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1.
Pan Afr Med J ; 33(Suppl 2): 10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31402968

RESUMO

Introduction: in spite of the efforts and resources committed by the division of infectious disease and epidemiology (DIDE) of the national public health institute of Liberia (NPHIL)/Ministry of health to strengthening integrated disease surveillance and response (IDSR) across the country, quality data management system remains a challenge to the Liberia NPHIL/MoH (Ministry of health), with incomplete and inconsistent data constantly being reported at different levels of the surveillance system. As part of the monitoring and evaluation strategy for IDSR continuous improvement, data quality assessment (DQA) of the IDSR system to identify successes and gaps in the disease surveillance information system (DSIS) with the aim of ensuring data accuracy, reliability and credibility of generated data at all levels of the health system; and to inform an operational plan to address data quality needs for IDSR activities is required. Methods: multi-stage cluster sampling that included stage 1: simple random sample (SRS) of five counties, stage 2: simple random sample of two districts and stage 3: simple random sample of three health facilities was employed during the study pilot assessment done in Montserrado County with Liberia institute of bio medical research (LIBR) inclusive. A total of thirty (30) facilities was targeted, twenty nine (29) of the facilities were successfully audited: one hospital, two health centers, twenty clinics and respondents included: health facility surveillance focal persons (HFSFP), zonal surveillance officers (ZSOs), district surveillance officers (DSOs) and County surveillance officers (CSOs). Results: the assessment revealed that data use is limited to risk communication and sensitization, no examples of use of data for prioritization or decision making at the subnational level. The findings indicated the following: 23% (7/29) of health facilities having dedicated phone for reporting, 20% (6/29) reported no cell phone network, 17% (5/29) reported daily access to internet, 56.6% (17/29) reported a consistent supply of electricity, and no facility reported access to functional laptop. It was also established that 40% of health facilities have experienced a stock out of laboratory specimens packaging supplies in the past year. About half of the surveyed health facilities delivered specimens through riders and were assisted by the DSOs. There was a large variety in the reported packaging process, with many staff unable to give clear processes. The findings during the exercise also indicated that 91% of health facility staff were mentored on data quality check and data management including the importance of the timeliness and completeness of reporting through supportive supervision and mentorship; 65% of the health facility assessed received supervision on IDSR core performance indicator; and 58% of the health facility officer in charge gave feedback to the community level. Conclusion: public health is a data-intensive field which needs high-quality data and authoritative information to support public health assessment, decision-making and to assure the health of communities. Data quality assessment is important for public health. In this review completeness, accuracy, and timeliness were the three most-assessed attributes. Quantitative data quality assessment primarily used descriptive surveys and data audits, while qualitative data quality assessment methods include primarily interviews, questionnaires administration, documentation reviews and field observations. We found that data-use and data-process have not been given adequate attention, although they were equally important factors which determine the quality of data. Other limitations of the previous studies were inconsistency in the definition of the attributes of data quality, failure to address data users' concerns and a lack of triangulation of mixed methods for data quality assessment. The reliability and validity of the data quality assessment were rarely reported. These gaps suggest that in the future, data quality assessment for public health needs to consider equally the three dimensions of data quality, data use and data process. Measuring the perceptions of end users or consumers towards data quality will enrich our understanding of data quality issues. Data use is limited to risk communication and sensitization, no examples of use of data for prioritization or decision making at the sub national level.


Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis/epidemiologia , Vigilância em Saúde Pública/métodos , Saúde Pública , Análise por Conglomerados , Comunicação , Confiabilidade dos Dados , Instalações de Saúde/estatística & dados numéricos , Humanos , Libéria/epidemiologia , Projetos Piloto , Reprodutibilidade dos Testes , Risco , Inquéritos e Questionários
2.
Lima; Perú. Ministerio de Salud; 20190700. 22 p. tab.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1007321

RESUMO

Contribuir a la mejora del acceso de la población a los dispositivos médicos identificados como esenciales en la prevención, tratamiento y control de las enfermedades prevalentes del pais, a traves de mecanismos para su disponibilidad y utilización en los establecimientos de salud, en concordancia con lo establecido en la Ley N° 29459, Ley de los Productos Farmacéuticos, Dispositivos Médicos y Productos Sanitarios.


Assuntos
Prevenção Primária , Terapêutica , Controle de Doenças Transmissíveis , Equipamentos e Provisões
6.
Epidemiol Mikrobiol Imunol ; 68(1): 40-45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31181951

RESUMO

A decontamination process plays a key role in management of biological incidents. While decontamination of surfaces and buildings located in the hot zone can be usually postponed until an agent is confirmed and an adequate planning phase is established, personnel wearing personal protective equipment must be decontaminated prior to their final exit from the hot zone. Because CBRN units require the shortest possible duration of this procedure, many factors must be considered, including concentration of biological agents, precleaning, disinfectant formulae, its concentration and spectrum of efficacy, contact time, external conditions (temperature, pH, relative humidity, soil load), technical assets used for decontamination, decontaminated surface (compatibility, pores), and staff performance. Experimental tests with surrogates of biological agents are thus necessary to identify above-mentioned points. Once an optimal decontamination procedure is recognized, a field rehearsal must follow and the method using a surrogate must be implemented into a training process of CBRN units.


Assuntos
Controle de Doenças Transmissíveis/métodos , Descontaminação , Meio Ambiente , Microbiologia Industrial/métodos , Fatores Biológicos , Desinfetantes , Humanos
8.
BMC Infect Dis ; 19(1): 517, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185927

RESUMO

BACKGROUND: Although Option B+ may be more costly than Options B, it may provide additional health benefits that are currently unclear in Yunnan province. We created deterministic models to estimate the cost-effectiveness of Option B+. METHODS: Data were used in two deterministic models simulating a cohort of 2000 HIV+ pregnant women. A decision tree model simulated the number of averted infants infections and QALY acquired for infants in the PMTCT period for Options B and B+. The minimum cost was calculated. A Markov decision model simulated the number of maternal life year gained and serodiscordant partner infections averted in the ten years after PMTCT for Option B or B+. ICER per life year gained was calculated. Deterministic sensitivity analyses were conducted. RESULTS: If fully implemented, Option B and Option B+ averted 1016.85 infections and acquired 588,01.02 QALYs.The cost of Option B was US$1,229,338.47, the cost of Option B+ was 1,176,128.63. However, when Options B and B+ were compared over ten years, Option B+ not only improved mothers'ten-year survival from 69.7 to 89.2%, saving more than 3890 life-years, but also averted 3068 HIV infections between serodiscordant partners. Option B+ yielded a favourable ICER of $32.99per QALY acquired in infants and $5149per life year gained in mothers. A 1% MTCT rate, a 90% coverage rate and a 20-year horizon could decrease the ICER per QALY acquired in children and LY gained in mothers. CONCLUSIONS: Option B+ is a cost-effective treatment for comprehensive HIV prevention for infants and serodiscordant partners and life-long treatment for mothers in Yunnan province, China. Option B+ could be implemented in Yunnan province, especially as the goals of elimination mother-to-child transmission of HIV and "90-90-90" achieved, Option B+ would be more attractive.


Assuntos
Controle de Doenças Transmissíveis , Infecções por HIV , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Complicações Infecciosas na Gravidez/economia , Complicações Infecciosas na Gravidez/terapia , Planos Governamentais de Saúde , Síndrome de Imunodeficiência Adquirida/economia , Síndrome de Imunodeficiência Adquirida/terapia , Síndrome de Imunodeficiência Adquirida/transmissão , Adulto , China/epidemiologia , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Análise Custo-Benefício , Árvores de Decisões , Feminino , HIV , Infecções por HIV/economia , Infecções por HIV/terapia , Infecções por HIV/transmissão , Custos de Cuidados de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/economia , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Masculino , Modelos Econométricos , Mães/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Planos Governamentais de Saúde/economia , Planos Governamentais de Saúde/organização & administração , Planos Governamentais de Saúde/normas , Resultado do Tratamento , Adulto Jovem
9.
Parasit Vectors ; 12(1): 297, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196161

RESUMO

BACKGROUND: Effective malaria control relies on evidence-based interventions. Anopheline behaviour and Plasmodium infections were investigated in North Cameroon, following long-lasting insecticidal net (LLIN) distribution in 2010. METHODS: During four consecutive years from 2011 to 2014, adult mosquitoes were collected indoors, outdoors and in exit traps across 38 locations in the Garoua, Pitoa and Mayo-Oulo health districts. Anophelines were morphologically and molecularly identified, then analysed for blood meal origins and Plasmodium falciparum circumsporozoite protein (Pf-CSP). Blood from children under 5 years-old using LLINs was examined for Plasmodium infections. RESULTS: Overall, 9376 anophelines belonging to 14 species/sibling species were recorded. Anopheles gambiae (s.l.) [An. arabiensis (73.3%), An. coluzzii (17.6%) and An. gambiae (s.s.) (9.1%)] was predominant (72%), followed by An. funestus (s.l.) (20.5%) and An. rufipes (6.5%). The recorded blood meals were mainly from humans (28%), cattle (15.6%) and sheep (11.6%) or mixed (45%). Pf-CSP rates were higher indoors (3.2-5.4%) versus outdoors (0.8-2.0%), and increased yearly (χ2 < 18, df = 10, P < 0.03). Malaria prevalence in children under 5 years-old, in households using LLINs was 30% (924/3088). CONCLUSIONS: The present study revealed the variability of malaria vector resting and feeding behaviour, and the persistence of Plasmodium infections regardless the use of LLINs. Supplementary interventions to LLINs are therefore needed to sustain malaria prevention in North Cameroon.


Assuntos
Anopheles/fisiologia , Controle de Doenças Transmissíveis , Comportamento Alimentar , Malária Falciparum/prevenção & controle , Animais , Anopheles/parasitologia , Sangue/parasitologia , Camarões/epidemiologia , Mosquiteiros Tratados com Inseticida , Malária Falciparum/epidemiologia , Controle de Mosquitos , Mosquitos Vetores/parasitologia , Mosquitos Vetores/fisiologia , Plasmodium falciparum , Proteínas de Protozoários/genética
11.
Zoonoses Public Health ; 66(5): 504-511, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31152500

RESUMO

Mass bat exposures (MBEs) occur when multiple people are exposed to a bat or a bat colony, often over an extended period. In August 2017, a public health investigation was started in response to an MBE that occurred during May-August 2017 at a national park research station in Wyoming. We identified 176 people who had slept primarily in two lodges (Lodges A and B) at the research station, and successfully contacted 165 (93.8%) of these individuals. Risk assessments (RAs) were administered to all 165 individuals to determine degree and type of exposures to bats (e.g., biting or scratching). Exposure status for research station guests was classified as "non-exposed," "low risk" or "high risk," and counselling was provided to guide post-exposure prophylaxis (PEP) recommendations. Prior to public health notification and intervention, 19 persons made the decision to pursue PEP. The healthcare-seeking behaviours of this group were taken to represent outcomes in the absence of public health intervention. (These persons received a RA, and their risk classification was retrospectively assigned.) Approximately 1-2 weeks after conducting the RAs, we conducted a follow-up survey to determine whether recommendations regarding PEP were ultimately followed. The proportion of individuals that unnecessarily pursued PEP was higher among the 19 individuals that sought health care prior to receiving the RA (p < 0.00001). Among those receiving the RA first, all persons classified as high risk followed public health guidance to seek PEP treatment. Despite this, upon re-interview, only 21/79 (26.6%) of guests could accurately recall their risk classification, with most people (55.7%) overestimating their risk. Study findings demonstrate that early public health interventions such as RAs can reduce unnecessary use of PEP and that messaging used during rabies counselling should be clear.


Assuntos
Quirópteros , Doenças Transmissíveis/transmissão , Zoonoses/epidemiologia , Animais , Controle de Doenças Transmissíveis , Habitação , Humanos , Parques Recreativos , Profilaxia Pós-Exposição , Saúde Pública , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Wyoming/epidemiologia
12.
Malar J ; 18(1): 190, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170984

RESUMO

Mozambique has historically been one of the countries with the highest malaria burden in the world. Starting in the 1960s, malaria control efforts were intensified in the southern region of the country, especially in Maputo city and Maputo province, to aid regional initiatives aimed to eliminate malaria in South Africa and eSwatini. Despite significant reductions in malaria prevalence, elimination was never achieved. Following the World Health Organization's renewed vision of a malaria-free-world, and considering the achievements from the past, the Mozambican National Malaria Control Programme (NMCP) embarked on the development and implementation of a strategic plan to accelerate from malaria control to malaria elimination in southern Mozambique. An initial partnership, supported by the Bill and Melinda Gates Foundation and the La Caixa Foundation, led to the creation of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) and the Malaria Technical and Advisory Committee (MTAC) to promote national ownership and partner coordination to work towards the goal of malaria elimination in local and cross-border initiatives. Surveillance systems to generate epidemiological and entomological intelligence to inform the malaria control strategies were strengthened, and an impact and feasibility assessment of various interventions aimed to interrupt malaria transmission were conducted in Magude district (Maputo Province) through the "Magude Project". The primary aim of this project was to generate evidence to inform malaria elimination strategies for southern Mozambique. The goal of malaria elimination in areas of low transmission intensity is now included in the national malaria strategic plan for 2017-22 and the NMCP and its partners have started to work towards this goal while evidence continues to be generated to move the national elimination agenda forward.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Erradicação de Doenças/organização & administração , Transmissão de Doença Infecciosa/prevenção & controle , Malária/epidemiologia , Malária/prevenção & controle , Financiamento de Capital , Controle de Doenças Transmissíveis/economia , Controle de Doenças Transmissíveis/métodos , Erradicação de Doenças/economia , Erradicação de Doenças/métodos , Política de Saúde , Humanos , Controle de Mosquitos/economia , Controle de Mosquitos/métodos , Controle de Mosquitos/organização & administração , Moçambique/epidemiologia
13.
BMC Vet Res ; 15(1): 208, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226988

RESUMO

BACKGROUND: Infectious diseases are an important role obstacle to high productivity in Ugandan cattle production. General disease prevention is particularly important in low-income countries, where veterinary services and adequate treatment regimens for many infectious diseases are insufficient. Improved biosecurity could lead to improved animal health and production with lower mortality and better reproductive rates. Any sustainable biosecurity interventions must be feasible for the farmers, from a practical as well as social and cultural aspect. An understanding of the farmers' view of biosecurity and the diseases it is intended to prevent is also needed. The aim of the study was to explore the perceived needs of Ugandan cattle farmers as regards disease prevention, tools and strategies for improved biosecurity, and to assess the feasibility of basic biosecurity practices, in order to contribute to long-term strategies for improved livestock management. We conducted two rounds of focus group (FG) discussions about infectious diseases and biosecurity with cattle farmers in the districts Kabarole, Kamwenge and Kasese in western Uganda. RESULTS: A thematic analysis revealed four organising themes: Disease prevention and biosecurity practices, Knowledge among farmers and other actors, Community and peer pressure and Services and infrastructure. From these four organising themes, a global theme of "Biosecurity is a common effort based on collective knowledge" could be derived. Diseases represent a loss of income and wealth for farmers. Lack of knowledge, training and education among farmers were seen as a challenge. While there were claims during the first round of FGs that many biosecurity measures would be impossible to practise, in all follow-up FGs at least someone had tried. Perceived barriers for implementing biosecurity were financial and cultural. Experiences that were shared were that practising biosecurity measures had made their cattle healthier, but it also incurred extra costs. CONCLUSION: The perceived needs of farmers that emerged include knowledge, access to veterinary services, resources and community involvement for a broader implementation of basic biosecurity. There is potential for improved cattle production by educating farmers about infectious diseases and disease prevention measures. Such training should be participatory, involve communities and encourage participants to overcome practical and cultural obstacles.


Assuntos
Doenças dos Bovinos/prevenção & controle , Doenças Transmissíveis/veterinária , Indústria de Laticínios , Fazendeiros , Adulto , Animais , Bovinos , Controle de Doenças Transmissíveis , Feminino , Grupos Focais , Humanos , Masculino , Determinação de Necessidades de Cuidados de Saúde , Uganda/epidemiologia
16.
Infect Dis Poverty ; 8(1): 40, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138293

RESUMO

BACKGROUND: In 2017, the Centre for Global Health (CGH) at the University of Oslo in collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI) and the Norwegian Agency for Development Cooperation (Norad) held a meeting to discuss together with leading figures in disease control, research and development the issue of neglected tropical diseases and emerging/re-emerging infectious diseases. This commentary has taken up this discussion and the conclusions drawn at this meeting to make a case for the opportunity the Sustainable Development Goals (SDGs) provide in highlighting the interconnectedness of factors that are relevant in the successful fight against neglected tropical diseases (NTDs) and emerging infectious diseases (EIDS). MAIN BODY: Despite NTDs being endemic and EIDS being epidemic, in order to prevent both disease groups effectively, it is important to appreciate that they share essential health determining factors, namely: neglect, poverty, a lack of access to clean water and sanitation facilities and an absence of or severely limited provision of healthcare as well as in many cases a zoonotic nature. Instead of looking to "simple disease management" for the answer, the SDGs help to understand the interplay of multiple priority areas and thereby help to promote a more holistic approach to addressing these two disease groups. CONCLUSIONS: Their commonalities mean that the Global Health community should leverage opportunities and efforts in the prevention and elimination of both NTDs and EIDs. Doing so using a One Health approach is considered to offer a "public health best-buy". Concrete solutions are proposed.


Assuntos
Controle de Doenças Transmissíveis/métodos , Doenças Transmissíveis Emergentes , Doenças Negligenciadas , Prática de Saúde Pública , Animais , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/prevenção & controle , Congressos como Assunto , Saúde Global , Política de Saúde , Humanos , Relações Interinstitucionais , Internacionalidade , Área Carente de Assistência Médica , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Noruega , Pobreza , Saneamento , Medicina Tropical , Organização Mundial da Saúde
19.
Lima; Perú. Ministerio de Salud; 1 ed; 20190500. 87 p. tab, graf.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1006658

RESUMO

Describe las disposiciones técnicas para la atención integral de las personas afectadas por lepra, que permitan planificar y programar intervenciones sanitarias a fin de reducir la carga de enfermedad por lepra en las regiones endémicas del país.


Assuntos
Serviço de Acompanhamento de Pacientes , Controle de Doenças Transmissíveis , Assistência Integral à Saúde , Normas Técnicas
20.
Nat Commun ; 10(1): 2269, 2019 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138799

RESUMO

This article examines financing in the fight against malaria. After briefly describing malaria control plans in Africa since 2000, it offers a stylized model of the economics of malaria and shows how health aid can help escape the malaria trap.


Assuntos
Controle de Doenças Transmissíveis/economia , Custos de Cuidados de Saúde , Financiamento da Assistência à Saúde , Cooperação Internacional , Malária/prevenção & controle , África , Humanos , Malária/tratamento farmacológico , Malária/epidemiologia
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