Prevention Of Communicable Diseases Research Articles

Developing a European framework for the prevention of communicable diseases: three points for attention.

The capacity to deliver programmes that prevent and control infectious diseases is a key public health function. The European Centre for Disease Prevention and Control (ECDC) aims to support and strengthen this capacity in European Union/ European Economic Area (EU/EEA) countries as part of its 2021-27 strategy which includes explicit attention to social and behavioural aspects of disease prevention. To achieve its strategic goals, it is important that ECDC improves its knowledge of prevention strategies, actors and activities in EU/EEA countries. In this Perspective, we summarise three challenges to implementing the prevention framework proposed by ECDC: (i) defining, recognising and identifying with 'prevention', (ii) integrating new understandings into established ways of thinking, and (iii) the need for more attention to prevention in governance. These challenges are derived from the findings of a project which conducted a preliminary mapping of prevention actors, networks and activities in four EU countries to support the development of a community of practice within the new ECDC prevention framework. This Perspective serves to draw attention to this prevention framework and the three identified challenges for those working on its implementation.

Cross-Country Assessment of Socio-Ecological Drivers of COVID-19 Dynamics in Africa: A Spatial Modelling Approach

Understanding how countries’ socio-economic, environmental, health status, and climate factors have influenced the dynamics of COVID-19 is essential for public health, particularly in Africa. This study explored the relationships between African countries’ COVID-19 cases and deaths and their socio-economic, environmental, health, clinical, and climate variables. It compared the performance of Ordinary Least Square (OLS) regression, the spatial lag model (SLM), the spatial error model (SEM), and the conditional autoregressive model (CAR) using statistics such as the Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), Root Mean Square Error (RMSE), and coefficient of determination (R2). Results showed that the SEM with the 10-nearest neighbours matrix weights performed better for the number of cases, while the SEM with the maximum distance matrix weights performed better for the number of deaths. For the cases, the number of tests followed by the adjusted savings, Gross Domestic Product (GDP) per capita, dependence ratio, and annual temperature were the strongest covariates. For deaths, the number of tests followed by malaria prevalence, prevalence of communicable diseases, adjusted savings, GDP, dependence ratio, Human Immunodeficiency Virus (HIV) prevalence, and moisture index of the moistest quarter play a critical role in explaining disparities across countries. This study illustrates the importance of accounting for spatial autocorrelation in modelling the dynamics of the disease while highlighting the role of countries’ specific factors in driving its dynamics.

Effective community-based interventions to prevent and control infectious diseases in urban informal settlements in low- and middle-income countries: a systematic review

BackgroundThe impact of rapid urbanization taking place across the world is posing variegated challenges. Especially in terms of communicable disease, the risk is more concentrated in urban poor areas where basic amenities are inadequate. This systematic review synthesizes evidence on the effective community-based interventions (CBIs) aimed at preventing and controlling infectious diseases among the urban poor in low- and middle-income countries (LMICs).MethodsThis systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. A comprehensive search across five major databases was conducted to capture literature on CBIs published between 2011 and 2021. Scientific articles of any design that reported any type of CBIs effective in preventing and controlling infectious diseases (tuberculosis, diarrhea, typhoid, dengue, hepatitis B and C, influenza, and COVID-19) were included. Screening and selection of studies were done by two pairs of independent researchers using the predefined eligibility criteria. The risk of bias in included studies was assessed using the modified checklist outlined in the Cochrane Handbook for Systematic Reviews of Interventions and Effective Public Health Practice Project (EPHPP). Analysis of effective CBIs was guided by the conceptual framework for integrated CBIs for neglected tropical diseases (NTDs), and narrative synthesis was carried out. Geographical restrictions were limited to LMICs and papers published in English.ResultsOut of 18,260 identified papers, 20 studies met the eligibility criteria and were included in this review. Community-based screening and socio-economic support, community-based vector control, behavior change communication, capacity building of the community health workers (CHWs), health education, and e- and m-health interventions were found as effective CBIs. Diversified CBIs were found to be effective for specific diseases, including tuberculosis (TB), diarrhea, dengue, influenza and ARI, and hepatitis B and C. Bundling of interventions were found to be effective against specific diseases. However, it was difficult to isolate the effectiveness of individual interventions within the bundle. The socio-cultural context was considered while designing and implementing these CBIs.ConclusionThe effectiveness of an intervention is inextricably linked to social context, stakeholder dimensions, and broader societal issues. System approach is recommended, emphasizing context-specific, multi-component interventions that address social determinants of health. Integrating these interventions with public health strategies and community involvement is crucial for sustainable outcomes. These findings can guide the design of future interventions for better prevention and control of communicable diseases in urban poor areas.Systematic review registrationPROSPERO CRD42021278689.

Tick-borne Encephalitis Clinical Characteristics in Adult Patients: A 10-year Retrospective Study in Stockholm, Sweden.

The incidence of Tick-borne encephalitis (TBE) has increased during the last decades in Europe. Our aim was to assess the clinical characteristics and outcome of TBE patients in Region Stockholm, as a high-risk area in Sweden. The notification database at the regional Department of Communicable Disease Control and Prevention was used to identify TBE cases during 2006-2015. Clinical data was retrieved from the included patients' medical records. The associations of specific variables to predefined outcomes of disease severity were evaluated with multivariate logistic regression models. Of 1004 identified TBE cases, 703 adult patients were included. Sixty-one percent were men, and the median age was 50 years (range 18-94). The majority were non-vaccinated. Comorbidity was present in 34%, and 4% had immunomodulatory therapy. Seventy-five percent were hospitalised, and 11% had severe disease. More than 70% of the 79 patients followed up for more than 6 months had persisting symptoms. The case fatality rate was 1.4%, with 15% in the group with immunomodulatory treatment. In the multivariate analysis, severe disease was associated with underlying comorbidities, age ≥50 years, and previous complete TBE vaccination. This is the largest cohort of TBE patients in Scandinavia. Our findings of a more severe course of disease in patients of older age, with immunomodulatory therapy, with comorbidities, and vaccination breakthrough infections must be interpreted in the context of hospitalised patients. Optimised prevention is needed for patients with immunomodulatory therapy, given the considerable case fatality rate. Follow-up visits and rehabilitation should be better standardised.

A Community based Non Communicable disease Prevention Intervention among Urban Slum population in Surat city

A Community based Non Communicable disease Prevention Intervention among Urban Slum population in Surat city

Relationship Between Health Literacy Level and the Adoption of Preventive Behaviors Against Coronavirus Disease

Background: Health literacy skills play a pivotal role in adopting preventive behaviors. The COVID-19 pandemic has brought renewed emphasis on health-oriented behaviors, and health literacy is considered one of the most influential indicators affecting health-centric behaviors. Objectives: This study was conducted to determine the relationship between the level of health literacy and the adoption of preventive behaviors against COVID-19 among students at Jundishapur University of Medical Sciences in Ahvaz. Methods: In this study, the research population comprised 223 newly enrolled students from seven main faculties at Jundishapur University of Medical Sciences in Ahvaz in the year 2022. Participants were randomly selected, and data collection instruments included a COVID-19 prevention questionnaire and a health literacy questionnaire for adults. The questionnaire links and study participation consent forms were sent to the participants. Inclusion criteria consisted of willingness and consent to participate in the study, and enrollment in the first year of study (either the first or second semester) in various academic levels at Ahvaz University of Medical Sciences. The exit criteria were defined as failure to respond to more than 5% of the questions. After data collection, descriptive statistics, correlation coefficient tests, and regression analysis were employed using SPSS software for data analysis. Results: The findings revealed that women, married individuals, employed participants, and those with underlying health conditions obtained higher scores in preventive behaviors against COVID-19 and health literacy. Regression coefficients indicated that a one-unit increase in health literacy scores could lead to a 0.439-unit increase in preventive behaviors against COVID-19. According to correlation analysis, a positive, direct, and significant correlation existed among all dimensions of health literacy and preventive behaviors against COVID-19 (P < 0.05), with the behavioral dimension being the only significant predictor of preventive behaviors. Specifically, a one-unit increase in the behavioral dimension score could result in a 0.373-unit increase in preventive behaviors against COVID-19 (P < 0.001). Conclusions: The results showed that health literacy is directly related to COVID-19 preventive behaviors. Therefore, to promote preventive behaviors against infectious diseases, special attention should be paid to health literacy and its influential dimensions. Recognizing the importance of advancing health literacy across various dimensions can significantly contribute to the control and prevention of communicable diseases.

Expressed preferences for public health education of students during COVID-19 vaccination intervention: a cross-sectional comparative study

BackgroundPublic health education is a powerful tool for improving communicable disease awareness and prevention protocols. Despite the fact that health education is crucial for the advancement of COVID-19 awareness and vaccination decisions, how a teacher approaches students to learn about health education during COVID-19 vaccination is a challenging issue. This study aimed to assess the preferences for public health education during COVID-19 vaccination intervention and compare the predictors of preferences between science and non-science university students in Bangladesh.MethodsA multi-item questionnaire was developed and an online link was conveniently sent to the encounters between 31st May, 2023 and 15th August, 2023. Binary logistic regression analysis was applied to rationalize the research objective.ResultsThe pooled preference for public health education was 71.3% (95% Confidence Interval [CI] 67.7–74.3) vs. 81.5% (95% CI 79.3–84.7) between science and non-science students. Out of twelve predictors “vaccine agreement”, “bio-safety behavior", and “disease awareness” were significantly associated (p < 0.01, p < 0.05) with the preference for public health education in both groups. Varied effects were also observed for some predictors: vaccine “safety” and “side effects” were significant (p < 0.05, p < 0.01) in science and non-science students, respectively. To address the conflict in decisions, non-science students significantly preferred “prevention alliance” whereas science students preferred “environmental health” issues (p < 0.05).ConclusionPublic health education was more preferred by non-science university students than by science students in making COVID-19 vaccine decisions . The focus of transformative public health education should be interdisciplinary, including information on communicable diseases, public health measures, and prevention alliances, as well as information about vaccines' side effects and safety.

Decoding the Future: Genomic Sequencing's Vital Role in Communicable Disease Prevention within Public Health Practice - A Scoping Review

Precision public health using genomic sequencing is a new field that has gained interest from public health practitioners for prevention and control measures. This study aims to identify the various applications of genomic sequencing for the prevention of communicable diseases in public health practice. Articles containing relevant keywords were determined using a systematic search strategy applied in Medline, Scopus, and Springer electronic databases. Full text included in the study was retrieved and categorised. A total of 24 articles were included in the final review. The main themes regarding the application of genomic sequencing in the prevention of communicable disease that were found in the articles were describing transmission patterns, investigating outbreaks, diagnosing infection, developing and evaluating interventions including vaccines, outcomes response treatment, and monitoring antimicrobial resistance. In conclusion, genomic sequencing has the potential to enhance the prevention and control of communicable diseases globally.

The relationship between risk and prevention awareness of infectious diseases and health literacy among prisoners

ObjectiveThis study aimed to explore the intricate relationship between the health literacy and the awareness of risks and prevention awareness of infection disease among prisoners. Study designA cross-sectional descriptive study was conducted among 1350 prisoners at an L Type Closed Penal Execution Institution in Turkey, using comprehensive criteria to ensure the inclusion of a diverse participant pool. MethodData was collected via face-to-face interviews using the “personal information form,” “health literacy scale (HLS),” and “communicable diseases risk awareness and protection Scale (CDRAPS).” Both scales exhibited high reliability. Statistical analyses, including Pearson correlation and linear regression, were conducted to evaluate the relationships between the dimensions of these scales. ResultsThe study was completed with 1031 prisoners. The participants' mean age was 38.65 with a majority being single (69.2%) and high school graduates (46.3%). A weak positive correlation (r = 0.448, P = 0.000) was observed between the CDRAPS (mean score 135.98 ± 24.00) and the HLS (mean score 89.85 ± 22.30), indicating health literacy explained a 20% variance in communicable diseases risk awareness and prevention. Furthermore, a significant relationship was established considering multiple variables including age, marital and educational status, family health personnel presence, smoking and alcohol use, and comorbidities, showing a combined effect on disease risk awareness and prevention (R2 = 0.203, β = 0.458, P = 0.000). ConclusionThese findings highlight the importance for governments and policy makers to implement preventive and educational programs that are focused on public health, aiming to increase prisoners' health literacy and awareness of infectious diseases.

Clustering of Communicable Diseases in Indonesia and the Factors that Affect Them: 2018 Basic Health Research Data Statistical Review

The prevalence of communicable diseases in Indonesia is still high and causes morbidity and mortality in several Indonesian provinces. This cross-sectional study classified provinces based on the prevalence of seven communicable diseases: acute respiratory infections (ARI), pneumonia, diarrhea, filariasis, malaria, hepatitis, and tuberculosis (TB). The study analyzed the 2018 Indonesian Basic Health Research data. It is essential to categorize these diseases to identify regions with low, moderate, and high prevalence and the factors that affect them to facilitate the treatment of these diseases. Grouping provinces and influenced factors were analyzed using K-means, ANOVA, and stepwise regression. The results revealed that Group 1 shows a high prevalence, except for hepatitis and diarrhea. Group 2 demonstrates a moderate prevalence, excluding hepatitis and diarrhea, while Group 3 has a low prevalence. Improved access to primary healthcare services reduced the prevalence of pneumonia and TB, while using insecticide-treated mosquito nets for less than three years increased the prevalence of ARI and pneumonia. Adequate bedroom lighting reduced the prevalence of ARI, whereas being underweight in individuals over 18 increased it. In individuals aged 16–18 with short stature, there was an increase in the prevalence of hepatitis and malaria. Regularly draining the bathtub once a week and ensuring proper bedroom ventilation reduced the incidence of diarrhea. Using improved long-lasting insecticidal nets (LLINs) for mosquitos led to a decrease in filariasis cases. Specific factors influence each communicable disease and necessitate a multisectoral approach for effective treatment.

Passion fruit (Passiflora edulis Sims) by-products as a source of bioactive compounds for non-communicable disease prevention: extraction methods and mechanisms of action: a systematic review.

The review titled Passion fruit by-products as a source of bioactive compounds for non-communicable disease prevention: extraction methods and mechanisms provide valuable insights into the health benefits and industrial applications of passion fruit waste. Passion fruits are a tropical and subtropical vine species, which produces edible fruits. Many food product types can be made from passion fruits. However, during passion fruit processing, large amounts of waste are released in to the environment. This review focuses on extraction methods of bioactive compounds from passion fruit by-products such as leaves, peels, seeds, and bagasse. This comprehensive review focuses on the bioactive compounds present in passion fruit by-products, emphasis on their mechanisms of action on non-communicable diseases. It also provides a detailed analysis of the extraction methods used to obtain these bioactive compounds, their potential industrial applications, and the factors that affect extraction efficiency. This review encourages further research and innovation in utilization of passion fruit waste as a source of bioactive compounds for non- communicable disease prevention and their mechanisms of action. This can advance the circular economy. It also highlights the importance of sustainable and green extraction methods, which have gained attention due to environmental concerns. Unlike previous reviews, this comprehensive article explores the potential health benefits of multiple passion fruit waste products. It also examines the possible applications of these extracts for industrial goods such as food additives, colorants, nutraceuticals, natural antioxidants, and antimicrobial agents. Overall, it contributes new information emphasizing the potential of passion fruit by-products as a source of bioactive, and the findings have implications for the scientific community and industry, promoting a deeper understanding of the health benefits and sustainable practices associated with passion fruit waste utilization.

Examining primary healthcare services following earthquake shocks in Turkiye: A critical analysis of the initial 3months and the vital role of humanitarian policy transfer for rapid response.

The purpose of this article is to discuss the importance of policy transfer by humanitarian NGOs to post-disaster regions and the effectiveness of mobile Primary Health Care (PHC) services immediately after disasters. This study also focused on analysing the first 3months aftermath of the earthquake and assessed the changes in the access and needs of vulnerable groups in emergency response creation and systematic interventions after disasters. In disasters that require urgent response such as earthquakes, the importance of the existing NGOs (Such as MdM) capacity in the countries has emerged in terms of rapid response and experience sharing. During the field work, it is observed that MdM Mobile Medical Units (MMU) teams had played a key role in terms of tracking PHC needs, functioning as early warning system for epidemics, and prevention of communicable diseases in the EQ effected areas. In this aspect, the changes in diagnoses in the first trimester is examined using the comparative analysis methods. This study used a cross-sectional mixed-method approach in terms of objective evaluation. The results from a quantitative needs assessment were complemented by qualitative data. Herein, the data were collected in two stages: First, primary data was collected through the field activities of MMU, and second field-based assessments was conducted with health professionals who have been working in the MMU teams since the first moments of the earthquake.

Use of social network analysis in health research: a scoping review protocol

IntroductionSocial networks can affect health beliefs, behaviours and outcomes through various mechanisms, including social support, social influence and information diffusion. Social network analysis (SNA), an approach which emerged from the...

Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review

BackgroundAchievement of evidence-informed decision making (EIDM) requires the integration of evidence into all practice decisions by identifying and synthesizing evidence, then developing and executing plans to implement and evaluate changes to practice. This rapid systematic review synthesizes evidence for strategies for the implementation of EIDM across organizations, mapping facilitators and barriers to the COM-B (capability, opportunity, motivation, behaviour) model for behaviour change. The review was conducted to support leadership at organizations delivering public health services (health promotion, communicable disease prevention) to drive change toward evidence-informed public health.MethodsA systematic search was conducted in multiple databases and by reviewing publications of key authors. Articles that describe interventions to drive EIDM within teams, departments, or organizations were eligible for inclusion. For each included article, quality was assessed, and details of the intervention, setting, outcomes, facilitators and barriers were extracted. A convergent integrated approach was undertaken to analyze both quantitative and qualitative findings.ResultsThirty-seven articles are included. Studies were conducted in primary care, public health, social services, and occupational health settings. Strategies to implement EIDM included the establishment of Knowledge Broker-type roles, building the EIDM capacity of staff, and research or academic partnerships. Facilitators and barriers align with the COM-B model for behaviour change. Facilitators for capability include the development of staff knowledge and skill, establishing specialized roles, and knowledge sharing across the organization, though staff turnover and subsequent knowledge loss was a barrier to capability. For opportunity, facilitators include the development of processes or mechanisms to support new practices, forums for learning and skill development, and protected time, and barriers include competing priorities. Facilitators identified for motivation include supportive organizational culture, expectations for new practices to occur, recognition and positive reinforcement, and strong leadership support. Barriers include negative attitudes toward new practices, and lack of understanding and support from management.ConclusionThis review provides a comprehensive analysis of facilitators and barriers for the implementation of EIDM in organizations for public health, mapped to the COM-B model for behaviour change. The existing literature for strategies to support EIDM in public health illustrates several facilitators and barriers linked to realizing EIDM. Knowledge of these factors will help senior leadership develop and implement EIDM strategies tailored to their organization, leading to increased likelihood of implementation success.Review registrationPROSPERO CRD42022318994.

Teachers’ knowledge about communicable disease control at primary schools in Mosul City: A cross-sectional study

Introduction: In emergency situations, particularly complicated ones including the collapse of health services and disease control programs, a major cause of mortality and morbidity is limited access to health care and communicable diseases. The aim of the study is to assess the primary school teachers’ knowledge of communicable illness control in Mosul City. Materials and Methods: A descriptive cross-sectional study design was employed, utilizing a purposeful sample of 149 teachers. The study was carried out at Mosul City primary schools in the first quarter of 2024. A survey was made specifically for this purpose. It was made up of two parts. The data were analyzed using SPSS version 26. Results: Findings of the current study showed that 7 (4.7%) teachers only had excellent knowledge of communicable disease prevention and control, while the majority of teachers, 105 (70.5%), had poor knowledge of these topics. Conclusion: The majority of elementary school teachers in Mosul City lack sufficient information on managing communicable diseases. The study advised the essential to work with the Ministry of Health and Environment to implement educational programs on communicable diseases and preventive measures to raise their level of awareness regarding the prevention and control of communicable illnesses. The following core competencies are addressed in this article: Medical knowledge, Practice-based learning and improvement, Systems-based practice.

Health State and Barriers to the Provision of Health Services among Forcibly Displaced Myanmar Nationals in Bangladesh

Background: Forcibly displaced Myanmar nationals (FDMNs) are one of the most persecuted minorities groups, suffering from an abundance of health issues. They are exposed to a wide range of stressful events that are associated with adverse health consequences, which leads to decreased life expectancy due to increased morbidity and mortality. Methodology: A descriptive cross-sectional survey among conveniently selected 203 healthcare workers (HCWs) to assess the health state and barriers to the provision of health services to FDMNs in the Kutupalong and Balukhali camps at Ukhiya Upazilla, Cox's Bazar. Data were collected by face-to-face interviews by using a semi-structured questionnaire. Results: The mean age of the HCW was 29.2±3.6 years and mean service duration was 5.8±4.1 months. Most of the health facilities provided treatment for CDs (62.5%) and NCDs (80.0%). About one-third of the facilities had no laboratory facilities for diagnosing CDs (32.2%) and NCDs (40.0%). More than half of HCCs (55.0%) were maintain sterilization processes, such as boiling (90.9%), chemical components (45.5%) and an autoclave machine (13.6%). One-fourth of the HCWs (25.6%) get training during their joining times and above two-thirds of the HCWs (69.5%) received training after joining their service. The most frequently cited challenges faced during the provision of health services were transportation barriers (96.4%), language barriers (87.2%), scarcity of drugs (67.5%), vague disease histories (60.9%), unfavorable weather (59.4%) and electricity problems (44.7%). Conclusion: This study suggests that an organized primary healthcare service, specially designed for communicable and non-communicable disease prevention and management is necessary to improve health condition of FDMNs. Eastern Med Coll J. July 2023; 8 (2): 33-39

Developing wastewater-based surveillance schemes for multiple pathogens: The WastPan project in Finland

Wastewater comprises multiple pathogens and offers a potential for wastewater-based surveillance (WBS) to track the prevalence of communicable diseases. The Finnish WastPan project aimed to establish wastewater-based pandemic preparedness for multiple pathogens (viruses, bacteria, parasites, fungi), including antimicrobial resistance (AMR). This article outlines WastPan's experiences in this project, including the criteria for target selection, sampling locations, frequency, analysis methods, and results communication. Target selection relied on epidemiological and microbiological evidence and practical feasibility. Within the WastPan framework, wastewater samples were collected between 2021 and 2023 from 10 wastewater treatment plants (WWTPs) covering 40 % of Finland's population. WWTP selection was validated for reported cases of Extended Spectrum Beta-lactamase-producing bacterial pathogens (Escherichia coli and Klebsiella pneumoniae) from the National Infectious Disease Register. The workflow included 24-h composite influent samples, with one fraction for culture-based analysis (bacteria and fungi) and the rest of the sample was reserved for molecular analysis (viruses, bacteria, antibiotic resistance genes, and parasites). The reproducibility of the monitoring workflow was assessed for SARS-CoV-2 through inter-laboratory comparisons using the N2 and N1 assays. Identical protocols were applied to same-day samples, yielding similar positivity trends in the two laboratories, but the N2 assay achieved a significantly higher detection rate (Laboratory 1: 91.5 %; Laboratory 2: 87.4 %) than the N1 assay (76.6 %) monitored only in Laboratory 2 (McNemar, p < 0.001 Lab 1, = 0.006 Lab 2). This result indicates that the selection of monitoring primers and assays may impact monitoring sensitivity in WBS. Overall, the current study recommends that the selection of sampling frequencies and population coverage of the monitoring should be based on pathogen-specific epidemiological characteristics. For example, pathogens that are stable over time may need less frequent annual sampling, while those that are occurring across regions may require reduced sample coverage. Here, WastPan successfully piloted WBS for monitoring multiple pathogens, highlighting the significance of one-litre community composite wastewater samples for assessing community health. The infrastructure established for COVID-19 WBS is valuable for monitoring various pathogens. The prioritization of the monitoring targets optimizes resource utilization. In the future legislative support in target selection, coverage determination, and sustained funding for WBS is recomended.

Development of Public Health Law in Malaysia

Public health law’s main objective is to pursue the highest possible level of physical and mental health in the population, consistent with the values of social justice. Most public health laws have compounding of offences as their first line with subsequent offences being in the realm of the courts. Public health agencies are the prime mover of public health law after its initial passing, through its enforcement. Public health laws enforced are divided by function, i.e. communicable disease control and prevention, food safety and quality, tobacco products control, drinking water quality control and occupational safety and health. Public health is also ensured by regulation of medical practitioners, and health facilities and services. Local authorities enforce by-laws for health in addition to enforcement of public health laws by the inspectorate units in the district health office. Public health law is an excellent example of law and whole-of-government approach that is most effective when seen and realised by the community itself to be fair and necessary in preventing illnesses and saving lives.

The invisibility of health effects associated with water pollution within disease burden estimates: Analysis from a Colombian Andean watershed

Modernization is marked by an increase in pollution-related health risks due to the rapid economic and technological growth. In the Global South, there is concern regarding the disease burden attributable to chemical contaminants released into the environment, especially in river basins, where populations are exposed through multiple pathways. While significant research exists linking chemical exposure to disease, mostly in occupational settings, less data is available for the open environment. Emerging pollutants have shown ecotoxicological and genotoxic effects at low concentrations in both terrestrial and aquatic ecosystems, with humans at the apex. Despite such evidence, water quality standards focus primarily on communicable diseases risks, and the burden of disease method mainly includes gastrointestinal and respiratory infections. Therefore, the use of DALYs as a prioritization strategy needs to be evaluated to suggest alternatives for integrated analysis. Our aim was to enhance the comprehension of watersheds as socioecological entities that necessitate inclusive indicators to display the intricate and diverse links between water, health, and the resultant inequities. Based on previous research and information collected in a tropical Andean watershed at southwestern Colombia, we characterized drivers of pollution and health hazards. Using standardized methods for calculating DALYs, we estimated the water-related environmental burden of communicable and noncommunicable diseases. Estimates of disease burden were analyzed to find out disparities driven by ethnic, gender and socioeconomic status. Results indicate that significant inequalities persist affecting the most vulnerable populations for preventable communicable diseases. Furthermore, the impact of noncommunicable diseases, which are linked to chemical pollution from individual substances and their cocktail effect, remains largely invisible due to insufficient data and research. The econometric approach of the DALY addition effect needs to be expanded with historical and critical perspectives to expose the profound social and health inequities present in the socioecological systems of the Global South.

Delay of Acceptance of Covid-19 Vaccine Among Health Care Workers in Western Kenya

Background: Healthcare workers play a key role in the prevention and control of communicable diseases but some studies have reported concerns with their vaccine hesitancy. To address the concerns, there is a need to investigate the time to acceptance to inform programmatic interventions. This study determined the time to acceptance and further investigated the possible reasons for the time to acceptance of the COVID-19 vaccine among the 256 healthcare workers in Homa Bay town sub-county, Homa Bay county in western Kenya.&#x0D; Method: A cross-sectional web-based study was done between August 2022 to October 2022. An online survey was used to collect quantitative data, which was analyzed using SPSS version 23 and Pearson’s Chi-square test. However, the qualitative data was analyzed using thematic.&#x0D; Results: The uptake level was at 98.8% and 60.9% of HCWs accepted the vaccine within the first six months of rollout, 83.6% accepted it within the first year of vaccine rollout and 1.2% did not accept it after more than one year of rollout. The qualitative results suggest the reason for the slow time to acceptance of the vaccine is side effects and concerns with the safety and effectiveness. &#x0D; Conclusion: The study shows that the time to acceptance of the vaccine by the HCW remains a public health concern. Consequently, there is a need to explore strategies to improve the time to acceptance of the vaccines given the increasing pandemics. We recommend further studies on time to acceptance with a cost-effective programmatic intervention.