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1.
JMIR Mhealth Uhealth ; 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-34854813

RESUMO

BACKGROUND: The growth of the novel coronavirus 2019 (COVID-19) pandemic in Africa is an urgent public health crisis. Estimated models project over 150,000 deaths and 4,600,000 hospitalizations in the first year of disease in the absence of adequate interventions. Electronic contact tracing and surveillance, therefore, offers a critical role in decreasing COVID-19 transmission; yet if not conducted properly 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 to quickly reverse growing trends and halt the pandemic. OBJECTIVE: This article aims to describe a COVID-19 contact tracing and health facility surveillance smart phone app with real-time visualization platform which was developed by the AFRO GIS centre, in collaboration with the WHO EPR team, through the expertise and experience gained from the numerous digital apps that had been developed for Polio surveillance and immunization programme in the WHO's Polio programme in the African Region. METHODS: We repurposed the Geographic Information System(GIS) infrastructures of the Polio Programme and database structure which relies on mobile data collection built on Open data Kit( ODK) and harnessed the 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 health facility for other diseases of public health importance .It was added as an appendage to the preexisting surveillance form called the Integrated Supportive Supervision( ISS) app .These two mobile apps collected information on cases and contact tracing alongside alerting information on any COVID-19 reports from Health Facility levels which are linked to visualization platforms to enable actionable insights . RESULTS: So far, the contact tracing app and platform was piloted between April and June 2020 then put to use in Zimbabwe, Benin , Cameroon, Uganda, Nigeria and South Sudan and its use had generated some palpable successes with respect to COVID-19 surveillance. However the COVID-19 health facility based Surveillance app has been more extensively used in 27 countries in the region. CONCLUSIONS: In light of the above, this article was written to give an overview on the apps and visualization platform development, deployment, ease of replicability and preliminary outcome evaluation of its use on the field. From the regional perspective, integration of the contact tracing and surveillance data into one platform provides AFRO with a more accurate method of monitoring country efforts in their response to COVID-19, while guiding public health decisions and the assessment of risk for COVID-19.

2.
Clin Infect Dis ; 73(9): 1605-1608, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34089588

RESUMO

BACKGROUND: Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide. Prior to rotavirus vaccine introduction, over one third of AGE hospitalizations in Africa were due to rotavirus. We describe the impact of rotavirus vaccines using data from the African Rotavirus Surveillance Network (ARSN). METHODS: For descriptive analysis, we included all sites reporting to ARSN for any length of time between 2008 and 2018. For vaccine impact analysis, continuous surveillance throughout the year was required to minimize potential bias due to enrollment of partial seasons and sites had to report a minimum of 100 AGE cases per year. We report the proportion of rotavirus AGE cases by year relative to vaccine introduction, and the relative reduction in the proportion of rotavirus AGE cases reported following vaccine introduction. RESULTS: From 2008 to 2018, 97 366 prospectively enrolled hospitalized children <5 years of age met the case definition for AGE, and 34.1% tested positive for rotavirus. Among countries that had introduced rotavirus vaccine, the proportion of hospitalized AGE cases positive for rotavirus declined from 39.2% in the prevaccine period to 25.3% in the postvaccine period, a 35.5% (95% confidence interval [CI]: 33.7-37.3) decline. No declines were observed among countries that had not introduced the vaccine over the 11-year period. CONCLUSIONS: Rotavirus vaccine introduction led to large and consistent declines in the proportion of hospitalized AGE cases that are positive for rotavirus. To maximize the public health benefit of these vaccines, efforts to introduce rotavirus vaccines in the remaining countries in the region and to improve coverage should continue.


Assuntos
Infecções por Rotavirus , Vacinas contra Rotavirus , Rotavirus , Adulto , Criança , Pré-Escolar , Diarreia , Hospitalização , Humanos , Lactente , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/prevenção & controle , Organização Mundial da Saúde
3.
J Immunol Sci ; Spec Issue(2): 1108, 2021 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-33954304

RESUMO

Mobile phone data collection tools are increasingly becoming very usable collecting, collating and analysing data in the health sector. In this paper, we documented the experiences with mobile phone data collection, collation and analysis in 5 countries of the East and Southern African, using Open Data Kit (ODK), where questionnaires were designed and coded on an XML form, uploaded and data collected using Android-Based mobile phones, with a web-based system to monitor data in real-time during EPI comprehensive review. The ODK interface supports in real-time monitoring of the flow of data, detection of missing or incomplete data, coordinate location of all locations visited, embedded charts for basic analysis. It also minimized data quality errors at entry level with the use of validation codes and constraint developed into the checklist. These benefits, combined with the improvement that mobile phones offer over paper-based in terms of timeliness, data loss, collation, and real-time data collection, analysis and uploading difficulties, make mobile phone data collection a feasible method of data collection that needs to be further explored in the conduct of all surveys in the organization.

4.
J Immunol Sci ; Spec Issue(2): 1114, 2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33954307

RESUMO

The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of services provided by front line health workers. This work is aimed to document the effects of ISS on the performance of health workers in Zambia using selected key surveillance and immunization process indicators. ISS data on WHO ODK server of all Integrated Supportive Supervisory (ISS) visits that were conducted in Zambia between 1st January 2018 to 30th September 2018 were analysed to determine the Percentage point difference between the first and the most recent ISS visits in order to determine whether an observed gap during first ISS visit had persisted during the most recent ISS visit. Our study demonstrated that ISS has remarkable percentage point increase between the first and the most recent ISS visits on availability of an updated monitoring chart, health workers knowledge of AFP case definition and AFP case files. However, there exist variations in the frequency of ISS visits across the provinces of the country. Future research effort should consider assessing the quality of the ISS data through periodic data validation missions.

5.
Pan Afr Med J ; 38: 159, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995766

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Sistemas de Informação Geográfica , Saúde Pública , COVID-19/diagnóstico , Estudos Transversais , Humanos , Síndrome Respiratória Aguda Grave/virologia , Análise Espacial , Zimbábue/epidemiologia
6.
Pan Afr Med J ; 38: 164, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995771

RESUMO

Introduction: the coronavirus disease (COVID-19) global pandemic has caused serious disruption to almost all aspect of human endeavor forcing countries to implement unprecedented public health measures aimed at mitigating its effects, such as total lockdown (inter and intra), travel bans, quarantine, social distancing in an effort to contain the spread of the virus. Supportive supervision is a functional component of the immunization systems that allows identification of existing gaps, provides an opportunity for onsite training, and document real-time findings for improvement of the program. The control measures of COVID-19 pandemic have also resulted in limitation of operations of the immunization system including supportive supervision. This has limited many aspects of supportive supervision for surveillance and routine immunization monitoring system in the East and Southern African countries. The aim of this study is to identify the effects of COVID-19 on Integrated Supportive Supervision visits for expanded programme on immunization (EPI) and how it influences the immunization and vaccine preventable disease (VPD) surveillance indicators, and its short-term effect towards notification of increase or decrease morbidity and mortality. Methods: we reviewed the integrated supportive supervision (ISS) data and the routine administrative coverage from 19 countries in the East and Southern Africa (ESA) for the period January to August 2019 to analyze the trends in the number of visits, vaccine-preventable diseases (VPD), and routine immunization (RI) indicators using t-test, and compare with the period January to August 2020 during the months of the COVID-19 pandemic. Results: thirteen countries out of the 19 considered, had shown a decline in the number of integrated supportive supervision (ISS) visits, with 10 (77%) having more than 59% decrease during the January-August 2020 as compared to the same period 2019. Eleven (57%) of the countries have shown a decrease (p-value < 0.05). Ethiopia and Kenya had the highest drop (p-value < 0.000). Six (32%) had an increase in the number of visits, with Madagascar, Zambia, and Zimbabwe having >100% increase in the number of visits. Sixty-seven percent (67%) of the countries that have decreased in the number of ISS visits have equally witnessed a drop in DPT3 administrative coverage. Countries with a low proportion of outreach sessions conducted in the period of January - August 2020, have all had sessions interruption, with more than 40% of the reasons associated with the lockdown. Conclusion: countries have experienced a decrease in the number of supportive supervision visits conducted, during the period of the COVID-19 pandemic and, this has influenced the routine immunization and vaccine-preventable diseases surveillance (VPD) process indicators monitored through the conduct of the visits. Continuous decrease in these performance indicators pose a great threat to the performance sustained and the functionality of the surveillance and immunization system, and consequently on increased surveillance sensitivity to promptly detect outbreaks and aiming to reducing morbidity and mortality in the sub-region.


Assuntos
COVID-19/prevenção & controle , Programas de Imunização , Vacinação/estatística & dados numéricos , Doenças Preveníveis por Vacina/prevenção & controle , África Oriental , África Austral , Surtos de Doenças/prevenção & controle , Humanos , Vigilância da População , Saúde Pública , Cobertura Vacinal , Vacinas/administração & dosagem
7.
JMIR Public Health Surveill ; 6(4): e18950, 2020 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-33263550

RESUMO

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.


Assuntos
Hipotonia Muscular/diagnóstico , Poliomielite/prevenção & controle , Vigilância da População/métodos , África/epidemiologia , Estudos de Avaliação como Assunto , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Hipotonia Muscular/epidemiologia , Poliomielite/epidemiologia , Avaliação de Programas e Projetos de Saúde/métodos
8.
BMC Public Health ; 18(Suppl 4): 1307, 2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30541495

RESUMO

BACKGROUND: Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a cross-sectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. METHODS: We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet. RESULTS: Of the 18 LGA Disease Surveillance and Notification Officers (DSNOs), only 2 (11%) and 5 (28%) had reports of polio outbreak investigations and supervisory visits at the lower levels, respectively. Furthermore, only 6 (33%) and 7 (39%) of the DSNOs had minutes of meetings and surveillance work plans, respectively. Of the 31 AFP cases investigated, only 39, 26, 23, and 23% had correct and complete information for the birth day, birth month, date of onset of paralysis, and date of investigation, respectively. Seventy-one percent of the clinicians at the AFP focal sites knew the correct definition for AFP compared with only 30% at the non-focal sites. Of the 38 caregivers (mothers), 16 (42%) did not remember the day or month the AFP investigation was conducted. However, 95% gave a correct number of stool samples collected and 40% mentioned that the samples were collected 24 h apart. Feedback was not given to 26 (68%) of the caregivers. The majority (79%) of the community leaders knew how to recognize a case of AFP and knew that the stool was the specimen required for the investigation, but 21% did not know to whom they should report a case of AFP in their community. CONCLUSION: This study revealed a gap in the quality indicators for polio eradication in the state, especially regarding knowledge and documentation for AFP surveillance at the operational level. Regular training of the DSNOs and focal persons, regular sensitization of clinicians, community education, supplies of reporting tools, and ensuring their judicious use will improve AFP surveillance in the state.


Assuntos
Erradicação de Doenças , Documentação/normas , Hipotonia Muscular/epidemiologia , Paralisia/epidemiologia , Poliomielite/prevenção & controle , Vigilância da População , Doença Aguda , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Poliomielite/epidemiologia
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