to emphasize and validate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.
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Affiliation(s)
- Jiyan Ma
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
- Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
- Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
- Institute for Global Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China
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15
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Alroy KA, Gwom LC, Ndongo CB, Kenmoe S, Monamele G, Clara A, Whitaker B, Manga H, Tayimetha CY, Tseuko D, Etogo B, Pasi O, Etoundi AG, Seukap E, Njouom R, Balajee A. Strengthening timely detection and reporting of unusual respiratory events from health facilities in Yaoundé, Cameroon. Influenza Other Respir Viruses 2020; 14:122-128. [PMID: 31923349 PMCID: PMC7040971 DOI: 10.1111/irv.12684] [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] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The International Health Regulations state that early detection and immediate reporting of unusual health events is important for early warning and response systems. OBJECTIVE To describe a pilot surveillance program established in health facilities in Yaoundé, Cameroon in 2017 which aimed to enable detection and reporting of public health events. METHODS Cameroon's Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event-based surveillance (EBS) in nine Yaoundé health facilities. Four signals were defined that could indicate possible public health events, and a reporting, triage, and verification system was established among partner organizations. A pre-defined laboratory algorithm was defined, and a series of workshops trained health facilities, laboratory, and public health staff for surveillance implementation. RESULTS From May 2017 to January 2018, 30 signals were detected, corresponding to 15 unusual respiratory events. All health facilities reported a signal at least once, and more than three-quarters of health facilities reported ≥2 times. Among specimens tested, the pathogens detected included Klebsiella pneumoniae, Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Pneumocystis jiroveci, influenza A (H1N1) virus, rhinovirus, and adenovirus. CONCLUSIONS The events detected in this pilot were caused by routine respiratory bacteria and viruses, and no novel influenza viruses or other emerging respiratory threats were identified. The surveillance system, however, strengthened relationships and communication linkages between health facilities and public health authorities. Astute clinicians can play a critical role in early detection and EBS is one approach that may enable reporting of emerging outbreaks and public health events.
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Affiliation(s)
- Karen A. Alroy
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Luc Christian Gwom
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | | | | | | | - Alexey Clara
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Brett Whitaker
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
| | - Henri Manga
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | | | - Dorine Tseuko
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | - Bienvenu Etogo
- National Public Health LaboratoryMinistry of HealthYaoundéCameroon
| | - Omer Pasi
- Division of Global Health ProtectionCenter for Global HealthAtlantaGAUSA
| | - Alain Georges Etoundi
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | - Elise Seukap
- Division for the Fight against Disease, Epidemics and PandemicsMinistry of HealthYaoundéCameroon
| | | | - Arunmozhi Balajee
- Division of Viral DiseasesNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionAtlantaGAUSA
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Ughasoro MD, Esangbedo DO, Udorah IM. Health-Care Workers' Perspectives on Preparedness of Health-Care Facilities for Outbreak of Communicable Diseases in Nigeria: A Qualitative Study. Am J Trop Med Hyg 2020; 100:1022-1028. [PMID: 30652657 DOI: 10.4269/ajtmh.18-0404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
A high probability of another outbreak of communicable disease exists in sub-Saharan African countries, after the Ebola virus disease outbreak of 2014. Thus, health-care facility (HCF) preparedness for a prompt and effective response to disease outbreaks needs to be ascertained. In this study, Nigerian health-care workers' (HCWs) knowledge of preparedness, perception of the level of preparedness existing in these HCFs, militating factors, and possible ways to improve, were evaluated through qualitative data collection, using focus group discussion and in-depth interview. Among the 193 HCWs which participated in the study, the perception of 190 (98.4%) was that their HCFs were insufficiently equipped to respond to disease outbreaks. None of the facilities had an emergency operation unit (EOU). Most HCWs perceived preparedness as observation of universal precautions. Other aspects of preparedness, such as training, routine emergency drills, disease surveillance, waste management, and design and location of HCFs were minimally mentioned. None of the participants had undergone any form of emergency drill training. Among the suggestions of how to improve on preparedness were immunization of staff, improved inter-departmental communication within the HCF, and routine training. The overall poor level of preparedness which exists in the HCFs means that they cannot prevent or contain a communicable disease outbreak. There is a need to improve universal precautions, communication within the HCFs, and routine interpretation of surveillance data by epidemiologists. There is also a need for the establishment of EOU in every HCF, a system that responds to, and manages emergency response to disease outbreaks, which also must be functional during non-outbreak periods.
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Affiliation(s)
- Maduka D Ughasoro
- Department of Paediatrics, University of Nigeria Enugu Campus, Enugu, Nigeria
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Kupferman N, Hanlin E. Review of Emerging Infectious Disease Preparedness Measures for the State of Delaware. Dela J Public Health 2019; 5:64-67. [PMID: 34467060 PMCID: PMC8352366 DOI: 10.32481/djph.2019.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Emerging infectious diseases (EIDs) are a growing global concern as more of these pathogens or their associated illnesses are identified, and human migration continues to increase. The state of Delaware has an intricate system to monitor, prepare for, and take action against these diseases. To effectively prepare for an outbreak of an infectious disease, there is a high level of inter- and intra-organizational communication, evolutions from previous situations, and cooperation with the public. EID preparedness plans are constantly changing to adapt to the situations at hand, making collaboration with all stakeholders crucial for a sufficient outbreak response.
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Affiliation(s)
- Nikki Kupferman
- Vaccine Preventable Disease Epidemiologist, Delaware Division of Public Health
| | - Emily Hanlin
- Epidemiologist, Office of Preparedness, Delaware Division of Public Health
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