scholarly journals Community Engagement during outbreak response: standards, approaches, and lessons from the 2014-2016 Ebola outbreak in Sierra Leone

2019 ◽  
Author(s):  
Jamie Bedson ◽  
Mohamed F. Jalloh ◽  
Danielle Pedi ◽  
Saiku M. Bah ◽  
Katharine Owen ◽  
...  
Keyword(s):  
Community Engagement ◽  
Sierra Leone ◽  
Action Planning ◽  
Integrated Approach ◽  
Community Action ◽  
Social Mobilization ◽  
Theory Of Change ◽  
List Type ◽  
Time Data ◽  
Outbreak Response

Summary pointsThe Social Mobilization Action Consortium (SMAC) was Sierra Leone’s largest coordinated community engagement initiative during the 2014 - 2016 Ebola outbreak. It worked in all 14 districts in Sierra Leone across >12,000 communities (approximately 70% of all communities), through 2,466 trained Community Mobilizers, a network of 2,000 mosques and churches, and 42 local radio stations.We describe SMAC’s Theory of Change and utilization of the Community-Led Ebola Action (CLEA) approach. We present an extensive dataset of community engagement and monitoring with a focus on over 50,000 SMAC weekly reports collected by Community Mobilizers between December 2014 and September 2015.Community engagement and real-time data collection at scale is achievable in the context of a health emergency if adequately structured, managed, coordinated and resourced.We describe a correlation between systemic community engagement, community action planning and Ebola-safe behaviors at community-level.The SMAC integrated approach demonstrates the scope of data – including surveillance data - that can be generated directly by communities through structured community engagement interventions implemented at scale during an Ebola outbreak.We highlight important insights gleaned over time on how to informally integrate social mobilization into community-based surveillance of sick people and deaths.

scholarly journals Community engagement in outbreak response: lessons from the 2014–2016 Ebola outbreak in Sierra Leone

2020 ◽  
Vol 5 (8) ◽  
pp. e002145 ◽  
Author(s):  
Jamie Bedson ◽  
Mohamed F Jalloh ◽  
Danielle Pedi ◽  
Saiku Bah ◽  
Katharine Owen ◽  
...  
Keyword(s):  
Community Engagement ◽  
Real Time ◽  
Sierra Leone ◽  
Large Scale ◽  
Action Plan ◽  
Community Action ◽  
Religious Leader ◽  
Action Plans ◽  
Engagement Interventions ◽  
Over Time

Documentation of structured community engagement initiatives and real-time monitoring of community engagement activities during large-scale epidemics is limited. To inform such initiatives, this paper analyses the Community Led Ebola Action (CLEA) approach implemented through the Social Mobilization Action Consortium (SMAC) during the 2014–2016 Ebola epidemic in Sierra Leone. The SMAC initiative consisted of a network of 2466 community mobilisers, >6000 religious leaders and 42 local radio stations across all 14 districts of Sierra Leone. Community mobilisers were active in nearly 70% of all communities across the country using the CLEA approach to facilitate community analysis, trigger collective action planning and maintain community action plans over time. CLEA was complemented by interactive radio programming and intensified religious leader engagement.Community mobilisers trained in the CLEA approach used participatory methods, comprised of an initial community ‘triggering’ event, action plan development and weekly follow-ups to monitor progress on identified action items. Mobilisers collected operational and behavioural data on a weekly basis as part of CLEA. We conducted a retrospective analysis of >50 000 weekly reports from approximately 12 000 communities from December 2014 to September 2015. The data showed that 100% of the communities that were engaged had one or more action plans in place. Out of the 63 110 cumulative action points monitored by community mobilisers, 92% were marked as ‘in-progress’ (85%) or ‘achieved’ (7%) within 9 months. A qualitative examination of action points revealed that the in-progress status was indicative of the long-term sustainability of most action points (eg, continuous monitoring of visitors into the community) versus one-off action items that were marked as achieved (eg, initial installation of handwashing station). Analysis of behavioural outcomes of the intervention indicate an increase over time in the fraction of reported safe burials and fraction of reported cases referred for medical care within 24 hours of symptom onset in the communities that were engaged.Through CLEA, we have demonstrated how large-scale, coordinated community engagement interventions can be achieved and monitored in real-time during future Ebola epidemics and other similar epidemics. The SMAC initiative provides a practical model for the design, implementation and monitoring of community engagement, integration and coordination of community engagement interventions with other health emergency response pillars, and adaptive strategies for large-scale community-based operational data collection.

scholarly journals Integrated digital system for community engagement and community-based surveillance during the 2014–2016 Ebola outbreak in Sierra Leone: lessons for future health emergencies

2020 ◽  
Vol 5 (12) ◽  
pp. e003936
Author(s):  
Mohamed F Jalloh ◽  
Paul Sengeh ◽  
Nyuma James ◽  
Saiku Bah ◽  
Mohammad B Jalloh ◽  
...  
Keyword(s):  
Public Health ◽  
Community Engagement ◽  
Sierra Leone ◽  
Reporting System ◽  
Scale Up ◽  
Time Data ◽  
Community Based ◽  
Health Crisis ◽  
Lessons Learnt ◽  
Essential Components

Community engagement and community-based surveillance are essential components of responding to infectious disease outbreaks, but real-time data reporting remains a challenge. In the 2014–2016 Ebola outbreak in Sierra Leone, the Social Mobilisation Action Consortium was formed to scale-up structured, data-driven community engagement. The consortium became operational across all 14 districts and supported an expansive network of 2500 community mobilisers, 6000 faith leaders and 42 partner radio stations. The benefit of a more agile digital reporting system became apparent within few months of implementing paper-based reporting given the need to rapidly use the data to inform the fast-evolving epidemic. In this paper, we aim to document the design, deployment and implementation of a digital reporting system used in six high transmission districts. We highlight lessons learnt from our experience in scaling up the digital reporting system during an unprecedented public health crisis. The lessons learnt from our experience in Sierra Leone have important implications for designing and implementing similar digital reporting systems for community engagement and community-based surveillance during public health emergencies.

scholarly journals Improving nursing documentation for surgical patients in a referral hospital in Freetown, Sierra Leone: protocol for assessing feasibility of a pilot multifaceted quality improvement hybrid type project

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nataliya Brima ◽  
Nick Sevdalis ◽  
K. Daoh ◽  
B. Deen ◽  
T. B. Kamara ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Sierra Leone ◽  
Referral Hospital ◽  
Audit And Feedback ◽  
Health System Strengthening ◽  
Theory Of Change ◽  
Improve Quality ◽  
Nursing Documentation

Abstract Background There is an urgent need to improve quality of care to reduce avoidable mortality and morbidity from surgical diseases in low- and middle-income countries. Currently, there is a lack of knowledge about how evidence-based health system strengthening interventions can be implemented effectively to improve quality of care in these settings. To address this gap, we have developed a multifaceted quality improvement intervention to improve nursing documentation in a low-income country hospital setting. The aim of this pilot project is to test the intervention within the surgical department of a national referral hospital in Freetown, Sierra Leone. Methods This project was co-developed and co-designed by in-country stakeholders and UK-based researchers, after a multiple-methodology assessment of needs (qualitative, quantitative), guided by a participatory ‘Theory of Change’ process. It has a mixed-method, quasi-experimental evaluation design underpinned by implementation and improvement science theoretical approaches. It consists of three distinct phases—(1) pre-implementation(project set up and review of hospital relevant policies and forms), (2) intervention implementation (awareness drive, training package, audit and feedback), and (3) evaluation of (a) the feasibility of delivering the intervention and capturing implementation and process outcomes, (b) the impact of implementation strategies on the adoption, integration, and uptake of the intervention using implementation outcomes, (c) the intervention’s effectiveness For improving nursing in this pilot setting. Discussion We seek to test whether it is possible to deliver and assess a set of theory-driven interventions to improve the quality of nursing documentation using quality improvement and implementation science methods and frameworks in a single facility in Sierra Leone. The results of this study will inform the design of a large-scale effectiveness-implementation study for improving nursing documentation practices for patients throughout hospitals in Sierra Leone. Trial registration Protocol version number 6, date: 24.12.2020, recruitment is planned to begin: January 2021, recruitment will be completed: December 2021.

scholarly journals Effectiveness of a community-level social mobilization intervention in achieving the outcomes of polio vaccination campaigns during the post-polio-endemic period: Evidence from CORE Group polio project in Uttar Pradesh, India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manojkumar Choudhary ◽  
Roma Solomon ◽  
Jitendra Awale ◽  
Rina Dey ◽  
Jagajeet Prasad Singh ◽  
...  
Keyword(s):  
Community Engagement ◽  
Statistical Significance ◽  
Uttar Pradesh ◽  
Social Mobilization ◽  
Community Level ◽  
Added Value ◽  
Synthetic Control ◽  
Core Group ◽  
Percentage Points ◽  
Polio Vaccination

Abstract Background A social mobilization (SM) initiative contributed to India’s success in polio elimination. This was the CORE Group Polio Project (CGPP) India, a partner of the Uttar Pradesh (UP) SM Network and which continued its SM activities, even during the polio-free period through a network of multi-level social mobilizers. This paper assesses the effects of this community-level SM (CLSM) intervention on the extent of community engagement and performance of polio Supplementary Immunization Activity campaigns (SIAs) during the post-polio-endemic period (i.e., from March 2012 to September 2017). Methods This study followed a quasi-experimental design. We used secondary, cluster-level data from CGPP India’s Management Information System, including 52 SIAs held from January 2008 to September 2017, covering 56 blocks from 12 districts of UP. We computed various indicators and performed Generalized Estimating Equations based analysis to assess the statistical significance of differences between the outcomes of intervention and non-intervention areas. We then estimated the effects of the SM intervention using Interrupted time-series, Difference-in-Differences and Synthetic Control Methods. Finally, we estimated the population influenced by the intervention. Results The performance of polio SIAs changed over time, with the intervention areas having better outcomes than non-intervention areas. The absence of CLSM intervention during the post-polio-endemic period would have negatively impacted the outcomes of polio SIAs. The percentage of children vaccinated at polio SIA booths, percentage of ‘X’ houses (i.e., households with unvaccinated children or households with out-of-home/out-of-village children or locked households) converted to ‘P’ (i.e., households with all vaccinated children or households without children eligible for vaccination), and percentage of resistant houses converted to polio acceptors would have gone down by 14.1 (Range: 12.7 to 15.5), 6.3 (Range: 5.2 to 7.3) and 7.4 percentage points, respectively. Community engagement would have reduced by 7.2 (Range: 6.6 to 7.7) percentage points. Conclusions The absence of CLSM intervention would have significantly decreased the level of community engagement and negatively impacted the performance of polio SIAs of the post-polio-endemic period. The study provides evidence of an added value of deploying additional human resource dedicated to social mobilization to achieve desired vaccination outcomes in hard-to-reach or programmatically challenging areas.

scholarly journals How Cooperative Engagement Programs Strengthen Sequencing Capabilities for Biosurveillance and Outbreak Response

2021 ◽  
Vol 9 ◽  
Author(s):  
Andrew W. Bartlow ◽  
Earl A. Middlebrook ◽  
Alicia T. Romero ◽  
Jeanne M. Fair
Keyword(s):  
Global Health ◽  
Technical Assistance ◽  
Emerging Infectious Diseases ◽  
Sequencing Data ◽  
Time Data ◽  
Outbreak Response ◽  
Health Security ◽  
The Face ◽  
Working Together ◽  
Etiological Agents

The threat of emerging and re-emerging infectious diseases continues to be a challenge to public and global health security. Cooperative biological engagement programs act to build partnerships and collaborations between scientists and health professionals to strengthen capabilities in biosurveillance. Biosurveillance is the systematic process of detecting, reporting, and responding to especially dangerous pathogens and pathogens of pandemic potential before they become outbreaks, epidemics, and pandemics. One important tool in biosurveillance is next generation sequencing. Expensive sequencing machines, reagents, and supplies make it difficult for countries to adopt this technology. Cooperative engagement programs help by providing funding for technical assistance to strengthen sequencing capabilities. Through workshops and training, countries are able to learn sequencing and bioinformatics, and implement these tools in their biosurveillance programs. Cooperative programs have an important role in building and sustaining collaborations among institutions and countries. One of the most important pieces in fostering these collaborations is trust. Trust provides the confidence that a successful collaboration will benefit all parties involved. With sequencing, this enables the sharing of pathogen samples and sequences. Obtaining global sequencing data helps to identify unknown etiological agents, track pathogen evolution and infer transmission networks throughout the duration of a pandemic. Having sequencing technology in place for biosurveillance generates the capacity to provide real-time data to understand and respond to pandemics. We highlight the need for these programs to continue to strengthen sequencing in biosurveillance. By working together to strengthen sequencing capabilities, trust can be formed, benefitting global health in the face of biological threats.

scholarly journals In Vivo CRISPR Screens Identify E3 Ligase Cop1 as a Modulator of Macrophage Infiltration and Cancer Immunotherapy Target

2020 ◽  
Author(s):  
Xiaoqing Wang ◽  
Collin Tokheim ◽  
Binbin Wang ◽  
Shengqing Stan Gu ◽  
Qin Tang ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Cancer Cells ◽  
Cancer Immunotherapy ◽  
Tumor Immunity ◽  
Large Scale ◽  
Integrated Approach ◽  
Immune Checkpoint Blockade ◽  
Macrophage Infiltration ◽  
List Type

SUMMARYDespite remarkable clinical efficacies of immune checkpoint blockade (ICB) in cancer treatment, ICB benefits in triple-negative breast cancer (TNBC) remain limited. Through pooled in vivo CRISPR knockout (KO) screens in syngeneic TNBC mouse models, we found that inhibition of the E3 ubiquitin ligase Cop1 in cancer cells decreases the secretion of macrophage-associated chemokines, reduces tumor macrophage infiltration, and shows synergy in anti-tumor immunity with ICB. Transcriptomics, epigenomics, and proteomics analyses revealed Cop1 functions through proteasomal degradation of the C/ebpδ protein. Cop1 substrate Trib2 functions as a scaffold linking Cop1 and C/ebpδ, which leads to polyubiquitination of C/ebpδ. Cop1 inhibition stabilizes C/ebpδ to suppress the expression of macrophage chemoattractant genes. Our integrated approach implicates Cop1 as a target for improving cancer immunotherapy efficacy by regulating chemokine secretion and macrophage levels in the TNBC tumor microenvironment.HighlightsLarge-scale in vivo CRISPR screens identify new immune targets regulating the tumor microenvironmentCop1 knockout in cancer cells enhances anti-tumor immunityCop1 modulates chemokine secretion and macrophage infiltration into tumorsCop1 targets C/ebpδ degradation via Trib2 and influences ICB response

scholarly journals 4474 READ-TV: Research and Exploratory Analysis Driven Time-data Visualization

2020 ◽  
Vol 4 (s1) ◽  
pp. 51-51
Author(s):  
John Del Gaizo ◽  
Alexander Alekseyenko ◽  
Kenneth Catchpole
Keyword(s):  
Data Visualization ◽  
Change Point ◽  
Web Application ◽  
Exploratory Analysis ◽  
Change Point Analysis ◽  
List Type ◽  
Event Analysis ◽  
Time Data ◽  
User Friendliness ◽  
Changepoint Analysis

OBJECTIVES/GOALS: A web interface that allows for easy upload of CSV text data to time-based visualizationsImplementation of change points analysis to identify and display points where event rates increased or decreasedcustomizable plots where the user can change point shapes, color, etc.customizable and advanced filtering supportsupport for plot comparisons and exportsMETHODS/STUDY POPULATION: We used the R/Shiny framework to develop a web application for visualization of time stamped data. The Research and Exploratory Analysis Driven Time-data Visualization (READ-TV) application allows for user-friendly mining for longitudinal patterns in data. READ-TV is built specifically for FD analysis, but is easily adaptable to other clinical use cases, as we allow for the use of general metadata on events and cases.The building of a quantitative framework for event analysis starts with the application of homogeneous Poisson processes, which relate the times of occurrence of events in terms of an underlying rate. To understand the changes in this underlying rate, changepoint analysis is used to model the rate as a function of time using piecewise constant approximations. The changepoint analysis allows us to identify the specific periods of time where the rate of FD is increased relative to a baseline or a desired operating range. RESULTS/ANTICIPATED RESULTS: READ-TV application allows for import of time stamped event data from multiple cases. Event and case metadata are supported to facilitate filtering and mining of interesting subsets of data. Stem plots are used for visualization of selected event timelines in chosen cases. This visualization is accompanied with summary of the number and estimates of rates of occurrence of specific event types (e.g. types of FD). Change-point analysis is implemented using the ‘changepoint‘ R library. These analyses allow the users to quickly understand whether the rates of events (FD) is changing across the case timeline and where exactly these changes are occurring. DISCUSSION/SIGNIFICANCE OF IMPACT: We have demonstrated the READ-TV application to the team of the AHRQ-funded Human Factors and Systems Integration in High Technology Surgery (HF-SIgHTS) study. The ability to visualize and perform quantitative analysis of the study data was received with unanimous positive feedback and enthusiasm. We continue READ-TV development focusing on (1) increased user-friendliness using the HF-SIgHTS as our focus group, (2) increased functionality, and (3) use of more general localization terminology to allow for other applications.

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