scholarly journals Monitoring the Control of Sexually Transmissible Infections and Blood-Borne Viruses: Protocol for the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) (Preprint)

2018 ◽  
Author(s):  
Denton Callander ◽  
Clarissa Moreira ◽  
Carol El-Hayek ◽  
Jason Asselin ◽  
Caroline van Gemert ◽  
...  

BACKGROUND New biomedical prevention interventions make the control or elimination of some blood-borne viruses (BBVs) and sexually transmissible infections (STIs) increasingly feasible. In response, the World Health Organization and governments around the world have established elimination targets and associated timelines. To monitor progress toward such targets, enhanced systems of data collection are required. This paper describes the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS). OBJECTIVE This study aims to establish a national surveillance network designed to monitor public health outcomes and evaluate the impact of strategies aimed at controlling BBVs and STIs. METHODS ACCESS is a sentinel surveillance system comprising health services (sexual health clinics, general practice clinics, drug and alcohol services, community-led testing services, and hospital outpatient clinics) and pathology laboratories in each of Australia’s 8 states and territories. Scoping was undertaken in each jurisdiction to identify sites that provide a significant volume of testing or management of BBVs or STIs or to see populations with particular risks for these infections (“priority populations”). Nationally, we identified 115 health services and 24 pathology laboratories as relevant to BBVs or STIs; purposive sampling was undertaken. As of March 2018, we had recruited 92.0% (104/113) of health services and 71% (17/24) of laboratories among those identified as relevant to ACCESS. ACCESS is based on the regular and automated extraction of deidentified patient data using specialized software called GRHANITE, which creates an anonymous unique identifier from patient details. This identifier allows anonymous linkage between and within participating sites, creating a national cohort to facilitate epidemiological monitoring and the evaluation of clinical and public health interventions. RESULTS Between 2009 and 2017, 1,171,658 individual patients attended a health service participating in ACCESS network comprising 7,992,241 consultations. Regarding those with unique BBV and STI-related health needs, ACCESS captured data on 366,441 young heterosexuals, 96,985 gay and bisexual men, and 21,598 people living with HIV. CONCLUSIONS ACCESS is a unique system with the ability to track efforts to control STIs and BBVs—including through the calculation of powerful epidemiological indicators—by identifying response gaps and facilitating the evaluation of programs and interventions. By anonymously linking patients between and within services and over time, ACCESS has exciting potential as a research and evaluation platform. Establishing a national health surveillance system requires close partnerships across the research, government, community, health, and technology sectors. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11028

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i45-i46
Author(s):  
A Peletidi ◽  
R Kayyali

Abstract Introduction Obesity is one of the main cardiovascular disease (CVD) risk factors.(1) In primary care, pharmacists are in a unique position to offer weight management (WM) interventions. Greece is the European country with the highest number of pharmacies (84.06 pharmacies per 100,000 citizens).(2) The UK was chosen as a reference country, because of the structured public health services offered, the local knowledge and because it was considered to be the closest country to Greece geographically, unlike Australia and Canada, where there is also evidence confirming the potential role of pharmacists in WM. Aim To design and evaluate a 10-week WM programme offered by trained pharmacists in Patras. Methods This WM programme was a step ahead of other interventions worldwide as apart from the usual measuring parameters (weight, body mass index, waist circumference, blood pressure (BP)) it also offered an AUDIT-C and Mediterranean diet score tests. Results In total,117 individuals participated. Of those, 97.4% (n=114), achieved the programme’s aim, losing at least 5% of their initial weight. The mean % of total weight loss (10th week) was 8.97% (SD2.65), and the t-test showed statistically significant results (P<0.001; 95% CI [8.48, 9.45]). The programme also helped participants to reduce their waist-to-height ratio, an early indicator of the CVD risk in both male (P=0.004) and female (P<0.001) participants. Additionally, it improved participants’ BP, AUDIT-C score and physical activity levels significantly (P<0.001). Conclusion The research is the first systematic effort in Greece to initiate and explore the potential role of pharmacists in public health. The successful results of this WM programme constitute a first step towards the structured incorporation of pharmacists in public’s health promotion. It proposed a model for effectively delivering public health services in Greece. This study adds to the evidence in relation to pharmacists’ CVD role in public health with outcomes that superseded other pharmacy-led WM programmes. It also provides the first evidence that Greek pharmacists have the potential to play an important role within primary healthcare and that after training they are able to provide public health services for both the public’s benefit and their clinical role enhancement. This primary evidence should support the Panhellenic Pharmaceutical Association, to “fight” for their rights for an active role in primary care. In terms of limitations, it must be noted that the participants’ collected data were recorded by pharmacists, and the analysis therefore depended on the accuracy of the recorded data, in particular on the measurements or calculations obtained. Although the sample size was achieved, it can be argued that it is small for the generalisation of findings across Greece. Therefore, the WM programme should be offered in other Greek cities to identify if similar results can be replicated, so as to consolidate the contribution of pharmacists in promoting public health. Additionally, the study was limited as it did not include a control group. Despite the limitations, our findings provide a model for a pharmacy-led public health programme revolving around WM that can be used as a model for services in the future. References 1. Mendis S, Puska P, Norrving B, World Health Organization., World Heart Federation., World Stroke Organization. Global atlas on cardiovascular disease prevention and control [Internet]. Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization; 2011 [cited 2018 Jun 26]. 155 p. Available from: http://www.who.int/cardiovascular_diseases/publications/atlas_cvd/en/ 2. Pharmaceutical Group of the European Union. Pharmacy with you throughout life:PGEU Annual Report [Internet]. 2015. Available from: https://www.pgeu.eu/en/library/530:annual-report-2015.html


2012 ◽  
Vol 42 (2) ◽  
pp. 341-357 ◽  
Author(s):  
Debabar Banerji

Two major research studies carried out in India fundamentally affected tuberculosis treatment practices worldwide. One study demonstrated that home treatment of the disease is as efficacious as sanatorium treatment. The other showed that BCG vaccination is of little protective value from a public health viewpoint. India had brought together an interdisciplinary team at the National Tuberculosis Institute (NTI) with a mandate to formulate a nationally applicable, socially acceptable, and epidemiologically sound National Tuberculosis Programme (NTP). Work at the NTI laid the foundation for developing an operational research approach to dealing with tuberculosis as a public health problem. The starting point for this was not operational research as enunciated by experts in this field; rather, the NTI achieved operational research by starting from the people. This approach was enthusiastically welcomed by the World Health Organization's Expert Committee on Tuberculosis of 1964. The NTP was designed to “sink or sail with the general health services of the country.” The program was dealt a major blow when, starting in 1967, a virtual hysteria was worked up to mobilize most of the health services for imposing birth control on the people. Another blow to the general health services occurred when the WHO joined the rich countries in instituting a number of vertical programs called “Global Initiatives.” An ill-conceived, ill-designed, and ill-managed Global Programme for Tuberculosis was one outcome. The WHO has shown rank public health incompetence in taking a very casual approach to operational research and has been downright quixotic in its thinking on controlling tuberculosis worldwide.


2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
◽  

Abstract   Europe is facing two major structural changes: the climate crisis, having a significant impact on public health, and digitalization of the economy, that could play a role in mitigating climate change and its impacts on public health. The COVID-19 pandemic has affected our lives in many ways including how we see public health, the climate change and has created the conditions for the almost exponential growth for telemedicine and digitalization in healthcare. Underlining that the world is facing an increasing innovation and integration of digital tools to address public health and environmental problems, as the UN Secretary-General and the Director-General of the World Health Organization both declared that we are currently fighting a climate “pandemic” in the same way as we are fighting COVID-19. Digital solutions have been implemented to address COVID-19 and impacted by reducing CO2 emissions and improving quality of life. Digital systems, including Artificial Intelligence, robots and drones, are now changing the paradigm of public health and environment management. Due to the complex nature of the information ecosystem our societies and communities live in, a digital public health approach can be managed to reduce harm to individual, community and population health, support social cohesion and trust in emergency response and interventions to deal with climate change. Digital health could, within 10 years establish a new paradigm in public and environmental health. Public health professionals need urgently to tackle digital health to bridge the gap with others areas of healthcare. During the COVID-19 crisis, national public health authorities have been challenged in the way they communicate with the public, engage with communities in collecting data to improve response, providing the scientific evidence, the day-to-day facts and figures. Likewise, The European Climate Pact provides a space for collectively develop and implement climate solutions. The Climate Pact is an open, inclusive and evolving initiative for climate action through an online platform and citizen dialogues and exchanges, it will foster the link between the digital and green transition. This workshop aims to share the experiences of digital public health interventions with significant impact on climate change mitigation during the pandemic. It will be organised as a round table, starting by setting the scene with an introduction to key digital health concepts and challenges. Each speaker will give a short pitch on how they have experienced the challenge of using digital systems in public health and how they approached its management during the crisis. This will be followed by a panel discussion. Participants will have ample time to ask questions to the panellists. The workshop will end with a summary of a selection of tools participants can use in their own environmental management activities and key take home messages from the panellist will be provided as a conclusion. Key messages Digital Public Health has been establishing evidence on interventions with significant effects on reducing the impact of climate crisis. A Partnership is needed across the health system and society to manage this crisis. European Green Deal and Climate Pact could be used as a roadmap in digital public health.


Author(s):  
Ian Sammy ◽  
Joanne Paul ◽  
Arvind Ramnarine ◽  
Joseph Ramdhanie

Objectives: Analysis of data from the World Health Organization over the past 50 years, has demonstrated a transition towards population ageing globally. This has a significant impact on acute care services as well as on the approach to patient care in the acute setting. Methods: A narrative review of the literature was undertaken using Medline, CINAHL and the Cochrane Database, supplemented by manual searches of the literature, and further guided by the reference lists of relevant papers identified in the electronic search. No restriction was placed on the type of paper to be included in the study. Results: The initial electronic search of the three databases included 239 papers, of which 87 were found to be relevant and included in this review. Among the papers included were those which described the unique challenges posed by the ageing population, proposed modifications to the delivery of health services and recommended adaptations in the approach to older patients in the acute care setting. Conclusion: Population ageing is a significant global phenomenon, affecting both developed and developing regions of the world. More work is needed, particularly in the developing world, to better understand the impact of ageing on our population.


2020 ◽  
Vol 7 (12) ◽  
pp. 59-69
Author(s):  
О. І. Деміхов

The purpose of the research is to study and find out the modern foreign technologies of public health policy in the context of the impact of urbanization processes, to explore the possibilities of implementation of best practices in Ukraine.Materials. Peculiarities of public health policy implementation in developed countries in the context of population density increase and agglomeration expansion are described in the article. The study is based on the analysis of statistics, publications in the media and scientific articles. The comparative statistical analysis of the countries of the world on the incidence of the incidence of different species and the correlation of these processes with the urbanization dynamics is made in the article. Expert assessments of UN and World Health Organization experts on processes of concentration of population around the world, deterioration of living conditions, quality of health, morbidity and appropriate prevention, promotion of healthy lifestyle and quality control of goods, works and services for the population are given in the article. Particular emphasis is placed on the environmental problems of densely populated areas, including through the proliferation of motor vehicles, substandard housing and uncontrolled industrial emissions. The connection of the dynamics of urbanization with the increase of the sedentary lifestyle of the citizens is also described. The urban way of life is assessed as requiring immediate influence by public health policy makers. The current experience of foreign public administration and public policy entities on a proactive approach to shaping the concept of public health in the context of urban transformation in society can be used in Ukraine. Practical results of the work of state institutions in developed countries should be implemented in Ukraine. Conclusions. On the example of the positive experience of the capitalist countries of the world, the further directions of the development of public health policy in Ukraine in the conditions of deepening urbanization processes are clearly defined.


2020 ◽  
Vol 221 (Supplement_5) ◽  
pp. S519-S524
Author(s):  
William Godwin ◽  
Joaquin M Prada ◽  
Paul Emerson ◽  
P J Hooper ◽  
Ana Bakhtiari ◽  
...  

Abstract Background As the World Health Organization seeks to eliminate trachoma by 2020, countries are beginning to control the transmission of trachomatous inflammation–follicular (TF) and discontinue mass drug administration (MDA) with oral azithromycin. We evaluated the effect of MDA discontinuation on TF1–9 prevalence at the district level. Methods We extracted from the available data districts with an impact survey at the end of their program cycle that initiated discontinuation of MDA (TF1–9 prevalence <5%), followed by a surveillance survey conducted to determine whether TF1–9 prevalence remained below the 5% threshold, warranting discontinuation of MDA. Two independent analyses were performed, 1 regression based and 1 simulation based, that assessed the change in TF1–9 from the impact survey to the surveillance survey. Results Of the 220 districts included, TF1–9 prevalence increased to >5% from impact to surveillance survey in 9% of districts. Regression analysis indicated that impact survey TF1–9 prevalence was a significant predictor of surveillance survey TF1–9 prevalence. The proportion of simulations with >5% TF1–9 prevalence in the surveillance survey was 2%, assuming the survey was conducted 4 years after MDA. Conclusion An increase in TF1–9 prevalence may represent disease resurgence but could also be due to measurement error. Improved diagnostic tests are crucial to elimination of TF1–9 as a public health problem.


Viruses ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 138 ◽  
Author(s):  
Hermann Meyer ◽  
Rosina Ehmann ◽  
Geoffrey L. Smith

Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.


Author(s):  
Rita M Traxler ◽  
Karlyn D Beer ◽  
David D Blaney ◽  
Wendy W J van de Sande ◽  
Ahmed H Fahal ◽  
...  

Abstract The Global Mycetoma Working Group (GMWG) was formed in January 2018 in response to the declaration of mycetoma as a neglected tropical disease (NTD) by the World Health Assembly. The aim of the working group is to connect experts and public health practitioners around the world to accelerate mycetoma prevention activities and reduce the impact of mycetoma on patients, healthcare providers and society in the endemic regions. The working group has made tangible contributions to mycetoma programming, awareness and coordination among scientists, clinicians and public health professionals. The group's connectivity has enabled rapid response and review of NTD documents in development, has created a network of public health professionals to provide regional mycetoma expertise and has enabled mycetoma to be represented within broader NTD organizations. The GMWG will continue to serve as a hub for networking and building collaborations for the advancement of mycetoma clinical management and treatment, research and public health programming.


2019 ◽  
Author(s):  
Christos Nicolaides ◽  
Demetris Avraam ◽  
Luis Cueto-Felgueroso ◽  
Marta C. González ◽  
Ruben Juanes

ABSTRACTHand hygiene is considered as an efficient and cost-effective way to limit the spread of diseases and, as such, it is recommended by both the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). While the effect of hand washing on individual transmissibility of a disease has been studied through medical and public-health research, its potential as a mitigation strategy against a global pandemic has not been fully explored yet. In this study, we investigate contagion dynamics through the world air transportation network and analyze the impact of hand-hygiene behavioural changes of airport population against the spread of infectious diseases worldwide. Using a granular dataset of the world air transportation traffic, we build a detailed individual mobility model that controls for the correlated and recurrent nature of human travel and the waiting-time distributions of individuals at different locations. We perform a Monte-Carlo simulation study to assess the impact of different hand-washing mitigation strategies at the early stages of a global epidemic. From the simulation results we find that increasing the hand cleanliness homogeneously at all airports in the world can inhibit the impact of a potential pandemic by 24 to 69%. By quantifying and ranking the contribution of the different airports to the mitigation of an epidemic outbreak, we identify ten key airports at the core of a cost-optimal deployment of the hand-washing strategy: increasing the engagement rate at those locations alone could potentially reduce a world pandemic by 8 to 37%. This research provides evidence of the effectiveness of hand hygiene in airports on the global spread of infectious diseases, and has important implications for the way public-health policymakers may design new effective strategies to enhance hand hygiene in airports through behavioral changes.


Author(s):  
Tarcísio M. Rocha Filho ◽  
Fabiana Sherine Ganem dos Santos ◽  
Victor Bertollo Gomes ◽  
Thiago Augusto Hernandes Rocha ◽  
Julio Henrique Rosa Croda ◽  
...  

AbstractIn January 2020 China reported to the World Health Organization an outbreak of pneumonia of undetermined origin in the city of Wuhan, Hubei. In January 30, 2020, the World Health Organization declared the outbreak of COVID-19 as a Public Health Emergency of International Interest (PHEI).ObjectivesThe aim of this study is to assess the impact of a COVID-19 epidemic in the metropolitan region of São Paulo, Brazil.MethodsWe used a generalized SEIR (Susceptibles, Exposed, Infectious, Recovered) model, with additional Hospitalized variables (SEIHR model) and age-stratified structure to analyze the expected time evolution during the onset of the epidemic in the metropolitan area of São Paulo. The model allows to determine the evolution of the number of cases, the number of patients admitted to hospitals and deaths caused by COVID-19. In order to investigate the sensibility of our results with respect to parameter estimation errors we performed Monte Carlo analysis with 100 000 simulations by sampling parameter values from an uniform distribution in the confidence interval.ResultsWe estimate 1 368 (IQR: 880, 2 407) cases, 301 (22%) in older people (≥60 years), 81 (50, 143) hospitalizations, and 14 (9, 26) deaths in the first 30 days, and 38 583 (IQR: 16 698, 113, 163) cases, 8 427 (21.8%) in older people (≥60 years), 2181 (914, 6392) hospitalizations, and 397(166, 1205) deaths in the first 60 days.LimitationsWe supposed a constant transmission probability Pc among different age-groups, and that every severe and critic case will be hospitalized, as well as that the detection capacity in all the primary healthcare services does not change during the outbreak.ConclusionSupposing the reported parameters in the literature apply in the city of São Paulo, our study shows that it is expected that the impact of a COVID-19 outbreak will be important, requiring special planning from the authorities. This is the first study for a major metropolitan center in the south hemisphere, and we believe it can provide policy makers with a prognosis of the burden of the pandemic not only in Brazil, but also in other tropical zones, allowing to estimate total cases, hospitalization and deaths, in support to the management of the public health emergence caused by COVID-19.


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