The CURE Protocol: Evaluation and External Validation of a New Public Health Strategy for Treatment of Paediatric Hydrocephalus in Low-Resource Countries

2019 ◽  
Author(s):  
Jacob Lepard ◽  
Michael C Dewan ◽  
Stephanie H Chen ◽  
Olufemi B Bankole ◽  
John Mugamba ◽  
...  
Keyword(s):  
Public Health ◽  
External Validation ◽  
Public Health Strategy ◽  
Low Resource ◽  
New Public Health ◽  
New Public ◽  
Health Strategy ◽  
Protocol Evaluation

scholarly journals The CURE Protocol: evaluation and external validation of a new public health strategy for treating paediatric hydrocephalus in low-resource settings

2020 ◽  
Vol 5 (2) ◽  
pp. e002100 ◽  
Author(s):  
Jacob R Lepard ◽  
Michael C Dewan ◽  
Stephanie H Chen ◽  
Olufemi B Bankole ◽  
John Mugamba ◽  
...  
Keyword(s):  
Public Health ◽  
External Validation ◽  
Similar Proportion ◽  
Public Health Strategy ◽  
Low Resource Settings ◽  
Low Resource ◽  
Shunt Placement ◽  
New Public Health ◽  
Health Strategy ◽  
Surgeon Experience

IntroductionManaging paediatric hydrocephalus with shunt placement is especially risky in resource-limited settings due to risks of infection and delayed life-threatening shunt obstruction. This study evaluated a new evidence-based treatment algorithm to reduce shunt-dependence in this context.MethodsA prospective cohort design was used. The CURE Protocol employs preoperative and intraoperative data to choose between endoscopic treatment and shunt placement. Data were prospectively collected for 730 children in Uganda (managed by local neurosurgeons highly experienced in the protocol) and, for external validation, 96 children in Nigeria (managed by a local neurosurgeon trained in the protocol).ResultsThe age distribution was similar between Uganda and Nigeria, but there were more cases of postinfectious hydrocephalus in Uganda (64.2% vs 26.0%, p<0.001). Initial treatment of hydrocephalus was similar at both centres and included either a shunt at first operation or endoscopic management without a shunt. The Nigerian cohort had a higher failure rate for endoscopic cases (adjusted HR 2.5 (95% CI 1.6 to 4.0), p<0.001), but not for shunt cases (adjusted HR 1.3 (0.5 to 3.0), p=0.6). Despite the difference in endoscopic failure rates, a similar proportion of the entire cohort was successfully treated without need for shunt at 6 months (55.2% in Nigeria vs 53.4% in Uganda, p=0.74).ConclusionUse of the CURE Protocol in two centres with different populations and surgeon experience yielded similar 6-month results, with over half of all children remaining shunt-free. Where feasible, this could represent a better public health strategy in low-resource settings than primary shunt placement.

The new public health strategy for England

BMJ ◽  
2010 ◽  
Vol 341 (dec08 2) ◽  
pp. c7049-c7049 ◽  
Author(s):  
L. Davies
Keyword(s):  
Public Health ◽  
Public Health Strategy ◽  
New Public Health ◽  
New Public ◽  
Health Strategy

Molecular characterization of SARS-CoV-2

2020 ◽  
Vol 20 ◽  
Author(s):  
Miribane Dërmaku-Sopjani ◽  
Mentor Sopjani
Keyword(s):  
Public Health ◽  
Drug Targets ◽  
Virus Genome ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Therapeutic Drugs ◽  
New Public Health ◽  
New Public ◽  
And Function

Abstract:: The coronavirus disease 2019 (COVID-19) is currently a new public health crisis threatening the world. This pandemic disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus has been reported to be originated in bats and by yet unknown intermediary animals were transmitted to humans in China 2019. The SARSCoV- 2 spreads faster than its two ancestors the SARS-CoV and Middle East respiratory syndrome coronavirus (MERSCoV) but has reduced fatality. At present, the SARS-CoV-2 has caused about a 1.16 million of deaths with more than 43.4 million confirmed cases worldwide, resulting in a serious threat to public health globally with yet uncertain impact. The disease is transmitted by inhalation or direct contact with an infected person. The incubation period ranges from 1 to 14 days. COVID-19 is accompanied by various symptoms, including cough, fatigue. In most people the disease is mild, but in some other people, such as in elderly and people with chronic diseases, it may progress from pneumonia to a multi-organ dysfunction. Many people are reported asymptomatic. The virus genome is sequenced, but new variants are reported. Numerous biochemical aspects of its structure and function are revealed. To date, no clinically approved vaccines and/or specific therapeutic drugs are available to prevent or treat the COVID-19. However, there are reported intensive researches on the SARSCoV- 2 to potentially identify vaccines and/or drug targets, which may help to overcome the disease. In this review, we discuss recent advances in understanding the molecular structure of SARS-CoV-2 and its biochemical characteristics.

scholarly journals Adoption of local public health plan for better health and quality of life in Belgrade

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Tamburkovski ◽  
G Belamarić ◽  
D Matijević ◽  
S Mladenović Janković
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Plan ◽  
Health Planning ◽  
City Council ◽  
Public Health Strategy ◽  
Public Health Planning ◽  
Health Strategy ◽  
Public Health Plan ◽  
The City

Abstract Issue Development of public health plan for the City of Belgrade, facilitate multisectoral participation and encourage local government to incorporate public health planning into integrated planning framework, including funding. Description of the Problem According to Public Health Low, adopted in Serbia in 2016 and Public health strategy (2018), Council for Health, as a professional body of the City government, was obliged to prepare draft of the Plan. Members of the City Council are representatives from different sectors: health care, public health, private sector, child care, education and civil society. Based on data and information from relevant institutions and organizations, situation analysis and health profile of the City have been prepared during 2018. Results Public health plan for the City of Belgrade has been drafted for a time period from 2020 to 2026, aligned and within time frame of the National public health strategy. Plan included: mission, vision, objectives, activities, responsible institutions, funding sources and indicators for monitoring. Focus was on health promotion and empowerment of citizens to adopt healthy lifestyle as well on investment in environmental sustainability, poverty and inequalities reduction and minimizing risks to human health and well-being. On December 2019, Belgrade City Assembly adopted this document, with full responsibility for implementation and budgeting specific programs and projects from 2020. Lessons Multisectoral working group, with clear defined scope of work, supported by regulations, encouraged and managed by experts in the field, highly motivated to be creator of changes is prerequisite for successful and productive public health planning process. Key messages Public health planning enabled communication and cooperation among experts and decision makers and represented a whole-of-local government approach to public health. Document is used as a resource and model for the other cities and municipalities.

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