The implementation and mechanisms of advance notification for cancer screening: A scoping review.

OBJECTIVE: To describe and synthesise information on the content and delivery of advance notifications (information about cancer screening delivered prior to invitation) used to increase cancer screening participation and to understand the mechanisms that may underlie their effectiveness. METHODS: Searches related to advance notification and cancer screening were conducted in six electronic databases (APA PsycINFO, CINAHL, Cochrane Library, Embase, PubMed, Web of Science) and results were screened for eligibility. Study characteristics, features of the advance notifications (cancer type, format, delivery time, and content), and the effect of the notifications on cancer screening participation were extracted. Features were summarised and compared across effective versus ineffective notifications. RESULTS: Thirty-two articles were included in this review, reporting on 33 unique advance notifications. Of these, 79% were sent via postal mail, 79% were distributed prior to bowel cancer screening, and most were sent 2 weeks before the screening offer. Twenty-two full versions of the advance notifications were obtained for content analysis. Notifications included information about cancer risk, the benefits of screening, barriers to participation, social endorsement of cancer screening, and what to expect throughout the screening process. Of the 19 notifications whose effect was tested statistically, 68% were found to increase screening (by 0.7%-16%). Effectiveness did not differ according to the format, delivery time, or content within the notification, although some differences in cancer type were observed. CONCLUSION: Future research should explore the effectiveness of advance notification via alternative formats and for other screening contexts and disentangle the intervention- and person-level factors driving its effect on screening participation.

Screening mammography frequency following dense breast notification among a predominantly Hispanic/Latina screening cohort.

PURPOSE: Nationally legislated dense breast notification (DBN) informs women of their breast density (BD) and the impact of BD on breast cancer risk and detection, but consequences for screening participation are unclear. We evaluated the association of DBN in New York State (NYS) with subsequent screening mammography in a largely Hispanic/Latina cohort. METHODS: Women aged 40-60 were surveyed in their preferred language (33% English, 67% Spanish) during screening mammography from 2016 to 2018. We used clinical BD classification from mammography records from 2013 (NYS DBN enactment) through enrollment (baseline) to create a 6-category variable capturing prior and new DBN receipt (sent only after clinically dense mammograms). We used this variable to compare the number of subsequent mammograms (0, 1, ≥ 2) from 10 to 30 months after baseline using ordinal logistic regression. RESULTS: In a sample of 728 women (78% foreign-born, 72% Hispanic, 46% high school education or less), first-time screeners and women who received DBN for the first time after prior non-dense mammograms had significantly fewer screening mammograms within 30 months of baseline (Odds Ratios range: 0.33 (95% Confidence Interval (CI) 0.12-0.85) to 0.38 (95% CI 0.17-0.82)) compared to women with prior mammography but no DBN. There were no differences in subsequent mammogram frequency between women with multiple DBN and those who never received DBN. Findings were consistent across age, language, health literacy, and education groups. CONCLUSION: Women receiving their first DBN after previous non-dense mammograms have lower mammography participation within 2.5 years. DBN has limited influence on screening participation of first-time screeners and those with persistent dense mammograms.

Design and implementation of automated notification systems and an electronic whiteboard for radiation therapy planning monitoring.

PURPOSE: Radiotherapy (RT) treatment and treatment planning is a complex process prepared and delivered by a multidisciplinary team of specialists. Efficient communication and notification systems among different team members are therefore essential to ensure the safe, timely delivery of treatments to patients. METHOD: To address this issue, we developed and implemented automated notification systems and an electronic whiteboard to track every CT simulation, contouring task, the new-start schedule, and physician's appointments and tasks, and notify team members of overdue and missing tasks and appointments. The electronic whiteboard was developed to have a straightforward view of current patients' planning workflow and to help different team members coordinate with each other. The systems were implemented and have been used at our center to monitor the progress of treatment-planning tasks for over 2 years. RESULTS: The last-minute plans were relatively reduced by about 40% in 2023 compared to 2021 and 2022 with a p-value < 0.05. The overdue contouring tasks of more than 1 day decreased from 46.8% in 2019 and 33.6% in 2020 to 20%-26.4% in 2021-2023 with a p-value < 0.05 after the implementation of the notification system. The rate of plans with 1-3 day planning time decreased by 20.31%, 39.32%, and 24.08% with a p-value < 0.05 and the rate of plans with 1-3 day planning time due to the contouring task overdue more than 1 day decreased by 49.49%, 56.89%, and 46.52% with a p-value < 0.05 after the implementation. The rate of outstanding appointments that are overdue by more than 7 days decreased by more than 5% with a p-value < 0.05 following the implementation of the system. CONCLUSIONS: Our experience shows that this system requires minimal human intervention, improves the treatment planning workflow and process by reducing errors and delays in the treatment planning process, positively impacts on-time treatment plan completion, and reduces the need for compressed or rushed treatment planning timelines.

Practical strategies for care of individuals impacted by suicide in the emergency department: A narrative review.

Introduction Suicide is among the leading causes of death and nurses care for survivors of suicide at many points in their grief journey. Every individual who dies by suicide leaves behind multiple affected survivors and how they are cared for immediately following the suicide influences how they cope with the death. The purpose of this article is to make recommendations for the care of survivors of suicide loss in the emergency department. METHODS: A narrative review of the current literature was conducted using the databases CINAHL and ProQuest. Articles focused on survivors of suicide loss and their care in the immediate period after the death were utilized. RESULTS: Four hundred and twenty-nine articles were found. Applying established inclusion and exclusion criteria and quality assessment using the SANSA guideline, 29 were included in the review. DISCUSSION: Three themes were identified: 1. Risks for suicide in survivors of suicide loss; 2. Interventions in the immediate period after suicide loss; and 3. Active suicide postvention as suicide prevention. Emergency department nurses need to have the ability to readily assess and recognize the survivors of suicide loss who are at higher risk for complicated grieving, and providing rapid and immediate services and resources will help promote coping and positive mental health outcomes in survivors.

Sexual health behaviours and partner notification practices related to sexually transmitted infections in young adults in Ireland.

BACKGROUND: Sexually transmitted infections (STIs) impose burdens on individuals and communities, while their prevalence in young people has risen continually in recent years. Partner notification is an effective public health strategy which can limit STI transmission. AIMS: This study aimed to explore young adults' sexual health behaviours, attitudes toward STI testing, and feelings toward visiting a sexual health clinic. It also aimed to investigate preferences for partner notification and the role of self-efficacy in people's intentions to notify a partner for STIs including the human immunodeficiency virus (HIV). METHODS: A quantitative, cross-sectional design was applied. Participants were 400 adults aged 18-34 years (M = 23 years; SD = 4.27), recruited from the Republic of Ireland. RESULTS: Over half of the participants reported never being tested for STIs. These young people placed less importance on undergoing regular STI testing and testing after unprotected sex than their counterparts who had been tested for STIs. Self-efficacy was significantly associated with intentions to notify partner(s) for STIs including HIV. CONCLUSIONS: As STIs are becoming increasingly prevalent in young adults, it is important to gain a deeper understanding of the interventions used to break the transmission chain and how different beliefs and attitudes may affect them. Self-efficacy was a key component in PN intentions, suggesting that the belief in someone's ability or skillset to perform a sexual health behaviour is positively related to their intention to perform the behaviour.

Integration of Partner Notification Services at a Sexually Transmitted Infections Clinic.

OBJECTIVES: PNS is critical to prevent the spread of STIs. We evaluated the feasibility of integrating PNS into an STI clinic focused on MSM. DESIGN/METHODS: The RI STI Clinic, in partnership with the RIDOH, implemented a PNS program in 2019. Interviews with patients diagnosed with gonorrhea/ syphilis were conducted. RIDOH attempted outreach to partners identified. We utilized interview data among MSM diagnosed with gonorrhea/syphilis in clinic from 1/1/19-12/31/2021. Bivariate analyses/multivariable logistic regression were conducted. RESULTS: 341 MSM were diagnosed with gonorrhea/syphilis during the three-year period, and 233 (68%) interviews were completed. Partner information was provided in 173 (74%) interviews. At least one workable partner was provided in 110 (47%) interviews. No statistically significant associations between provision of workable partners and index patient age/race/ethnicity were found. CONCLUSIONS: PNS at an STI clinic was successful, but challenges led to suboptimal information. Research is needed to identify barriers to integrate/optimize PNS in STI clinics.

Pre-Exposure Prophylaxis Care Cascade Among Men Who Have Sex with Men Engaging in Partner Notification Services at a Sexually Transmitted Infections Clinic.

Partner notification services (PNS) offers opportunities to discuss HIV pre-exposure prophylaxis (PrEP) and provide referrals. We evaluated the PrEP care cascade among men who have sex with men (MSM) engaging in PNS within a sexually transmitted infections clinic. Among 121 MSM eligible for PrEP during PNS, 21% subsequently initiated PrEP.

The impact of breast density notification on psychosocial outcomes in racial and ethnic minorities: A systematic review.

BACKGROUND: High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the impact of breast density (BD) information and/or notification on women's psychosocial outcomes among women from racial and ethnic minority groups. METHODS: A systematic search was performed in March 2023, and the articles were identified using CINHAL, Embase, Medline, and PsychInfo databases. The search strategy combined the terms "breast", "density", "notification" and synonyms. The authors specifically kept the search terms broad and did not include terms related to race and ethnicity. Full-text articles were reviewed for analysis by race, ethnicity and primary language of participants. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias. RESULTS: Of 1784 articles, 32 articles published from 2003 to 2023 were included. Thirty-one studies were conducted in the United States and one in Australia, with 28 quantitative and four qualitative methodologies. The overall results in terms of breast density awareness, knowledge, communication with healthcare professionals, screening intentions and supplemental screening practice were heterogenous across studies. Barriers to understanding BD notifications and intentions/access to supplemental screening among racial and ethnic minorities included socioeconomic factors, language, health literacy and medical mistrust. CONCLUSIONS: A one-size approach to inform women about their BD may further disadvantage racial and ethnic minority women. BD notification and accompanying information should be tailored and translated to ensure readability and understandability by all women.

Use of Digital COVID-19 Exposure Notifications at a Large Gathering: Survey Analysis of Public Health Conference Attendees.

BACKGROUND: WA Notify was Washington State's smartphone-based COVID-19 digital exposure notification (EN) tool, which was used to help limit the spread of COVID-19 between November 30, 2020, and May 11, 2023. Following the 2022 Washington State Public Health Association Annual Conference, attendees who had WA Notify activated began receiving ENs alerting them to a possible COVID-19 exposure during the conference. A survey was emailed to all conference attendees to measure WA Notify adoption, mechanisms through which attendees received ENs, and self-reported engagement in protective behaviors postexposure. OBJECTIVE: This study aimed to learn more about the experiences of WA Notify adopters and nonadopters who may have been exposed to COVID-19 at a large group gathering. METHODS: A web-based survey administered through REDCap (Research Electronic Data Capture; Vanderbilt University) was sent to all attendees of the Washington State Public Health Association conference. Self-reported demographic information and characteristics of respondents were summarized. Regression models were used to estimate relative risks to compare WA Notify adoption and testing behaviors between groups. RESULTS: Of the 464 total registered attendees who were sent the survey, 205 (44%) responses were received; 201 eligible attendees were included in this analysis. Of those, 149 (74%) respondents reported having WA Notify activated on their phones at the time of the conference. Among respondents with WA Notify activated, 54% (n=77) reported learning of their potential exposure from a WA Notify EN. Respondents who reported that they did not have WA Notify activated and learned of their potential exposure via the event-wide email from conference organizers were 39% less likely to test for COVID-19 compared to respondents with WA Notify activated who learned of their potential exposure from the email (relative risk 0.61, 95% CI 0.40-0.93; P=.02), and this gap was even larger when compared to respondents who learned of their exposure from a WA Notify EN. The most commonly cited reason for not having WA Notify activated was privacy concerns (n=17, 35%), followed by not wanting to receive ENs (n=6, 12%) and being unaware of WA Notify (n=5, 10%). CONCLUSIONS: Digital EN systems are an important tool to directly and anonymously notify close contacts of potential exposures and provide guidance on the next steps in a timely manner. Given the privacy concerns, there is still a need for increasing transparency surrounding EN technology to increase uptake by the public if this technology were to be used in the future to slow the spread of communicable diseases.

The Role of Trust as a Driver of Private-Provider Participation in Disease Surveillance: Cross-Sectional Survey From Nigeria.

BACKGROUND: Recognition of the importance of valid, real-time knowledge of infectious disease risk has renewed scrutiny into private providers' intentions, motives, and obstacles to comply with an Integrated Disease Surveillance Response (IDSR) framework. Appreciation of how private providers' attitudes shape their tuberculosis (TB) notification behaviors can yield lessons for the surveillance of emerging pathogens, antibiotic stewardship, and other crucial public health functions. Reciprocal trust among actors and institutions is an understudied part of the "software" of surveillance. OBJECTIVE: We aimed to assess the self-reported knowledge, motivation, barriers, and TB case notification behavior of private health care providers to public health authorities in Lagos, Nigeria. We measured the concordance between self-reported notification, TB cases found in facility records, and actual notifications received. METHODS: A representative, stratified sample of 278 private health care workers was surveyed on TB notification attitudes, behavior, and perceptions of public health authorities using validated scales. Record reviews were conducted to identify the TB treatment provided and facility case counts were abstracted from the records. Self-reports were triangulated against actual notification behavior for 2016. The complex health system framework was used to identify potential predictors of notification behavior. RESULTS: Noncompliance with the legal obligations to notify infectious diseases was not attributable to a lack of knowledge. Private providers who were uncomfortable notifying TB cases via the IDSR system scored lower on the perceived benevolence subscale of trust. Health care workers who affirmed "always" notifying via IDSR monthly reported higher median trust in the state's public disease control capacity. Although self-reported notification behavior was predicted by age, gender, and positive interaction with public health bodies, the self-report numbers did not tally with actual TB notifications. CONCLUSIONS: Providers perceived both risks and benefits to recording and reporting TB cases. To improve private providers' public health behaviors, policy makers need to transcend instrumental and transactional approaches to surveillance to include building trust in public health, simplifying the task, and enhancing the link to improved health. Renewed attention to the "software" of health systems (eg, norms, values, and relationships) is vital to address pandemic threats. Surveys with private providers may overestimate their actual participation in public health surveillance.

Partner notification service utilization and associated factors among clients attending anti-retroviral therapy clinics of public health facilities in Gimbi Town, West Ethiopia, 2023: a facility-based mixed-method cross-sectional study.

BACKGROUND: Partner Notification Service is among the strategies used to conduct targeted Human Immunodeficiency Virus Testing Service by obtaining information about sexual contacts of index clients to refer for testing. But most people living with Human Immunodeficiency Virus are still unaware of their status, including Ethiopia. Limited studies are available on the magnitude of partner notification service utilization and associated factors in Ethiopia. OBJECTIVE: The aim of this study was to assess the magnitude of partner notification service utilization and associated factors among people living with Human Immunodeficiency Virus attending anti-retroviral therapy clinics of public health facilities in Gimbi town, West Ethiopia. METHODS: A facility-based mixed-method cross-sectional study design was used. Total of 455 study participants were selected by systematic random sampling for quantitative data and health workers were purposively selected for qualitative data until saturation of ideas was reached. The study was conducted from December 1, 2022 to January 30, 2023. Structured questionnaires and key informant interview guides were used for data collection. Quantitative data were analyzed using Statistical Package for Social Science version 25. Open code 4.02 software was used for qualitative data analysis. Frequencies and proportions were used to summarize descriptive statistics. Bivariable and multivariable logistic regression was used to identify associated factors then variables with a p value < 0.05 were declared to have an association with the dependent variable. RESULT: Exactly 298 (65.5%) of the study participants were notified their HIV status to their sexual partners. Factors associated with Partner Notification Service Utilization were depression AOR: 0.12 (95% CI: 0.07, 0.20), urban settlers AOR: 2.21 (95% CI: 1.2, 3.83), fear of support loss AOR: 0.24 (95% CI: 0.14, 0.40) and intimate partner violence AOR: 0.55 (95% CI: 0.31, 0.97). From qualitative part of this study, factors associated to Partner Notification service utilization were fear of stigma, discrimination and fear of divorce. CONCLUSION: Two-third of the study participants were utilized partner notification service, and efforts are important to prevent depression and intimate partner violence. Local government bodies and stakeholders should implement economic strengthening and strategies to address the rural community for HIV/AIDS prevention. Promotion of supportive and inclusive environment for PLHIV should also considered as way to increase PNS utilization.

Acceptance of assisted partner notification among HIV-positive adults with severe mental illness at a national referral hospital in Uganda: a cross-sectional study.

BACKGROUND: HIV mostly affects people with severe mental illnesses (SMIs) than the general population. In 2015, the World Health Organization (WHO) introduced assisted partner notification (APN) as a strategy to increase HIV testing. Although research has demonstrated the effectiveness of APN in the general population, its use among people living with HIV (PLHIV) who have SMI is not well understood. This study sought to determine the acceptance of the APN strategy among PLHIV who had a diagnosis of SMI. METHODS: This study used a cross-sectional study design that was retrospective to determine acceptance of APN among PLHIV with a documented diagnosis of SMI. We enrolled participants with a diagnosis of both HIV and SMI from August 2018 to January 2022, attending the HIV clinic at Butabika Hospital. We used pretested questionnaires to extract participants' demographic and clinical data from their existing clinical charts, antiretroviral therapy (ART) registers and APN registers. We defined acceptance of APN as the number of PLHIV with SMI diagnoses who agreed to provide information about their sexual partners. We used modified Poisson regression analysis to assess the factors associated with the acceptance of APN. RESULTS: A total of 125 participants were enrolled, of whom 83 (66.4%) were female. The median age was 30 (interquartile range (IQR) (25-34)), and 41 (33%) of them accepted APN (95% CI: 25.05-41.61). Receipt of at least three counselling sessions before enrollment in APN (aPR = 1.8, 95% CI: 1.72-1.98) was the most significant factor associated with increased acceptance of APN. Poor adherence to ART (aPR = 0.62, 95% CI: 0.54-0.80), being escorted to hospital by a distant relative (aPR = 0.55, 95% CI: 0.39-0.80), being married/cohabiting (aPR = 0.65, 95% CI: 0.60-0.81), and being a Seventh Day Adventist (SDA) (aPR = 0.53, 95% CI: 0.45-0.71) or Pentecostal (aPR = 0.44, 95% CI: 0.22-0.98) by faith were associated with reduced acceptance of APN. CONCLUSION AND RECOMMENDATION: The acceptance of APN is low among PLHIV with a diagnosis of SMI. More structured counselling would facilitate earlier identification of undiagnosed HIV-positive partners. We recommend a follow-up study to compare acceptance of APN among PLHIV with SMI and those without SMI.

Electronic Partner Notification for Sexually Transmitted Infections: A Qualitative Assessment of Patient, Clinical Staff, and State Field Epidemiologist Perspectives.

In Massachusetts (MA), partner notification is routinely offered for new HIV and infectious syphilis cases, but there are no formal partner notification services for gonorrhea and chlamydia. Electronic partner notification (ePN), which allows patients to anonymously notify their partners of sexually transmitted infection exposure, could fill this gap. We evaluated the acceptability of and ideal characteristics for a statewide ePN service in MA. We performed semistructured interviews with patients at a Boston area sexual health clinic and conducted focus groups with clinicians and Massachusetts Department of Public Health Field Epidemiologists (FEs). We developed a codebook and thematically analyzed interview and focus group data; 25% of interviews were double coded. We identified six main themes from our data: (1) partner notification is a relational process and (2) partner notification is situation dependent. There are three pairs of challenges and core values for an effective ePN system: (3) stigmatization versus inclusivity, (4) trust versus mistrust, and (5) privacy versus helpful information sharing. Therefore, (6) a statewide ePN platform must be customizable at each possible step. Although ePN was acceptable across all three groups, the likelihood of individual use was grounded in a patient's sociocultural context, interpersonal relationships, trust in the platform and health authorities, desire to avoid stigmatization, and privacy needs. These factors are best accommodated by a platform that adapts to users' preferences and needs. ePN presents an opportunity to link partners at risk for gonorrhea or chlamydia to clinical care that is complementary to the more labor-intensive FE role.

Epidemiological Data and Antimicrobial Resistance of Campylobacter spp. in Portugal from 13 Years of Surveillance.

This study extensively analyzed campylobacteriosis surveillance in Portugal from 2009 to 2021, aiming to investigate demographic shifts, seasonal variations, and antimicrobial resistance (AMR) within Campylobacter isolates. Surveillance network and sentinel laboratory-based system data revealed a substantial under-notification of campylobacteriosis cases, suggesting an underestimated disease burden. Notification rates exhibited a paradigm shift, with a notable prevalence among the pediatric population, particularly in children aged 1-4 years, diverging from European reports. Additionally, an emerging trend of Campylobacter infections in younger adults (15-44 years) was observed. The study unveiled a unique seasonal distribution of cases, defying typical summer peaks seen elsewhere. AMR analysis revealed high resistance to ciprofloxacin and tetracycline, in both C. jejuni (93.7% and 79.2%, respectively) and C. coli (96.5% and 93.2%, respectively), stable throughout the studied period (2013-2021). C. coli exhibited significantly higher resistance to erythromycin, gentamicin, ampicillin and ertapenem compared to C. jejuni (p < 0.001). Multilocus Sequence Typing (MLST) data demonstrated the distribution of resistance markers across diverse sequence types, challenging the notion of a clonal origin for multidrug-resistant isolates. In conclusion, the study highlights the need for enhanced surveillance and raises concerns about alarming AMR levels, recommending the implementation of whole-genome sequencing (WGS)-based surveillance for a deeper comprehension of disease patterns and an evolving AMR landscape.

From greenwashing to screenwashing?

In this viewpoint, we introduce the term 'screenwashing', which describes the phenomenon whereby social media platforms, such as TikTok and Instagram, pretend to be more socially responsible than they actually are. That is, social media platforms pretend to be thoughtful about children's health and the prevention of problematic social media use, but this often turns out to be nothing more than "a lick of paint". We describe how features like the one-hour notification on TikTok and Instagram are considered screenwashing and why we believe so. Screenwashing, an unethical practice, has the potential to mislead parents and young users. Consequently, we advocate for increased government intervention to protect our youth from the potential hazards associated with problematic social media use.

Enhancing the notification system for surveillance of infectious diseases in Qatar during the FIFA World Cup 2022: project overview.

BACKGROUND: In 2022, the Surveillance Department of the Ministry of Public Health in Qatar adopted an integrated project called the Notification Enhancement Project (NEP) to enhance the infectious disease notification system. Efficient surveillance and notification promote early alerts and allow immediate interference in reducing morbidity and mortality from outbreaks. The project was designed to improve the knowledge, attitudes, practices, and notification processes of healthcare workers in Qatar by increasing their reporting rates. METHODS: The strategy for comprehensively enhancing notifications was based on the observation and evaluation of the current notification system, the implementation of interventions, and post-evaluation follow-up. To implement the project, we relied on three aspects: effective methods used in previous relevant studies through a literature review, feedback received from healthcare workers, and suggestions from public health surveillance experts from the Ministry of Public Health, Qatar. A preassessment was conducted through an online survey by the Ministry of Public Health. The effectiveness of the different interventions was assessed by analyzing the data of notified patients reported through the Disease Surveillance and Reporting Electronic System. Pre- and postintervention assessments were performed by comparing the percentage of patients notified by healthcare providers with that of patients confirmed by healthcare providers in the laboratory to compare the notification rates over three time periods between January and December 2022. RESULTS: There was significant improvement in the infectious disease notification process. A comparison before and after the implementation of the interventions revealed an increase in the communicable disease notification rate among healthcare workers. Pre- and postintervention data were compared. Infectious disease notification activities by healthcare workers increased from 2.5% between January and May 2022 to 41.4% between November and December 2022. CONCLUSION: This study highlights the efficiency of different interventions in correcting the underreporting of infectious diseases. Our findings suggest that implementing the Notification Enhancement Project significantly improves notification rates. We recommend continuing interventions through constant education and training, maintaining solid communication with HCWs through regular reminder emails and feedback, periodic assessment of the electronic notification system, and engagement of healthcare workers and other stakeholders to sustain and expand progress achieved through continuous evaluation.

An IoT Real-Time Potable Water Quality Monitoring and Prediction Model Based on Cloud Computing Architecture.

In order to achieve the Sustainable Development Goals (SDG), it is imperative to ensure the safety of drinking water. The characteristics of each drinkable water, encompassing taste, aroma, and appearance, are unique. Inadequate water infrastructure and treatment can affect these features and may also threaten public health. This study utilizes the Internet of Things (IoT) in developing a monitoring system, particularly for water quality, to reduce the risk of contracting diseases. Water quality components data, such as water temperature, alkalinity or acidity, and contaminants, were obtained through a series of linked sensors. An Arduino microcontroller board acquired all the data and the Narrow Band-IoT (NB-IoT) transmitted them to the web server. Due to limited human resources to observe the water quality physically, the monitoring was complemented by real-time notifications alerts via a telephone text messaging application. The water quality data were monitored using Grafana in web mode, and the binary classifiers of machine learning techniques were applied to predict whether the water was drinkable or not based on the data collected, which were stored in a database. The non-decision tree, as well as the decision tree, were evaluated based on the improvements of the artificial intelligence framework. With a ratio of 60% for data training: at 20% for data validation, and 10% for data testing, the performance of the decision tree (DT) model was more prominent in comparison with the Gradient Boosting (GB), Random Forest (RF), Neural Network (NN), and Support Vector Machine (SVM) modeling approaches. Through the monitoring and prediction of results, the authorities can sample the water sources every two weeks.

Improving HIV Case Finding Through Index Testing: Findings from Health Facilities in 12 Districts of South Africa, October 2019-September 2021.

To assess the importance of index testing in HIV case finding, we analyzed quarterly data from October 2019 to September 2021 from 371 facilities in 12 districts in South Africa. Index testing accounted for 2.6% of all HIV tests (index and non-index) (n = 163,633), but 17.8% of all HIV-positive results, with an HIV-positivity 4-times higher than non-index testing modalities (4.1%). Despite twice as many adult females ≥ 15 years accepting index testing (n = 206,715) compared to adult males ≥ 15 years (n = 102,180), females identified fewer contacts (n = 91,123) than males (n = 113,939). Slightly more than half (51.2%) of all contacts elicited were tested (n = 163,633/319,680), while 19.7% (n = 62,978) of elicited contacts were previously diagnosed as HIV-positive and not eligible for further testing. These findings indicate index testing can be effective in increasing HIV diagnoses in South Africa. Further operational research is needed to address gaps identified in the index testing cascade, including elicitation and testing of contacts.