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Alkhattabi EF, Hart A, Issa F, Hertelendy A, Alrusyani Y, Voskanyan A, Ciottone G. Syndromic Surveillance Implementation During Disaster Events. Disaster Med Public Health Prep 2023; 17:e542. [PMID: 38031255 DOI: 10.1017/dmp.2023.204] [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: 12/01/2023]
Abstract
INTRODUCTION Disease surveillance is an integral part of public health. These systems monitor disease trends and detect outbreaks, whereas they should be evaluated for efficacy. The United States Centres for Disease Control and Prevention publish Guidelines for Evaluating Surveillance Systems to encourage efficient and effective use of public health surveillance that are accepted worldwide. OBJECTIVE This study reviews syndromic surveillance during natural and man-made disasters internationally. It aims to (1) review the performance of syndromic surveillance via pre-specified attributes during disaster and to (2) understand its strengths and limitations. METHODS PubMed was systematically searched for the articles assessing syndromic surveillance during a disaster. A narrative review was carried out based on those articles. Updated Guidelines for Evaluating Public Health Surveillance Systems were used to review performance of systems. RESULTS 5,059 studies from PubMed were evaluated, and 16 met inclusion criteria. The majority of these studies considered the implementation of syndromic surveillance useable during disaster events. Studies described systems giving relevant and timely information. Simplicity and timeliness were the most highlighted attributes. CONCLUSION Syndromic surveillance is simple, flexible, useful and usable during a disaster. Timely data can be obtained, but the quality of this type of data is sensitive to incomplete and erroneous reporting; because of this, a standardized approach is necessary to optimize these systems.
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Affiliation(s)
- Eyad F Alkhattabi
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Ministry of Interior, Saudi Arabia
- Harvard Medical School, Boston, MA, USA
| | - Alexander Hart
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Hartford Hospital, Hartford, CT, USA
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Fadi Issa
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Attila Hertelendy
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, USA
| | - Yasir Alrusyani
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Ministry of Health, Saudi Arabia
| | - Amalia Voskanyan
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Gregory Ciottone
- BIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Hameed MA, Rahman MM, Khanam R. The health consequences of civil wars: evidence from Afghanistan. BMC Public Health 2023; 23:154. [PMID: 36690962 PMCID: PMC9872361 DOI: 10.1186/s12889-022-14720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/24/2022] [Indexed: 01/24/2023] Open
Abstract
This study examines the effects of long-run civil wars on healthcare, which is an important component of human capital development and their causality nexus in Afghanistan using the MVAR (modified vector autoregressive) approach and the Granger non-causality model covering data period 2002Q3-2020Q4. The primary results support a significant long-run relationship between variables, while the results of the MVAR model indicate the per capita cost of war, per capita GDP, and age dependency ratio have significantly positive impacts on per capita health expenditures, whereas child mortality rate and crude death rate have negative impacts. The results of the Granger non-causality approach demonstrate that there is a statistically significant bidirectional causality nexus between per capita health expenditure, per capita cost of war, per capita GDP, child mortality rate, crude death rate, and age dependency ratio, while it also supports the existence of strong and significant interconnectivity and multidimensionality between per capita cost of war and per capita health expenditure, with a significantly strong feedback response from the control variables. Important policy implications sourced from the key findings are also discussed.
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Affiliation(s)
- Mohammad Ajmal Hameed
- School of Business; Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia.
| | - Mohammad Mafizur Rahman
- School of Business; Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
| | - Rasheda Khanam
- School of Business; Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
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Jaung MS, Willis R, Sharma P, Aebischer Perone S, Frederiksen S, Truppa C, Roberts B, Perel P, Blanchet K, Ansbro É. Models of care for patients with hypertension and diabetes in humanitarian crises: a systematic review. Health Policy Plan 2021; 36:509-532. [PMID: 33693657 PMCID: PMC8128021 DOI: 10.1093/heapol/czab007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 01/02/2023] Open
Abstract
Care for non-communicable diseases, including hypertension and diabetes (HTN/DM), is recognized as a growing challenge in humanitarian crises, particularly in low- and middle-income countries (LMICs) where most crises occur. There is little evidence to support humanitarian actors and governments in designing efficient, effective, and context-adapted models of care for HTN/DM in such settings. This article aimed to systematically review the evidence on models of care targeting people with HTN/DM affected by humanitarian crises in LMICs. A search of the MEDLINE, Embase, Global Health, Global Indexus Medicus, Web of Science, and EconLit bibliographic databases and grey literature sources was performed. Studies were selected that described models of care for HTN/DM in humanitarian crises in LMICs. We descriptively analysed and compared models of care using a conceptual framework and evaluated study quality using the Mixed Methods Appraisal Tool. We report our findings according to PRISMA guidelines. The search yielded 10 645 citations, of which 45 were eligible for this review. Quantitative methods were most commonly used (n = 34), with four qualitative, three mixed methods, and four descriptive reviews of specific care models were also included. Most studies detailed primary care facility-based services for HTN/DM, focusing on health system inputs. More limited references were made to community-based services. Health care workforce and treatment protocols were commonly described framework components, whereas few studies described patient centredness, quality of care, financing and governance, broader health policy, and sociocultural contexts. There were few programme evaluations or effectiveness studies, and only one study reported costs. Most studies were of low quality. We concluded that an increasing body of literature describing models of care for patients with HTN/DM in humanitarian crises demonstrated the development of context-adapted services but showed little evidence of impact. Our conceptual framework could be used for further research and development of NCD models of care.
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Affiliation(s)
- Michael S Jaung
- Department of Health Services Research & Policy and Centre for Global Chronic Conditions, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- Department of Emergency Medicine, Baylor College of Medicine, 1504 Ben Taub Loop, Houston, 77030, TX, USA
| | - Ruth Willis
- Department of Health Services Research & Policy and Centre for Global Chronic Conditions, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Piyu Sharma
- Department of Health Services Research & Policy and Centre for Global Chronic Conditions, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sigiriya Aebischer Perone
- Health Unit, international Committee of the Red Cross, Avenue de la Paix 19, 1202 Geneva, Switzerland
| | | | - Claudia Truppa
- Health Unit, international Committee of the Red Cross, Avenue de la Paix 19, 1202 Geneva, Switzerland
| | - Bayard Roberts
- Department of Health Services Research & Policy and Centre for Global Chronic Conditions, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Pablo Perel
- Department of Non-Communicable Disease Epidemiology and Centre for Global Chronic Conditions, Faculty of Epidemiology and Population Health, Keppel Street, London WC1E 7HT, UK
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, University of Geneva, 24 rue du Général-Dufour, Geneva, Switzerland
| | - Éimhín Ansbro
- Department of Health Services Research & Policy and Centre for Global Chronic Conditions, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Ramos Jaraba SM, Quiceno Toro N, Ochoa Sierra M, Ruiz Sánchez L, García Jiménez MA, Salazar-Barrientos MY, Bedoya Bedoya E, Vélez Álvarez GA, Langer A, Gausman J, Garcés-Palacio IC. Health in conflict and post-conflict settings: reproductive, maternal and child health in Colombia. Confl Health 2020; 14:33. [PMID: 32514298 PMCID: PMC7254675 DOI: 10.1186/s13031-020-00273-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 04/14/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In conflict-afflicted areas, pregnant women and newborns often have higher rates of adverse health outcomes. OBJECTIVE To describe maternal and child health indicators and interventions between 1998 and 2016 comparing high and low conflict areas in Colombia. METHODS Mixed study of convergent triangulation. In the quantitative component, 16 indicators were calculated using official, secondary data sources. The victimization rate resulting from armed conflict was calculated by municipality and grouped into quintiles. In the qualitative component, a comparative case study was carried out in two municipalities of Antioquia: one with high rates of armed conflict and another with low rates. A total of 41 interviews and 8 focus groups were held with local and national government officials, health professionals, community informants, UN agencies and NGOs. RESULTS All of the indicators show improvement, however, four show statistically significant differences between municipalities with high victimization rates versus low ones. The maternal mortality ratio was higher in the municipalities with greater victimization in the periods 1998-2004, 2005-2011 and 2012-2016. The percentage of cesarean births and women who received four or more antenatal visits was lower among women who experienced the highest levels of victimization for the period 1998-2000, while the fertility rate for women between 15 and 19 years was higher in these municipalities between 2012 and 2016. In the context of the armed conflict in Colombia, maternal and child health was affected by the limited availability of interventions given the lack of human resources in health, supplies, geographical access difficulties and insecurity. The national government was the one that mostly provided the programs, with difficulties in continuity and quality. UN Agencies and NGOs accessed more easily remote and intense armed conflict areas. Few specific health interventions were identified in the post-conflict context. CONCLUSIONS In Colombia, maternal and child health indicators have improved since the conflict, however a pattern of inequality is observed in the municipalities most affected by the armed conflict.
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Affiliation(s)
- Sara Milena Ramos Jaraba
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Natalia Quiceno Toro
- Grupo Cultura, Violencia y Territorio, Instituto de Estudios Regionales, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - María Ochoa Sierra
- Hegemonía, Guerras y Conflictos, Instituto de Estudios Políticos, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Laura Ruiz Sánchez
- Facultad de ciencias sociales y humanas, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Marlly Andrea García Jiménez
- Grupo Cultura, Violencia y Territorio, Instituto de Estudios Regionales, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Mary Y. Salazar-Barrientos
- Nacer Salud Sexual Reproductiva, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Edison Bedoya Bedoya
- Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Gladis Adriana Vélez Álvarez
- Nacer Salud Sexual Reproductiva, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
| | - Ana Langer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 651 Huntington Avenue, FXB Building 7th Floor, Boston, USA
| | - Jewel Gausman
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 651 Huntington Avenue, FXB Building 7th Floor, Boston, USA
| | - Isabel C. Garcés-Palacio
- Grupo de Epidemiologia, Facultad Nacional de Salud Pública, Universidad de Antioquia UdeA, Calle 70 No. 52-72, Medellín, Colombia
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Research Frontiers of Health Emergency and Disaster Risk Management: What Do We Know So Far? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051807. [PMID: 32164370 PMCID: PMC7084795 DOI: 10.3390/ijerph17051807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 12/01/2022]
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Durrance-Bagale A, Salman OM, Omar M, Alhaffar M, Ferdaus M, Newaz S, Krishnan S, Howard N. Lessons from humanitarian clusters to strengthen health system responses to mass displacement in low and middle-income countries: A scoping review. J Migr Health 2020; 1-2:100028. [PMID: 33458716 PMCID: PMC7790453 DOI: 10.1016/j.jmh.2020.100028] [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: 12/02/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022] Open
Abstract
Potential scope for health-system learning from cluster responses to mass displacement. Non-health clusters can contribute to health improvements during mass displacement. Cluster approaches are often siloed with insufficient cross-cluster learning. Equitable power dynamics between displaced people, humanitarian actors, and governments are still needed.
The humanitarian cluster approach was established in 2005 but clarity on how lessons from humanitarian clusters can inform and strengthen health system responses to mass displacement in low and middle-income countries (LMIC) is lacking. We conducted a scoping review to examine the extent and nature of existing research and identify relevant lessons. We used Arksey and O'Malley's scoping framework with Levac's 2010 revisions and Khalil's 2016 refinements, focussing on identifying lessons from discrete humanitarian clusters that could strengthen health system responses to mass population displacement. We summarised thematically by cluster. Of 186 sources included, 56% were peer-reviewed research articles. Most related to health (37%), protection (18%), or nutrition (13%) clusters. Key lessons for health system responses included the necessity of empowering women; ensuring communities are engaged in decision-making processes (e.g. planning and construction of camps and housing) to strengthen trust and bonds between and within communities; and involving potential end-users in technological innovations development (e.g. geographical information systems) to ensure relevance and applicability. Our review provided evidence that non-health clusters can contribute to improving health outcomes using focussed interventions for implementation by government or humanitarian partners to inform LMIC health system responses to mass displacement.
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Affiliation(s)
- Anna Durrance-Bagale
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Omar Mukhtar Salman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Maryam Omar
- Bart's Health NHS Trust, The Royal London Hospital, Whitechapel Road, London E1 1BB, United Kingdom
| | - Mervat Alhaffar
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom
| | - Muhammad Ferdaus
- BRAC University, UB04 - 66 Bir Uttam AK Khandakar Road, Dhaka 1212, Bangladesh
| | - Sanjida Newaz
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg MB R3E 0W2, Canada
| | - Sneha Krishnan
- Environment, Technology and Community Health (ETCH) Consultancy Services, Mumbai, India
| | - Natasha Howard
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, United Kingdom.,National University of Singapore, Saw Swee Hock School of Public Health, 12 Science Drive 2, 117549, Singapore
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