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McOwen H, Wasserheit JN, Rabinowitz P. US Academic and NGO Engagement in Pandemic Preparedness and Response. Health Secur 2024; 22:167-171. [PMID: 38394310 DOI: 10.1089/hs.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Helene McOwen
- Helene L. McOwen, MPH, is a Research Coordinator, Division of Allergy and Infectious Diseases; at the University of Washington, Seattle, WA
| | - Judith N Wasserheit
- Judith N. Wasserheit, MD, MPH, is a Professor, Departments of Global Health, Medicine and Epidemiology; at the University of Washington, Seattle, WA
- Judith N. Wasserheit is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
| | - Peter Rabinowitz
- Peter M. Rabinowitz, MD, MPH, is a Professor, Departments of Environmental and Occupational Health Sciences, Family Medicine, and Global Health, and Director, University of Washington Center for One Health Research; at the University of Washington, Seattle, WA
- Peter M. Rabinowitz is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
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Suri RK, Liu C, Marini A. Global equity and timely access: COVID-19 & beyond 23rd DCVMN Annual General Meeting 2022 report. Vaccine X 2023; 15:100353. [PMID: 37533681 PMCID: PMC10391680 DOI: 10.1016/j.jvacx.2023.100353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 08/04/2023] Open
Abstract
The 23rd Annual General Meeting of the Developing Countries Vaccine Manufacturers' Network (DCVMN), co-hosted by Serum Institute of India (SII), gathered over 365 delegates and more than 90 high-level speakers for three days of presentations, discussions, and networking, in Pune, India. The meeting provided a platform for vaccine manufacturers from developing countries to voice their experience, challenges and successes, as they play a critical role in the global research, development and supply of vaccines for achieving vaccine equity through increased collaborations and partnerships. The key topics of the 23rd Annual General Meeting revolved around: the key learnings from COVID-19, pandemic preparedness, vaccine sustainability and scalability, strengthening Africa's local manufacturing, partnerships & collaborations, financing, innovations, and vaccine hesitancy. The overarching theme focused on equity, timely access and sustainability, which was carried through in each session, with each panelist providing their contribution to answering - how can we create a sustainable vaccine ecosystem?
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Affiliation(s)
- Rajinder Kumar Suri
- DCVMN International, 1025, Lotus Villas, Phase IV, DLF City, Gurgaon, Haryana 122009, India
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Ahmed T, Tahir MF, Boden L, Kingston T. Future directions for One Health research: Regional and sectoral gaps. One Health 2023; 17:100584. [PMID: 38024280 PMCID: PMC10665172 DOI: 10.1016/j.onehlt.2023.100584] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/13/2023] [Accepted: 06/13/2023] [Indexed: 12/01/2023] Open
Abstract
Implementation of a One Health approach varies considerably between different geographical regions and remains challenging to implement without greater inclusivity of different disciplinary capacity and expertise. We performed comparative analyses of abstracts presented at the 1st World One Health Congress (WOHC 2011) and 6th WOHC (2020) to explore and describe the evolving demographics and disciplinary scope of One Health research. We classified abstracts into six One Health research categories and twenty-three subcategories. We also recorded corresponding authors' country and regional affiliation as well as study country (i.e., the country in which the research was conducted) to explore potential asymmetries between funding recipients and study subjects. The WOHC has seen a significant expansion in participation over the last 10 years. The numbers of abstracts accepted to the Congress increased threefold over the last decade (i.e., 302 abstracts in 2010, and 932 abstracts in 2020). At both Congresses, "Disease Surveillance" accounted for the largest proportion (105/302 (35%) and 335/932 (36%) in 2010 and 2020, respectively) of all abstracts accepted. However, "Environmental and Ecological Issues" (33/302 (10%) and 94/932 (11%)), and "Sustainable Food Systems" (19/302 (6%) and 44/932 (4%)) were less well-represented categories of One Health research in both 1st and 6th WOHC respectively. In contrast, "Antimicrobial Resistance" related research increased substantially over time (4/302 (1%) in 2011) and (119/932 (13%) in 2020). There were also differences in the type of research by authors based in "Very High Human Development" index countries compared to "Medium and Low Human Development. "Public Policy" dominated the former, whereas "Disease Surveillance" dominated the latter, suggesting potential regional differences regarding One Health research priorities. The results of the study highlight potential regional gaps and differences in One Health research priorities, with respect to emphasis on operational (surveillance) versus strategic (policy) One Health activities.
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Affiliation(s)
- Touseef Ahmed
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Bat Conservation Pakistan, Islamabad, Pakistan
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Muhammad Farooq Tahir
- Bat Conservation Pakistan, Islamabad, Pakistan
- Food and Agriculture Organization, United Nation, Islamabad, Pakistan
- Integral Global, Atlanta, Georgia, USA
| | - Lisa Boden
- Global Academy of Agriculture and Food Systems, The University of Edinburgh, Edinburgh, UK
| | - Tigga Kingston
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
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Ibrahim M, Abdelmagid N, AbuKoura R, Khogali A, Osama T, Ahmed A, Alabdeen IZ, Ahmed SAE, Dahab M. Finding the fragments: community-based epidemic surveillance in Sudan. Glob Health Res Policy 2023; 8:20. [PMID: 37291620 PMCID: PMC10250173 DOI: 10.1186/s41256-023-00300-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
Sudan faces inter-sectional health risks posed by escalating violent conflict, natural hazards and epidemics. Epidemics are frequent and overlapping, particularly resurgent seasonal outbreaks of diseases such as malaria, cholera. To improve response, the Sudanese Ministry of Health manages multiple disease surveillance systems, however, these systems are fragmented, under resourced, and disconnected from epidemic response efforts. Inversely, civic and informal community-led systems have often organically led outbreak responses, despite having limited access to data and resources from formal outbreak detection and response systems. Leveraging a communal sense of moral obligation, such informal epidemic responses can play an important role in reaching affected populations. While effective, localised, and organised-they cannot currently access national surveillance data, or formal outbreak prevention and response technical and financial resources. This paper calls for urgent and coordinated recognition and support of community-led outbreak responses, to strengthen, diversify, and scale up epidemic surveillance for both national epidemic preparedness and regional health security.
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Affiliation(s)
- Mona Ibrahim
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
| | - Nada Abdelmagid
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Rahaf AbuKoura
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Alhadi Khogali
- Julius Global Health, University Medical Centre Utrecht, Utrecht, The Netherlands
- National Ribat University, Khartoum, Sudan
| | - Tasnime Osama
- Department of Primary Care & Public Health, Imperial College London, London, UK
| | | | - Israa Zain Alabdeen
- Sudan COVID-19 Research Group, Khartoum, Sudan
- University of Khartoum, Khartoum, Sudan
| | | | - Maysoon Dahab
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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Wouters OJ, Forman R, Anderson M, Mossialos E, McKee M. The launch of the EU Health Emergency Preparedness and Response Authority (HERA): Improving global pandemic preparedness? Health Policy 2023; 133:104844. [PMID: 37269803 DOI: 10.1016/j.healthpol.2023.104844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023]
Abstract
The crowded global health landscape has been joined by the European Union Health Emergency Preparedness and Response Authority (HERA). HERA will assume four broad areas of responsibility: horizon scanning for major health threats; research and development; support for capacity to manufacture drugs, vaccines, and equipment; and procuring and stockpiling key medical countermeasures. In this Health Reform Monitor article, we outline the reform process and describe HERA's structure and responsibilities, explore issues that arise from the creation of this new organisation, and suggest options for collaboration with existing bodies in Europe and beyond. The COVID-19 pandemic and other infectious disease outbreaks have shown the need to treat health as a cross-border issue, and there is now a broad consensus that greater direction and coordination at the European level is needed. This ambition has been matched with a considerable increase in EU funding to tackle cross-border health threats, and HERA can be used to deploy this funding in an effective manner. Yet this is contingent upon clearly defining its role and responsibilities vis-à-vis existing agencies to reduce redundancies.
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Affiliation(s)
- Olivier J Wouters
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
| | - Rebecca Forman
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Da'ar OB, Kalmey F. The level of countries' preparedness to health risks during Covid-19 and pre-pandemic: the differential response to health systems building blocks and socioeconomic indicators. Health Econ Rev 2023; 13:16. [PMID: 36917372 PMCID: PMC10012285 DOI: 10.1186/s13561-023-00428-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The global health security (GHS) Index assesses countries' level of preparedness to health risks. However, there is no evidence on how and whether the effects of health systems building blocks and socioeconomic indicators on the level of preparedness differ for low and high prepared countries. The aim of this study was to examine the contributions of health systems building blocks and socioeconomic indicators to show differences in the level of preparedness to health risks. The study also aimed to examine trends in the level of preparedness and the World Health Organization (WHO) regional differences before and during the Covid-19 pandemic. We used the 2021 GHS index report data and employed quantile regression, log-linear, double-logarithmic, and time-fixed effects models. As robustness checks, these functional form specifications corroborated with one another, and interval validity tests confirmed. The results show that increases in effective governance, supply chain capacity in terms of medicines and technologies, and health financing had positive effects on countries' level of preparedness to health risks. These effects were considerably larger for countries with higher levels of preparedness to health risks. The positive gradient trends signaled a sense of capacity on the part of countries with higher global health security. However, the health workforce including doctors, and health services including hospital beds, were not statistically significant in explaining variations in countries' level of preparedness. While economic factors had positive effects on the level of preparedness to health risks, their impacts across the distribution of countries' level of preparedness to health risks were mixed. The effects of Social Development Goals (SDGs) were greater for countries with higher levels of preparedness to health risks. The effect of the Human Development Index (HDI) was greatest for countries whose overall GHS index lies at the midpoint of the distribution of countries' level of preparedness. High-income levels were associated with a negative effect on the level of preparedness, especially if countries were in the lower quantiles across the distributions of preparedness. Relative to poor countries, middle- and high-income groups had lower levels of preparedness to health risks, an indication of a sense of complacency. We find the pandemic period (year 2021) was associated with a decrease in the level of preparedness to health risks in comparison to the pre-pandemic period. There were significant WHO regional differences. Apart from the Eastern Mediterranean, the rest of the regions were more prepared to health risks compared to Africa. There was a negative trend in the level of preparedness to health risks from 2019 to 2021 although regional differences in changes over time were not statistically significant. In conclusion, attempts to strengthen countries' level of preparedness to health shocks should be more focused on enhancing essentials such as supply chain capacity in terms of medicines and technologies; health financing, and communication infrastructure. Countries should also strengthen their already existing health workforce and health services. Together, strengthening these health systems essentials will be beneficial to less prepared countries where their impact we find to be weaker. Similarly, boosting SDGs, particularly health-related sub-scales, will be helpful to less prepared countries. Moreover, there is a need to curb complacency in preparedness to health risks during pandemics by high-income countries. The negative trend in the level of preparedness to health risks would suggest that there is a need for better preparedness during pandemics by conflating national health with global health risks. This will ensure the imperative of having a synergistic response to global health risks, which is understood by and communicated to all countries and regions.
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Affiliation(s)
- Omar B Da'ar
- Department of Health Systems Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
- Institute for Cost Analysis and Research Evaluation, Minneapolis, MN, USA.
| | - Farah Kalmey
- Institute for Cost Analysis and Research Evaluation, Minneapolis, MN, USA
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Organizational Health and Wellbeing at the Division of Health Research, Lancaster University, Lancaster, UK
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Kiggundu R, Lusaya E, Seni J, Waswa JP, Kakooza F, Tjipura D, Kikule K, Muiva C, Joshi MP, Stergachis A, Kitutu FE, Konduri N. Identifying and addressing challenges to antimicrobial use surveillance in the human health sector in low- and middle-income countries: experiences and lessons learned from Tanzania and Uganda. Antimicrob Resist Infect Control 2023; 12:9. [PMID: 36759872 PMCID: PMC9909883 DOI: 10.1186/s13756-023-01213-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a global health security threat and is associated with increased morbidity and mortality. One of the key drivers of AMR is the inappropriate use of antibiotics. A key component of improving antibiotic use is conducting antimicrobial use (AMU) surveillance. METHODS USAID Medicines Technologies and Pharmaceutical Services Program has supported the implementation of antimicrobial stewardship activities, including setting up systems for AMU surveillance in Tanzania and Uganda. Results from both countries have been previously published. However, additional implementation experience and lessons learned from addressing challenges to AMU surveillance have not been previously published and are the subject of this narrative article. RESULTS The team identified challenges including poor quality data, low digitalization of tools, and inadequate resources including both financial and human resources. To address these gaps, the Program has supported the use of continuous quality improvement approaches addressing gaps in skills, providing tools, and developing guidelines to fill policy gaps in AMU surveillance. Recommendations to fill these gaps, based on the Potter and Brough systematic capacity building model have been proposed. CONCLUSIONS Strengthening AMU surveillance through using a capacity-building approach will fill gaps and strengthen efforts for AMR control in both countries.
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Affiliation(s)
- Reuben Kiggundu
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda.
| | - Edgar Lusaya
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Dar Es Salaam, Tanzania
| | - Jeremiah Seni
- grid.411961.a0000 0004 0451 3858Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - J. P. Waswa
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Kampala, Uganda
| | - Francis Kakooza
- grid.11194.3c0000 0004 0620 0548Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Dinah Tjipura
- grid.436296.c0000 0001 2203 2044USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA 22203 USA
| | - Kate Kikule
- grid.436296.c0000 0001 2203 2044USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA 22203 USA
| | - Cecilia Muiva
- USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Nairobi, Kenya
| | - Mohan P. Joshi
- grid.436296.c0000 0001 2203 2044USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA 22203 USA
| | - Andy Stergachis
- grid.34477.330000000122986657Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA 98105 USA ,grid.34477.330000000122986657Department of Global Health, School of Public Health, University of Washington, Seattle, WA 98105 USA
| | - Freddy Eric Kitutu
- grid.11194.3c0000 0004 0620 0548Sustainable Pharmaceutical Systems (SPS) Unit, Pharmacy Department, Makerere University School of Health Sciences, P.O. Box 10217, Kampala, Uganda
| | - Niranjan Konduri
- grid.436296.c0000 0001 2203 2044USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program, Management Sciences for Health, Arlington, VA 22203 USA
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Sarker M, Hossain P, Ahmed ST, Barua M, Sutradhar I, Ahmed SM. A critical look at synergies and fragmentations of universal health coverage, global health security, and health promotion in delivery of frontline health care services: A case study of Bangladesh. Lancet Reg Health Southeast Asia 2022; 7:100087. [PMID: 37383936 PMCID: PMC10305878 DOI: 10.1016/j.lansea.2022.100087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Universal Health Coverage (UHC) and Global Health Security (GHS) activities encompass mitigation of risks to health and well-being rights posed by infectious disease outbreaks and facilitated by health promotion (HP) activities. This case study investigated Bangladesh's readiness and capacity to 'prevent, detect and respond' to such outbreaks of an epidemic/pandemic nature. A rapid review of relevant documents, key informant interviews with policymakers/practitioners, and a deliberative dialogue with a crisscross of stakeholders were used to identify challenges and opportunities for 'synergy' among these streams of activities. Findings reveal conceptual ambiguity among respondents about the scope of the three `agendas and their inter-linkages. They perceived the synergy between UHC and GHS superfluous and were obsessed with losing their respective constituencies and resources. Poor coordination among the focal agencies in field activities, lack of supporting infrastructure, and shortage of human and financial resources posed additional challenges for better pandemic/epidemic preparation in future. Funding This study, "Researching the UHC-GHS-HP Triangle in Bangladesh," was funded by the Wellcome Trust, UK.
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Affiliation(s)
- Malabika Sarker
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Institute of Global Health, Heidelberg University, Germany
| | - Puspita Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Syeda Tahmina Ahmed
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Mrittika Barua
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Ipsita Sutradhar
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Syed Masud Ahmed
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Hayman B, Kumar Suri R, Downham M. Sustainable vaccine manufacturing in low- and middle-Income countries. Vaccine 2022; 40:7288-7304. [PMID: 36334966 DOI: 10.1016/j.vaccine.2022.10.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/24/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
The sustainable manufacturing of vaccines in developing countries is critical to increasing equitable access to vaccines and pandemic preparedness globally. Sustainable manufacturing requires that organizations engaged in the development, production and supply of vaccines have viable business models and incentives to manufacture vaccine products. The expanding manufacturing capabilities and capacities of developing countries vaccine manufacturers (DCVMs) are increasingly positioning these organizations to meet the national and regional public health needs in developing countries; however, key industry challenges such as regulatory barriers, low prices and demand uncertainty for vaccine products, and limited R&D funding threaten the long-term viability of vaccine manufacturers. This study assesses the technical capabilities, manufacturing capacities, and aspirational plans of DCVMs, exemplifying the business models and strategies undertaken to sustainably manufacture vaccines in developing countries. The public health importance of a healthy vaccine industry which enables manufacturers is discussed throughout. Vaccine manufacturers reported diverse product portfolios and R&D pipelines and utilized an array of vaccine technology platforms. Large manufacturing capacities were reported, a critical factor in manufacturers achieving economies of scale and supplying large volumes of vaccine doses to the world's most populous regions. Partnerships and collaboration within the industry and with international organizations along the vaccine value-chain were cited with high frequency. Manufacturers also reported aspirational plans to enter new markets, acquire new technologies and invest in the development of novel and improved vaccines. As DCVMs aim to have an increasing impact on the global vaccine ecosystem, a coordinated multi-stakeholder approach is required alleviate critical industry barriers to ensure that all efforts produce vaccines are sustainable and enable developing countries to realize the public health benefit of vaccines.
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Affiliation(s)
- Benoit Hayman
- DCVMN International, Route de Crassier 7, 1262 Eysins-Nyon, Switzerland.
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Fasina FO, Nanyingi M, Wangila RS, Gikonyo S, Omani R, Nyariki T, Wahome LW, Kiplamai J, Tenge E, Kivaria F, Okuthe S, Nzietchueng S, Kimani T, Kimutai J, Mucheru G, Njagi O, Njogu G, Rono R, Maina GN, Mogaka D, Mathooko J, Sirdar MM, Mogoa EG, Makumi A, Bett B, Mwatondo A, Kimonye VK, Rwego IB, Adan A, Wakhusama S, Bastiaensen P, Bebay C. Co-creation and priority setting for applied and implementation research in One Health: Improving capacities in public and animal health systems in Kenya. One Health 2022; 15:100460. [PMID: 36532669 PMCID: PMC9754982 DOI: 10.1016/j.onehlt.2022.100460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Kenyan government has successfully been implementing sector specific and multisectoral projects aligned to the Global Health Security Agenda (GHSA). For operational readiness and to enhance the effective planning and implementation of Global Health Security Programs (GHSP) at national and subnational level, there is an urgent need for stakeholders' engagement process to seek input in identifying challenges, prioritise activities for field implementation, and identify applied research and development questions, that should be addressed in the next five years. Methods The modified Child Health and Nutrition Research Initiative (CHNRI) method was used to identify global health security related priorities for multisectoral implementation in Kenya. Subject matter experts from human, animal and environmental health sectors at national and subnational level contributed to predefined research questions from a number of sources and activities for consideration for implementation using a One Health approach. Sixty-two experts scored the 193 questions based on five pre-defined criteria: 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equity. Data resulting from this process was then analysed in a Microsoft Excel spreadsheet to determine the research priorities and experts' agreements. Results Among the priority activities identified for implementation research were; strengthening One Health governance and legal frameworks; integration of ecosystem health into One Health programming; strengthening disease reporting, integrated data collection, information sharing and joint outbreak response; socio-anthropological and gender-based approaches in improving risk and behavioural change communication and community engagement; and one health workforce development. In addition, the potentials to invest in collaborative predictive risk modelling to enhance epidemic intelligence systems, while strengthening the One Health approach in the food safety incident and emergency response plans are feasible. Interpretation Successful multisectoral implementation of global health security program in Kenya calls for a whole of society approach that will harness community and private sector knowledge to build preparedness and response capacities while targeting neglected and marginalised populations. This research provides a framework that is worth emulating for cost-effective planning and implementation of overarching One Health programs.
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Affiliation(s)
- Folorunso O. Fasina
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya,Corresponding author.
| | - Mark Nanyingi
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya,Faculty of Health and Life Sciences, Department of One Health, University of Liverpool, Liverpool, UK
| | - Rinah S. Wangila
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Stephen Gikonyo
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Ruth Omani
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Thomas Nyariki
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Lucy W. Wahome
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Joy Kiplamai
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Evans Tenge
- Emergency Center for Transboundary Animal Diseases (ECTAD), Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Fredrick Kivaria
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Sam Okuthe
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Serge Nzietchueng
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Tabitha Kimani
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Joshua Kimutai
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Gerald Mucheru
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Obadiah Njagi
- Directorate of Veterinary Services (DVS), Ministry of Agriculture, Livestock, Fisheries and Co-operatives, Nairobi, Kenya
| | - George Njogu
- Emergency Center for Transboundary Animal Diseases (ECTAD), Regional Office for Eastern Africa, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Robert Rono
- Department of Health Services, Baringo County Government, Kabarnet, Kenya
| | - Grace N. Maina
- Directorate of Veterinary Services, Murang'a County Government, Murang'a, Kenya
| | - Dan Mogaka
- World Health Organization (WHO), World Health Emergencies (WHE), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Joseph Mathooko
- Inclusive Value Chain, Food and Agriculture Organization of the United Nations (FAO), United Nations Office in Nairobi (UNON), Gigiri, Nairobi, Kenya
| | - Mohammed M. Sirdar
- Sub-Regional Representation for Southern Africa, World Organization for Animal Health, Gaborone, Botswana
| | - Eddy G.M. Mogoa
- Africa One Health University Network (AFROHUN) Kenya, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Angela Makumi
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Bernard Bett
- International Livestock Research Institute (ILRI), Nairobi, Kenya
| | - Athman Mwatondo
- Zoonotic Disease Unit (ZDU), Ministry of Health, Nairobi, Kenya
| | | | - Innocent B. Rwego
- CORE Group Polio-Global Health Security Project, Kenya and Somalia, Nairobi, Kenya
| | - Abdirahman Adan
- CORE Group Polio-Global Health Security Project, Kenya and Somalia, Nairobi, Kenya
| | - Samuel Wakhusama
- Sub-Regional Representation for Eastern Africa, World Organization for Animal Health, Nairobi, Kenya
| | - Patrick Bastiaensen
- Sub-Regional Representation for Eastern Africa, World Organization for Animal Health, Nairobi, Kenya
| | - Charles Bebay
- Faculty of Health and Life Sciences, Department of One Health, University of Liverpool, Liverpool, UK
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11
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Richter P, Aslam M, Kostova D, Lasu AAR, Vliet GV, Courtney LP, Chisenga T. The Case for Integrating Health Systems to Manage Noncommunicable and Infectious Diseases in Low- and Middle-Income Countries: Lessons Learned From Zambia. Health Secur 2022; 20:286-297. [PMID: 35904943 DOI: 10.1089/hs.2022.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Noncommunicable diseases (NCDs) are the leading cause of death in the world, and 80% of all NCD deaths occur in low- and middle-income countries (LMICs). The COVID-19 pandemic has demonstrated that patients with NCDs are at increased risk of becoming severely ill from the virus. Disproportionate investment in vertical health programs can result in health systems vulnerable to collapse when resources are strained, such as during pandemics. Although NCDs are largely preventable, globally there is underinvestment in efforts to address them. Integrating health systems to collectively address NCDs and infectious diseases through a wide range of services in a comprehensive manner reduces the economic burden of healthcare and strengthens the healthcare system. Health system resiliency is essential for health security. In this article, we provide an economically sound approach to incorporating NCDs into routine healthcare services in LMICs through improved alignment of institutions that support prevention and control of both NCDs and infectious diseases. Examples from Zambia's multisector interventions to develop and support a national NCD action plan can inform and encourage LMIC countries to invest in systems integration to reduce the social and economic burden of NCDs and infectious diseases.
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Affiliation(s)
- Patricia Richter
- Patricia Richter, PhD, is Chief, Office of Global Noncommunicable Diseases, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Maria Aslam
- Maria Aslam, PhD, is an Economist, Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Deliana Kostova
- Deliana Kostova, PhD, is a Senior Economist, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Ally A R Lasu
- Ally A. R. Lasu, MPH, is a Research Public Health Analyst, RTI International, Research Triangle Park, NC
| | - Gretchen Van Vliet
- Gretchen Van Vliet, MPH, is Senior Public Health Project Director, RTI International, Research Triangle Park, NC
| | - Lauren P Courtney
- Lauren P. Courtney, MPH, is a Research Epidemiologist, RTI International, Research Triangle Park, NC
| | - Tina Chisenga
- Tina Chisenga, MD, MPH, is Assistant Director, Communicable Diseases, Ministry of Health, Lusaka, Zambia
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Stone AB, Weg AL, Petzing SR, Rollings A, Perdue CL. Lack of Alignment Between WHO Joint External Evaluation and State Party Self-Assessment Scores Undermines Utility as Evaluation Tools for the Department of Defense. Health Secur 2022; 20:321-330. [PMID: 35881868 DOI: 10.1089/hs.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International Health Regulations 2005 (IHR) set standards for countries to detect and respond to public health threats such as COVID-19. The US Department of Defense engages with partner nations to build IHR-related health security capacities. In this article, we compare 2 elements of the IHR Monitoring and Evaluation Framework to determine if they align in a useful way. The version of the State Party Annual Reporting tool (SPAR) used for this study is a self-assessment of 13 capacities, while the Joint External Evaluation (JEE) requires collaboration with international subject matter experts to evaluate 19 capacities. The SPAR indicators are scored separately from 0% to 100%, whereas the JEE uses a rank-ordered scale from 1 to 5 for variable numbers of indicators in each capacity. Using 2018-2019 data from the World Health Organization, we quantitatively and qualitatively evaluated the alignment of the SPAR and JEE scoring systems, using paired t tests for related capacities and 3 approaches to matching the scales. Whether using a simple, evenly divided scale for the SPAR or downscaling the SPAR scores to match with lower JEE scores, the paired t tests indicate that the JEE and SPAR scoring systems are not aligned. Many of the capacities in the JEE and SPAR are defined differently, pointing to one of the reasons for the discordance. We discuss implications for revision of the JEE and SPAR assessment tools along with ways in which the scores might be used for planning global health engagement capacity-building activities.
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Affiliation(s)
- Alexandra B Stone
- Alexandra B. Stone, PhD, MSc, is Senior Advisor for Assessment, Monitoring, and Evaluation, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Alden L Weg
- Alden L. Weg, MD, MPH, is Director, Combatant Command Support, Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Stephanie R Petzing
- Stephanie R. Petzing, PhD, is Senior Global Health Security Advisor, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Amber Rollings
- Amber Rollings, PhD, is an Assessment, Monitoring, and Evaluation Data Analyst, The Henry M. Jackson Foundation for the Advancement of Military Medicine and the Center for Global Health Engagement, at the Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Christopher L Perdue
- Christopher L. Perdue, MD, MPH, is a Senior Policy Analyst, Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington, DC
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13
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Neogi SB, Pandey S, Preetha GS, Swain S. The predictors of COVID-19 mortality among health systems parameters: an ecological study across 203 countries. Health Res Policy Syst 2022; 20:75. [PMID: 35761378 DOI: 10.1186/s12961-022-00878-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Health systems responsiveness is the key to addressing infectious disease threats such as pandemics. The paper outlines an assessment of health systems resilience by exploring the association of health systems and Global Health Security (GHS) parameters with case load and mortality resulting from COVID-19 across 203 countries using an ecological design. Methodology Correlation analysis was performed to assess the relationship of each of the indicators with COVID 19 cases and deaths per million population. Stepwise multiple regression models were developed to determine the predictors of COVID-19 cumulative cases and deaths per million population separately. Results Global health security indicators seemed to have a strong association when analyzed individually but those did not necessarily translate into less burden of cases or deaths in the multivariable analysis. The predictors of cumulative deaths per million population included general government expenditure on health as a proportion of general government expenditure, responsiveness of the system to prevent the emergence and release of pathogens and governance related voice and accountability. Conclusion To conclude, health financing parameters and preventive activities with regard to emergence of pathogens were better predictors of cumulative COVID-19 cases and deaths per million population compared to other health systems and global health security indicators. Health financing parameters are better predictors of cumulative COVID-19 cases and deaths per million population compared to other health systems and global health security indicators. More robust and valid indicators are required to assess the performance of health system.
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14
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Kevany S, Martin S, Reid M. A case-based approach to teaching epidemic and pandemic-related global health diplomacy and security in African countries. Global Health 2022; 18:56. [PMID: 35619181 PMCID: PMC9134128 DOI: 10.1186/s12992-022-00849-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
A challenging concept to teach, few combined courses on epidemic-related global health diplomacy and security exist, and no known courses are currently available that have been exclusively designed for African nationals. In response, the University of California, San Francisco’s Center for Global Health Delivery, Diplomacy and Economics (CGHDDE) developed and delivered a workshop for LMIC learners to better understand how politics, policy, finance, governance and security coalesce to influence global health goals and outcomes.
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Affiliation(s)
- Sebastian Kevany
- Asia-Pacific Center for Security Studies, 2058 Maluhia Road, Honolulu, HI, 96815, USA.
| | | | - Mike Reid
- University of California, San Francisco, USA
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15
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Kumar Suri R, Hayman B, Prasad SD, Makhoana M, Tippoo P. Vaccines: New challenges, new paradigms, new opportunities: Report of the 22nd DCVMN Annual General Meeting. Vaccine 2022; 40:3495-3505. [PMID: 35577632 PMCID: PMC9106412 DOI: 10.1016/j.vaccine.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/04/2022] [Accepted: 05/02/2022] [Indexed: 10/31/2022]
Abstract
The Developing Countries Vaccine Manufacturers Network held its 22nd Annual General Meeting in October 2021. Vaccine manufacturing experts, leaders from global public health organizations and dignitaries from governments and multilateral organizations discussed the challenges and opportunities emerging from the COVID-19 pandemic. Over 350 delegates from 33 countries, representing over 70 organizations partook in the meetings deliberations. The development and scaled-up production of several safe and effective vaccines against COVID-19 resulted in over 12 billion doses being produced by the end of 2021. Unfortunately, this scientific achievement and outstanding industry effort has been overshadowed by the striking inequity in access to COVID-19 vaccines. High and upper middle-income countries have received 75% of the vaccines, while in Africa, less than 5% of the people are fully vaccinated. The inequitable access to vaccines is an issue of national health security, which has stressed the need to establish local vaccine manufacturing capacity in Africa. Key partnerships, initiatives and the deliberate strategies required to achieve sustainable manufacturing on the continent were discussed. The ability to acquire technology, access markets and financing mechanisms, and workforce development were reported as key enablers to achieving a healthy ecosystem. Innovative vaccine technologies, new regulatory approaches, and the importance of voluntary technology transfers in increasing the global supply capacity of both COVID-19 vaccines and traditional vaccines were highlighted. In reviewing the lessons learned from the pandemic, speakers shared a consensus that innovation and partnerships will be central to any solution proposed to mitigate the current pandemic and prepare for future ones.
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Affiliation(s)
| | - Benoit Hayman
- DCVMN International, Route de Crassier 7, 1262 Eysins-Nyon, Switzerland.
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Debie A, Khatri RB, Assefa Y. Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature. Health Res Policy Syst 2022; 20:50. [PMID: 35501898 PMCID: PMC9059443 DOI: 10.1186/s12961-022-00858-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/13/2022] [Indexed: 01/15/2023] Open
Abstract
Background The shift in the global burden of disease from communicable to noncommunicable was a factor in mobilizing support for a broader post-Millennium Development Goals (MDGs) health agenda. To curb these and other global health problems, 193 Member States of the United Nations (UN) became signatories of the Sustainable Development Goals (SDGs) and committed to achieving universal health coverage (UHC) by 2030. In the context of the coronavirus disease 2019 (COVID-19) pandemic, the importance of health systems governance (HSG) is felt now more than ever for addressing the pandemic and continuing to provide essential health services. However, little is known about the successes and challenges of HSG with respect to UHC and health security. This study, therefore, aims to synthesize the evidence and identify successes and challenges of HSG towards UHC and health security. Methods We conducted a structured narrative review of studies published through 28 July 2021. We searched the existing literature using three databases: PubMed, Scopus and Web of Science. Search terms included three themes: HSG, UHC and health security. We synthesized the findings using the five core functions of HSG: policy formulation and strategic plans; intelligence; regulation; collaboration and coalition; and accountability. Results A total of 58 articles were included in the final review. We identified that context-specific health policy and health financing modalities helped to speed up the progress towards UHC and health security. Robust health intelligence, intersectoral collaboration and coalition were also essential to combat the pandemic and ensure the delivery of essential health services. On the contrary, execution of a one-size-fits-all HSG approach, lack of healthcare funding, corruption, inadequate health workforce, and weak regulatory and health government policies were major challenges to achieving UHC and health security. Conclusions Countries, individually and collectively, need strong HSG to speed up the progress towards UHC and health security. Decentralization of health services to grass root levels, support of stakeholders, fair contribution and distribution of resources are essential to support the implementation of programmes towards UHC and health security. It is also vital to ensure independent regulatory accreditation of organizations in the health system and to integrate quality- and equity-related health service indicators into the national social protection monitoring and evaluation system; these will speed up the progress towards UHC and health security. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00858-7.
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Affiliation(s)
- Ayal Debie
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Resham B Khatri
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
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17
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Woldetsadik MA, Fitzpatrick K, Del Castillo L, Miller B, Jarvis D, Carnevale C, Ravat F, Cassell CH, Williams A, Young SK, Clemente J, Baggett HC, Bratton S. Stakeholders' assessment of US Centers for Disease Control and Prevention's contributions to the development of National Public Health Institutes in seven countries. J Public Health Policy 2021; 42:589-601. [PMID: 34811465 PMCID: PMC9387635 DOI: 10.1057/s41271-021-00310-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2021] [Indexed: 11/21/2022]
Abstract
National Public Health Institutes (NPHIs) can strengthen countries' public health capacities to prevent, detect, and respond to public health emergencies. This qualitative evaluation assessed the role of the US Centers for Disease Control and Prevention (CDC) in NPHI development and strengthening of public health functions. We interviewed NPHI staff (N = 43), non-NPHI government staff (N = 29), and non-governmental organization staff (N = 24) in seven countries where CDC has supported NPHI development: Cambodia, Colombia, Liberia, Mozambique, Nigeria, Rwanda, and Zambia. Participants identified four areas of support that were the most important: workforce capacity building, technical assistance for key public health functions, identifying institutional gaps and priorities, and funding to support countries' priorities. Participants underscored the need for capacity building directed toward country-driven priorities during planning and implementation. Continued support for NPHI development from CDC and other partners is vital to building stronger public health systems, improving population health, and strengthening global health security.
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Affiliation(s)
- Mahlet A Woldetsadik
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA.
| | - Kaitlin Fitzpatrick
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | | | - Bridget Miller
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Dennis Jarvis
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Caroline Carnevale
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Fatima Ravat
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Cynthia H Cassell
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Alice Williams
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Stephanie K Young
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Jacob Clemente
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Henry C Baggett
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
| | - Shelly Bratton
- Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, 1825 Century Blvd NE, Room 3018, Atlanta, GA, 30345, USA
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18
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Norlock SM, Okanya PW, Trataris A, Hildebrand ME, Baziki JDD, Belkourati I, Ellis M. South-to-south mentoring as a vehicle for implementing sustainable health security in Africa. One Health Outlook 2021; 3:20. [PMID: 34610850 PMCID: PMC8492092 DOI: 10.1186/s42522-021-00050-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND While sustainability has become a universal precept in the development of global health security systems, supporting policies often lack mechanisms to drive policies into regular practice. 'On-paper' norms and regulations are to a great extent upheld by frontline workers who often lack the opportunity to communicate their first-hand experiences to decisionmakers; their role is an often overlooked, yet crucial, aspect of a sustainable global health security landscape. Initiatives and programs developing transdisciplinary professional skills support the increased bidirectional dialogue between these frontline workers and key policy- and decisionmakers which may sustainably narrow the gap between global health security policy design and implementation. METHODS The International Federation of Biosafety Associations' (IFBA) Global Mentorship Program recruits biosafety and biosecurity champions across Africa to provide local peer mentorship to developing professionals in their geographic region. Mentors and mentees complete structured one year program cycles, where they are provided with written overviews of monthly discussion topics, and attend optional virtual interactive activities. Feedback from African participants of the 2019-2020 program cycle was collected using a virtual Exit Survey, where aspects of program impact and structure were assessed. RESULTS Following its initial call for applications, the IFBA Global Mentorship Program received considerable interest from professionals across the African continent, particularly in East and North Africa. The pilot program cycle matched a total of 62 individuals from an array of professional disciplines across several regions, 40 of which were located on the African continent. The resulting mentorship pairs shared knowledge, skills, and experiences towards translating policy objectives to action on the front lines. Mentorship pairs embraced multidisciplinary approaches to harmonize health security strategies across the human and animal health sectors. South-to-South mentorship therefore provided mentees with locally relevant support critical to translation of best technical practices to local capacity and work. CONCLUSION The IFBA's South-to-South Global Mentorship Program has demonstrated its ability to form crucial links between frontline biosafety professionals, laboratory workers, and policy- and decision-makers across several implicated sectors. By supporting regionally relevant peer mentorship programs, the gap between health security policy development and implementation may be narrowed.
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Affiliation(s)
- Stephanie Marie Norlock
- International Federation of Biosafety Associations (IFBA), Ottawa, Canada.
- Carleton University, Ottawa, Canada.
| | - Patrick W Okanya
- International Federation of Biosafety Associations (IFBA), Ottawa, Canada
- Technical University of Kenya, Nairobi, Kenya
| | - Anastasia Trataris
- National Institute for Communicable Diseases (NICD), Johannesburg, South Africa
| | | | - Jean de Dieu Baziki
- African Union - Pan African Veterinary Vaccine Centre (AU-PANVAC), Debre Zeit, Ethiopia
| | | | - Maureen Ellis
- International Federation of Biosafety Associations (IFBA), Ottawa, Canada.
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19
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Miranda E, Meara JG, Pendleton A, Peters AW, Santhirapala V, Ashraf N, Alonso N, Hakizimana S, Bekele A, Park KB, Farmer P. Harvard Medical School Department of Global Health and Social Medicine COVID-19 seminar series: COVID and surgical, anesthetic and obstetric care. BMC Proc 2021; 15:20. [PMID: 34551790 PMCID: PMC8457896 DOI: 10.1186/s12919-021-00218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
On May 21, 2020, the Harvard Program in Global Surgery and Social Change (PGSSC) hosted a webinar as part of the Harvard Medical School Department of Global Health and Social Medicine’s COVID-19 webinar series. The goal of PGSSC’s virtual webinar was to share the experiences of surgical, anesthesia, and obstetric (SAO) providers on the frontlines of the COVID pandemic, from both high-income countries (HICs), such as the United States and the United Kingdom, as well as low- and middle-income countries (LMICs). Providers shared not only their experiences delivering SAO care during this global pandemic, but also solutions and innovations they and their colleagues developed to address these new challenges. Additionally, the seminar explored the relationship between surgery and health system strengthening and pandemic preparedness, and outlined the way forward, including a roadmap for prioritization and investment in surgical system strengthening. Throughout the discussion, other themes emerged as well, such as the definition of elective surgery and its implications during a persistent global pandemic, the safe and ethical reintroduction of surgical services, and the social inequities exposed by the stress placed on health systems by COVID-19. These proceedings document the perspectives shared by participants through their invited lectures as well as through the panel discussion at the end of the seminar.
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Affiliation(s)
- Elizabeth Miranda
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA. .,Division of Vascular Surgery, University of Southern California, Los Angeles, CA, USA.
| | - John G Meara
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Alaska Pendleton
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA
| | | | | | | | - Nivaldo Alonso
- Department of Plastic Surgery, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Abebe Bekele
- University of Global Health Equity, Butaro, Rwanda
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA
| | - Paul Farmer
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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20
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Steele SG, Toribio JALML, Mor SM. Global health security must embrace a One Health approach: Contributions and experiences of veterinarians during the COVID-19 response in Australia. One Health 2021; 13:100314. [PMID: 34485671 PMCID: PMC8397892 DOI: 10.1016/j.onehlt.2021.100314] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 01/03/2023] Open
Abstract
SARS-CoV-2, a betacoronavirus of likely zoonotic origin, was first reported in December 2019. Its rapid worldwide spread precipitated a range of interventions, including by veterinarians, due to impacts on human health and well-being as well as animal health and welfare. We conducted 36 key informant interviews to explore the responses of Australian veterinarians, their engagement in One Health collaboration and cooperation, and their existing and developed insights to the COVID-19 pandemic. Responses were analysed using thematic analysis. Australian veterinarians provided valuable contributions to the national COVID-19 response by protecting animal welfare, maintaining local food security, providing essential veterinary services while mitigating human health risks in clinical settings and providing both key skills and surge capacity to the human health response. This was all guided by skills in scientific literacy and evidence-based communication. Informants identified a clear and urgent need for greater One Health coordination during pandemic prevention, preparedness, and response, even in the case of a disease which largely only affects humans. Veterinarians provided key skills and surge capacity in epidemiology and laboratory analysis within the national COVID-19 response. Maintenance of veterinary services assisted pet owners, many of whom saw their pets as a source of emotional and physical support during the pandemic. Veterinarians identified an urgent need for improved One Health coordination to strengthen preparedness and response to future pandemic. Both intra- and inter-professional silos were recognised as perpetual obstacles to operationalising One Health.
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Affiliation(s)
- Sandra G Steele
- The University of Sydney, Faculty of Science, School of Veterinary Science, NSW 2006, Australia
| | - Jenny-Ann L M L Toribio
- The University of Sydney, Faculty of Science, School of Veterinary Science, NSW 2006, Australia
| | - Siobhan M Mor
- University of Liverpool, Institute of Infection, Veterinary and Ecological Sciences, Merseyside L3 5RF, United Kingdom
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Sharma A, Luvsansharav UO, Paul P, Lutgring JD, Call DR, Omulo S, Laserson K, Araos R, Munita JM, Verani J, Chowdhury F, Muneer SME, Espinosa-Bode A, Ramay B, Cordon-Rosales C, Kumar CPG, Bhatnagar T, Gupta N, Park B, Smith RM. Multi-country cross-sectional study of colonization with multidrug-resistant organisms: protocol and methods for the Antibiotic Resistance in Communities and Hospitals (ARCH) studies. BMC Public Health 2021; 21:1412. [PMID: 34271883 PMCID: PMC8285890 DOI: 10.1186/s12889-021-11451-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 07/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Antimicrobial resistance is a global health emergency. Persons colonized with multidrug-resistant organisms (MDROs) are at risk for developing subsequent multidrug-resistant infections, as colonization represents an important precursor to invasive infection. Despite reports documenting the worldwide dissemination of MDROs, fundamental questions remain regarding the burden of resistance, metrics to measure prevalence, and determinants of spread. We describe a multi-site colonization survey protocol that aims to quantify the population-based prevalence and associated risk factors for colonization with high-threat MDROs among community dwelling participants and patients admitted to hospitals within a defined population-catchment area. METHODS Researchers in five countries (Bangladesh, Chile, Guatemala, Kenya, and India) will conduct a cross-sectional, population-based prevalence survey consisting of a risk factor questionnaire and collection of specimens to evaluate colonization with three high-threat MDROs: extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESCrE), carbapenem-resistant Enterobacteriaceae (CRE), and methicillin-resistant Staphylococcus aureus (MRSA). Healthy adults residing in a household within the sampling area will be enrolled in addition to eligible hospitalized adults. Colonizing isolates of these MDROs will be compared by multilocus sequence typing (MLST) to routinely collected invasive clinical isolates, where available, to determine potential pathogenicity. A colonizing MDRO isolate will be categorized as potentially pathogenic if the MLST pattern of the colonizing isolate matches the MLST pattern of an invasive clinical isolate. The outcomes of this study will be estimates of the population-based prevalence of colonization with ESCrE, CRE, and MRSA; determination of the proportion of colonizing ESCrE, CRE, and MRSA with pathogenic characteristics based on MLST; identification of factors independently associated with ESCrE, CRE, and MRSA colonization; and creation an archive of ESCrE, CRE, and MRSA isolates for future study. DISCUSSION This is the first study to use a common protocol to evaluate population-based prevalence and risk factors associated with MDRO colonization among community-dwelling and hospitalized adults in multiple countries with diverse epidemiological conditions, including low- and middle-income settings. The results will be used to better describe the global epidemiology of MDROs and guide the development of mitigation strategies in both community and healthcare settings. These standardized baseline surveys can also inform future studies seeking to further characterize MDRO epidemiology globally.
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Affiliation(s)
- Aditya Sharma
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Ulzii-Orishikh Luvsansharav
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Prabasaj Paul
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Joseph D Lutgring
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Douglas R Call
- Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA, 99164, USA
| | - Sylvia Omulo
- Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA, 99164, USA
| | - Kayla Laserson
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Rafael Araos
- Instituto de Ciencias e Innovación en Medicina Universidad del Desarrollo, Av. Las Condes, 12461, Santiago, Chile
- Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Av. Las Condes, 12461, Santiago, Chile
| | - Jose M Munita
- Instituto de Ciencias e Innovación en Medicina Universidad del Desarrollo, Av. Las Condes, 12461, Santiago, Chile
- Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R), Av. Las Condes, 12461, Santiago, Chile
| | - Jennifer Verani
- Division of Global Health Protection, KEMRI Complex, Kenya Office, Mbagathi road off Mbagathi Way, PO Box 606-00621, Nairobi, Kenya
| | | | | | - Andres Espinosa-Bode
- Division of Global Health Protection, Central America Region Office, Edificio Instituto de Investigación 2 (II-2), Interior Universidad Del Valle, 18 Avenida 11-37, Vista Hermosa 3, Zona 15, Guatemala City, Guatemala
| | - Brooke Ramay
- Paul G. Allen School for Global Animal Health, Washington State University, 240 SE Ott Road, Pullman, WA, 99164, USA
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Celia Cordon-Rosales
- Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - C P Girish Kumar
- National Institute of Epidemiology, II Main Road, TNHB, Ayapakkam, Chennai, 600 077, India
| | - Tarun Bhatnagar
- National Institute of Epidemiology, II Main Road, TNHB, Ayapakkam, Chennai, 600 077, India
| | - Neil Gupta
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Benjamin Park
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA
| | - Rachel M Smith
- Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Office of the Director, 1600 Clifton Rd NE, MS H16-2, Atlanta, GA, 30029, USA.
- Division of Global Health Protection, KEMRI Complex, Kenya Office, Mbagathi road off Mbagathi Way, PO Box 606-00621, Nairobi, Kenya.
- Division of Global Health Protection, Central America Region Office, Edificio Instituto de Investigación 2 (II-2), Interior Universidad Del Valle, 18 Avenida 11-37, Vista Hermosa 3, Zona 15, Guatemala City, Guatemala.
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22
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Abstract
Noncommunicable diseases and their risk factors are important for all aspects of outbreak preparedness and response, affecting a range of factors including host susceptibility, pathogen virulence, and health system capacity. This conceptual analysis has 2 objectives. First, we use the Haddon matrix paradigm to formulate a framework for assessing the relevance of noncommunicable diseases to health security efforts throughout all phases of the disaster life cycle: before, during, and after an event. Second, we build upon this framework to identify 6 technical action areas in global health security programs that are opportune integration points for global health security and noncommunicable disease objectives: surveillance, workforce development, laboratory systems, immunization, risk communication, and sustainable financing. We discuss approaches to integration with the goal of maximizing the reach of global health security where infectious disease threats and chronic disease burdens overlap.
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Affiliation(s)
- Deliana Kostova
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Patricia Richter
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Gretchen Van Vliet
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Michael Mahar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
| | - Ronald L Moolenaar
- Deliana Kostova, PhD, is a Senior Economist; Patricia Richter, PhD, is Branch Chief, Global Noncommunicable Diseases Branch; Michael Mahar, PhD, is a Public Health Advisor; and Ronald L. Moolenaar, MD, is Associate Director for Science; all in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Gretchen Van Vliet, MPH, is Senior Public Health Project Director, Global Public Health Impact Center, RTI International, Research Triangle Park, NC
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23
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de Vázquez CC, Jou YC, Nyan HHL, Asakura M, Watanabe K, Lowbridge C. Estimating Joint External Evaluation Scores Using Country Data from 77 Countries, 2016-2018. Health Secur 2021; 19:150-162. [PMID: 33769893 DOI: 10.1089/hs.2019.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Since 2016, Joint External Evaluations (JEEs) help countries assess their health security preparedness and capacity to respond to public health risks. JEEs are 1 of 4 components of the International Health Regulations 2005 (IHR) Monitoring and Evaluation Framework. Compared with the mandatory State Party Self-Assessment Annual Reporting tool, JEEs use a transparent, rigorous, and collaborative process with international and in-country experts to evaluate IHR implementation. Because it is voluntary and not all States Parties have completed JEEs, we conducted a multiple linear regression model using publicly available JEE data to estimate global IHR implementation. We extracted JEE scores from the published JEE reports for 78 States Parties to the IHR and 12 sociodemographic, economic, and health indicator variables from 3 official reports and 3 official databases for all 194 World Health Organization Member States. Our final model consisted of 4 variables that significantly account for the variance of JEE score: total score from IHR annual reporting, lost disability-adjusted life years due to communicable diseases, gross domestic product, and health professional density (adjusted R2 = 0.833; P < .0001). We estimated only 1 in 10 countries (n = 19, 9.7%) worldwide had achieved average scores indicating demonstrated capacity or sustainable capacity across the 19 technical areas in the JEE tool. All 19 of these countries were in the high-income group, according to the World Bank classification, and were ranked very high on the Human Development Index, according to the United Nations Development Programme. These findings highlight the importance of ongoing efforts toward advancing global health security, especially in middle- to lower-income countries with limited resources.
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Affiliation(s)
- Cindy Chiu de Vázquez
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Yuwen Cynthia Jou
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Hein Htet Linn Nyan
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Momoka Asakura
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Kaho Watanabe
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Christopher Lowbridge
- Cindy Chiu de Vázquez, PhD, MPH, was a Junior Associate Professor; Yuwen Cynthia Jou was a Research Assistant and Consultant; and Momoka Asakura and Kaho Watanabe were Research Students; all in the Department of Community Health, Tohoku University Graduate School of Medicine, Sendai, Japan, when this research was conducted. Hein Htet Linn Nyan, MBBS, was an Independent Consultant. Toungup, Myanmar. Christopher Lowbridge, DrPH, MPH, is a Research Fellow, Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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24
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Wenham C, Abagaro C, Arévalo A, Coast E, Corrêa S, Cuéllar K, Leone T, Valongueiro S. Analysing the intersection between health emergencies and abortion during Zika in Brazil, El Salvador and Colombia. Soc Sci Med 2021; 270:113671. [PMID: 33486425 DOI: 10.1016/j.socscimed.2021.113671] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 01/19/2023]
Abstract
The Zika outbreak of 2015-7 is a lens to analyse the positioning of abortion within in global health security. The sequelae of the virus almost exclusively affected newborn children, manifested through Congenital Zika Syndrome (CZS), and a focus on women at risk of, planning or being pregnant. At the global level, debate considered whether Zika would provide impetus for regulatory change for reproductive rights in Latin America, a region with some of the most restrictive abortion regulation in the world. However, regulatory change for abortion did not occur. We analyse why the Zika health emergency did not lead to any changes in abortion regulation through multi-method analysis of the intersection between Zika, health emergencies and abortion in Brazil, Colombia and El Salvador. These case study countries were purposefully selected; each had Zika infected women (albeit with differing incidence) yet represent diverse regulatory environments for abortion. Our comparative research is multi-method: framework analysis of key informant interviews (n = 49); content analysis of women's enquiries to a medical abortion telemedicine provider; and, policy analysis of (inter)national-level Zika response and abortion policies. We consider this within literature on global health security, and the prioritisation of a particular approach to epidemic control. Within this securitized landscape, despite increased public debate about abortion regulatory change, no meaningful change occurred, due to a dominant epidemiological approach to the Zika health emergency in all three countries and prominent conservative forces in government and within anti-abortion rights movements. Simultaneously, we demonstrate that regulation did not deter all women from seeking such service clandestinely. Zika affected reproductive decision making, but did not impact abortion regulation. Epidemiological framing ignored reproductive dimensions of emergency responses. Conservative forces instrumentalized disability concerns to oppose abortion rights. Women sought abortions clandestinely, citing Zika as a justification. Abortion provision must form part of health emergency planning and response.
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25
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Kharaishvili N, Hudson TML, Kannan JK, Ettenger V, Mirje S. Global Health Security Risk Assessment in the Biological Threat Reduction Program. Health Secur 2020; 18:177-185. [PMID: 32559155 PMCID: PMC10818034 DOI: 10.1089/hs.2019.0132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 01/31/2020] [Accepted: 02/18/2020] [Indexed: 11/12/2022] Open
Abstract
In 2014, the Biological Threat Reduction Program (BTRP) developed a country assessment tool to assess the risk to a country's biosurveillance, biosafety, and biosecurity systems and their vulnerability to naturally occurring, accidental, or nefarious release of weaponizable pathogens. The country assessment tool is a unique method of assessing public health and veterinary systems at the national and subnational levels. The assessment process is led by a multisectoral, multidisciplinary team composed of 8 subject matter experts who conduct a combination of document reviews, individual and focus group interviews, and in-person assessments. The intent of the tool was to standardize the BTRP program planning process and support quantitative metrics to measure partner country capacities and capabilities throughout BTRP engagement. Used in more than 25 countries to establish a baseline of the health security risk landscape, the tool provides a foundation for identifying and prioritizing system-wide risk mitigation and management activities as well as periodic evaluations of the impacts of these activities.
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Affiliation(s)
- Nino Kharaishvili
- Nino Kharaishvili, MD, MBA, is Principal, Health System Resilience, Federal and Environmental Solutions, Jacobs, Arlington, VA
| | - Toni-Marie L. Hudson
- Toni-Marie L. Hudson, MSPH, and Seema Mirje, MD, are Associates; Vera Ettenger, PhD, is a Lead Associate; all at the Global Defense Group, Booz Allen Hamilton, McLean, VA
| | - Jaya K. Kannan
- Jaya K. Kannan, DVM, is a Veterinary Epidemiologist, Defense Systems, Northrop Grumman Corporation, McLean, VA
| | - Vera Ettenger
- Toni-Marie L. Hudson, MSPH, and Seema Mirje, MD, are Associates; Vera Ettenger, PhD, is a Lead Associate; all at the Global Defense Group, Booz Allen Hamilton, McLean, VA
| | - Seema Mirje
- Toni-Marie L. Hudson, MSPH, and Seema Mirje, MD, are Associates; Vera Ettenger, PhD, is a Lead Associate; all at the Global Defense Group, Booz Allen Hamilton, McLean, VA
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26
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Wang Z, Duan Y, Jin Y, Zheng ZJ. Coronavirus disease 2019 (COVID-19) pandemic: how countries should build more resilient health systems for preparedness and response. ACTA ACUST UNITED AC 2020; 4:139-145. [PMID: 33312747 PMCID: PMC7719199 DOI: 10.1016/j.glohj.2020.12.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/06/2020] [Accepted: 12/03/2020] [Indexed: 12/18/2022]
Abstract
Objective A resilient health system plays a crucial role in pandemic preparedness and response. Although the World Health Organization (WHO) has required all states parties to strengthen core capacities to respond to public health emergencies under the International Health Regulations (2005), the actions of most countries to combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This cross-sectional study aimed to examine the health system resilience of selected countries and analyze their strategies and measures in response to the COVID-19 pandemic. Methods This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K., and the U.S., based on the severity of the national epidemic, the geographical location, and the development level. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure the severity of the impact of the pandemic in each country; WHO State Parties Self-Assessment Annual Reporting (SPAR) Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience; and research articles and press materials were summarized to identify the strategies and measures adopted by countries during response to COVID-19. This study applied the resilient health systems framework to analyze health system resilience in the selected countries from five dimensions, including awareness, diversity, self-regulation, integration and adaptation. Results The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and the U.S. were above the global and regional averages; the SPAR Scores of Iran were above the global average while the GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. invested more health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategy of extensive testing and identification of suspected patients. In terms of specific measures, all the five countries adopted measures such as restrictions on entry and international travel, closure of schools and industries, lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied across countries, based on the response strategies. Conclusion Although SPAR Scores and GHS Index have evaluated the national core capacities for preparedness and response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries still do not build resilient health systems in response to public health emergencies. Health system strengthening and health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach to developing resilient health systems.
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Affiliation(s)
- Zhebin Wang
- 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
| | - Yuqi Duan
- 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
| | - Yinzi Jin
- 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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27
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Copper FA, Mayigane LN, Pei Y, Charles D, Nguyen TN, Vente C, Chiu de Vázquez C, Bell A, Njenge HK, Kandel N, Ho ZJM, Omaar A, de la Rocque S, Chungong S. Simulation exercises and after action reviews - analysis of outputs during 2016-2019 to strengthen global health emergency preparedness and response. Global Health 2020; 16:115. [PMID: 33261622 PMCID: PMC7705853 DOI: 10.1186/s12992-020-00632-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
Background Under the International Health Regulations (2005) [IHR (2005)] Monitoring and Evaluation Framework, after action reviews (AAR) and simulation exercises (SimEx) are two critical components which measure the functionality of a country’s health emergency preparedness and response under a “real-life” event or simulated situation. The objective of this study was to describe the AAR and SimEx supported by the World Health Organization (WHO) globally in 2016–2019. Methods In 2016–2019, WHO supported 63 AAR and 117 SimEx, of which 42 (66.7%) AAR reports and 56 (47.9%) SimEx reports were available. We extracted key information from these reports and created two central databases for AAR and SimEx, respectively. We conducted descriptive analysis and linked the findings according to the 13 IHR (2005) core capacities. Results Among the 42 AAR and 56 SimEx available reports, AAR and SimEx were most commonly conducted in the WHO African Region (AAR: n = 32, 76.2%; SimEx: n = 32, 52.5%). The most common public health events reviewed or tested in AAR and SimEx, respectively, were epidemics and pandemics (AAR: n = 38, 90.5%; SimEx: n = 46, 82.1%). For AAR, 10 (76.9%) of the 13 IHR core capacities were reviewed at least once, with no AAR conducted for food safety, chemical events, and radiation emergencies, among the reports available. For SimEx, all 13 (100.0%) IHR capacities were tested at least once. For AAR, the most commonly reviewed IHR core capacities were health services provision (n = 41, 97.6%), risk communication (n = 39, 92.9%), national health emergency framework (n = 39, 92.9%), surveillance (n = 37, 88.1%) and laboratory (n = 35, 83.3%). For SimEx, the most commonly tested IHR core capacity were national health emergency framework (n = 56, 91.1%), followed by risk communication (n = 48, 85.7%), IHR coordination and national IHR focal point functions (n = 45, 80.4%), surveillance (n = 31, 55.4%), and health service provision (n = 29, 51.8%). For AAR, the median timeframe between the end of the event and AAR was 125 days (range = 25–399 days). Conclusions WHO has recently published guidance for the planning, execution, and follow-up of AAR and SimEx. Through the guidance and the simplified reporting format provided, we hope to see more countries conduct AAR and SimEx and standardization in their methodology, practice, reporting and follow-up. Supplementary information Supplementary information accompanies this paper at 10.1186/s12992-020-00632-w.
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Affiliation(s)
- Frederik Anton Copper
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland. .,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.
| | - Landry Ndriko Mayigane
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Yingxin Pei
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Denis Charles
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Thanh Nam Nguyen
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Candice Vente
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Cindy Chiu de Vázquez
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Allan Bell
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Hilary Kagume Njenge
- Country Simulation Exercises & Reviews (CER), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland.,Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Nirmal Kandel
- Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Zheng Jie Marc Ho
- Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Abbas Omaar
- Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Stéphane de la Rocque
- Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
| | - Stella Chungong
- Health Security Preparedness (HSP), World Health Organization Headquarters, 20 Avenue Appia, CH-1211, Geneva, Switzerland
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Abstract
All-hazards preparedness and response planning requires ongoing individual, organisational and multi-jurisdictional learning. Disaster after-action reviews are an established emergency management practice to acquire knowledge through a process of analysing what happened and why, to improve the emergency response before the next crisis. After-action reviews help individuals and organisations learn, and are an essential step in the preparedness cycle. Human and animal health authorities have begun to employ after-action reviews for disaster preparedness and response among public health and Veterinary Services. The World Organisation for Animal Health (OIE) encourages Members to establish after-action reviews and share best practice. The adoption of afteraction review is an essential step for all provincial, national and multinational emergency management authorities to mitigate the impact of disasters on human and animal health. Emerging and re-emerging infectious diseases with pandemic potential pose unique preparedness challenges, requiring high-level policy attention to close long-standing gaps. A review of after-action reports from the 2001 anthrax bioterror attacks and of naturally occurring infectious disease crises, from the 2003 outbreak of severe acute respiratory syndrome (SARS) to the 2014 Ebola epidemic, reveal a similar pattern of repeated weakness and failures. These phenomena are described as 'lessons observed but not lessons learned'. Most infectious disease outbreaks with pandemic potential are zoonotic and require a One Health approach to prevent, prepare for and respond to global health security crises. After-action reviews in a One Health security context are essential to improve the pandemic preparedness of public health and Veterinary Services. After-action reviews can also provide the evidence-based 'feedback loop' needed to galvanise public policy and political will to translate lessons observed into sustained and applied lessons learned.
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Williams SG, Fontaine RE, Turcios Ruiz RM, Walke H, Ijaz K, Baggett HC. One Field Epidemiologist per 200,000 Population: Lessons Learned from Implementing a Global Public Health Workforce Target. Health Secur 2020; 18:S113-S118. [PMID: 32004135 DOI: 10.1089/hs.2019.0119] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The World Health Organization monitoring and evaluation framework for the International Health Regulations (IHR, 2005) describes the targets for the Joint External Evaluation (JEE) indicators. For workforce development, the JEE defines the optimal target for attaining and complying with the IHR (2005) as 1 trained field epidemiologist (or equivalent) per 200,000 population. We explain the derivation and use of the current field epidemiology workforce development target and identify the limitations and lessons learned in applying it to various countries' public health systems. This article also proposes a way forward for improvements and implementation of this workforce development target.
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Affiliation(s)
- Seymour G Williams
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Robert E Fontaine
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Reina M Turcios Ruiz
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Henry Walke
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Kashef Ijaz
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Henry C Baggett
- Seymour G. Williams, MD, is Team Lead, Field Epidemiology Training Program; Robert E. Fontaine, MD, is Senior Advisor, Field Epidemiology Training Program; Reina M. Turcios Ruiz, MD, is Team Lead, Monitoring and Evaluation; all in the Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention (CDC), Atlanta, GA. Henry Walke, MD, is Director, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA. Kashef Ijaz, MD, is Principal Deputy Director, and Henry C. Baggett, MD, is Chief, Workforce and Institute Development Branch; both in the Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA. Dr. Williams and Dr. Baggett are senior co-authors. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
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Greiner AL, Stehling-Ariza T, Bugli D, Hoffman A, Giese C, Moorhouse L, Neatherlin JC, Shahpar C. Challenges in Public Health Rapid Response Team Management. Health Secur 2020; 18:S8-S13. [PMID: 32004121 DOI: 10.1089/hs.2019.0060] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The International Health Regulations (2005) dictate the need for states parties to establish capacity to respond promptly and effectively to public health risks. Public health rapid response teams (RRTs) can fulfill this need as a component of a larger public health emergency response infrastructure. However, lack of a standardized approach to establishing and managing RRTs can lead to substantial delays in effective response measures. As part of the Global Health Security Agenda, national governments have sought to develop and more formally institute their RRTs. RRT challenges were identified from 21 countries spanning 4 continents from 2016 to 2018 through direct observation of RRTs deployed during public health emergencies, discussions with RRT managers involved in outbreak response, and during formal RRT management training workshops. One major challenge identified is the development and maintenance of an RRT roster to ensure deployable surge staff identification, selection, and availability. Another challenge is ensuring that RRT members are trained and have the relevant competencies to be effective in the field. Finally, the lack of defined RRT standard operating procedures covering both nonemergency maintenance measures and the multistage emergency response processes required for RRT function can delay the RRT's response time and effectiveness. These findings highlight the importance of planning to preemptively address these challenges to ensure rapid and effective response measures, ultimately strengthening global health security.
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Affiliation(s)
- Ashley L Greiner
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Tasha Stehling-Ariza
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Dante Bugli
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Adela Hoffman
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Coralie Giese
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Lisa Moorhouse
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - John C Neatherlin
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Cyrus Shahpar
- Ashley L. Greiner, MD, MPH, is Emergency Response Capacity Development Unit Lead, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.Tasha Stehling-Ariza, PhD, Dante Bugli, MPH, Adela Hoffman, MPH, and Coralie Giese, MSc, are Epidemiologists;Lisa Moorhouse, MPH, is Deputy Team Lead;John C. Neatherlin, MPH, is West Africa Regional Advisor;Cyrus Shahpar, MD, MPH, is Team Lead; all of the Global Rapid Response Team, Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA.The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Clara A, Ndiaye SM, Joseph B, Nzogu MA, Coulibaly D, Alroy KA, Gourmanon DC, Diarrassouba M, Toure-Adechoubou R, Houngbedji KA, Attiey HB, Balajee SA. Community-Based Surveillance in Côte d'Ivoire. Health Secur 2020; 18:S23-S33. [PMID: 32004127 DOI: 10.1089/hs.2019.0062] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Community-based surveillance can be an important component of early warning systems. In 2016, the Côte d'Ivoire Ministry of Health launched a community-based surveillance project in 3 districts along the Guinea border. Community health workers were trained in detection and immediate reporting of diseases and events using a text-messaging platform. In December 2017, surveillance data from before and after implementation of community-based surveillance were analyzed in intervention and control districts. A total of 3,734 signals of priority diseases and 4,918 unusual health events were reported, of which 420 were investigated as suspect diseases and none were investigated as unusual health events. Of the 420 suspected cases reported, 23 (6%) were laboratory confirmed for a specific pathogen. Following implementation of community-based surveillance, 5-fold and 8-fold increases in reporting of suspected measles and yellow fever clusters, respectively, were documented. Reporting incidence rates in intervention districts for suspected measles, yellow fever, and acute flaccid paralysis were significantly higher after implementation, with a difference of 29.2, 19.0, and 2.5 cases per 100,000 person-years, respectively. All rate differences were significantly higher in intervention districts (p < 0.05); no significant increase in reporting was noted in control districts. These findings suggest that community-based surveillance strengthened detection and reporting capacity for several suspect priority diseases and events. However, the surveillance program was very sensitive, resulting in numerous false-positives. Learning from the community-based surveillance implementation experience, the ministry of health is revising signal definitions to reduce sensitivity and increase specificity, reviewing training materials, considering scaling up sustainable reporting platforms, and standardizing community health worker roles.
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Affiliation(s)
- Alexey Clara
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Serigne M Ndiaye
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Benie Joseph
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Maurice A Nzogu
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Daouda Coulibaly
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Karen A Alroy
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Djebo C Gourmanon
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Mamadou Diarrassouba
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Ramatou Toure-Adechoubou
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Koffi Ange Houngbedji
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Henry Banny Attiey
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - S Arunmozhi Balajee
- Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office Côte d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, Côte d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, Côte d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Health Coordinator; Koffi Ange Houngbedji, MD, MPH, is Health Coordinator; and Henry Banny Attiey has a master's degree in monitoring evaluation and is Monitoring Evaluation Health Coordinator Health Sector; all at the International Rescue Committee, Abidjan, Côte d'Ivoire. Dr. Clara and Dr. Ndiaye contributed equally to this article. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Biribawa C, Atuhairwe JA, Bulage L, Okethwangu DO, Kwesiga B, Ario AR, Zhu BP. Measles outbreak amplified in a pediatric ward: Lyantonde District, Uganda, August 2017. BMC Infect Dis 2020; 20:398. [PMID: 32503450 PMCID: PMC7274507 DOI: 10.1186/s12879-020-05120-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 05/27/2020] [Indexed: 01/09/2023] Open
Abstract
Background Measles is a highly infectious viral disease. In August 2017, Lyantonde District, Uganda reported a measles outbreak to Uganda Ministry of Health. We investigated the outbreak to assess the scope, factors facilitating transmission, and recommend control measures. Methods We defined a probable case as sudden onset of fever and generalized rash in a resident of Lyantonde, Lwengo, or Rakai Districts from 1 June-30 September 2017, plus ≥1 of the following: coryza, conjunctivitis, or cough. A confirmed case was a probable case with serum positivity of measles-specific IgM. We conducted a neighborhood- and age-matched case-control study to identified exposure factors, and used conditional logistic regression to analyze the data. We estimated vaccine effectiveness and vaccination coverage. Results We identified 81 cases (75 probable, 6 confirmed); 4 patients (4.9%) died. In the case-control study, 47% of case-patients and 2.3% of controls were hospitalized at Lyantonde Hospital pediatric department for non-measles conditions 7–21 days before case-patient’s onset (ORadj = 34, 95%CI: 5.1–225). Estimated vaccine effectiveness was 95% (95%CI: 75–99%) and vaccination coverage was 76% (95%CI: 68–82%). During the outbreak, an “isolation” ward was established inside the general pediatric ward where there was mixing of both measles and non-measles patients. Conclusions This outbreak was amplified by nosocomial transmission and facilitated by low vaccination coverage. We recommended moving the isolation ward outside of the building, supplemental vaccination, and vaccinating pediatric patients during measles outbreaks.
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Affiliation(s)
| | | | - Lilian Bulage
- Uganda Public Health Fellowship Program, Kampala, Uganda
| | | | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Kampala, Uganda.,Ministry of Health, Kampala, Uganda
| | - Bao-Ping Zhu
- US Centers for Disease Control and Prevention, Kampala, Uganda.,Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, USA
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Chattu VK, Adisesh A, Yaya S. Canada's role in strengthening global health security during the COVID-19 pandemic. Glob Health Res Policy 2020; 5:16. [PMID: 32328533 PMCID: PMC7167363 DOI: 10.1186/s41256-020-00146-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/13/2020] [Indexed: 12/05/2022] Open
Abstract
The world is confronted by the current pandemic of Corona Virus Disease (COVID-19), which is a wake-up call for all nations irrespective of their development status or geographical location. Since the start of the century we have seen five big infectious outbreaks which proved that epidemics are no more regarded as historic and geographically confined threats. The Canadian government underlined that these infectious disease outbreaks are threats to global health security and disrupt societal wellbeing and development. In this context, the Public Health Agency of Canada is proactive and has shown its preparedness for outbreaks of emerging and epidemic-prone diseases, and in dealing with these pathogens. Even before the declaration of pandemic, Canada has proved its global health leadership by ensuring collective action and multisectoral coordination which still remains a serious challenge especially for low and middle- income countries with existing poor health systems. In this article we discuss how Canada is addressing the global challenges posed by the COVID-19 pandemic through its leadership and practice of global health diplomacy.
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Affiliation(s)
- Vijay Kumar Chattu
- 1Division of Occupational Medicine, Department of Medicine, University of Toronto, Toronto, ON Canada.,2Occupational Medicine Clinic, St. Michael's Hospital, Unity Health Toronto, Toronto, ON Canada.,3Institute of International Relations, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Anil Adisesh
- 1Division of Occupational Medicine, Department of Medicine, University of Toronto, Toronto, ON Canada.,2Occupational Medicine Clinic, St. Michael's Hospital, Unity Health Toronto, Toronto, ON Canada
| | - Sanni Yaya
- 4School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, Ottawa, ON Canada.,5The George Institute for Global Health, University of Oxford, Oxford, UK
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Dama E, Nikiema A, Nichols K, Bicaba BW, Porgho S, Greco Koné R, Tarnagda Z, Cissé A, Ngendakumana I, Adjami A, Medah I, Ake F, Mirza SA. Designing and Piloting a Specimen Transport System in Burkina Faso. Health Secur 2020; 18:S98-S104. [PMID: 32004130 DOI: 10.1089/hs.2019.0068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Efficient specimen transport systems are critical for early disease detection and reporting by laboratory networks. In Burkina Faso, centralized reference laboratories receive specimens from multiple surveillance sites for testing, but transport methods vary, resulting in potential delays and risk to specimen quality. The ministry of health and partners, under the Global Health Security Agenda implementation, piloted a specimen transport system for severe acute respiratory illness (SARI) surveillance in 4 Burkina Faso districts. A baseline assessment was conducted of the current specimen transport network structure and key stakeholders. Assessment results and guidelines for processing SARI specimens informed the pilot specimen transport system design and implementation. Monitoring and evaluation performance indicators included: proportion of packages delivered, timeliness, and quality of courier services (missed or damaged packages). Our baseline assessment found that laboratorians routinely carried specimens from the health center to reference laboratories, resulting in time away from laboratory duties and potential specimen delays or loss of quality. The pilot specimen transport system design engaged Sonapost, the national postal service, to transport specimens from SARI sites to the influenza national reference laboratory. From May 2017 to December 2018, the specimen transport system transported 557 packages containing 1,158 SARI specimens; 95% (529/557) were delivered within 24 hours of pick-up and 77% (892/1,158) within 48 hours of collection. No packages were lost. This article highlights lessons learned that may be useful for other countries considering establishment of a specimen transport system to strengthen laboratory system infrastructure in global health security implementation.
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Affiliation(s)
- Emilie Dama
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Abdoulaye Nikiema
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Kameko Nichols
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Brice Wilfried Bicaba
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Souleymane Porgho
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Rebecca Greco Koné
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Zekiba Tarnagda
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Assana Cissé
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Irene Ngendakumana
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Aimé Adjami
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Isaïe Medah
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Flavien Ake
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
| | - Sara A Mirza
- Emilie Dama, PhD, is Senior Laboratory Advisor; Rebecca Greco Koné, MPH, is Country Director, Burkina Faso; and Irene Ngendakumana, MD, is Technical Advisor, Eagle Global Services, a CDC contractor; all with the Division of Global Health Protection, Country Office Burkina Faso, Center for Global Health, US Centers for Disease Control and Prevention, Ouagadougou, Burkina Faso. Abdoulaye Nikièma, PharmD, MSc, is Senior Laboratory Specialist and Global Health Security Program Manager for Burkina, African Society for Laboratory Medicine, Ouagadougou, Burkina Faso. Kameko Nichols is a Transport and Logistics Consultant, The Nichols Group LLC, Washington, DC. Brice Wilfried Bicaba, MD, MSc, is an Epidemiologist and Director; Souleymane Porgho, MSc, is an Epidemiologist and Data Manager; and Isaïe Medah, MD, is Director; all at Direction de la Protection de la Santé de la Population, Ministère de la Santé, Ouagadougou, Burkina Faso. Zékiba Tarnagda, DVM, PhD, is Head of Influenza, and Assana Cissé, MSc, is a Bacteriologist and Virologist, Influenza; both at the National Reference Laboratory, Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Aimé Adjami, PhD, is a Biologist and Executive Director, and Flavien Ake, PhD, is Director; both at DAVYCAS International, Ouagadougou, Burkina Faso. Sara A. Mirza, PhD, is an Epidemiologist, US Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, GA. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention
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Standley CJ, MacDonald PDM, Attal-Juncqua A, Barry AM, Bile EC, Collins DL, Corvil S, Ibrahima DB, Hemingway-Foday JJ, Katz R, Middleton KJ, Reynolds EM, Sorrell EM, Lamine SM, Wone A, Martel LD. Leveraging Partnerships to Maximize Global Health Security Improvements in Guinea, 2015-2019. Health Secur 2020; 18:S34-S42. [PMID: 32004131 DOI: 10.1089/hs.2019.0089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In response to the 2014-2016 West Africa Ebola virus disease (EVD) outbreak, a US congressional appropriation provided funds to the US Centers for Disease Control and Prevention (CDC) to support global health security capacity building in 17 partner countries, including Guinea. The 2014 funding enabled CDC to provide more than 300 deployments of personnel to Guinea during the Ebola response, establish a country office, and fund 11 implementing partners through cooperative agreements to support global health security engagement efforts in 4 core technical areas: workforce development, surveillance systems, laboratory systems, and emergency management. This article reflects on almost 4 years of collaboration between CDC and its implementing partners in Guinea during the Ebola outbreak response and the recovery period. We highlight examples of collaborative synergies between cooperative agreement partners and local Guinean partners and discuss the impact of these collaborations in strengthening the above 4 core capacities. Finally, we identify the key elements of the successful collaborations, including communication and information sharing as a core cooperative agreement activity, a flexible funding mechanism, and willingness to adapt to local needs. We hope these observations can serve as guidance for future endeavors seeking to establish strong and effective partnerships between government and nongovernment organizations providing technical and operational assistance.
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Affiliation(s)
- Claire J Standley
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Pia D M MacDonald
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Aurelia Attal-Juncqua
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Alpha Mahmoud Barry
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Ebi Celestin Bile
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Doreen L Collins
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Salomon Corvil
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Diallo Boubabar Ibrahima
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Jennifer J Hemingway-Foday
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Rebecca Katz
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Kathy J Middleton
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Eileen M Reynolds
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Erin M Sorrell
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Soumah Mohamed Lamine
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Abdoulaye Wone
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
| | - Lise D Martel
- Claire J. Standley, PhD, is Assistant Research Professor; Aurelia Attal-Juncqua, MSc, is Senior Research Associate; Rebecca Katz, PhD, is Professor and Director; and Erin M. Sorrell, PhD, is Assistant Research Professor; all at the Center for Global Health Science and Security, Georgetown University, Washington, DC. Pia D. M. MacDonald, PhD, is Senior Director; Jennifer J. Hemingway-Foday, MPH, is a Research Epidemiologist; and Eileen M. Reynolds, MA, is Senior IT Project Manager; all at RTI International, Research Triangle Park, NC. Alpha Mahmoud Barry, DrPH, is Professor and Executive Director, University of Conakry and Santé Plus Organization, Conakry, Guinea. Ebi Celestin Bile, MSc, is Team Lead, IDDS Project, IDDS West Africa-Guinea, FHI360, Conakry, Guinea. Doreen L. Collins, MPH, is Director, Global Project Management, FHI Clinical, Durham, NC. Salomon Corvil, MD, is FETP-Guinea Resident Advisor, AFENET, Conakry, Guinea. Diallo Boubabar Ibrahima, MPH, is Chief of Party, RTI International, Conakry, Guinea. Kathy J. Middleton, MPH, is a Public Health Advisor, and Lise D. Martel, PhD, is Guinea Country Director; both with the Division of Global Health Protection, Center for Global Health, the US Centers for Disease Control and Prevention, Atlanta, GA. Soumah Mohamed Lamine, MD, is an Emergency Management Technical Assistant, and Abdoulaye Wone, MD, is Public Health Coordinator; both with the International Organization for Migration, Conakry, Guinea. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention
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Tsai FJ, Turbat B. Is countries' transparency associated with gaps between countries' self and external evaluations for IHR core capacity? Global Health 2020; 16:10. [PMID: 31959196 PMCID: PMC6972006 DOI: 10.1186/s12992-020-0541-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/08/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND This study aims to evaluate the gap between countries' self-evaluation and external evaluation regarding core capacity of infectious disease control required by International Health Regulations and the influence factors of the gap. METHODS We collected countries' self-evaluated scores (International Health Regulations Monitoring tool, IHRMT) of 2016 and 2017, and external evaluation scores (Joint External Evaluation, JEE) from WHO website on 4rd and 27rd November, 2018. There were 127 and 163 countries with IHRMT scores in 2016 and in 2017, and 74 countries with JEE scores included in the analysis. The gap between countries' self-evaluation and external evaluation was represented by the difference between condensed IHR scores and JEE. Civil liberties (CL) scores were collected as indicators of the transparency of each country. The Human Development Index (HDI) and data indicating the density of physicians and nurses (HWD) were collected to reflect countries' development and health workforce statuses. Then, chi-square test and logistic regression were performed to determine the correlation between the gap of IHRMT and JEE, and civil liberties, human development, and health workforce status. RESULTS Countries' self-evaluation scores significantly decreased from 2016 to 2017. Countries' external evaluation scores are consistently 1 to 1.5 lower than self-evaluation scores. There were significantly more countries with high HDI status, high CL status and high HWD status in groups with bigger gap between IHRMT and JEE. And countries with higher HDI status presented a higher risk of having bigger gap between countries' self and external scores (OR = 3.181). CONCLUSION Our study result indicated that countries' transparency represented by CL status do play a role in the gap between IHR and JEE scores. But HDI status is the key factor which significantly associated with the gap. The main reason for the gap in the current world is the different interpretation of evaluation of high HDI countries, though low CL countries tended to over-scored their capacity.
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Affiliation(s)
- Feng-Jen Tsai
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 110 Taiwan
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Battsetseg Turbat
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, 110 Taiwan
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Kayiwa J, Kasule JN, Ario AR, Sendagire S, Homsy J, Lubwama B, Aliddeki D, Kagirita A, Komakech I, Brown V, Wetaka MM, Zhu BP, Opar B, Kyazze S, Okware P, Okot P, Matseketse D, Tusiime P, Mwebesa H, Makumbi I. Conducting the Joint External Evaluation in Uganda: The Process and Lessons Learned. Health Secur 2019; 17:174-180. [PMID: 31206322 DOI: 10.1089/hs.2018.0137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Uganda is currently implementing the Global Health Security Agenda (GHSA), aiming at accelerating compliance to the International Health Regulations (IHR) (2005). To assess progress toward compliance, a Joint External Evaluation (JEE) was conducted by the World Health Organization (WHO). Based on this evaluation, we present the process and lessons learned. Uganda's methodological approach to the JEE followed the WHO recommendations, including conducting a whole-of-government in-country self-assessment prior to the final assessment, using the same tool at both assessments, and generating consensus scores during the final assessment. The in-country self-assessment process began on March 24, 2017, with a multisectoral representation of 203 subject matter experts from 81 institutions. The final assessment was conducted between June 26 and 30, 2017, by 15 external evaluators. Discrepancies between the in-country and final scores occurred in 27 of 50 indicators. Prioritized gaps from the JEE formed the basis of the National Action Plan for Health Security. We learned 4 major lessons from this process: subject matter experts should be adequately oriented on the scoring requirements of the JEE tool; whole-of-government representation should be ensured during the entire JEE process; equitable multisectoral implementation of IHR activities must be ensured; and over-reliance on external support is a threat to sustainability of GHSA gains.
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Affiliation(s)
- Joshua Kayiwa
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Juliet-Namuga Kasule
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Alex-Riolexus Ario
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Steven Sendagire
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Jaco Homsy
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Benard Lubwama
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Dativa Aliddeki
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Atek Kagirita
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Innocent Komakech
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Vance Brown
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Milton-Makoba Wetaka
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Bao-Ping Zhu
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Benard Opar
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Simon Kyazze
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Paul Okware
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Paul Okot
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - David Matseketse
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Patrick Tusiime
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Henry Mwebesa
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
| | - Issa Makumbi
- Joshua Kayiwa, MS, is an Information Analyst; Milton-Makoba Wetaka is a Laboratory Specialist; Simon Kyazze, MS, is a GIS Specialist; and Issa Makumbi, MS, is a Director; all in the Public Health Emergency Operations Center, Ministry of Health, Kampala, Uganda. Juliet-Namuga Kasule, MS, is a Public Health Specialist; Jaco Homsy, MS, is a Director; Vance Brown, MS, is Deputy Director of Operations; and Bao-Ping Zhu, PhD, is Resident Advisor; all in the Division of Global Health Protection, Centers for Disease Control and Prevention, Kampala. Alex-Riolexus Ario, PhD, is the Director, Institute of Public Health; Benard Lubwama, MS, is an Epidemiologist, Epidemiology and Surveillance Division; Dativa Aliddeki, MS, is a Fellow, Uganda Public Health Fellowship Program; Atek Kagirita, MS, is Assistant Commissioner, Public Health Laboratory Services; Benard Opar, MS, is Manager, Uganda National Expanded Program on Immunization; Paul Okware, MS, is Chief Stores and Operations Officer, National Medical Stores; Patrick Tusiime, MS, is Commissioner, National Diseases Control; and Henry Mwebesa, MS, is Director of General Health Services; all in the Ministry of Health, Kampala. Steven Sendagire, MS, is Senior Resident Mentor, Health Policy Planning and Management, Makerere University School of Public Health, Kampala. Innocent Komakech, MS, is Emergency Preparedness Focal Person, World Health Organization, Kampala. Paul Okot, MS, is Emergency Response Manager, Red Cross Society of Uganda, Kampala. David Matseketse, MS, is Emergency Preparedness Officer, United Nations Children's Fund, Kampala. The views expressed in this article are the authors' own, and not the official position of the Uganda Ministry of Health, the Uganda Country offices of the World Health Organization, the United States Agency for International Development, or the Centers for Disease Control and Prevention or any other institutions herein quoted
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Murphy SC, Negron ME, Pieracci EG, Deressa A, Bekele W, Regassa F, Wassie BA, Afera B, Hajito KW, Walelign E, Abebe G, Newman S, Rwego IB, Mutonga D, Gulima D, Kebede N, Smith WA, Kramer LM, Kibria A, Bonnenfant YT, Mortenson JA, Vieira AR, Kadzik M, Sugerman D, Amare B, Kanter T, Walke H, Belay E, Gallagher K. One Health collaborations for zoonotic disease control in Ethiopia. REV SCI TECH OIE 2019; 38:51-60. [PMID: 31564741 DOI: 10.20506/rst.38.1.2940] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Zoonotic diseases require a One Health approach for successful control and elimination due to the nature of their transmission between animals and humans. One Health recognises that the health of humans, animals, and the environment are all interconnected. Ethiopia has committed itself to controlling five prioritised zoonotic diseases (rabies, anthrax, brucellosis, leptospirosis and echinococcosis), using a One Health approach. The National One Health Steering Committee (NOHSC) provides a framework for national stakeholders to address gaps in multisectoral communication, coordination and collaboration. In addition, the NOHSC oversees the formation of several specialised disease-focused groups, referred to as 'Technical Working Groups' (TWGs). These TWGs are responsible for developing disease prevention and control strategies, as well as implementing disease-focused public health activities and providing recommendations to the NOHSC. Ethiopia's success using the One Health approach and its efficient control of zoonotic diseases will depend on the commitment of all member Ministries to support the NOHSC and TWGs, as well as to build capacity in Ethiopia's workforce and laboratories, a task supported by its many international partners.
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M'zah S, Lopes Cardozo B, Evans DP. Mental Health Status and Service Assessment for Adult Syrian Refugees Resettled in Metropolitan Atlanta: A Cross-Sectional Survey. J Immigr Minor Health 2019; 21:1019-1025. [PMID: 30109534 PMCID: PMC6375803 DOI: 10.1007/s10903-018-0806-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Because little is known about the mental health status of Syrian refugees in the United States, we conducted a survey among a convenience sample of those resettled in Atlanta between March 2011 and 2017. Though home visits, we delivered a questionnaire including standardized instruments (HSCL25 and PTSD-8) to assess symptoms of anxiety, depression and Posttraumatic Stress Disorder. We found high rates of anxiety (60%), depression (44%) and Posttraumatic Stress Disorder (84%) symptoms; however, only 20% of participants had seen a mental health professional. Reported reasons for not seeking professional help were lack of transportation and access to information. Findings of this survey indicate the high burden of mental health symptoms and the need for services to the study population. A longitudinal study with a larger sample size would improve the understanding of mental health needs and resilience factors of Syrian refugees resettled in the US.
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Affiliation(s)
- Skander M'zah
- Center for Humanitarian Emergencies, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
- , Tunis, Tunisia.
| | - Barbara Lopes Cardozo
- Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dabney P Evans
- Center for Humanitarian Emergencies, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Ravi SJ, Meyer D, Cameron E, Nalabandian M, Pervaiz B, Nuzzo JB. Establishing a theoretical foundation for measuring global health security: a scoping review. BMC Public Health 2019; 19:954. [PMID: 31315597 PMCID: PMC6637489 DOI: 10.1186/s12889-019-7216-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/20/2019] [Indexed: 01/08/2023] Open
Abstract
Background Since the 2014–2016 West Africa Ebola epidemic, the concept of measuring health security capacity has become increasingly important within the broader context of health systems-strengthening, enhancing responses to public health emergencies, and reducing global catastrophic biological risks. Efforts to regularly and sustainably track the evolution of health security capabilities and capacities over time – while also accounting for political, social, and environmental risks – could help countries progress toward eliminating sources of health insecurity. We sought to aggregate evidence-based principles that capture a country’s baseline public health and healthcare capabilities, its health security system performance before and during infectious disease crises, and its broader social, political, security, and ecological risk environments. Methods We conducted a scoping review of English-language scholarly and gray literature to identify evidence- and practice-based indicators and proxies for measuring health security at the country level over time. We then used a qualitative coding framework to identify recurrent themes in the literature and synthesize foundational principles for measuring global health security. Documents reviewed included English-language literature published after 2001 until the end of the research period—September 2017—to ensure relevance to the current global health security landscape; literature examining acute infectious disease threats with potential for transnational spread; and literature addressing global health security efforts at the country level. Results We synthesized four foundational principles for measuring global health security: measurement requires assessment of existing capacities, as well as efforts to build core public health, healthcare, and biosecurity capabilities; assessments of national programs and efforts to mitigate a critical subset of priority threats could inform efforts to generate useful metrics for global health security; there are measurable enabling factors facilitating health security-strengthening efforts; and finally, measurement requires consideration of social, political, and ecological risk environments. Conclusion The themes identified in this review could inform efforts to systematically assess the impacts and effectiveness of activities undertaken to strengthen global health security. Electronic supplementary material The online version of this article (10.1186/s12889-019-7216-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sanjana J Ravi
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD, 21201, USA.
| | - Diane Meyer
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD, 21201, USA
| | - Elizabeth Cameron
- Nuclear Threat Initiative, 1776 Eye Street NW, Suite 600, Washington, DC, 20006, USA
| | - Michelle Nalabandian
- Nuclear Threat Initiative, 1776 Eye Street NW, Suite 600, Washington, DC, 20006, USA
| | - Beenish Pervaiz
- Watson Institute for International & Public Affairs, Brown University, 111 Thayer Street, Suite 215, Box 1970, Providence, RI, 02912, USA
| | - Jennifer B Nuzzo
- The Johns Hopkins Center for Health Security, 621 East Pratt Street, Pier IV Building, Suite 210, Baltimore, MD, 21201, USA
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Katz R, Graeden E, Kerr J, Eaneff S. Tracking the Flow of Funds in Global Health Security. Ecohealth 2019; 16:298-305. [PMID: 30820704 PMCID: PMC6682579 DOI: 10.1007/s10393-019-01402-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 01/16/2019] [Accepted: 01/28/2019] [Indexed: 05/31/2023]
Abstract
Countries, philanthropies, and private sector organizations have been actively investing in global health security around the world. However, despite the coordinated approach to funding within the Global Health Security Agenda, there is currently no well-established method to track the commitment and disbursal of funds for global health security from funders to recipients or to identify the activities supported by existing funding initiatives. To address this need, we developed the Global Health Security Tracking Dashboard. This interactive, publicly available, Web-based dashboard maps the flow of funds from funder to recipient and categorizes the target efforts of those funds, allowing users to identify patterns of influence and success in health security funding implementation. The dashboard provides an evidence-based approach for defining targets for future funding by identifying the areas in which funds have not yet been effectively allocated, showcasing successes, and providing a source of information to promote mutual accountability.
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Affiliation(s)
- Rebecca Katz
- Georgetown University, 3900 Reservoir Road, NW, 305 SW Med Dent, Washington, D.C., 20057 USA
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Hegde S, Benoit SR, Arvelo W, Lindblade K, López B, McCracken JP, Bernart C, Roldan A, Bryan JP. Burden of laboratory-confirmed shigellosis infections in Guatemala 2007-2012: results from a population-based surveillance system. BMC Public Health 2019; 19:474. [PMID: 32326929 PMCID: PMC6696707 DOI: 10.1186/s12889-019-6780-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND We describe the epidemiology and antimicrobial susceptibility patterns of culture-confirmed Shigella infections in facility-based surveillance sites in Guatemala. Current studies using quantitative molecular diagnostics suggest Shigella may contribute most to the global diarrheal disease burden. Since identification of Shigella requires culturing techniques using stool specimens and few laboratories in Guatemala routinely culture for this pathogen, little is known about the true burden of Shigella in Guatemala or, importantly, the antimicrobial resistance patterns. METHODS Clinical, epidemiological, and laboratory data were collected on 5399 patients with acute diarrhea (≥3 loose stools in 24 h) from June 2007-August 2012. Multidrug resistance (MDR) was defined as resistance to ampicillin and trimethoprim/sulfamethoxazole. RESULTS Five percent (261) of stool specimens yielded Shigella spp. The annual incidence of laboratory-confirmed infections ranged from 5.0 to 24.1 per 100,000 persons in Santa Rosa and 0.3 to 6.2 per 100,000 in Quetzaltenango; 58% of cases occurred in children < 5 years of age. Thirty patients were hospitalized; one patient died. Oral rehydration or intravenous solution was used to treat 72% of hospitalized and 15% of ambulatory cases. Fifty-nine percent of cases were S. flexneri and 51% of cases were MDR. CONCLUSIONS Shigella is an important cause of bacterial diarrhea in children and prevalence of MDR highlights the importance of appropriate treatment regimens. This study demonstrates that strengthening laboratory capacity in Guatemala can help determine causes which can lead to prevention of diarrheal diseases, particularly in children. Such capacity building is also critical for rapid detection and control of public health threats at their source and therefore for global health security.
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Affiliation(s)
- Sonia Hegde
- Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Johns Hopkins University, Baltimore, MD, USA.
| | | | - Wences Arvelo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim Lindblade
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Beatriz López
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - John P McCracken
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Chris Bernart
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Aleida Roldan
- Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala
| | - Joe P Bryan
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Hagan LM, Kasradze A, Salyer SJ, Gamkrelidze A, Alkhazashvili M, Chanturia G, Chitadze N, Sukhiashvili R, Shakhnazarova M, Russell S, Blanton C, Kuchukhidze G, Baliashvili D, Hariri S, Ko S, Imnadze P, Drobeniuc J, Morgan J, Averhoff F. Hepatitis C prevalence and risk factors in Georgia, 2015: setting a baseline for elimination. BMC Public Health 2019; 19:480. [PMID: 32326913 PMCID: PMC6696670 DOI: 10.1186/s12889-019-6784-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The country of Georgia launched the world's first Hepatitis C Virus (HCV) Elimination Program in 2015 and set a 90% prevalence reduction goal for 2020. We conducted a nationally representative HCV seroprevalence survey to establish baseline prevalence to measure progress toward elimination over time. METHODS A cross-sectional seroprevalence survey was conducted in 2015 among adults aged ≥18 years using a stratified, multi-stage cluster design (n = 7000). Questionnaire variables included demographic, medical, and behavioral risk characteristics and HCV-related knowledge. Blood specimens were tested for antibodies to HCV (anti-HCV) and HCV RNA. Frequencies were computed for HCV prevalence, risk factors, and HCV-related knowledge. Associations between anti-HCV status and potential risk factors were calculated using logistic regression. RESULTS National anti-HCV seroprevalence in Georgia was 7.7% (95% confidence interval (CI) = 6.7, 8.9); HCV RNA prevalence was 5.4% (95% CI = 4.6, 6.4). Testing anti-HCV+ was significantly associated with male sex, unemployment, urban residence, history of injection drug use (IDU), incarceration, blood transfusion, tattoos, frequent dental cleanings, medical injections, dialysis, and multiple lifetime sexual partners. History of IDU (adjusted odds ratio (AOR) = 21.4, 95% CI = 12.3, 37.4) and blood transfusion (AOR = 4.5, 95% CI = 2.8, 7.2) were independently, significantly associated with testing anti-HCV+ after controlling for sex, age, urban vs. rural residence, and history of incarceration. Among anti-HCV+ participants, 64.0% were unaware of their HCV status, and 46.7% did not report IDU or blood transfusion as a risk factor. CONCLUSIONS Georgia has a high HCV burden, and a majority of infected persons are unaware of their status. Ensuring a safe blood supply, implementing innovative screening strategies beyond a risk-based approach, and intensifying prevention efforts among persons who inject drugs are necessary steps to reach Georgia's HCV elimination goal.
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Affiliation(s)
- Liesl M. Hagan
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Ana Kasradze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Stephanie J. Salyer
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | | | - Gvantsa Chanturia
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | | | | | - Steven Russell
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Curtis Blanton
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | - Davit Baliashvili
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Susan Hariri
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Stephen Ko
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA USA
- School of Public Health, Boston University, Boston, MA USA
| | - Paata Imnadze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Jan Drobeniuc
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Juliette Morgan
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA USA
- Global Disease Detection – South Caucasus Regional Center, Centers for Disease Control and Prevention, Tbilisi, Georgia
| | - Francisco Averhoff
- Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, GA USA
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44
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Hunsperger E, Juma B, Onyango C, Ochieng JB, Omballa V, Fields BS, Njenga MK, Mwangi J, Bigogo G, Omore R, Otieno N, Chaves SS, Munyua P, Njau DM, Verani J, Lowther S, Breiman RF, Montgomery JM, De Cock KM, Widdowson MA. Building laboratory capacity to detect and characterize pathogens of public and global health security concern in Kenya. BMC Public Health 2019; 19:477. [PMID: 32326916 PMCID: PMC6696698 DOI: 10.1186/s12889-019-6770-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Since 1979, multiple CDC Kenya programs have supported the development of diagnostic expertise and laboratory capacity in Kenya. In 2004, CDC’s Global Disease Detection (GDD) program within the Division of Global Health Protection in Kenya (DGHP-Kenya) initiated close collaboration with Kenya Medical Research Institute (KEMRI) and developed a laboratory partnership called the Diagnostic and Laboratory Systems Program (DLSP). DLSP built onto previous efforts by malaria, human immunodeficiency virus (HIV) and tuberculosis (TB) programs and supported the expansion of the diagnostic expertise and capacity in KEMRI and the Ministry of Health. First, DLSP developed laboratory capacity for surveillance of diarrheal, respiratory, zoonotic and febrile illnesses to understand the etiology burden of these common illnesses and support evidenced-based decisions on vaccine introductions and recommendations in Kenya. Second, we have evaluated and implemented new diagnostic technologies such as TaqMan Array Cards (TAC) to detect emerging or reemerging pathogens and have recently added a next generation sequencer (NGS). Third, DLSP provided rapid laboratory diagnostic support for outbreak investigation to Kenya and regional countries. Fourth, DLSP has been assisting the Kenya National Public Health laboratory-National Influenza Center and microbiology reference laboratory to obtain World Health Organization (WHO) certification and ISO15189 accreditation respectively. Fifth, we have supported biosafety and biosecurity curriculum development to help Kenyan laboratories safely and appropriately manage infectious pathogens. These achievements, highlight how in collaboration with existing CDC programs working on HIV, tuberculosis and malaria, the Global Health Security Agenda can have significantly improve public health in Kenya and the region. Moreover, Kenya provides an example as to how laboratory science can help countries detect and control of infectious disease outbreaks and other public health threats more rapidly, thus enhancing global health security.
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Affiliation(s)
- Elizabeth Hunsperger
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya. .,CDC, CGH, DGHP, Epidemiology, Informatics, Surveillance and Laboratory Branch, Atlanta, GA, USA.
| | - Bonventure Juma
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya
| | - Clayton Onyango
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya
| | - John B Ochieng
- Kenya Medical Research Institute (KEMRI), Center for Global Health Research (CGHR), Kisumu, Kenya
| | | | - Barry S Fields
- CDC, CGH, DGHP, Epidemiology, Informatics, Surveillance and Laboratory Branch, Atlanta, GA, USA
| | | | - Jane Mwangi
- CDC, CGH, Division of Global HIV and TB (DGHT), Nairobi, Kenya
| | - Godfrey Bigogo
- Kenya Medical Research Institute (KEMRI), Center for Global Health Research (CGHR), Kisumu, Kenya
| | - Richard Omore
- Kenya Medical Research Institute (KEMRI), Center for Global Health Research (CGHR), Kisumu, Kenya
| | - Nancy Otieno
- Kenya Medical Research Institute (KEMRI), Center for Global Health Research (CGHR), Kisumu, Kenya
| | - Sandra S Chaves
- CDC, National Center for Immunization and Respiratory Diseases, Influenza Division, Nairobi, Kenya
| | - Peninah Munyua
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya
| | - Daniel Macharia Njau
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya
| | - Jennifer Verani
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya.,CDC, CGH, DGHP, Epidemiology, Informatics, Surveillance and Laboratory Branch, Atlanta, GA, USA
| | - Sara Lowther
- CDC, DGHP, Workforce Institute Development Branch, Nairobi, Kenya
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, GA, USA
| | - Joel M Montgomery
- CDC, CGH, DGHP, Epidemiology, Informatics, Surveillance and Laboratory Branch, Atlanta, GA, USA
| | - Kevin M De Cock
- CDC, CGH, Division of Global HIV and TB (DGHT), Nairobi, Kenya
| | - Marc-Alain Widdowson
- Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global Health Protection (DGHP), Nairobi, Kenya.,CDC, CGH, DGHP, Epidemiology, Informatics, Surveillance and Laboratory Branch, Atlanta, GA, USA
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45
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Kandeel A, Palms DL, Afifi S, Kandeel Y, Etman A, Hicks LA, Talaat M. An educational intervention to promote appropriate antibiotic use for acute respiratory infections in a district in Egypt- pilot study. BMC Public Health 2019; 19:498. [PMID: 32326918 PMCID: PMC6696705 DOI: 10.1186/s12889-019-6779-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Antibiotic overuse is the most important modifiable factor contributing to antibiotic resistance. We conducted an educational campaign in Minya, Egypt targeting prescribers and the public through communications focused on appropriate antibiotic use for acute respiratory infections (ARIs). Methods The entire population of Minya was targeted by the campaign. Physicians and pharmacists were invited to participate in the pre-intervention assessments. Acute care hospitals and a sample of primary healthcare centers in Minya were randomly selected for a pre-intervention survey and all patients exiting outpatient clinics on the day of the survey were invited to participate. The same survey methodology was conducted for the post-intervention assessments. Descriptive comparisons were made through three assessments conducted pre- and post-intervention. We quantitated antibiotic prescribing through a survey administered to patients with an ARI exiting outpatient clinics. Additionally, physicians, pharmacists, and patients were interviewed regarding their attitudes and beliefs towards antibiotic prescribing. Finally, physicians were tested on three clinical scenarios (cold, bronchitis, and sinusitis) to measure their knowledge on antibiotic use. Results Post-intervention patient exit surveys revealed a 23.1% decrease in antibiotic prescribing for ARIs in this population (83.7 to 64.4%) and physicians and pharmacists self-reported less frequently prescribing antibiotics for ARIs on their follow-up surveys. We also found an increase in correct responses to the clinical scenarios and in attitude and belief scores for physicians, pharmacists, and patients regarding antibiotic use in the post-intervention sample. Conclusions Overall, the samples surveyed after the community-based educational campaign reported a lower frequency of antibiotic prescribing and improved knowledge and attitudes regarding antibiotic misuse compared to the samples surveyed before the campaign. Ongoing interventions educating providers and patients are needed to decrease antibiotic misuse and reduce the spread of antibiotic resistance in Egypt.
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Affiliation(s)
| | - Danielle L Palms
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA.
| | - Salma Afifi
- Global Disease Detection Center, US CDC, Cairo, Egypt
| | | | | | - Lauri A Hicks
- Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Maha Talaat
- Global Disease Detection Center, US CDC, Cairo, Egypt
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Russell S, Sturua L, Li C, Morgan J, Topuridze M, Blanton C, Hagan L, Salyer SJ. The burden of non-communicable diseases and their related risk factors in the country of Georgia, 2015. BMC Public Health 2019; 19:479. [PMID: 32326912 PMCID: PMC6696664 DOI: 10.1186/s12889-019-6785-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Non-communicable diseases (NCDs), mainly cardiovascular diseases, are a substantial cause of mortality in the country of Georgia, accounting for approximately 93% of all deaths (standardized mortality rate 630.7 deaths per 100,000 persons per year) and an important threat to health security. We conducted a nationally representative survey examining the prevalence of NCDs and their risk factors as part of a 2015 Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) serosurvey. Methods We conducted a cross-sectional serosurvey among adults aged ≥18 years using a stratified, multi-stage cluster design (n = 7000). We asked participants standardized questions from the Global Adult Tobacco Survey and the WHO STEPwise approach to Surveillance (STEPS) Survey. We also measured blood pressure and Body Mass Index for each participant. Weighted frequencies were computed for NCD and risk factor prevalence and compared to 2010 STEPS results. Results Georgians reported high rates of smoking, alcohol use, elevated blood pressure, obesity, diabetes and cardiovascular disease. An estimated 27.1% (95% confidence interval [CI]: 25.3, 28.8%) of adults (51.5% of men and 6.0% of women) reported daily use of tobacco products and 27.5% (95% CI: 25.7, 29.2%) of adults (52.1% of men and 7.0% of women) reported binge drinking within the last 30 days. Physical measurements revealed that 37.5% (95% CI: 35.8, 39.3%) of adults had elevated blood pressure and 33.4% (95% CI: 31.8, 35.0%) had obesity. 5.4% (95% CI: 4.6, 6.2%) of adults had self-reported diagnosed diabetes and 15.3% (95% CI: 14.1, 16.6%) had self-reported diagnosed cardiovascular disease. From 2010 to 2015, the prevalence of obesity increased by 8.3 percentage points (95% CI: 5.9, 10.7%; p < 0.01) and the prevalence of elevated blood pressure increased by 4.1 percentage points (95% CI: 1.4, 6.8%; p < 0.01). Conclusions Georgia has a high NCD burden, and results from the survey showed an increase in obesity and elevated blood pressure since 2010. The prevalence of other major NCDs have remained near levels reported in the 2010 STEPs survey. Comprehensive public health interventions are needed to control the heath security threats of major NCDs and their risk factors in the future. Electronic supplementary material The online version of this article (10.1186/s12889-019-6785-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Steven Russell
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Chaoyang Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA
| | - Juliette Morgan
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.,Global Disease Detection - South Caucasus Regional Center, Centers for Disease Control and Prevention, Tbilisi, Georgia
| | - Marina Topuridze
- National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Curtis Blanton
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3005 Chamblee Tucker Rd, Atlanta, GA, 30341, USA
| | - Liesl Hagan
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and Prevention, 3 Corporate Blvd NE, Atlanta, GA, 30329, USA
| | - Stephanie J Salyer
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA.
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47
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Nayak P, Sodha SV, Laserson KF, Padhi AK, Swain BK, Hossain SS, Shrivastava A, Khasnobis P, Venkatesh SR, Patnaik B, Dash KC. A cutaneous Anthrax outbreak in Koraput District of Odisha-India 2015. BMC Public Health 2019; 19:470. [PMID: 32326927 PMCID: PMC6696704 DOI: 10.1186/s12889-019-6787-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Cutaneous anthrax in humans is associated with exposure to infected animals or animal products and has a case fatality rate of up to 20% if untreated. During May to June 2015, an outbreak of cutaneous anthrax was reported in Koraput district of Odisha, India, an area endemic for anthrax. We investigated the outbreak to identify risk factors and recommend control measures. Method We defined a cutaneous anthrax case as skin lesions (e.g., papule, vesicle or eschar) in a person residing in Koraput district with illness onset between February 1 and July 15, 2015. We established active surveillance through a house to house survey to ascertain additional cases and conducted a 1:2 unmatched case control study to identify modifiable risk factors. In case control study, we included cases with illness onset between May 1 and July 15, 2015. We defined controls as neighbours of case without skin lesions since last 3 months. Ulcer exudates and rolled over swabs from wounds were processed in Gram stain in the Koraput district headquarter hospital laboratory. Result We identified 81 cases (89% male; median age 38 years [range 5–75 years]) including 3 deaths (case fatality rate = 4%). Among 37 cases and 74 controls, illness was significantly associated with eating meat of ill cattle (OR: 14.5, 95% CI: 1.4–85.7) and with close handling of carcasses of ill animals such as burying, skinning, or chopping (OR: 342, 95% CI: 40.5–1901.8). Among 20 wound specimens collected, seven showed spore-forming, gram positive bacilli, with bamboo stick appearance suggestive of Bacillus anthracis. Conclusion Our investigation revealed significant associations between eating and handling of ill animals and presence of anthrax-like organisms in lesions. We immediately initiated livestock vaccination in the area, educated the community on safe handling practices and recommended continued regular anthrax animal vaccinations to prevent future outbreaks.
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Affiliation(s)
- Priyakanta Nayak
- National Centre for Disease Control, 22 Shamnath Marg, Civil Lines, New Delhi, India.
| | - Samir V Sodha
- United States Centers for Disease Control and Prevention, Delhi, India.,Division of Global Health Protection, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Kayla F Laserson
- United States Centers for Disease Control and Prevention, Delhi, India.,Division of Global Health Protection, Centers for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Arun K Padhi
- Directorate of Health Services, Bhubaneswar, Odisha, India
| | | | - Shaikh S Hossain
- United States Centers for Disease Control and Prevention, Delhi, India
| | - Aakash Shrivastava
- National Centre for Disease Control, 22 Shamnath Marg, Civil Lines, New Delhi, India
| | - Pradeep Khasnobis
- National Centre for Disease Control, 22 Shamnath Marg, Civil Lines, New Delhi, India
| | - Srinivas R Venkatesh
- National Centre for Disease Control, 22 Shamnath Marg, Civil Lines, New Delhi, India
| | - Bikash Patnaik
- Directorate of Health Services, Bhubaneswar, Odisha, India
| | - Kailash C Dash
- Directorate of Health Services, Bhubaneswar, Odisha, India
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Abstract
BACKGROUND Following the SARS outbreak, the World Health Organization revised the International Health Regulations to include risk communication as one of the core capacity areas. In 2006, the U.S. Centers for Disease Control and Prevention's Global Disease Detection [GDD] program began collaborating with China to enhance China's risk communication capacity to address gaps in the SARS communication response. This article describes tangible improvements in China's public health emergency risk communication capacity between the SARS and H7N9 outbreaks; documents U.S. CDC GDD cooperative technical assistance during 2006-2017; and shares lessons learnt to benefit other countries and contribute to enhance global health security. METHOD A questionnaire based on the WHO Joint External Evaluation tool [Risk Communication section] was developed. A key communications official from the China National Health Commission [NHC] completed the questionnaire retrospectively to reflect China's capacity to manage communication response before, during and after the outbreaks of SARS in 2003, influenza H1N1 in 2009, and influenza H7N9 in 2013. A literature search was also conducted in English and Chinese to further substantiate the results of the questionnaire completed by NHC. RESULTS China demonstrated significantly improved risk communication capacities of pre-event, during event and post event responses to H7N9 when compared to the SARS response. China NHC improved its response through preparedness, availability of dedicated staff and resources for risk communication, internal clearance mechanisms, standard operating procedures with national response parties external to NHC, rumor management, communication with international agencies and consistent messaging with healthcare and private sectors. Correspondingly, the perceived level of trust that the public had in the NHC following outbreaks rose between the SARS and H7N9 response. CONCLUSION Risk communication capacities in China have increased during the ten years between the SARS outbreak of 2003 and the H7N9 outbreak of 2013. Long-term risk communication capacity building efforts in bilateral collaborations are uncommon. The U.S. CDC GDD project was one of the first such collaborations worldwide. The lessons learned from this project may benefit lower and middle-income countries as they build their national emergency risk communication capacity.
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Affiliation(s)
- Melinda Frost
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA USA
- US Centers for Disease Control and Prevention, Beijing, China
| | - Richun Li
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA USA
- US Centers for Disease Control and Prevention, Beijing, China
| | - Ronald Moolenaar
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA USA
- US Centers for Disease Control and Prevention, Beijing, China
| | - Qun’an Mao
- National Health Commission, Beijing, China
| | - Ruiqian Xie
- Chinese Center for Health Education, Beijing, China
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49
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Harris AM, Chokoshvili O, Biddle J, Turashvili K, Japaridze M, Burjanadze I, Tsertsvadze T, Sharvadze L, Karchava M, Talakvadze A, Chakhnashvili K, Demurishvili T, Sabelashvili P, Foster M, Hagan L, Butsashvili M, Morgan J, Averhoff F. An evaluation of the hepatitis C testing, care and treatment program in the country of Georgia's corrections system, December 2013 - April 2015. BMC Public Health 2019; 19:466. [PMID: 32326938 PMCID: PMC6696696 DOI: 10.1186/s12889-019-6783-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The country of Georgia has a high burden of chronic hepatitis C virus (HCV) infection, and prisoners are disproportionately affected. During 2013, a novel program offering no cost screening and treatment of HCV infection for eligible prisoners was launched. METHODS The HCV treatment program implemented a voluntary opt-in anti-HCV testing policy to all prisoners. Anti-HCV positive persons received HCV RNA and genotype testing. Transient elastography was also performed on prisoners with positive HCV RNA results. Prisoners with chronic HCV infection who had ≥F2 Metavir stage for liver fibrosis and a prison sentence ≥ 6 months were eligible for interferon-based treatment, which was the standard treatment prior to 2015. We conducted an evaluation of the HCV treatment program among prisoners from the program's inception in December 2013 through April 2015 by combining data from personal interviews with corrections staff, prisoner data in the corrections database, and HCV-specific laboratory information. RESULTS Of an estimated 30,000 prisoners who were incarcerated at some time during the evaluation period, an estimated 13,500 (45%) received anti-HCV screening, of whom 5175 (38%) tested positive. Of these, 3840 (74%) received HCV RNA testing, 2730 (71%) tested positive, and 880 (32%) met treatment eligibility. Of these, 585 (66%) enrolled; 405 (69%) completed treatment, and 202 (50%) achieved a sustained virologic response at least 12 weeks after treatment completion. CONCLUSIONS HCV infection prevalence among Georgian prisoners was high. Despite challenges, we determined HCV treatment within Georgian Ministry of Correction facilities was feasible. Efforts to address HCV infection among prison population is one important component of HCV elimination in Georgia.
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Affiliation(s)
- Aaron M. Harris
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA 30329 USA
| | - Otar Chokoshvili
- Infectious diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Joshua Biddle
- Hubert Fellowship, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | - Maia Japaridze
- Global Disease Detection, Division of Global Health Protection, Centers for Disease Control and Prevention, Tbilisi, Georgia
| | - Irma Burjanadze
- National Center for Disease Control and Public Health of Georgia, Ministry of Labour Health and Social Affairs (MoLHSA) of Georgia, Tbilisi, Georgia
| | - Tengiz Tsertsvadze
- Infectious diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Lali Sharvadze
- Infectious diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | - Marine Karchava
- Infectious diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia
| | | | | | | | | | - Monique Foster
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA 30329 USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Liesl Hagan
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA 30329 USA
| | | | - Juliette Morgan
- Global Disease Detection, Division of Global Health Protection, Centers for Disease Control and Prevention, Tbilisi, Georgia
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Francisco Averhoff
- Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS: G37, Atlanta, GA 30329 USA
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50
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Rhodes J, Jorakate P, Makprasert S, Sangwichian O, Kaewpan A, Akarachotpong T, Srisaengchai P, Thamthitiwat S, Khemla S, Yuenprakhon S, Paveenkittiporn W, Kerdsin A, Whistler T, Baggett HC, Gregory CJ. Population-based bloodstream infection surveillance in rural Thailand, 2007-2014. BMC Public Health 2019; 19:521. [PMID: 32326935 PMCID: PMC6696817 DOI: 10.1186/s12889-019-6775-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Bloodstream infection (BSI) surveillance is essential to characterize the public health threat of bacteremia. We summarize BSI epidemiology in rural Thailand over an eight year period. Methods Population-based surveillance captured clinically indicated blood cultures and associated antimicrobial susceptibility results performed in all 20 hospitals in Nakhon Phanom (NP) and Sa Kaeo (SK) provinces. BSIs were classified as community-onset (CO) when positive cultures were obtained ≤2 days after hospital admission and hospital-onset (HO) thereafter. Hospitalization denominator data were available for incidence estimates for 2009–2014. Results From 2007 to 2014 a total of 11,166 BSIs were identified from 134,441 blood cultures. Annual CO BSI incidence ranged between 89.2 and 123.5 cases per 100,000 persons in SK and NP until 2011. Afterwards, CO incidence remained stable in SK and increased in NP, reaching 155.7 in 2013. Increases in CO BSI incidence over time were limited to persons aged ≥50 years. Ten pathogens, in rank order, accounted for > 65% of CO BSIs in both provinces, all age-groups, and all years: Escherichia coli, Klebsiella pneumoniae, Burkholderia pseudomallei, Staphylococcus aureus, Salmonella non-typhi spp., Streptococcus pneumoniae, Acinetobacter spp., Streptococcus agalactiae, Streptococcus pyogenes, Pseudomonas aeruginosa. HO BSI incidence increased in NP from 0.58 cases per 1000 hospitalizations in 2009 to 0.91 in 2014, but were higher (ranging from 1.9 to 2.3) in SK throughout the study period. Extended-spectrum beta-lactamase production among E. coli isolates and multi-drug resistance among Acinetobacter spp. isolates was common (> 25% of isolates), especially among HO cases (> 50% of isolates), and became more common over time, while methicillin-resistance among S. aureus isolates (10%) showed no clear trend. Carbapenem-resistant Enterobacteriaceae were documented in 2011–2014. Conclusions Population-based surveillance documented CO BSI incidence estimates higher than previously reported from Thailand and the region, with temporal increases seen in older populations. The most commonly observed pathogens including resistance profiles were similar to leading pathogens and resistance profiles worldwide, thus; prevention strategies with demonstrated success elsewhere may prove effective in Thailand. Electronic supplementary material The online version of this article (10.1186/s12889-019-6775-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julia Rhodes
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
| | - Possawat Jorakate
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Sirirat Makprasert
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Ornuma Sangwichian
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Anek Kaewpan
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Thantapat Akarachotpong
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Prasong Srisaengchai
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Somsak Thamthitiwat
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | | | | | - Wantana Paveenkittiporn
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Anusak Kerdsin
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand.,Faculty of Public Health, Kasetsart University Chalermphrakiat, Sakon Nakhon Province, Thailand
| | - Toni Whistler
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
| | - Henry C Baggett
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
| | - Christopher J Gregory
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
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