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Akpan GU, Mohammed HF, Touray K, Kipterer J, Bello IM, Ngofa R, Stein A, Seaman V, Mkanda P, Cabore J. Conclusions of the African Regional GIS Summit (2019): using geographic information systems for public health decision-making. BMC Proc 2022; 16:3. [PMID: 35715765 PMCID: PMC9206237 DOI: 10.1186/s12919-022-00233-y] [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] [Indexed: 11/19/2022] Open
Abstract
The use of geographic information system (GIS) technologies to improve access to health is gaining momentum in Africa. This has become more pertinent with the increasing penetration of mobile-phone technology and internet use, and calls for innovative strategies to support implementation of the World Health Organization Sustainable Development Goals for universal health coverage on the continent. The huge potential benefits of GIS to advance health service delivery in Africa is, however, yet to be fully harnessed due to critical challenges such as proliferation of pilot projects, poor coordination, inadequate preparedness of the health workforce for GIS, lack of interoperability, and inadequate sustainable financing. To discuss these challenges and propose the way forward for rapid, cost-effective, and sustainable deployment of GIS, the African Regional GIS Summit was held in Brazzaville, Republic of the Congo, on 7–10 October 2019 under the umbrella of the AFRO GIS Centre.
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Affiliation(s)
- Godwin Ubong Akpan
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo.
| | | | - Kebba Touray
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
| | - John Kipterer
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
| | - Isah Mohammed Bello
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
| | - Reuben Ngofa
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
| | - Andrew Stein
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Vince Seaman
- Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Pascal Mkanda
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
| | - Joseph Cabore
- World Health Organization Regional Office for Africa, Djoue, Brazzaville, Congo
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Akpan GU, Bello IM, Mohamed HF, Touray K, Kipterer J, Ngofa R, Oyaole DR, Atagbaza A, Ticha JM, Manengu C, Chikwanda C, Nshuti MB, Omoleke S, Oviaesu D, Diallo M, Ndoutabe M, Seaman V, Mkanda P. The digitization of Active Surveillance: An insight-based evaluation of Interactive visualization of active case search for Polio surveillance to support decision making in Africa (Preprint). JMIR Public Health Surveill 2022. [DOI: 10.2196/37450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cooper LV, Bandyopadhyay AS, Gumede N, Mach O, Mkanda P, Ndoutabé M, Okiror SO, Ramirez-Gonzalez A, Touray K, Wanyoike S, Grassly NC, Blake IM. Risk factors for the spread of vaccine-derived type 2 polioviruses after global withdrawal of trivalent oral poliovirus vaccine and the effects of outbreak responses with monovalent vaccine: a retrospective analysis of surveillance data for 51 countries in Africa. Lancet Infect Dis 2022; 22:284-294. [PMID: 34648733 PMCID: PMC8799632 DOI: 10.1016/s1473-3099(21)00453-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Expanding outbreaks of circulating vaccine-derived type 2 poliovirus (cVDPV2) across Africa after the global withdrawal of trivalent oral poliovirus vaccine (OPV) in 2016 are delaying global polio eradication. We aimed to assess the effect of outbreak response campaigns with monovalent type 2 OPV (mOPV2) and the addition of inactivated poliovirus vaccine (IPV) to routine immunisation. METHODS We used vaccination history data from children under 5 years old with non-polio acute flaccid paralysis from a routine surveillance database (the Polio Information System) and setting-specific OPV immunogenicity data from the literature to estimate OPV-induced and IPV-induced population immunity against type 2 poliomyelitis between Jan 1, 2015, and June 30, 2020, for 51 countries in Africa. We investigated risk factors for reported cVDPV2 poliomyelitis including population immunity, outbreak response activities, and correlates of poliovirus transmission using logistic regression. We used the model to estimate cVDPV2 risk for each 6-month period between Jan 1, 2016, and June 30, 2020, with different numbers of mOPV2 campaigns and compared the timing and location of actual mOPV2 campaigns and the number of mOPV2 campaigns required to reduce cVDPV2 risk to low levels. FINDINGS Type 2 OPV immunity among children under 5 years declined from a median of 87% (IQR 81-93) in January-June, 2016 to 14% (9-37) in January-June, 2020. Type 2 immunity from IPV among children under 5 years increased from 3% (<1-6%) in January-June, 2016 to 35% (24-47) in January-June, 2020. The probability of cVDPV2 poliomyelitis among children under 5 years was negatively correlated with OPV-induced and IPV-induced immunity and mOPV2 campaigns (adjusted odds ratio: OPV 0·68 [95% CrI 0·60-0·76], IPV 0·82 [0·68-0·99] per 10% absolute increase in estimated population immunity, mOPV2 0·30 [0·20-0·44] per campaign). Vaccination campaigns in response to cVDPV2 outbreaks have been smaller and slower than our model shows would be necessary to reduce risk to low levels, covering only 11% of children under 5 years who are predicted to be at risk within 6 months and only 56% within 12 months. INTERPRETATION Our findings suggest that as mucosal immunity declines, larger or faster responses with vaccination campaigns using type 2-containing OPV will be required to stop cVDPV2 transmission. IPV-induced immunity also has an important role in reducing the burden of cVDPV2 poliomyelitis in Africa. FUNDING Bill & Melinda Gates Foundation, Medical Research Council Centre for Global Infectious Disease Analysis, and WHO. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Laura V Cooper
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK,Correspondence to: Dr Laura V Cooper, Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London W2 1PG, UK
| | | | - Nicksy Gumede
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Ondrej Mach
- Polio Eradication Department, World Health Organization, Geneva, Switzerland
| | - Pascal Mkanda
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Modjirom Ndoutabé
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Samuel O Okiror
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Alejandro Ramirez-Gonzalez
- Expanded Programme on Immunization, Vaccines, and Biologicals Department, World Health Organization, Geneva, Switzerland
| | - Kebba Touray
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Sarah Wanyoike
- Regional Office for Africa, World Health Organization, Brazzaville, Republic of Congo
| | - Nicholas C Grassly
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Isobel M Blake
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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Voorman A, O'Reilly K, Lyons H, Goel AK, Touray K, Okiror S. Real-time prediction model of cVDPV2 outbreaks to aid outbreak response vaccination strategies. Vaccine 2021; 41 Suppl 1:A105-A112. [PMID: 34483024 PMCID: PMC10109086 DOI: 10.1016/j.vaccine.2021.08.064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/26/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Circulating vaccine-derived poliovirus outbreaks are spreading more widely than anticipated, which has generated a crisis for the global polio eradication initiative. Effectively responding with vaccination activities requires a rapid risk assessment. This assessment is made difficult by the low case-to-infection ratio of type 2 poliovirus, variable transmissibility, changing population immunity, surveillance delays, and limited vaccine supply from the global stockpile. The geographical extent of responses have been highly variable between countries. METHODS We develop a statistical spatio-temporal model of short-term, district-level poliovirus spread that incorporates known risk factors, including historical wild poliovirus transmission risk, routine immunization coverage, population immunity, and exposure to the outbreak virus. RESULTS We find that proximity to recent cVDPV2 cases is the strongest risk factor for spread of an outbreak, and find significant associations between population immunity, historical risk, routine immunization, and environmental surveillance (p < 0.05). We examine the fit of the model to type 2 vaccine derived poliovirus spread since 2016 and find that our model predicts the location of cVDPV2 cases well (AUC = 0.96). We demonstrate use of the model to estimate appropriate scope of outbreak response activities to current outbreaks. CONCLUSION As type 2 immunity continues to decline following the cessation of tOPV in 2016, outbreak responses to new cVDPV2 detections will need to be faster and larger in scope. We provide a framework that can be used to support decisions on the appropriate size of a vaccination response when new detections are identified. While the model does not account for all relevant local factors that must be considered in the overall vaccination response, it enables a quantitative basis for outbreak response size.
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Affiliation(s)
- Arend Voorman
- The Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA 98109, United States.
| | - Kathleen O'Reilly
- The London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT United Kingdom
| | - Hil Lyons
- The Institute for Disease Modelling, 500 5th Ave N, Seattle, WA 98109, United States
| | - Ajay Kumar Goel
- The World Health Organization, Avenue Appia 20, 1202 Genève, Switzerland
| | - Kebba Touray
- The World Health Organization Regional Office for Africa, Cité du Djoué, P.O.Box 06, Brazzaville, Republic of Congo
| | - Samuel Okiror
- The World Health Organization Regional Office for Africa, Cité du Djoué, P.O.Box 06, Brazzaville, Republic of Congo
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Akpan GU, Bello IM, Touray K, Ngofa R, Oyaole D, Maleghemi S, Babona Nshuti MA, Chikwanda CS, Poy A, Roland Mboussou FF, Ogundiran O, Impouma B, Mihigo R, Yao NKM, Ticha JM, Tuma J, Mohammed HFAH, Kanmodi K, Ejiofor NE, Manengu C, Kasolo F, Seaman V, Mkanda P. Leveraging Polio GIS platforms in the African Region for mitigating Covid-19 contact tracing and Surveillance challenges. JMIR Mhealth Uhealth 2021; 10:e22544. [PMID: 34854813 PMCID: PMC8972111 DOI: 10.2196/22544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/01/2021] [Accepted: 05/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background The ongoing COVID-19 pandemic in Africa is an urgent public health crisis. Estimated models projected over 150,000 deaths and 4,600,000 hospitalizations in the first year of the disease in the absence of adequate interventions. Therefore, electronic contact tracing and surveillance have critical roles in decreasing COVID-19 transmission; yet, if not conducted properly, these methods can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms and surveillance reporting are necessary for standardizing real-time reporting of new chains of infection in order to quickly reverse growing trends and halt the pandemic. Objective This paper aims to describe a COVID-19 contact tracing smartphone app that includes health facility surveillance with a real-time visualization platform. The app was developed by the AFRO (African Regional Office) GIS (geographic information system) Center, in collaboration with the World Health Organization (WHO) emergency preparedness and response team. The app was developed through the expertise and experience gained from numerous digital apps that had been developed for polio surveillance and immunization via the WHO’s polio program in the African region. Methods We repurposed the GIS infrastructures of the polio program and the database structure that relies on mobile data collection that is built on the Open Data Kit. We harnessed the technology for visualization of real-time COVID-19 data using dynamic dashboards built on Power BI, ArcGIS Online, and Tableau. The contact tracing app was developed with the pragmatic considerations of COVID-19 peculiarities. The app underwent testing by field surveillance colleagues to meet the requirements of linking contacts to cases and monitoring chains of transmission. The health facility surveillance app was developed from the knowledge and assessment of models of surveillance at the health facility level for other diseases of public health importance. The Integrated Supportive Supervision app was added as an appendage to the pre-existing paper-based surveillance form. These two mobile apps collected information on cases and contact tracing, alongside alert information on COVID-19 reports at the health facility level; the information was linked to visualization platforms in order to enable actionable insights. Results The contact tracing app and platform were piloted between April and June 2020; they were then put to use in Zimbabwe, Benin, Cameroon, Uganda, Nigeria, and South Sudan, and their use has generated some palpable successes with respect to COVID-19 surveillance. However, the COVID-19 health facility–based surveillance app has been used more extensively, as it has been used in 27 countries in the region. Conclusions In light of the above information, this paper was written to give an overview of the app and visualization platform development, app and platform deployment, ease of replicability, and preliminary outcome evaluation of their use in the field. From a regional perspective, integration of contact tracing and surveillance data into one platform provides the AFRO with a more accurate method of monitoring countries’ efforts in their response to COVID-19, while guiding public health decisions and the assessment of risk of COVID-19.
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Affiliation(s)
- Godwin Ubong Akpan
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Kebba Touray
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Reuben Ngofa
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | | | - Marie Aimee Babona Nshuti
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Chanda Sangawambi Chikwanda
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Alain Poy
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Franck Fortune Roland Mboussou
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Opeayo Ogundiran
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Benido Impouma
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Richard Mihigo
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - N'da Konan Michel Yao
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Johnson Muluh Ticha
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Jude Tuma
- World Health Organization, Geneva, CH
| | - Hani Farouk Abdel Hai Mohammed
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Nonso Ephraim Ejiofor
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Casimir Manengu
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | - Francis Kasolo
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
| | | | - Pascal Mkanda
- World Health Organization, Regional Office of Africa, World Health Organization,Regional Office for AfricaCite Du Djoue ,, Brazzaville, CG
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Bello IM, Moyo TN, Munyanyi M, Akpan GU, Isibor I, Sunganai LC, Umar AS, Krishnan RSSG, Touray K, Rupfutse M, Manangazira P, Ntale AG, Fussum D, Mkanda P. Use of geographic information systems web mapping application to support active case search to guide public health and social measures in the context of COVID-19 in Zimbabwe: a preliminary report to guide replication of methods in similar resource settings. Pan Afr Med J 2021; 38:159. [PMID: 33995766 PMCID: PMC8077638 DOI: 10.11604/pamj.2021.38.159.27143] [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: 11/25/2020] [Accepted: 02/05/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model construction, visualization and platform construction among others. METHODS we conducted a geospatial analysis to develop a web mapping application using ArcMap and ArcGIS online to guide and support active case search of potential COVID-19 cases, within 500m radius of COVID-19 confirmed cases to improve detection and testing of suspected cases. RESULTS the web mapping application tool guides the active case search teams in the field, with clear boundaries on the houses to be visited within 500-meter radius of confirmed positive cases, to conduct active case search of all cases of severe acute respiratory illnesses (SARI), acute respiratory illnesses (ARI), pneumonia etc, to detect and test for COVID-19 towards containing the pandemic. CONCLUSION the use of GIS and spatial statistical tools have become an important and valuable tool in decision-making and, more importantly, guiding health care professional and other stakeholders in the response being carried out in a more coherent and easy manner. It has proven to be effective in supporting the active case search process to rapidly detect, test and isolate cases during the process, towards containing the COVID-19 pandemic.
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Affiliation(s)
- Isah Mohammed Bello
- World Health Organization, Inter-Country Support Team office for East and Southern Africa, Harare, Zimbabwe
| | | | | | | | - Irene Isibor
- World Health Organization, African Regional Office, Brazzaville, Congo
| | | | | | | | - Kebba Touray
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Maxwell Rupfutse
- World Health Organization, African Regional Office, Brazzaville, Congo
| | | | | | - Daniel Fussum
- World Health Organization, Inter-Country Support Team office for East and Southern Africa, Harare, Zimbabwe
| | - Pascal Mkanda
- World Health Organization, Headquarters, Geneva, Switzerland
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Ticha JM, Akpan GU, Paige LM, Senouci K, Stein A, Briand P, Tuma J, Oyaole DR, Ngofa R, Maleghemi S, Touray K, Salihu AA, Diallo M, Tegegne SG, Bello IM, Idris UK, Maduka O, Manengu C, Shuaib F, Galway M, Mkanda P. Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study. JMIR Public Health Surveill 2020; 6:e18950. [PMID: 33263550 PMCID: PMC7744265 DOI: 10.2196/18950] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/19/2020] [Accepted: 08/03/2020] [Indexed: 11/23/2022] Open
Abstract
Background As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. Objective This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. Methods This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. Results Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. Conclusions This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification.
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Affiliation(s)
| | - Godwin Ubong Akpan
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Lara Mf Paige
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Kamel Senouci
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Andrew Stein
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | | | - Jude Tuma
- World Health Organization, Geneva, Switzerland
| | | | - Reuben Ngofa
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Kebba Touray
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Mamadou Diallo
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | - Casimir Manengu
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Faisal Shuaib
- National Primary Health Care Delivery Agency (NPHCDA), Abuja, Nigeria
| | - Michael Galway
- Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Pascal Mkanda
- World Health Organization Regional Office for Africa, Brazzaville, Congo
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Gali E, Mkanda P, Banda R, Korir C, Bawa S, Warigon C, Abdullahi S, Abba B, Isiaka A, Yahualashet YG, Touray K, Chevez A, Tegegne SG, Nsubuga P, Etsano A, Shuaib F, Vaz RG. Revised Household-Based Microplanning in Polio Supplemental Immunization Activities in Kano State, Nigeria. 2013-2014. J Infect Dis 2016; 213 Suppl 3:S73-8. [PMID: 26908755 PMCID: PMC4818558 DOI: 10.1093/infdis/jiv589] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 11/14/2022] Open
Abstract
BACKGROUND Remarkable progress had been made since the launch of the Global Polio Eradication Initiative in 1988. However endemic wild poliovirus transmission in Nigeria, Pakistan, and Afghanistan remains an issue of international concern. Poor microplanning has been identified as a major contributor to the high numbers of chronically missed children. METHODS We assessed the contribution of the revised household-based microplanning process implemented in Kano State from September 2013 to April 2014 to the outcomes of subsequent polio supplemental immunization activities using used preselected planning and outcome indicators. RESULTS There was a 38% increase in the number of settlements enumerated, a 30% reduction in the number of target households, and a 54% reduction in target children. The reported number of children vaccinated and the doses of oral polio vaccine used during subsequent polio supplemental immunization activities showed a decline. Postvaccination lot quality assurance sampling and chronically missed settlement reports also showed a progressive reduction in the number of children and settlements missed. CONCLUSIONS We observed improvement in Kano State's performance based on the selected postcampaign performance evaluation indicators and reliability of baseline demographic estimates after the revised household-based microplanning exercise.
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Affiliation(s)
- Emmanuel Gali
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Charity Warigon
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Suleiman Abdullahi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ayodeji Isiaka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Kebba Touray
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Ana Chevez
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Andrew Etsano
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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Craig KT, Verma H, Iliyasu Z, Mkanda P, Touray K, Johnson T, Walla A, Banda R, Tegegne SG, Yehualashet YG, Abba B, Ahmad-Shehu A, Takane M, Sutter RW, Nsubuga P, Muhammad AJG, Vaz RG. Role of Serial Polio Seroprevalence Studies in Guiding Implementation of the Polio Eradication Initiative in Kano, Nigeria: 2011-2014. J Infect Dis 2016; 213 Suppl 3:S124-30. [PMID: 26908720 PMCID: PMC4818560 DOI: 10.1093/infdis/jiv774] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/13/2022] Open
Abstract
BACKGROUND Nigeria was one of 3 polio-endemic countries before it was de-listed in September 2015 by the World Health Organization, following interruption of transmission of the poliovirus. During 2011-2014, Nigeria conducted serial polio seroprevalence surveys (SPS) in Kano Metropolitan Area, comprising 8 local government areas (LGAs) in Kano that is considered very high risk (VHR) for polio, to monitor performance of the polio eradication program and guide the program in the adoption of innovative strategies. METHODS Study subjects who resided in any of the 8 local government areas of Kano Metropolitan Area and satisfied age criteria were recruited from patients at Murtala Mohammed Specialist Hospital (Kano) for 3 seroprevalence surveys. The same methods were used to conduct each survey. RESULTS The 2011 study showed seroprevalence values of 81%, 75%, and 73% for poliovirus types 1, 2, and 3, respectively, among infants aged 6-9 months age. Among children aged 36-47 months, seroprevalence values were greater (91%, 87%, and 85% for poliovirus types 1, 2, and 3, respectively).In 2013, the results showed that the seroprevalence was unexpectedly low among infants aged 6-9 months, remained high among children aged 36-47 months, and increased minimally among children aged 5-9 years and those aged 10-14 years. The baseline seroprevalence among infants aged 6-9 months in 2014 was better than that in 2013. CONCLUSIONS The results from the polio seroprevalence surveys conducted in Kano Metropolitan Area in 2011, 2013, and 2014 served to assess the trends in immunity and program performance, as well as to guide the program, leading to various interventions being implemented with good effect, as evidenced by the reduction of poliovirus circulation in Kano.
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Affiliation(s)
| | | | - Zubairu Iliyasu
- Aminu Kano Teaching Hospital Bayero University, Kano, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Kebba Touray
- World Health Organization, Country Representative Office
| | - Ticha Johnson
- World Health Organization, Country Representative Office
| | | | - Richard Banda
- World Health Organization, Country Representative Office
| | | | | | - Bashir Abba
- World Health Organization, Country Representative Office
| | | | | | | | | | | | - Rui G Vaz
- World Health Organization, Country Representative Office
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10
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Tegegne SG, MKanda P, Yehualashet YG, Erbeto TB, Touray K, Nsubuga P, Banda R, Vaz RG. Implementation of a Systematic Accountability Framework in 2014 to Improve the Performance of the Nigerian Polio Program. J Infect Dis 2016; 213 Suppl 3:S96-100. [PMID: 26823334 PMCID: PMC4818547 DOI: 10.1093/infdis/jiv492] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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] [Indexed: 12/05/2022] Open
Abstract
Background. An accountability framework is a central feature of managing human and financial resources. One of its primary goals is to improve program performance through close monitoring of selected priority activities. The principal objective of this study was to determine the contribution of a systematic accountability framework to improving the performance of the World Health Organization (WHO)–Nigeria polio program staff, as well as the program itself. Methods. The effect of implementation of the accountability framework was evaluated using data on administrative actions and select process indicators associated with acute flaccid paralysis (AFP) surveillance, routine immunization, and polio supplemental immunization activities. Data were collected in 2014 during supportive supervision, using Magpi software (a company that provides service to collect data using mobile phones). A total of 2500 staff were studied. Results. Data on administrative actions and process indicators from quarters 2–4 in 2014 were compared. With respect to administrative actions, 1631 personnel (74%) received positive feedback (written or verbal commendation) in quarter 4 through the accountability framework, compared with 1569 (73%) and 1152 (61%) during quarters 3 and 2, respectively. These findings accorded with data on process indicators associated with AFP surveillance and routine immunization, showing statistically significant improvements in staff performance at the end of quarter 4, compared with other quarters. Conclusions. Improvements in staff performance and process indicators were observed for the WHO-Nigeria polio program after implementation of a systematic accountability framework.
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Affiliation(s)
- Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal MKanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Tesfaye B Erbeto
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Kebba Touray
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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11
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Touray K, Mkanda P, Tegegn SG, Nsubuga P, Erbeto TB, Banda R, Etsano A, Shuaib F, Vaz RG. Tracking Vaccination Teams During Polio Campaigns in Northern Nigeria by Use of Geographic Information System Technology: 2013-2015. J Infect Dis 2015; 213 Suppl 3:S67-72. [PMID: 26609004 PMCID: PMC4818548 DOI: 10.1093/infdis/jiv493] [Citation(s) in RCA: 22] [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: 11/13/2022] Open
Abstract
INTRODUCTION Nigeria is among the 3 countries in which polio remains endemic. The country made significant efforts to reduce polio transmission but remains challenged by poor-quality campaigns and poor team performance in some areas. This article demonstrates the application of geographic information system technology to track vaccination teams to monitor settlement coverage, reduce the number of missed settlements, and improve team performance. METHODS In each local government area where tracking was conducted, global positioning system-enabled Android phones were given to each team on a daily basis and were used to record team tracks. These tracks were uploaded to a dashboard to show the level of coverage and identify areas missed by the teams. RESULTS From 2012 to June 2015, tracking covered 119 immunization days. A total of 1149 tracking activities were conducted. Of these, 681 (59%) were implemented in Kano state. There was an improvement in the geographic coverage of settlements and an overall reduction in the number of missed settlements. CONCLUSIONS The tracking of vaccination teams provided significant feedback during polio campaigns and enabled supervisors to evaluate performance of vaccination teams. The reports supported other polio program activities, such as review of microplans and the deployment of other interventions, for increasing population immunity in northern Nigeria.
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Affiliation(s)
- Kebba Touray
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Pascal Mkanda
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Sisay G Tegegn
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Tesfaye B Erbeto
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | | | - Rui G Vaz
- World Health Organization, Country Representative Office, Abuja, Nigeria
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Mackenzie GA, Plumb ID, Sambou S, Saha D, Uchendu U, Akinsola B, Ikumapayi UN, Baldeh I, Usuf E, Touray K, Jasseh M, Howie SRC, Wattiaux A, Lee E, Knoll MD, Levine OS, Greenwood BM, Adegbola RA, Hill PC. Monitoring the introduction of pneumococcal conjugate vaccines into West Africa: design and implementation of a population-based surveillance system. PLoS Med 2012; 9:e1001161. [PMID: 22272192 PMCID: PMC3260317 DOI: 10.1371/journal.pmed.1001161] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Routine use of pneumococcal conjugate vaccines (PCVs) in developing countries is expected to lead to a significant reduction in childhood deaths. However, PCVs have been associated with replacement disease with non-vaccine serotypes. We established a population-based surveillance system to document the direct and indirect impact of PCVs on the incidence of invasive pneumococcal disease (IPD) and radiological pneumonia in those aged 2 months and older in The Gambia, and to monitor changes in serotype-specific IPD. Here we describe how this surveillance system was set up and is being operated as a partnership between the Medical Research Council Unit and the Gambian Government. This surveillance system is expected to provide crucial information for immunisation policy and serves as a potential model for those introducing routine PCV vaccination in diverse settings.
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Touray K, Adetifa IM, Jallow A, Rigby J, Jeffries D, Cheung YB, Donkor S, Adegbola RA, Hill PC. Spatial analysis of tuberculosis in an urban west African setting: is there evidence of clustering? Trop Med Int Health 2010; 15:664-72. [PMID: 20406427 DOI: 10.1111/j.1365-3156.2010.02533.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the pattern of tuberculosis (TB) occurrence in Greater Banjul, The Gambia with Geographical Information Systems (GIS) and Spatial Scan Statistics (SaTScan) and to determine whether there is significant TB case clustering. METHODS In Greater Banjul, where 80% of all Gambian TB cases arise, all patients with TB registered at chest clinics between March 2007 and February 2008 were asked to participate. Demographic, clinical characteristics and GPS co-ordinates for the residence of each consenting TB case were recorded. A spatial scan statistic was used to identify purely spatial and space-time clusters of tuberculosis among permanent residents. RESULTS Of 1145 recruited patients with TB, 84% were permanent residents with 88% living in 37 settlements that had complete maps available down to settlement level. Significant high- and low-rate spatial and space-time clusters were identified in two districts. The most likely cluster of high rate from both the purely spatial analysis and the retrospective space-time analysis were from the same geographical area. A significant secondary cluster was also identified in one of the densely populated areas of the study region. CONCLUSIONS There is evidence of significant clustering of TB cases in Greater Banjul, The Gambia. Systematic use of cluster detection techniques for regular TB surveillance in The Gambia may aid effective deployment of resources. However, passive case detection dictates that community-based active case detection and risk factor surveys would help confirm the presence of true clusters and their causes.
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Affiliation(s)
- K Touray
- Bacterial Diseases Programme, MRC Laboratories, Banjul, The Gambia.
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