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1.
Health Res Policy Syst ; 20(1): 96, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064411

RESUMO

BACKGROUND: Effectively addressing the coronavirus disease 2019 (COVID-19) pandemic caused by the new pathogen requires continuous generation of evidence to inform decision-making. Despite an unprecedented amount of research occurring globally, the need to identify gaps in knowledge and prioritize a research agenda that is linked to public health action is indisputable. The WHO South-East Asia Region (SEAR) is likely to have region-specific research needs. METHODS: We aimed to identify a priority research agenda for guiding the regional and national response to the COVID-19 pandemic in SEAR countries. An online, anonymous research prioritization exercise using recent WHO guidance was conducted among the technical staff of WHO's country and regional offices engaged with the national COVID-19 response during October 2020. They were each asked to contribute up to five priority research ideas across seven thematic areas. These research ideas were reviewed, consolidated and scored by a core group on six parameters: regional specificity, relevance to the COVID-19 response, feasibility within regional research capacity, time to availability for decision-making, likely impact on practice, and promoting equity and gender responsiveness. The total scores for individual suggestions were organized in descending order, and ideas in the upper tertile were considered to be of high priority. RESULTS: A total of 203 priority research ideas were received from 48 respondents, who were primarily research and emergency response focal points in country and regional offices. These were consolidated into 78 research ideas and scored. The final priority research agenda of 27 items covered all thematic areas-health system (n=10), public health interventions (n=6), disease epidemiology (n=5), socioeconomic and equity (n=3), basic sciences (n=1), clinical sciences (n=1) and pandemic preparedness (n=1). CONCLUSIONS: This exercise, a part of WHO's mandate to "shape the research agenda", can help build a research roadmap ensuring efficient use of limited resources. This prioritized research agenda can act as a catalyst for Member States to accelerate research that could impact the COVID-19 response in SEAR.


Assuntos
COVID-19 , Saúde Pública , Ásia Oriental , Humanos , Pandemias , Pesquisa , Inquéritos e Questionários , Organização Mundial da Saúde
2.
Int J Public Health ; 67: 1604958, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35936996

RESUMO

Objectives: This study aims to assess the trade-offs between vulnerability and efficiency attributes of contact tracing programmes based on preferences of COVID-19 contact tracing practitioners, researchers and other relevant stakeholders at the global level. Methods: We conducted an online discrete choice experiment (DCE). Respondents were recruited globally to explore preferences according to country income level and the prevailing epidemiology of COVID-19 in the local setting. The DCE attributes represented efficiency (timeliness, completeness, number of contacts), vulnerability (vulnerable population), cooperation and privacy. A mixed-logit model and latent class analysis were used. Results: The number of respondents was 181. Timeliness was the most important attribute regardless of country income level and COVID-19 epidemiological condition. Vulnerability of contacts was the second most important attribute for low-to-lower-middle-income countries and third for upper-middle-to-high income countries. When normalised against conditional relative importance of timeliness, conditional relative importance of vulnerability ranged from 0.38 to 0.42. Conclusion: Vulnerability and efficiency criteria were both considered to be important attributes of contact tracing programmes. However, the relative values placed on these criteria varied significantly between epidemiological and economic context.


Assuntos
COVID-19 , Busca de Comunicante , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comportamento de Escolha , Humanos , Modelos Logísticos , Preferência do Paciente , Inquéritos e Questionários
3.
Front Public Health ; 10: 830893, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35284359

RESUMO

The COVID-19 pandemic exemplifies a One Health issue at the intersection of human, animal, and environmental health that requires collaboration across sectors to manage it successfully. The global One Health community includes professionals working in many different fields including human medicine, veterinary medicine, public health, ecosystem health, and, increasingly, social sciences. The aims of this cross-sectional study were to describe the involvement of the global One Health community in COVID-19 pandemic response activities. One Health networks (OHNs) have formed globally to serve professionals with common interests in collaborative approaches. We assessed the potential association between being part of an OHN and involvement in COVID-19 response activities. Data were collected in July-August 2020 using an online questionnaire that addressed work characteristics, perceived connection to OHNs, involvement in COVID-19 pandemic response activities, and barriers and facilitators to the involvement. The sample included 1,050 respondents from 94 countries across a range of organizations and work sectors including, but not restricted to, those typically associated with a One Health approach. Sixty-four percent of survey respondents indicated involvement in pandemic response activities. Being part of an OHN was positively associated with being involved in the COVID-19 response (odds ratio: 1.8, 95% confidence interval: 1.3-2.4). Lack of opportunities was a commonly reported barrier to involvement globally, with lack of funding the largest barrier in the WHO African region. This insight into diverse workforce involvement in the pandemic helps fill a gap in the global health workforce and public health education literature. An expanded understanding of the perceived roles and value of OHNs can inform targeted interventions to improve public health education and workforce capacity to prepare for and respond to public health emergencies.


Assuntos
COVID-19 , Saúde Única , COVID-19/epidemiologia , Estudos Transversais , Ecossistema , Humanos , Pandemias
4.
BMC Infect Dis ; 22(1): 101, 2022 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-35093019

RESUMO

BACKGROUND: We investigate the completeness of contact tracing for COVID-19 during the first wave of the COVID-19 pandemic in Thailand, from early January 2020 to 30 June 2020. METHODS: Uni-list capture-recapture models were applied to the frequency distributions of index cases to inform two questions: (1) the unobserved number of index cases with contacts, and (2) the unobserved number of index cases with secondary cases among their contacts. RESULTS: Generalized linear models (using Poisson and logistic families) did not return any significant predictor (age, sex, nationality, number of contacts per case) on the risk of transmission and hence capture-recapture models did not adjust for observed heterogeneity. Best fitting models, a zero truncated negative binomial for question 1 and zero-truncated Poisson for question 2, returned sensitivity estimates for contact tracing performance of 77.6% (95% CI = 73.75-81.54%) and 67.6% (95% CI = 53.84-81.38%), respectively. A zero-inflated negative binomial model on the distribution of index cases with secondary cases allowed the estimation of the effective reproduction number at 0.14 (95% CI = 0.09-0.22), and the overdispersion parameter at 0.1. CONCLUSION: Completeness of COVID-19 contact tracing in Thailand during the first wave appeared moderate, with around 67% of infectious transmission chains detected. Overdispersion was present suggesting that most of the index cases did not result in infectious transmission chains and the majority of transmission events stemmed from a small proportion of index cases.


Assuntos
COVID-19 , Busca de Comunicante , Humanos , Pandemias , SARS-CoV-2 , Tailândia/epidemiologia
5.
Glob Health Action ; 14(1): 1868055, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33475046

RESUMO

Background: Antimicrobial resistance (AMR) is a growing public health threat in Africa. AMR prevention and control requires coordination across multiple sectors of government and civil society partners. Objectives: To assess the current role, needs, and capacities of CSOs working in AMR in Africa. Methods: We conducted an online survey of 35 CSOs working in 37 countries across Africa. The survey asked about priorities for AMR, current AMR-specific activities, monitoring practices, training needs, and preferences for sharing information on AMR. Further data were gathered on the main roles of the organisations, the length of time engaged in and budget spent on AMR-related activities, and their involvement in the development and implementation of National Action Plans (NAPs). Results were assessed against The Africa Centres for Disease Control and Prevention (Africa CDC) Framework for Antimicrobial Resistance (2018-2023). Results: CSOs with AMR-related activities are working in all four areas of Africa CDC's Framework: improving surveillance, delaying emergence, limiting transmission, and mitigating harm from infections caused by AMR microorganisms. Engagement with the four objectives is mainly through advocacy, followed by accountability and service delivery. There were limited monitoring activities reported by CSOs, with only seven (20%) providing an example metric used to monitor their activities related to AMR, and 27 (80%) CSOs reporting having no AMR-related strategy. Half the CSOs reported engaging with the development and implementation of NAPs; however, only three CSOs are aligning their work with these national strategies. Conclusion: CSOs across Africa are supporting AMR prevention and control, however, there is potential for more engagement. Africa CDC and other government agencies should support the training of CSOs in strategies to control AMR. Tailored training programmes can build knowledge of AMR, capacity for monitoring processes, and facilitate further identification of CSOs' contribution to the AMR Framework and alignment with NAPs and regional strategies.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , África , Governo , Humanos , Saúde Pública
6.
PLoS Negl Trop Dis ; 14(8): e0008545, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32841252

RESUMO

The analysis of zoonotic disease risk requires the consideration of both human and animal geo-referenced disease incidence data. Here we show an application of joint Bayesian analyses to the study of echinococcosis granulosus (EG) in the province of Rio Negro, Argentina. We focus on merging passive and active surveillance data sources of animal and human EG cases using joint Bayesian spatial and spatio-temporal models. While similar spatial clustering and temporal trending was apparent, there appears to be limited lagged dependence between animal and human outcomes. Beyond the data quality issues relating to missingness at different times, we were able to identify relations between dog and human data and the highest 'at risk' areas for echinococcosis within the province.


Assuntos
Doenças do Cão/epidemiologia , Equinococose/epidemiologia , Vigilância em Saúde Pública/métodos , Zoonoses/epidemiologia , Adolescente , Animais , Argentina/epidemiologia , Teorema de Bayes , Criança , Cães , Echinococcus granulosus , Humanos , Modelos Biológicos
7.
One Health Outlook ; 2: 7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33829129

RESUMO

BACKGROUND: The inappropriate use of antibiotics is a major issue in clinical practice in Greece with serious implications for public health and animal health. The purpose of the present study was to provide a first insight into the use of antibiotics by small animal practitioners in Greece and assess their compliance with general rules for the rational use of antibiotics. This is the first survey of its kind in Greece. METHODS: A questionnaire was designed to collect basic information on the use of antibiotics by pet veterinarians. The questionnaire was sent to a total of 70 veterinarians mainly operating in the region of Attica, a region that comprises almost 50% of the Greek population and where veterinarians are engaged solely in small animal practice. The questionnaire consisted of 37 closed questions dealing with various aspects on the use of antibiotics. RESULTS: The majority of practitioners report cases where the pet owner initiated antibiotic treatment without veterinary prescription. Almost every clinician reported owner-compliance challenges. Regarding microbiological analysis, 73% of respondents initiate empirical treatment while waiting for laboratory results or use antibiogram only when the treatment is unsuccessful. Eighty-eight per cent declared to use antimicrobials postoperatively in clean surgical procedures. Different types of antimicrobials and treatment durations than the ones proposed by guidelines on rational use of antibiotics are preferred for various organ systems e.g. in urinary and gastrointestinal infections. CONCLUSIONS: Our findings suggest the need for guidelines on antibiotic use in small animal practice in Greece, and the deployment of systematic surveillance on antimicrobials use and resistance to inform the initial choice of antibiotics upon local antimicrobial resistance profiles. Targeting the other end of the problem, pet owners, our findings indicate the need to educate them on the rational use of antibiotics and, critically, stop antibiotic availability without prescription.

8.
Am J Trop Med Hyg ; 101(1): 93-100, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162014

RESUMO

The large number of activities contributing to zoonoses surveillance and control capability, on both human and animal domains, and their likely heterogeneous implementation across administrative units make assessment and comparisons of capability performance between such units a complex task. Such comparisons are important to identify gaps in capability development, which could lead to clusters of vulnerable areas, and to rank and subsequently prioritize resource allocation toward the least capable administrative units. Area-level preparedness is a multidimensional entity and, to the best of our knowledge, there is no consensus on a single comprehensive indicator, or combination of indicators, in a summary metric. We use Bayesian spatial factor analysis models to jointly estimate and rank disease control and surveillance capabilities against visceral leishmaniasis (VL) at the municipality level in Brazil. The latent level of joint capability is informed by four variables at each municipality, three reflecting efforts to monitor and control the disease in humans, and one variable informing surveillance capability on the reservoir, the domestic dog. Because of the large volume of missing data, we applied imputation techniques to allow production of comprehensive rankings. We were able to show the application of these models to this sparse dataset and present a ranked list of municipalities based on their overall VL capability. We discuss improvements to our models, and additional applications.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/prevenção & controle , Animais , Teorema de Bayes , Brasil/epidemiologia , Humanos , Modelos Biológicos , Vigilância da População
9.
Rev Panam Salud Publica ; 43: e89, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31889951

RESUMO

OBJECTIVE: To compare the performance of polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for diagnosing Echinococcus granulosus in dog feces among national reference laboratories in Argentina, Chile, Peru, and Uruguay. METHODS: National laboratories affiliated with the Ministry of Health/Agriculture of each country exchanged panels of 10 positive/negative samples obtained from their regular national surveillance programs in November 2015 - November 2016. All laboratories applied PCR; two also applied ELISA techniques. Sensitivity and specificity were determined for each laboratory and concordance of results among the laboratories was evaluated by Cohen Kappa coefficient. RESULTS: Poor concordance (3 of 10 paired comparisons had values of Kappa > 0.4), low sensitivity and specificity across all laboratories, and poor performance of both techniques in detecting E. granulosus in canine feces was demonstrated in this study. An ex-post comparison of the laboratories' test protocols showed substantial heterogeneity that could partially explain poor concordance of results. CONCLUSION: The results underscore the heterogeneity of canine echinococcosis diagnosis across the region and indicate possible sources of variability. Efforts to standardize canine echinococcosis testing must be included in the plan of action for the Regional Initiative for the Control of Cystic Echinococcosis. Future comparisons with fecal samples of known parasite load are needed.

10.
PLoS Negl Trop Dis ; 12(3): e0006271, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29558465

RESUMO

Through national efforts and regional cooperation under the umbrella of the Regional Program for the Elimination of Rabies, dog and human rabies have decreased significantly in Latin America and Caribbean (LAC) countries over the last three decades. To achieve this decline, LAC countries had to develop national plans, and consolidate capabilities such as regular mass dog vaccination, opportune post-exposure prophylaxis and sensitive surveillance. This paper presents longitudinal data for 21 LAC countries on dog vaccination, PEP and rabies surveillance collected from the biannual regional meeting for rabies directors from 1998-2014 and from the Regional Epidemiologic Surveillance System for Rabies (SIRVERA). Differences in human and dog rabies incidence rates and dog vaccination rates were shown between low, middle and high-income countries. At the peak, over 50 million dogs were vaccinated annually in national campaigns in the countries represented. The reported number of animal exposures remained fairly stable during the study period with an incidence rate ranging from 123 to 191 reported exposures per 100,000 people. On average, over 2 million doses of human vaccine were applied annually. In the most recent survey, only 37% of countries reported that they had sufficient financial resources to meet the program objectives. The data show a sufficient and sustained effort of the LAC countries in the area of dog vaccination and provide understanding of the baseline effort required to reduce dog-mediated rabies incidence.


Assuntos
Doenças do Cão/prevenção & controle , Vacina Antirrábica , Raiva/epidemiologia , Animais , Região do Caribe/epidemiologia , Doenças do Cão/epidemiologia , Doenças do Cão/virologia , Cães , Humanos , América Latina/epidemiologia , Vacinação em Massa/veterinária , Profilaxia Pós-Exposição , Raiva/transmissão , Raiva/veterinária , Raiva/virologia , Vacina Antirrábica/administração & dosagem , Vacina Antirrábica/economia , Inquéritos e Questionários , Vacinação/economia , Vacinação/estatística & dados numéricos , Vacinação/veterinária
11.
PLoS Negl Trop Dis ; 11(4): e0005427, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28369139

RESUMO

The direct fluorescent antibody test (DFA), is performed in all rabies reference laboratories across Latin America and the Caribbean (LAC). Despite DFA being a critical capacity in the control of rabies, there is not a standardized protocol in the region. We describe the results of the first inter-laboratory proficiency exercise of national rabies laboratories in LAC countries as part of the regional efforts towards dog-maintained rabies elimination in the American region. Twenty three laboratories affiliated to the Ministries of Health and Ministries of Agriculture participated in this exercise. In addition, the laboratories completed an online questionnaire to assess laboratory practices. Answers to the online questionnaire indicated large variability in the laboratories throughput, equipment used, protocols availability, quality control standards and biosafety requirements. Our results will inform actions to improve and harmonize laboratory rabies capacities across LAC in support for the regional efforts towards elimination of dog-maintained rabies.


Assuntos
Doenças do Cão/diagnóstico , Ensaio de Proficiência Laboratorial/normas , Saúde Pública , Vírus da Raiva/imunologia , Raiva/diagnóstico , Animais , Encéfalo/virologia , Região do Caribe , Erradicação de Doenças , Doenças do Cão/prevenção & controle , Doenças do Cão/virologia , Cães , Técnica Direta de Fluorescência para Anticorpo , Humanos , Cooperação Internacional , Internet , América Latina , Controle de Qualidade , Raiva/prevenção & controle , Raiva/virologia , Vírus da Raiva/isolamento & purificação , Sensibilidade e Especificidade , Inquéritos e Questionários
12.
PLoS One ; 12(3): e0174175, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28333986

RESUMO

BACKGROUND: In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola and Zika. Additionally, endemic zoonoses, such as rabies, burden countries year after year, placing demands on limited finances and personnel. To survey the baseline status of the emerging and endemic zoonoses programmes of the Latin American and the Caribbean (LAC) countries, the Pan American Health Organization (PAHO) conducted a survey of priority emerging and endemic zoonoses, countries´ prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control. METHODS: A fillable online questionnaire was sent to the zoonoses programme managers of the Ministries of Health (MOH) and Ministries of Agriculture (MAg) of 33 LAC countries from January to April of 2015. The questionnaire comprised 36 single, multiple choice and open-ended questions to inform the objectives of the survey. A descriptive exploratory analysis was completed. RESULTS: Fifty-four ministries (26 MOH, 25 MAg, and 3 combined responses) in 31 LAC countries responded to the survey. Within the ministries, 22 (85%) MOH, 5 (20%) MAg, and 2 (67%) combined entities indicated they had specialized zoonoses units. For endemic zoonoses, 32 of 54 ministries responded that they conduct formal prioritization exercises, most of them annually (69%). The three priority endemic zoonoses for the MOHs were leptospirosis, rabies, and brucellosis while the three priorities for the MAgs were brucellosis, rabies, and tuberculosis. Diagnosis for rabies and leptospirosis were cited as the capacities most in need of development. The most needed cross-cutting capacity was coordination between stakeholders. For emerging zoonoses, 28 ministries performed formal prioritization exercises. The top prioritization criteria were probability of introduction into the country and impact. The three priority emerging zoonoses for the MOHs were Ebola viral disease, avian influenza, and Chikungunya while for the MAgs were avian influenza, bovine spongiform encephalopathy and West Nile virus disease. Surveillance for avian influenza and Ebola, and diagnosis for BSE were quoted as the capacities most needed. For all zoonoses, the majority of respondents (69%) ranked their relationship with the other Ministry as productive or very productive, and 31% minimally productive. Many countries requested a formal regional network, better regional communication and collaboration, and integrated surveillance. CONCLUSIONS: The survey is the first comprehensive effort to date to inform the status of zoonoses programmes in LAC. The information collected here will be used to develop a regional strategy for zoonoses (both endemic and emerging), increase efforts, advocacy, and promote prompt identification and management of EIDs and improvement of endemic programmes.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Zoonoses/prevenção & controle , Animais , Região do Caribe , América Central , Controle de Doenças Transmissíveis/estatística & dados numéricos , Prioridades em Saúde/organização & administração , Prioridades em Saúde/estatística & dados numéricos , Humanos , América do Sul , Inquéritos e Questionários
13.
Front Vet Sci ; 4: 4, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28197407

RESUMO

In Latin American and Caribbean (LAC) countries, the number of cases of dog-mediated human rabies is at its lowest since the onset of the Regional Program for Rabies Elimination in 1983, a commitment from LAC countries to eliminate dog-mediated rabies coordinated by the Pan American Health Organization. Despite minor setbacks, the decline in the number of human cases has been constant since 1983. While many LAC countries have significantly reduced rabies to a level where it is no longer significant public health concern, elimination has proven elusive and pockets of the disease remain across the region. In the 33-year period since 1983, the region has set and committed to four dates for elimination (1990, 2000, 2012, and 2015). In this paper, we ponder on the multiple causes behind the elusive goal of rabies elimination, such as blanket regional goals oblivious to the large heterogeneity in national rabies capacities. Looking ahead to the elimination of dog-mediated rabies in the region, now established for 2022, we also review the many challenges and questions that the region faces in the last mile of the epidemic. Given the advanced position of the Americas in the race toward elimination, our considerations could provide valuable knowledge to other regions pursuing elimination goals.

14.
PLoS Negl Trop Dis ; 9(6): e0003806, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26110845

RESUMO

The American region has pledged to eliminate dog-mediated human rabies by 2015. As part of these efforts, we describe the findings of a desk and field mission review of Haiti's rabies situation by the end of 2013. While government officials recognize the importance of dog-mediated rabies control, and the national rabies plan adequately contemplates the basic capacities to that effect, regular and sufficient implementation, for example, of dog vaccination, is hampered by limited funding. Compounding insufficient funding and human resources, official surveillance figures do not accurately reflect the risk to the population, as evidenced by the large number of rabid dogs detected by focalized and enhanced surveillance activities conducted by the Ministry of Agriculture, Natural Resources and Rural Development (MARNDR) and the Health and Population Ministry (MSPP) with the technical assistance of the United States Centers for Disease Control and Prevention. Although international support is common, either in the form of on-the-ground technical support or donations of immunobiologicals, it is not comprehensive. In addition, there is limited coordination with MARNDR/MSPP and with other actors at the strategic or operational level due to human resources limitations. Given these findings, the 2015 elimination goal in the region is compromised by the situation in Haiti where control of the disease is not yet in sight despite the best efforts of the resolute national officials. More importantly, dog-mediated rabies is still a threat to the Haitian population.


Assuntos
Erradicação de Doenças/métodos , Doenças do Cão/epidemiologia , Doenças do Cão/prevenção & controle , Doenças do Cão/transmissão , Doenças Negligenciadas/veterinária , Raiva/veterinária , Zoonoses/prevenção & controle , Animais , Erradicação de Doenças/economia , Cães , Monitoramento Epidemiológico/veterinária , Haiti/epidemiologia , Humanos , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Raiva/epidemiologia , Raiva/prevenção & controle , Raiva/transmissão , Vacinação/veterinária , Zoonoses/epidemiologia , Zoonoses/virologia
15.
Prev Vet Med ; 120(3-4): 253-64, 2015 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-25962955

RESUMO

In disease surveillance, capture-recapture approaches have been used to estimate the frequency of endemic diseases monitored by imperfect surveillance systems. A standard output of these techniques is an estimate of the sensitivity of the surveillance. In addition, capture-recapture applications contribute to a better understanding of the disease detection processes and of the relationships between different surveillance data sources, and help identify variables associated with the under-detection of diseases. Although capture-recapture approaches have long been used in public health, their application to livestock disease surveillance is only recent. In this paper, we review the different capture-recapture approaches applied in livestock disease surveillance, and discuss their benefits and limitations in the light of the characteristics of the surveillance and control practices used in animal health.


Assuntos
Doenças dos Animais/epidemiologia , Gado , Doenças dos Animais/etiologia , Animais , Vigilância da População
16.
Pathog Glob Health ; 107(7): 340-5, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24392676

RESUMO

The region of the Americas pledged to eliminate dog-transmitted human rabies by 2015. After 30 years of sustained efforts, regional elimination appears possible as dog-mediated human rabies cases are at an all-time low, and a number of countries and territories have already eliminated the disease. In this setting, there is an opportunity to generate a framework to support countries strategies in the achievement and maintenance of rabies-free status (RFS). To this end, we describe the development of a multi-criteria decision analysis (MCDA) model to help the evaluation of rabies programmes and the identification of the best investment strategy for countries and territories to improve and efficiently maintain their rabies status. The model contemplates human and animal related capacities, six in each area, to comprehensively assess the wide scope of rabies programmes. An initial elicitation of expert opinion of values and weights for the MCDA model was performed via a web-based questionnaire. Even at this pilot stage, the model produces comparable capacity-scores, and overall (combined for public and animal health areas) as well as area-specific investment strategies. The model is being developed by the Pan American Health Organization (PAHO) as part of the regional efforts towards dog-mediated human rabies elimination and will be presented to the countries for review, refinement, contextualization, and testing. The aspiration is that countries use the model to identify the best allocation of resources towards the elimination of dog-mediated human rabies.


Assuntos
Erradicação de Doenças , Doenças do Cão/prevenção & controle , Prioridades em Saúde , Doenças Negligenciadas/prevenção & controle , Saúde Pública , Raiva/prevenção & controle , América/epidemiologia , Animais , Técnicas de Apoio para a Decisão , Cães , Feminino , Humanos , Cooperação Internacional , Masculino , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/veterinária , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Raiva/epidemiologia , Raiva/veterinária , Vacina Antirrábica , Inquéritos e Questionários
17.
Prev Vet Med ; 108(2-3): 94-102, 2013 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-22954461

RESUMO

The UK's Department for Environment, Food and Rural Affairs supports the use of systematic tools for the prioritisation of known and well defined animal diseases to facilitate long and medium term planning of surveillance and disease control activities. The recognition that emerging events were not covered by the existing disease-specific approaches led to the establishment of the Veterinary Risk Group (VRG), constituted of government officials, and supporting structures such as the Risk Management Cycle and the Emerging Threat Highlight Report (ETHiR), to facilitate the identification, reporting and assessment of emerging threats to UK's animal health. Since its inception in November 2009 to the end of February 2011, the VRG reviewed 111 threats and vulnerabilities (T&V) reported through ETHiR. In July 2010 a decision support system (DSS) based on multi-criteria-decision-analysis (MCDA) improved ETHiR to allow the systematic prioritisation of emerging T&V. The DSS allows the regular ranking of emerging T&V by calculating a set of measurement indices related to the actual impact, possible impact on public perception and level of available capabilities associated with every T&V. The systematic characterisation of the processes leading to the assessment of T&V by the VRG has led to a consistent, auditable and transparent approach to the identification and assessment of emerging risks. The regular use of MCDA to manage a portfolio of emerging risks represents a different and novel application of MCDA in a health related context.


Assuntos
Doenças Transmissíveis Emergentes/veterinária , Técnicas de Apoio para a Decisão , Criação de Animais Domésticos/normas , Animais , Animais Domésticos , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Doenças Transmissíveis Emergentes/transmissão , Formulação de Políticas , Medição de Risco , Reino Unido
18.
Biom J ; 54(3): 385-404, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22685004

RESUMO

When analyzing the geographical variations of disease risk, one common problem is data sparseness. In such a setting, we investigate the possibility of using Bayesian shared spatial component models to strengthen inference and correct for any spatially structured sources of bias, when distinct data sources on one or more related diseases are available. Specifically, we apply our models to analyze the spatial variation of risk of two forms of scrapie infection affecting sheep in Wales (UK) using three surveillance sources on each disease. We first model each disease separately from the combined data sources and then extend our approach to jointly analyze diseases and data sources. We assess the predictive performances of several nested joint models through pseudo cross-validatory predictive model checks.


Assuntos
Doença , Métodos Epidemiológicos , Geografia , Modelos Estatísticos , Animais , Teorema de Bayes , Viés , Métodos Epidemiológicos/veterinária , Risco , Fatores de Risco , Scrapie/epidemiologia , Ovinos , País de Gales/epidemiologia
19.
Vet J ; 187(2): 207-11, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20056463

RESUMO

Several surveillance techniques have been used to quantify the prevalence of both classical and atypical scrapie in British sheep, namely the recording of clinical suspects (RC) and the testing of animals slaughtered at abattoir (AS) or reported as fallen stock (FS). Any estimate of prevalence based on a particular source is likely to have been affected by demographic differences in the populations sampled. In this study, the demographic characteristics of scrapie-affected holdings detected by each of the surveillance streams (RC, AS, FS) in Great Britain were compared. Analyses of all three streams indicated that the probability of an affected holding being detected by a particular stream differed by geographical area, the number of animals brought onto the holding, the type of scrapie identified (classical vs. atypical) and the year. More detailed analysis of AS and FS suggested that the annual and regional differences between these surveys could be explained by differences in sampling effort.


Assuntos
Demografia , Scrapie/epidemiologia , Matadouros , Animais , Viés , Vigilância da População/métodos , Prevalência , Viés de Seleção , Ovinos , Reino Unido/epidemiologia
20.
Prev Vet Med ; 96(3-4): 218-25, 2010 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-20692059

RESUMO

Movement records are often used to identify animal sample provenance by retracing the movements of individuals. Here we present an alternative method, which uses the same identity tags and movement records as are used to retrace movements, but ignores individual movement paths. The first step uses a simple query to identify the most likely birth holding for every identity tag included in a database recording departures from agricultural holdings. The second step rejects a proportion of the birth holding locations to leave a list of birth holding locations that are relatively reliable. The method was used to trace the birth locations of sheep sampled for scrapie in abattoirs, or on farm as fallen stock. Over 82% of the sheep sampled in the fallen stock survey died at the holding of birth. This lack of movement may be an important constraint on scrapie transmission. These static sheep provided relatively reliable birth locations, which were used to define criteria for selecting reliable traces. The criteria rejected 16.8% of fallen stock traces and 11.9% of abattoir survey traces. Two tests provided estimates that selection reduced error in fallen stock traces from 11.3% to 3.2%, and in abattoir survey traces from 8.1% to 1.8%. This method generated 14,591 accepted traces of fallen stock from samples taken during 2002-2005 and 83,136 accepted traces from abattoir samples. The absence or ambiguity of flock tag records at the time of slaughter prevented the tracing of 16-24% of abattoir samples during 2002-2004, although flock tag records improved in 2005. The use of internal scoring to generate and evaluate results from the database query, and the confirmation of results by comparison with other database fields, are analogous to methods used in web search engines. Such methods may have wide application in tracing samples and in adding value to biological datasets.


Assuntos
Matadouros , Sistemas de Identificação Animal , Scrapie/epidemiologia , Vigilância de Evento Sentinela/veterinária , Animais , Curva ROC , Scrapie/transmissão , Ovinos , Reino Unido/epidemiologia
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