Epidemic Preparedness Research Articles

Big data for epidemic preparedness in southeast Asia: An integrative study

This integrative study explores the pivotal role of big data in enhancing epidemic preparedness and response strategies in Southeast Asia. The region, characterized by its diverse socio-economic landscape and frequent exposure to infectious disease threats, necessitates innovative approaches to mitigate the impact of epidemics. Big data, with its vast and varied sources, offers unprecedented opportunities to revolutionize epidemic surveillance, prediction, and management. Drawing on a comprehensive review of literature and case studies, this paper delves into the multifaceted applications of big data in epidemic preparedness. It examines the utilization of diverse data sources, including social media, mobile phones, and IoT devices, for real-time monitoring of disease outbreaks and trends. Moreover, it elucidates the role of advanced analytics techniques, such as machine learning and data visualization, in informing timely and targeted response strategies. Furthermore, this study underscores the importance of collaborative efforts and partnerships in leveraging big data for epidemic preparedness. It explores successful initiatives that have demonstrated the effectiveness of data sharing and interdisciplinary collaboration in enhancing epidemic response capabilities across borders. However, the integration of big data into epidemic preparedness initiatives presents various challenges, including data quality issues, privacy concerns, and the need for robust infrastructure and expertise. Addressing these challenges requires concerted efforts from governments, healthcare organizations, and the private sector. In conclusion, this study advocates for continued research, investment, and policy support to harness the full potential of big data in epidemic preparedness. By embracing innovative technologies and fostering collaboration, Southeast Asia can build resilient health systems capable of effectively combating emerging infectious disease threats.

Safety and immunogenicity of the live-attenuated hRVFV-4s vaccine against Rift Valley fever in healthy adults: a dose-escalation, placebo-controlled, first-in-human, phase 1 randomised clinical trial

Rift Valley fever virus, a pathogen to ruminants, camelids, and humans, is an emerging mosquito-borne bunyavirus currently endemic to Africa and the Arabian Peninsula. Although animals are primarily infected via mosquito bites, humans mainly become infected following contact with infected tissues or fluids of infected animals. There is an urgent need for adequate countermeasures, especially for humans, because effective therapeutics or vaccines are not yet available. Here we assessed the safety, tolerability, and immunogenicity of a next-generation, four-segmented, live-attenuated vaccine candidate, referred to as hRVFV-4s, in humans. A first-in-human, single-centre, randomised, double-blind, placebo-controlled trial was done in Belgium in which a single dose of hRVFV-4s was administered to healthy volunteers aged 18-45 years. Participants were randomly assigned using an interactive web response system. The study population encompassed 75 participants naive to Rift Valley fever virus infection, divided over three dosage groups (cohorts) of 25 participants each. All participants were followed up until 6 months. Using a staggered dose escalating approach, 20 individuals of each cohort were injected in the deltoid muscle of the non-dominant arm with either 104 (low dose), 105 (medium dose), or 106 (high dose) of 50% tissue culture infectious dose of hRVFV-4s as based on animal data, and five individuals per cohort received formulation buffer as a placebo. Primary outcome measures in the intention-to-treat population were adverse events and tolerability. Secondary outcome measures were vaccine-induced viraemia, vaccine virus shedding, Rift Valley fever virus nucleocapsid antibody responses (with ELISA), and neutralising antibody titres. Furthermore, exploratory objectives included the assessment of cellular immune responses by ELISpot. The trial was registered with the EU Clinical Trials Register, 2022-501460-17-00. Between August and December, 2022, all 75 participants were vaccinated. No serious adverse events or vaccine-related severe adverse events were reported. Pain at the injection site (51 [85%] of 60 participants) was most frequently reported as solicited local adverse event, and headache (28 [47%] of 60) and fatigue (28 [47%] of 60) as solicited systemic adverse events in the active group. No vaccine virus RNA was detected in any of the blood, saliva, urine, or semen samples. Rift Valley fever virus nucleocapsid antibody responses were detected in most participants who were vaccinated with hRVFV-4s (43 [72%] of 60 on day 14) irrespective of the administered dose. In contrast, a clear dose-response relationship was observed for neutralising antibodies on day 28 with four (20%) of 20 participants responding in the low-dose group, 13 (65%) of 20 responding in the medium-dose group, and all participants (20 [100%] of 20) responding in the high-dose group. Consistent with the antibody responses, cellular immune responses against the nucleocapsid protein were detected in all dose groups, whereas a more dose-dependent response was observed for the Gn and Gc surface glycoproteins. Neutralising antibody titres declined over time, whereas nucleocapsid antibody responses remained relatively stable for at least 6 months. The hRVFV-4s vaccine showed a high safety profile and excellent tolerability across all tested dose regimens, eliciting robust immune responses, particularly with the high-dose administration. The findings strongly support further clinical development of this candidate vaccine for human use. The Coalition for Epidemic Preparedness Innovations with support from the EU Horizon 2020 programme.

Increased Trend of Adenovirus Activity After the COVID-19 Pandemic in South Korea: Analysis of National Surveillance Data.

The adenovirus detection rate is <10% throughout the year in South Korea; however, during the summer of 2023, it showed an unusual increase. We analyzed the adenovirus detection rate using data from the Korea Respiratory Integrated Surveillance System before and after coronavirus disease (COVID-19) collected from 2019 to week 36 of 2023. Before the COVID-19 outbreak in 2019, the mean detection rate was 8.2%, which decreased to 6.1% during the COVID-19 pandemic from 2020 to 2022. In 2023, the mean detection rate was 14.3% in week 36 and the highest in week 34, at 42.2%, and adenovirus was predominantly detected in the summer. The detection rate by age group showed substantially high activity among 0-12-yr-olds after the pandemic. This age group had a steady mean rate of 9.5% during the pandemic, without seasonality. In 2023, the detection rate surged in the 0-6-yr and 7-12-yr age groups, peaking at 61.6% and 57.1%, respectively. The dominant epidemic serotypes were HAdV-1 and HAdV-2 during and HAdV-3 after the pandemic. The multifaceted non-pharmaceutical interventions during the COVID-19 pandemic considerably impacted the prevalence of common respiratory viruses and complicated respiratory virus patterns after the pandemic. Constant surveillance is crucial for epidemic preparedness to monitor the possible surge of certain respiratory viruses.

Essential Factors on Effective Response at the Onset of the COVID-19 Pandemic; Comment on "Experiences and Implications of the First Wave of the COVID-19 Emergency in Italy: A Social Science Perspective"

The COVID-19 pandemic in Italy is a stark reminder of the necessity of incorporating the social, economic, and political context in planning responses to public health emergencies. During the ongoing global COVID-19 crisis, it's not just crucial but a shared responsibility to supplement epidemiological approaches with insights from the social sciences. This ensures effective and equitable policies, and it's a responsibility that each of us in the field shares. This discussion is relevant and timely, relating directly to the current global crisis and its potential implications for future public health strategies. This comment underscores the key points of Masino and Enria's paper (2023), illuminating the importance of integrating social sciences into public health strategies, the pivotal role of inequalities in shaping pandemic experiences, and, most importantly, the profound and urgent implications for future epidemic preparedness and response. The urgency of these implications cannot be overstated, and we must act on them swiftly and decisively.

Awareness, perceptions and challenges among public transport operators during the implementation of COVID-19 preventive measures in eastern Uganda: a qualitative study

BackgroundPublic transportation plays a major role in the transmission of SARS-CoV2, the virus that causes COVID-19, due to the confined spaces in vehicles. It is therefore very crucial to apply COVID-19 prevention measures in public transportation to reduce risk of COVID-19 transmission. The implementation of these measures depends largely on the public transportation users. We explored the awareness, perceptions and challenges among public transport operators during the implementation of COVID-19 preventive measures in Eastern Uganda.MethodsThis qualitative study was done in Eastern Uganda in January and February 2021. We conducted four focus group discussions, six in-depth interviews and three key informant interviews to document the awareness, perceptions and challenges faced by public transport operators including 10 boda boda riders, 19 taxi operators and 11 truck (cargo) transporters. All interviews were audio-recorded, transcribed verbatim, and analyzed with the help of NVIVO software version 12 plus using a thematic framework approach.ResultsWe relied on the health belief model to report on four broad themes including: Perceived threat, perceived benefits, perceived barriers and cues to action.Perceived threatParticipants were aware of the gravity / seriousness of COVID-19. They were aware that it is an unusual flu whose symptoms are severe and clearly distinguishable from the common flu. They also knew that COVID-19 is easily and quickly transmitted. However they were not aware of the cause of COVID-19. Perceived benefits: the participants perceived a number covid 19 preventive measures as beneficial in preventing COVID-19. These included: COVID 19 vaccination, observing hand hygiene, avoiding touching the ‘soft parts’ (eyes, nose and mouth), quarantining in a hospital setting, wearing a face mask, social distancing,. Perceived barriers: participants reported barriers to implementing COVID 19 preventive measures included Misconceptions about COVID 19, scepticism about COVID-19 vaccination, not breathing well or respiratory problems hinders use of face masks, fear of covid 19 transmission during home isolation, design of the vehicles do not favour social distancing, passengers unwilling to pay the fare, natural reflexes come in the way of not touching soft parts, financial constraints, hostility from passengers due to increased transport fares, law enforcement officials prioritizing the driving permit over implementation of the measures, hostility from law enforcement officials, religious beliefs against the use of alcohol, competing for passengers among public transporters.Cues to action includedMass sensitization by the Ugandan government through the ministry of health with the help of media platforms like television.Conclusions and recommendationOur study brings to light the likely barriers that impede the use of preventive measures in public transportation use during an epidemic / pandemic like COVID-19 which could potentially escalate transmission. During cues to action like sensitization through media, focus should be put to the demystification of myths on COVID-19, highlighting on benefits of using preventive measures and risk of disease. Public transport passengers should be sensitized on risk of COVID-19 transmission during public transportation use and on the importance of complying with COVID-19 preventive measures. We recommend further exploration on the challenges faced by the public transportation passengers in implementing preventive measures in the event of an epidemic like COVID-19. Future research is required to establish a more robust transport model in crisis situations such as a pandemic. In addition, there is need for integration between the public health and public transportation sectors to foster epidemic preparedness for future crises in the context of public transportation.

Enhancing the capacity of community health workers in prevention and control of epidemics and pandemics in Wakiso district, Uganda: evaluation of a pilot project

BackgroundCommunity Health Workers (CHWs) play a crucial role in outbreak response, including health education, contact tracing, and referral of cases if adequately trained. A pilot project recently trained 766 CHWs in Wakiso district Uganda on epidemic and pandemic preparedness and response including COVID-19. This evaluation was carried out to generate evidence on the outcomes of the project that can inform preparations for future outbreaks in the country.MethodsThis was a qualitative evaluation carried out one year after the project. It used three data collection methods: 30 in-depth interviews among trained CHWs; 15 focus group discussions among community members served by CHWs; and 11 key informant interviews among community health stakeholders. The data was analysed using a thematic approach in NVivo (version 12).ResultsFindings from the study are presented under four themes. (1) Improved knowledge and skills on managing epidemics and pandemics. CHWs distinguished between the two terminologies and correctly identified the signs and symptoms of associated diseases. CHWs reported improved communication, treatment of illnesses, and report writing skills which were of great importance including for managing COVID-19 patients. (2) Enhanced attitudes towards managing epidemics and pandemics as CHWs showed dedication to their work and more confidence when performing tasks specifically health education on prevention measures for COVID-19. (3) Improved health practices such as hand washing, vaccination uptake, and wearing of masks in the community and amongst CHWs. (4) Enhanced performance in managing epidemics and pandemics which resulted in increased work efficiency of CHWs. CHWs were able to carry out community mobilization through door-to-door household visits and talks on community radios as part of the COVID-19 response. CHWs were also able to prioritize health services for the elderly, and support the management of patients with chronic diseases such as HIV, TB and diabetes by delivering their drugs.ConclusionsThese findings demonstrate that CHWs can support epidemic and pandemic response when their capacity is enhanced. There is need to invest in routine training of CHWs to contribute to outbreak preparedness and response.

How feasible or useful are timeliness metrics as a tool to optimise One Health outbreak responses?

IntroductionAs timeliness metrics gain traction to assess and optimise outbreak detection and response performance, implementation and scale-up require insight into the perspectives of stakeholders adopting these tools. This study sought...

A comparative analysis of COVID-19 physical distancing policies in South Africa and Uganda.

COVID-19 responses internationally have depended on physical distancing policies to manage virus transmission, given the initial absence of treatments and limitations on vaccine availability. Different jurisdictions have different contexts affecting their responses such as past epidemic experience, ratings of epidemic preparedness, and income level. COVID-19 responses in African countries have not been well-studied. A qualitative multiple embedded case study design was used to examine the COVID-19 policies in South Africa and Uganda from January 2020 to November 2021. This study included a documentary review using government websites and reports, news articles, and peer-reviewed journal articles to obtain data on policy responses and contextual factors. Epidemiological data were collected from public sources. Key informant interviews with relevant stakeholders were used to confirm findings and cover missing information. A comparative analysis was conducted to explore differences in implementation of different types of physical distancing policies and potential consequences of lifting or prolonging public health measures. South African and Ugandan policy responses included physical distancing measures such as lockdown, international travel bans, school closures, public transportation measures, and curfew, in addition to socioeconomic relief programs and vaccinations. Differences between jurisdiction policy responses existed in terms of overarching strategy, timing, and stringency. This study provided in-depth comparisons of COVID-19 policy responses and relevant contextual factors in South Africa and Uganda. The study showed how contextual factors such as population age, geographic distribution, and recent epidemic response experience can influence COVID-19 transmission and response. The study also showed differences in overall strategy, timing, and strictness of epidemic management policies in these jurisdictions. These findings suggest it may be important to have sustained, strict measures to limit the spread of COVID-19 and manage the course of a pandemic, which need to be further explored alongside other important social and economic pandemic outcomes.

Workplace Safety and Screening of Healthcare Workers for SARS-CoV-2 at a Tertiary Care Hospital in the Northern Emirates of United Arab Emirates

Background: Coronavirus disease 2019 (COVID-19) was first reported in December 2019 in Wuhan, People’s Republic of China, and caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), As the virus took hold in the world, health experts paced efforts to solve the unknown nature of this threat. Methodology: We studied the clinical characteristics, laboratory biomarkers of healthcare workers in the single center, analytical cross-sectional study conducted in tertiary care hospital of the UAE. Sample size of 600 HCWs were screened for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction (rRT-PCR) assay using Seegene Allplex and Andis FAST SARS-CoV-2 RT-qPCR detection kits for a period of 6 months. Findings: All the health care workers (HCWs) were vaccinated for the SARS-CoV-2. Out of these, 240 HCWs were reported to be positive. rRT-PCR with a Ct value of &lt;38 was taken as positive &gt;38. The laboratory investigations of the positive cases were collected and analysed further. A comparison of the laboratory tests was made between (I) COVID severe (Ct &lt; 25) and nonsevere (Ct &gt; 25) groups and (II) frontline workers and non-frontline workers. Besides finding short-term and sudden relief, investigators directed their efforts to provide a long-term solution for an ensuing pandemic that influenced all areas of life in unprecedented ways. Conclusion: Awareness among healthcare workers and further long-term studies focusing on their mental health the overall wellness and especially the psychological burden on doctors have received heightened awareness in media and research publications. This information can assist in developing surveillance and infection and control policies and preparedness for future COVID epidemics in similar scenarios in the future.

Determinants of willingness and level of COVID-19 vaccination uptake among intra-city transporters in Benin Metropolis, Nigeria

The COVID-19 pandemic was a litmus test for the epidemic preparedness and response mechanism of health systems. Road Transporters constitute a large at-risk group for spread and morbidity related to the disease. This study assessed determinants of willingness and level of COVID-19 vaccination uptake among intra-city road transporters in the Benin City Metropolis of Edo State Nigeria. An analytic cross-sectional design was utilized for this study using 389 structured questionnaires distributed among intra-city drivers selected via a multi-stage sampling technique across bus parks in Benin City metropolis. The mean age of respondents studied was 38.7 ± 9.3 years. Less than one-tenth 30 (7.7%) of respondents had taken the COVID-19 vaccine. Willingness to take COVID-19 vaccine was a significant determinant of uptake of COVID-19 vaccine (OR = 8.082; 95% Cl = 2.208 – 29.584; p = 0.002). There is need to initiate appropriate health promotional interventions to address vaccine hesitancy for improve vaccination uptake.

SARS-CoV-2 viral titer measurements in Ontario, Canada wastewaters throughout the COVID-19 pandemic

During the COVID-19 pandemic, the Province of Ontario, Canada, launched a wastewater surveillance program to monitor SARS-CoV-2, inspired by the early work and successful forecasts of COVID-19 waves in the city of Ottawa, Ontario. This manuscript presents a dataset from January 1, 2021, to March 31, 2023, with RT-qPCR results for SARS-CoV-2 genes and PMMoV from 107 sites across all 34 public health units in Ontario, covering 72% of the province’s and 26.2% of Canada’s population. Sampling occurred 2–7 times weekly, including geographical coordinates, serviced populations, physico-chemical water characteristics, and flowrates. In doing so, this manuscript ensures data availability and metadata preservation to support future research and epidemic preparedness through detailed analyses and modeling. The dataset has been crucial for public health in tracking disease locally, especially with the rise of the Omicron variant and the decline in clinical testing, highlighting wastewater-based surveillance’s role in estimating disease incidence in Ontario.

Infection prevention and control in Dutch general practices before and during the COVID-19 pandemic and its implications for pandemic preparedness and seasonal respiratory epidemics: a qualitative study on lessons learned

BackgroundThe COVID-19 pandemic has prompted a re-evaluation of infection prevention and control (IPC) in general practices, highlighting the need for comprehensive IPC implementation. This study aimed to evaluate healthcare workers’ (HCWs) experiences and perspectives regarding IPC in general practices before and during the COVID-19 pandemic, and its implications for post-pandemic IPC implementation.MethodsThis qualitative study involved semi-structured, in-depth interviews during two time periods: (1) prior to the COVID-19 pandemic (July 2019-February 2020), involving 14 general practitioners (GPs) and medical assistants; and (2) during the COVID-19 pandemic (July 2022-February 2023), including 22 GPs and medical assistants. Data analysis included thematic analysis that addressed multiple system levels.ResultsFindings indicated a shift towards comprehensive IPC implementation and organisation during the pandemic compared to the pre-pandemic period. Since the Omicron variant, some general practices maintained a broad set of IPC measures, while others released most measures. HCWs’ future expectations on post-pandemic IPC implementation varied: some anticipated reduced implementation due to the desire to return to the pre-pandemic standard, while others expected IPC to be structurally scaled up during seasonal respiratory epidemics. Main contextual challenges included patient cooperation, staff shortages (due to infection), shortages of IPC materials/equipment, and frequently changing and ambiguous guidelines. Key lessons learned were enhanced preparedness (e.g., personal protective equipment supply), and a new perspective on care organisation (e.g., digital care). Main recommendations reported by HCWs were to strengthen regional collaboration within primary care, and between primary care, public health, and secondary care.ConclusionHCWs’ experiences, perspectives and recommendations provide insights to enhance preparedness for future epidemics and pandemics, and sustain IPC in general practices. For IPC improvement strategies, adopting an integrated system-based approach that encompasses actions across multiple levels and engages multiple stakeholders is recommended.

"As I dropped the phone, she slapped me for the first time": Experiences of intimate partner violence among Nigerian men during COVID-19 restrictions.

Limited literature exists on men's experiences with intimate partner violence (IPV) during the COVID-19 lockdown, especially in resource-constrained settings like Nigeria. We investigated the prevalence, risk factors, and lifetime experiences of IPV among men in Nigeria, during COVID-19 restrictions. Using a mixed methods design, we interviewed 420 married men with a structured questionnaire and conducted 20 in-depth interviews. Logistic regression and a framework approach were used for data analysis. Approximately 86.4% of respondents (n=363) experienced IPV at some point in their lifetime. The prevalence of IPV during the COVID-19 restrictions was 76.2% (n=320). Over a lifetime, verbal (67.4%), physical (78.1%), and sexual coercion (81.0%) were the most common forms of IPV. During the COVID-19 lockdown, the corresponding proportions were 48.6%, 69.5%, and 57.4%, respectively. Male- and female-perpetrated IPV over a lifetime (88.3% vs 87.6%) and during COVID-19 restrictions (88.3% vs 81.4%) were similar (p>0.05). Older age, non-Muslim religion, longer marital duration, partner's profession, and no formal education were associated with higher IPV risk. Home confinement, financial stress, childbirth, disrespect towards spouse's parents, emotional detachment, disputes about child discipline, and suspected infidelity contributed to IPV. Men's active involvement in family life, improved communication, and increased transparency emerged as protective factors. Our findings highlight the high rates of IPV during the pandemic, with men as both perpetrators and victims. Future epidemic preparedness plans should prioritize IPV prevention strategies that enhance partner communication, promote male involvement in family life, address the gender education gap, and provide support services.

Strategies to foster community engagement for epidemic and pandemic preparedness and response in sub-Saharan Africa: a scoping review protocol

IntroductionThe surge of public health emergencies over the past decade has disproportionately affected sub-Saharan Africa. These include outbreaks of infectious diseases such as Ebola, Monkeypox and COVID-19. Experience has shown...

Development and validation of a PCR-based method to differentiate human sex in blood-fed Aedes aegypti (Diptera: Culicidae).

Monitoring mosquito host choice to identify high-risk groups for different vector-borne diseases is important to devise vector control strategies and disease management. The present study was conducted to develop and validate a PCR-based method to identify human sex in blood-fed Aedes aegypti mosquitoes. Several human genes present in both the X and Y chromosomes were screened and diagnostic PCR primers were successfully designed and amplified for the human STS gene. The limit of detection of this PCR assay was carried out on Ae. aegypti fed with human blood up to 5 days (120 hours) post blood-meal under laboratory condition. The efficiency of this PCR assay was evaluated in field-collected Ae. aegypti mosquitoes and compared with other existing methods. The developed PCR primers can successfully amplify and distinguish human sex in mosquitoes up to 72 hours after a blood meal, with an amplified product of 627bp and 298bp for male (XY) and 627bp for female (XX) blood-fed mosquitoes. Further, validation of this assay in field-collected Ae. aegypti mosquitoes revealed that this assay could detect human sex in mosquito blood meal substantially more efficiently (c2 = 4.5, p = 0.034) than other PCR based assay. The newly developed PCR assay highly specific to human DNA and can distinguish male and female DNA for up to 72 hours. This assay can be is used for identifying highrisk groups and extended to other medically important hematophagous insects to assess their role in disease transmission and epidemic preparedness.

Changes in seasonal respiratory viral infections among pediatric population around the COVID-19 pandemic; 2019-2023.

This study aims to describe the prevalence and the fluctuations of respiratory viral infections among the pediatric population in a tertiary care center during 2019-2023, parallel with the COVID-19 pandemic, and the specific preventative measures applied in the region during this time. In this observational study, we extracted all respiratory virus PCR tests collected from pediatric patients (< 15 years old) between January 2019 and March 2023. Data on the positivity rate and prevalence of 18 respiratory viruses were presented over the study period. The lowest rate for the studied respiratory viruses was observed in 2020/2021 (during the COVID-19 pandemic), followed by a gradual increase in positive cases in the 2021/2022 season. Timing (seasonality) was altered during 2022/2023 with an early circulation of respiratory viruses in May-June followed by an early start of the usual respiratory viruses' season in September, leading to prolonged respiratory virus activity. Most respiratory viruses were circulating at unprecedented levels during the 2022/2023 season, with rhinovirus/enterovirus being the most commonly detected virus in all seasons. Other viruses that had atypical activity after the COVID-19 pandemic were influenza A(H3) virus, adenovirus, and parainfluenza 3 virus. Our study demonstrates the extended influence of the COVID-19 pandemic and its associated community restriction measures on the timing and distribution of other respiratory viruses. Continuous monitoring of changes in the circulation of respiratory viruses is crucial for the success of related public health measures such as vaccination distributions and epidemic preparedness.

Public-private partnerships in health sector innovation: Lessons from around the world

Public-Private Partnerships (PPPs) have emerged as a crucial mechanism for fostering innovation in the health sector globally. This review encapsulates the lessons learned from diverse PPP models worldwide, highlighting their significance and impact. PPPs in healthcare innovation entail collaboration between governmental bodies, private enterprises, and sometimes non-profit organizations to address challenges, such as limited resources, expertise, and infrastructure, while leveraging the strengths of each sector. The success of PPPs relies on effective governance structures, clear objectives, and mutual accountability. One notable example is the United Kingdom's NHS Innovation Accelerator, which partners with industry leaders to fast-track the adoption of innovative healthcare technologies within the National Health Service (NHS). Through this initiative, pioneering solutions, ranging from digital health platforms to medical devices, have been implemented, enhancing patient care and operational efficiency. Similarly, in low-resource settings like sub-Saharan Africa, PPPs have played a pivotal role in improving access to essential healthcare services. Projects such as the Medicines for Malaria Venture (MMV) collaborate with pharmaceutical companies, governments, and research institutions to develop affordable antimalarial drugs tailored to the region's needs. In the realm of medical research and development, partnerships like the Coalition for Epidemic Preparedness Innovations (CEPI) have demonstrated the power of international collaboration in addressing global health threats. CEPI brings together governments, philanthropic organizations, and the private sector to expedite the development of vaccines against emerging infectious diseases, as witnessed during the COVID-19 pandemic. However, challenges persist in PPP implementation, including complex regulatory frameworks, funding uncertainties, and divergent interests among stakeholders. Lessons from successful PPPs underscore the importance of transparent communication, stakeholder engagement, and sustained political commitment. In conclusion, PPPs in the health sector represent a dynamic avenue for catalyzing innovation and driving transformative change. By drawing insights from diverse experiences worldwide, policymakers and practitioners can refine existing frameworks and foster sustainable partnerships to tackle evolving health challenges effectively.

Epidemic preparedness and innovations in digital healthcare: enhancing post-pandemic speech-language pathology services for child and adolescent mental health in Qatar

BackgroundThis paper discusses the critical importance of epidemic preparedness and innovations in digital health care by examining the transformative impact on speech-language pathology (SLP) services in a specialist outpatient child and adolescent service (CAMHS).MethodThis retrospective review analyzes referral data from three periods: pre-pandemic (15 March 2019–14 March 2020), pandemic (15 March 2020–14 March 2021), and post-pandemic (15 March 2021–14 March 2022). Statistical analyses assess trends in referrals and diagnoses during these periods. Feedback was also obtained from Parents of children who received virtual consultations during the pandemic.ResultsThe results reveal an increase in the demand for SLP services during and after the pandemic, with a surge in referrals (increased from 9.7 to 12.9% when compared pre-pandemic to post-pandemic periods; Chi-Square value 3.33, P = 0.068) for children with social communication challenges and autism spectrum disorder. Phone and video consultations were effectively adopted. Feedback from families shows a positive response (69%–98% of participants responded as strongly agreed and agreed on various items listed in feedback form specifically designed in line with the service objectives) to telehealth interventions, with many parents finding virtual consultations effective and helpful.ConclusionsThe study emphasizes the importance of telehealth SLP services in meeting the increasing demand for mental health interventions among children and adolescents. It suggests integrating telehealth into clinical practice beyond the pandemic and highlights the need for long-term evaluation and addressing potential barriers to access.

Exploring the Chikungunya virus landscape in a dengue-endemic Brazilian area

We aimed to describe the landscape, including molecular, epidemiological, and clinical aspects of CHIKV infections in the Ribeirao Preto region, an area endemic to dengue. We randomly screened 3744 plasma samples that had undergone DENV diagnosis to evaluate CHIKV-RNA using an in-house RT-PCR assay. Positive samples were followed clinically, and RNA samples were submitted to whole genome sequencing. Seventeen cases (0.5 %) were positive for CHIKV-RNA despite being negative for DENV-RNA. Notably, half of the patients experienced prolonged arthralgia lasting more than 90 days. Compared with the healthy control group, leukopenia and thrombocytopenia were observed in all CHIKV-positive individuals with statistically significant P values (P < 0.0001 and P = 0.0003, respectively). The genomic analysis revealed that the CHIKV strains being studied are classified within the East-Central-South-African (ECSA) genotype. This analysis identified new mutations, E1: K211E and E2: V264A, while the previously known mutation E1: A226V was not detected among these strains. This study highlights the need for epidemiological surveillance and preparedness for potential CHIKV epidemics in Brazil, particularly where other arboviruses co-circulate.

Health systems challenges, mitigation strategies and adaptations to maintain essential health services during the COVID-19 pandemic: learnings from the six geopolitical regions in Nigeria

BackgroundThe COVID-19 pandemic control strategies disrupted the smooth delivery of essential health services (EHS) globally. Limited evidence exists on the health systems lens approach to analyzing the challenges encountered in maintaining EHS during the COVID-19 pandemic. This study aimed to identify the health system challenges encountered and document the mitigation strategies and adaptations made across geopolitical zones (GPZs) in Nigeria.MethodsThe national qualitative survey of key actors across the six GPZs in Nigeria involved ten states and the Federal Capital Territory (FCT) which were selected based on resilience, COVID-19 burden and security considerations. A pre-tested key informant guide was used to collect data on service utilization, changes in service utilization, reasons for changes in primary health centres’ (PHCs) service volumes, challenges experienced by health facilities in maintaining EHS, mitigation strategies implemented and adaptations to service delivery. Emerging sub-themes were categorized under the appropriate pillars of the health system.ResultsA total of 22 respondents were interviewed. The challenges experienced in maintaining EHS cut across the pillars of the health systems including: Human resources shortage, shortages in the supply of personal protective equipments, fear of contracting COVID-19 among health workers misconception, ignorance, socio-cultural issues, lockdown/transportation and lack of equipment/waiting area (. The mitigation strategies included improved political will to fund health service projects, leading to improved accessibility, affordability, and supply of consumables. The health workforce was motivated by employing, redeploying, training, and incentivizing. Service delivery was reorganized by rescheduling appointments and prioritizing some EHS such as maternal and childcare. Sustainable systems adaptations included IPC and telehealth infrastructure, training and capacity building, virtual meetings and community groups set up for sensitization and engagement.ConclusionThe mitigation strategies and adaptations implemented were important contributors to EHS recovery especially in the high resilience LGAs and have implications for future epidemic preparedness plans.