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2.
Microbes Infect ; 22(2): 86-91, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32088333

RESUMO

Only a month after the outbreak of pneumonia caused by 2019-nCoV, more than forty-thousand people were infected. This put enormous pressure on the Chinese government, medical healthcare provider, and the general public, but also made the international community deeply nervous. On the 25th day after the outbreak, the Chinese government implemented strict traffic restrictions on the area where the 2019-nCoV had originated-Hubei province, whose capital city is Wuhan. Ten days later, the rate of increase of cases in Hubei showed a significant difference (p = 0.0001) compared with the total rate of increase in other provinces of China. These preliminary data suggest the effectiveness of a traffic restriction policy for this pandemic thus far. At the same time, solid financial support and improved research ability, along with network communication technology, also greatly facilitated the application of epidemic prevention measures. These measures were motivated by the need to provide effective treatment of patients, and involved consultation with three major groups in policy formulation-public health experts, the government, and the general public. It was also aided by media and information technology, as well as international cooperation. This experience will provide China and other countries with valuable lessons for quickly coordinating and coping with future public health emergencies.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Epidemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Animais , China , Quirópteros/virologia , Comunicação , Governo , Humanos , Saúde Pública/métodos , Viagem , Zoonoses/virologia
4.
BMC Infect Dis ; 19(1): 1075, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864298

RESUMO

BACKGROUND: Cholera is a major public health concern in displaced-person camps, which often contend with overcrowding and scarcity of resources. Maela, the largest and longest-standing refugee camp in Thailand, located along the Thai-Burmese border, experienced four cholera outbreaks between 2005 and 2010. In 2013, a cholera vaccine campaign was implemented in the camp. To assist in the evaluation of the campaign and planning for subsequent campaigns, we developed a mathematical model of cholera in Maela. METHODS: We formulated a Susceptible-Infectious-Water-Recovered-based transmission model and estimated parameters using incidence data from 2010. We next evaluated the reduction in cases conferred by several immunization strategies, varying timing, effectiveness, and resources (i.e., vaccine availability). After the vaccine campaign, we generated case forecasts for the next year, to inform on-the-ground decision-making regarding whether a booster campaign was needed. RESULTS: We found that preexposure vaccination can substantially reduce the risk of cholera even when <50% of the population is given the full two-dose series. Additionally, the preferred number of doses per person should be considered in the context of one vs. two dose effectiveness and vaccine availability. For reactive vaccination, a trade-off between timing and effectiveness was revealed, indicating that it may be beneficial to give one dose to more people rather than two doses to fewer people, given that a two-dose schedule would incur a delay in administration of the second dose. Forecasting using realistic coverage levels predicted that there was no need for a booster campaign in 2014 (consistent with our predictions, there was not a cholera epidemic in 2014). CONCLUSIONS: Our analyses suggest that vaccination in conjunction with ongoing water sanitation and hygiene efforts provides an effective strategy for controlling cholera outbreaks in refugee camps. Effective preexposure vaccination depends on timing and effectiveness. If a camp is facing an outbreak, delayed distribution of vaccines can substantially alter the effectiveness of reactive vaccination, suggesting that quick distribution of vaccines may be more important than ensuring every individual receives both vaccine doses. Overall, this analysis illustrates how mathematical models can be applied in public health practice, to assist in evaluating alternative intervention strategies and inform decision-making.


Assuntos
Vacinas contra Cólera/administração & dosagem , Cólera/prevenção & controle , Modelos Teóricos , Saúde Pública/métodos , Campos de Refugiados , Vacinação/métodos , Cólera/epidemiologia , Cólera/transmissão , Vacinas contra Cólera/provisão & distribução , Surtos de Doenças/prevenção & controle , Humanos , Saneamento , Tailândia/epidemiologia
5.
BMC Infect Dis ; 19(1): 1000, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775654

RESUMO

BACKGROUND: The prevalence of HIV among men who have sex with men (MSM) has become a significant public health challenge. The aim was to comprehensively estimate the national prevalence of HIV among MSM and its time trends through a large-scale systematic analysis. METHODS: Systematic search of Cochrane Library, PubMed, EMBASE, CNKI, VIP, and Wanfang Data databases without language restriction for studies on the prevalence of HIV among MSM published before Dec.31, 2018. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used validated assessment methods to assess the prevalence of HIV among MSM. Estimates were pooled using random-effects analysis. RESULTS: Data were extracted from 355 cross-sectional studies (571,328 individuals) covered 59 cities from 30 provinces and municipalities of China. The overall national prevalence of HIV among MSM from 2001 to 2018 was estimated to be 5.7% (95% CI: 5.4-6.1%), with high between-study heterogeneity (I2 = 98.0%, P <  0.001). Our study showed an increased tendency in the HIV prevalence as time progressed by meta-regression analysis (I2 = 95.9%, P <  0.0001). HIV prevalence was the highest in those aged 50 years and older with HIV prevalence of 19.3% (95%CI: 13.1-27.4%, N = 13). HIV was more prevalent in the illiterate population (16.8%), than in those who had received an education. Although the internet was a major venue for Chinese MSM seeking male sex partners (35.6, 95%CI: 32.3-39.9%, N = 101), seeking MSM in bathhouses/saunas had the highest associated prevalence of HIV (13.4, 95%CI: 10.3-17.1%, N = 22). The HIV prevalence among MSM varied by location: compared with other regions in China, HIV was highly prevalent among MSM in the southwest (10.7, 95%CI: 9.3-12.2%, N = 91). Compared to participants who sometimes or always used condoms, participants who had never used a condom in the past 6 months had a higher risk of HIV infection, with odds ratios of 0.1 (95%CI: 0.08-0.14). CONCLUSIONS: Our analysis provided reliable estimates of China's HIV burden among MSM, which appears to present an increasing national public health challenge. Effective government responses are needed to address this challenge and include the implementation of HIV prevention.


Assuntos
Infecções por HIV/epidemiologia , Saúde Pública/métodos , Minorias Sexuais e de Gênero , Adolescente , Adulto , Fatores Etários , China/epidemiologia , Cidades/epidemiologia , Preservativos , Estudos Transversais , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Internet , Alfabetização , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Parceiros Sexuais , Adulto Jovem
6.
Kathmandu Univ Med J (KUMJ) ; 17(65): 40-45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31734677

RESUMO

Background Visceral leishmaniasis (VL) and leprosy are important public health problem in Nepal. Female Community Health Volunteers (FCHVs) play pivotal role to promote community based health services. Therefore, we designed an implementation research to assess the effectiveness of active case detection (ACD) and information education and communication (IEC) campaign of Visceral leishmaniasis cases along with leprosy cases through Female Community Health Volunteers in Visceral leishmaniasis endemic 10 Village Development Committees of both Visceral leishmaniasis and leprosy prevalent Sarlahi district of Nepal. Objective To determine the effectiveness of active case search strategy of visceral leishmaniasis along with leprosy through Female Community Health Volunteers in Sarlahi district. Method One hundred fifty one Female Community Health Volunteers of twelve Village Development Committees were oriented on detection, identification and referral of Visceral leishmaniasis and leprosy patients. They were oriented on referring the patients to district hospital for confirmatory diagnosis and treatment. The intervention was continued up to ten months after training of Female Community Health Volunteers. Data on number of Visceral leishmaniasis and leprosy patients detected and referred by Female Community Health Volunteers and detected through passively at district hospital were collected and indicators was calculated. Result Altogether 151 Female Community Health Volunteers were trained from 12 (Village Development Committees) VDCs of Sarlahi district. Their knowledge on leprosy and Visceral leishmaniasis related information subsequently increased after training. None of the Visceral leishmaniasis or leprosy cases were detected actively through Female Community Health Volunteers. However, two leprosy cases were detected through household screening. Conclusion Female Community Health Volunteers should be provided sufficient knowledge to use them in community based active case detection of Visceral leishmaniasis and leprosy.


Assuntos
Agentes Comunitários de Saúde/normas , Leishmaniose Visceral/diagnóstico , Hanseníase/diagnóstico , Voluntários/educação , Agentes Comunitários de Saúde/educação , Feminino , Humanos , Nepal/epidemiologia , Prevalência , Saúde Pública/métodos
7.
Malar J ; 18(1): 338, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31581941

RESUMO

Resistance threatens all our currently available anti-malarial drugs. Triple artemisinin-containing combination anti-malarial treatments (TACTs) combine an artemisinin derivative with two slowly eliminated partner drugs. TACTs are undergoing large-scale trials. If they prove safe, well-tolerated and efficacious then they should be deployed. This is in order to protect and extend the useful therapeutic life of the current generation of anti-malarial drugs, which are so essential for malaria control and elimination.


Assuntos
Antimaláricos/química , Artemisininas/uso terapêutico , Resistência a Medicamentos , Malária/tratamento farmacológico , Combinação de Medicamentos , Humanos , Malária/prevenção & controle , Saúde Pública/legislação & jurisprudência , Saúde Pública/métodos
9.
J Athl Train ; 54(10): 1013-1020, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31633411

RESUMO

Sport specialization was thought to affect a relatively small number of elite athletes, but it is now a common practice in youth sport culture. Recent research in the field of sport specialization has led to a better understanding of the influence this issue is having on youth (ie, younger than 19 years of age) today. This review focuses on sport specialization from a public health perspective to elucidate the effect that this practice is having within the United States. The specific goals of this review are to describe (1) the prevalence of sport specialization and the factors that may affect the decision to specialize, (2) the costs of youth sport-related injuries in the context of sport specialization, (3) the financial costs that sport specialization has for families, and (4) how sport specialization may be affecting physical literacy.


Assuntos
Traumatismos em Atletas , Saúde Pública/métodos , Especialização , Esportes Juvenis , Adolescente , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Humanos , Prevalência , Fatores de Risco , Especialização/economia , Especialização/estatística & dados numéricos , Estados Unidos , Esportes Juvenis/classificação , Esportes Juvenis/economia , Esportes Juvenis/lesões
10.
BMC Med ; 17(1): 175, 2019 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-31530275

RESUMO

BACKGROUND: The introduction of highly effective direct-acting antiviral (DAA) therapy for hepatitis C has led to calls to eliminate it as a public health threat through treatment-as-prevention. Recent studies suggest it is possible to develop a vaccine to prevent hepatitis C. Using a mathematical model, we examined the potential impact of a hepatitis C vaccine on the feasibility and cost of achieving the global WHO elimination target of an 80% reduction in incidence by 2030 in the era of DAA treatment. METHODS: The model was calibrated to 167 countries and included two population groups (people who inject drugs (PWID) and the general community), features of the care cascade, and the coverage of health systems to deliver services. Projections were made for 2018-2030. RESULTS: The optimal incidence reduction strategy was to implement test and treat programmes among PWID, and in settings with high levels of community transmission undertake screening and treatment of the general population. With a vaccine available, the optimal strategy was to include vaccination within test and treat programmes, in addition to vaccinating adolescents in settings with high levels of community transmission. Of the 167 countries modelled, between 0 and 48 could achieve an 80% reduction in incidence without a vaccine. This increased to 15-113 countries if a 75% efficacious vaccine with a 10-year duration of protection were available. If a vaccination course cost US$200, vaccine use reduced the cost of elimination for 66 countries (40%) by an aggregate of US$7.4 (US$6.6-8.2) billion. For a US$50 per course vaccine, this increased to a US$9.8 (US$8.7-10.8) billion cost reduction across 78 countries (47%). CONCLUSIONS: These findings strongly support the case for hepatitis C vaccine development as an urgent public health need, to ensure hepatitis C elimination is achievable and at substantially reduced costs for a majority of countries.


Assuntos
Erradicação de Doenças , Hepacivirus/imunologia , Hepatite C/prevenção & controle , Modelos Teóricos , Vacinação , Vacinas contra Hepatite Viral/uso terapêutico , Antivirais/economia , Antivirais/uso terapêutico , Erradicação de Doenças/economia , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Erradicação de Doenças/estatística & dados numéricos , Hepatite C/economia , Hepatite C/epidemiologia , Hepatite C Crônica/economia , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/prevenção & controle , Humanos , Incidência , Saúde Pública/economia , Saúde Pública/métodos , Abuso de Substâncias por Via Intravenosa/economia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/virologia , Vacinação/normas , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Vacinas contra Hepatite Viral/economia
11.
Rev Med Suisse ; 15(663): 1661-1665, 2019 Sep 18.
Artigo em Francês | MEDLINE | ID: mdl-31532117

RESUMO

Substance use in adolescence can have a negative impact in the short and long terms. Fighting the deleterious effects of substance abuse is a public health issue. All adults who supervise adolescents, both specialized and not specialized professionals, can be involved in preventive actions. Young people at risk must be identified early enough and referred to appropriate care. It is therefore crucial that first-line professionals should be able to detect nascent problems and to understand signs of appeal. Professionals must be willing to raise drug consumption topics in their interviews and, thereafter, seek advice and guidance from specialized organizations. One such organization is DEPART which offers an intervention model for adolescents and their families as well as for professionals by offering them support and training.


Assuntos
Saúde Pública , Transtornos Relacionados ao Uso de Substâncias , Humanos , Modelos Teóricos , Saúde Pública/métodos , Saúde Pública/tendências , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/terapia
13.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(3): 333-336, 2019 Jul 23.
Artigo em Chinês | MEDLINE | ID: mdl-31544421

RESUMO

Earthquake is a serious natural disaster. The earthquake that occurs in schistosomiasis-endemic areas not only causes direct human and economic losses, but also induces secondary disasters that greatly threaten public health safety in affected areas. This paper analyzed the impact of the 2008 Wenchuan Earthquake and 2013 Lushan Earthquake on schistosomiasis transmission in Sichuan Province, and proposed emergency measures and assessment activitiesresponding to schistosomiasis following earthquake disasters. The experiences from schistosomiasis control after two earthquake disasters in Sichuan Province may provide insights into the emergency control in other regions or after other natural disasters.


Assuntos
Terremotos , Serviços Médicos de Emergência , Saúde Pública , Esquistossomose , China , Serviços Médicos de Emergência/métodos , Humanos , Saúde Pública/métodos , Esquistossomose/prevenção & controle , Esquistossomose/transmissão
16.
BMC Pregnancy Childbirth ; 19(1): 329, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492146

RESUMO

BACKGROUND: Each year nearly 7.7 million children under five years die around the world; out of which approximately 3.1 million of the newborns die during the neonatal period and almost all these (99%) deaths occur in the developing countries. According to the World Health Organization's estimation neonatal deaths account for 45% of the under-five deaths. More than one-third of these deaths occur in the first 24 h of birth, whereas three-quarter of the neonatal deaths takes place in the first seven days of birth. The purpose of this study is to assess the knowledge, attitude, and practices (KAP) among mothers about newborns' care and its related factors in district Badin Sindh province of Pakistan. METHODS: A community-based cross-sectional study was conducted from July 2017 to August 2017 to assess the Knowledge, Attitude, and Practices (KAP) in mothers regarding newborn care. A structured questionnaire was administered, after pretest, for data gathering through face to face interview. All survey participants were identified using multi-stage cluster sampling. A scoring system was used to calculate the level of KAP among participants. Independent sample t-test, ANOVA, and GLM were applied to identify the statistical difference between the means of various groups. RESULT: A total of 518 survey participants were interviewed. Among the study sample, more than half of the newborns were bathed within six hours of delivery. Around 50% started breastfeeding after 1 h of birth. A substantial proportion (45%) of mothers gave pre-lacteal feeding and 44.8% of them did not feed colostrum to their newborns. Among those who administered pre-lacteal to their newborn babies included animal/formula milk (15.4%), honey (24.5%) and fresh butter/ghee (5.2. %). Mothers with no education had less significant KAP score about newborn care as compared to those who had higher education (p < 0.05). CONCLUSION: This study revealed that high-risk factors such as immediate bathing, application of traditional substances on the cord, delayed initiation of breastfeeding, discarding colostrum and giving pre-lacteal feed to newborns were highly prevalent. This requires urgent attention of Maternal, Newborn and Child Health (MNCH) programs and health care delivery system to prevent harmful care practices and adopt healthy practices especially in the rural settings.


Assuntos
Aleitamento Materno , Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente , Comportamento Materno/psicologia , Adulto , Aleitamento Materno/métodos , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Cuidado do Lactente/métodos , Cuidado do Lactente/estatística & dados numéricos , Recém-Nascido , Masculino , Mães/psicologia , Mães/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Paquistão , Gravidez , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , População Rural , Fatores Socioeconômicos , População Urbana
17.
PLoS Med ; 16(9): e1002929, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31560684

RESUMO

BACKGROUND: Civil registration and vital statistics (CRVS) systems play a key role in upholding human rights and generating data for health and good governance. They also can help monitor progress in achieving the United Nations Sustainable Development Goals. Although many countries have made substantial progress in strengthening their CRVS systems, most low- and middle-income countries still have underdeveloped systems. The objective of this systematic review is to identify national policies that can help countries strengthen their systems. METHODS AND FINDINGS: The ABI/INFORM, Embase, JSTOR, PubMed, and WHO Index Medicus databases were systematically searched for policies to improve birth and/or death registration on 24 January 2017. Global stakeholders were also contacted for relevant grey literature. For the purposes of this review, policies were categorised as supply, demand, incentive, penalty, or combination (i.e., at least two of the preceding policy approaches). Quantitative results on changes in vital event registration rates were presented for individual comparative articles. Qualitative systematic review methodology, including meta-ethnography, was used for qualitative syntheses on operational considerations encompassing acceptability to recipients and staff, human resource requirements, information technology or infrastructure requirements, costs to the health system, unintended effects, facilitators, and barriers. This study is registered with PROSPERO, number CRD42018085768. Thirty-five articles documenting experience in implementing policies to improve birth and/or death registration were identified. Although 25 countries representing all global regions (Africa, the Americas, Southeast Asia, the Western Pacific, Europe, and the Eastern Mediterranean) were reflected, there were limited countries from the Eastern Mediterranean and Europe regions. Twenty-four articles reported policy effects on birth and/or death registration. Twenty-one of the 24 articles found that the change in registration rate after the policy was positive, with two supply and one penalty articles being the exceptions. The qualitative syntheses identified 15 operational considerations across all policy categories. Human and financial resource requirements were not quantified. The primary limitation of this systematic review was the threat of publication bias wherein many countries may not have documented their experience; this threat is most concerning for policies that had neutral or negative effects. CONCLUSIONS: Our systematic review suggests that combination policy approaches, consisting of at least a supply and demand component, were consistently associated with improved registration rates in different geographical contexts. Operational considerations should be interpreted based on health system, governance, and sociocultural context. More evaluations and research are needed from the Eastern Mediterranean and Europe regions. Further research and evaluation are also needed to estimate the human and financial resource requirements required for different policies.


Assuntos
Confiabilidade dos Dados , Coleta de Dados/métodos , Direitos Humanos , Formulação de Políticas , Vigilância da População/métodos , Saúde Pública/métodos , Sistema de Registros , Estatísticas Vitais , Coleta de Dados/estatística & dados numéricos , Direitos Humanos/estatística & dados numéricos , Humanos , Saúde Pública/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos
18.
BMC Res Notes ; 12(1): 475, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370867

RESUMO

OBJECTIVES: We study the transmission dynamics of cholera in the presence of limited resources, a common feature of the developing world. The model is used to gain insight into the impact of available resources of the health care system on the spread and control of the disease. A deterministic model that includes a nonlinear recovery rate is formulated and rigorously analyzed. Limited treatment is described by inclusion of a special treatment function. Center manifold theory is used to show that the model exhibits the phenomenon of backward bifurcation. Matlab has been used to carry out numerical simulations to support theoretical findings. RESULTS: The model analysis shows that the disease free steady state is locally stable when the threshold [Formula: see text]. It is also shown that the model has multiple equilibria and the model exhibits the phenomenon of backward bifurcation whose implications to cholera infection are discussed. The results are useful for the public health planning in resource allocation for the control of cholera transmission.


Assuntos
Cólera/prevenção & controle , Número de Leitos em Hospital/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Modelos Estatísticos , Saúde Pública/estatística & dados numéricos , Cólera/economia , Cólera/epidemiologia , Cólera/transmissão , Simulação por Computador , Países em Desenvolvimento , Humanos , Saúde Pública/economia , Saúde Pública/métodos , Vibrio cholerae/patogenicidade , Zimbábue/epidemiologia
20.
Soc Stud Sci ; 49(4): 459-475, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31382859

RESUMO

In recent years and across many nations, public health has become subject to forms of governance that are said to be aimed at establishing accountability. In this introduction to a special issue, From Person to Population and Back: Exploring Accountability in Public Health, we suggest opening up accountability assemblages by asking a series of ostensibly simple questions that inevitably yield complicated answers: What is counted? What counts? And to whom, how and why does it count? Addressing such questions involves staying attentive to the technologies and infrastructures through which data come into being and are made available for multiple political agendas. Through a discussion of public health, accountability and datafication we present three key themes that unite the various papers as well as illustrate their diversity.


Assuntos
Agregação de Dados , Análise de Dados , Saúde Pública/métodos , Responsabilidade Social , Humanos , Saúde Pública/estatística & dados numéricos
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