Good Surveillance System Research Articles

Dengue Hemorrhagic Fever Surveillance System Training And Case Mapping For Dengue Hemorrhagic Fever Program Managers At Community Health Center Level In Bogor City In 2022

Background: Bogor City has an incidence rate of 21.4 per 100,000 population, but the CFR is quite high at 2.49%. Therefore, it is necessary to increase knowledge about surveillance among DHF program holders in Bogor City in 2022. Method: The study design in this DBD operational research is a non-experimental pre-test and post-test design study. Primary data starts from the results of the pretest-posttest for the DHF program manager using a questionnaire, while mapping skills are taken from the observation sheet that has been made. Meanwhile, secondary data is obtained from the profile analysis results of the Bogor City Health Service. Data analysis was carried out using univariate, bivariate and normality tests. Results: there was a difference in the knowledge of DBD Community Health Center program holders after training in terms of knowledge of DHF surveillance (Pvalue < 0.05). There is a difference in increasing skills in mapping dengue cases among community health center dengue fever program holders after training in mapping using applications (Pvalue < 0.05), and there is an increase in interpreting data and determining regional stratification of dengue cases (Pvalue < 0.05 ) Conclusion: increasing the knowledge and skills of dengue program holders is carried out using appropriate interventions, so that dengue program holders can implement a good surveillance system in preventing and controlling dengue fever

The Role of Metformin as Chemopreventive Strategies for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies globally, while its mortality rate is the second-highest in the world. HCC has mostly been involved by some underlying issues, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol, and non-alcohol fatty liver disease (NAFLD). Metabolic syndrome and diabetes mellitus currently are independent risk factors to develop HCC in these patients by chronic inflammation and insulin resistance. The next issues following HCC were lack of a good surveillance system, which will result in delayed diagnosis establishment, limited therapeutical option, poor prognosis, and poor survival rates. These problems allow chemoprevention can be a worth to try option in the management of chronic hepatitis patients. Metformin has been known as one of the most often used anti-diabetic agents worldwide and provided many benefits. Based on several recent studies, metformin induces the prevention effect toward the development of HCC with several mechanisms either by the AMPK-dependent or AMPK-independent pathway. In this review article, we will discuss metformin as a promising chemoprevention agent against HCC from mechanisms, current limitations, and future prospects.

‘Metastatic seed’ of cholera in Edo State, Nigeria: a case report

There were reported cholera epidemics in some States in Nigeria. Cholera is an acute diarrhea disease with marked epidemic propensity, caused by colonization of the small intestine by Vibrio cholerae serogroup 01 or 0139. Cholera, like other infectious diseases epidemics, has propensity for sending metastatic seed to any susceptible remote community. If the metastatic seed can be promptly diagnosed and managed appropriately, the spread and development of new epicenter can be aborted. This report is a case of metastatic cholera who presented in a tertiary hospital in Edo State, Nigeria. The case was promptly detected and effectively managed using good surveillance system, inter-departmental collaboration, swift responses, good laboratory practices, patient isolation and infection prevention and control measures, coupled with appropriate fluid and antimicrobial treatments. This prevented cholera epidemic in the hospital and Edo State in general.

Adverse drug reactions to herbal medicines

Summary Herbal medicines may cause adverse drug reactions (ADRs) due to effects of known constituent(s), substitution with other herbal ingredients, or contamination or adulteration with additional substances. Healthcare professionals (HCPs) should always take a full medicines history, including use of herbal medicines and other complementary products (e.g., food supplements and other dietary supplements). A range of resources are available to inform HCPs and the public/patients/ carers about possible ADRs associated with herbal medicines. HCPs and the public/patients also need to be made aware of the importance of reporting suspected ADRs to the appropriate regulatory agency. Good safety surveillance systems can thus help to ensure that those who choose to take herbal medicines are able to do so with acceptable safety.

A View on 20 Years of Antimicrobial Resistance in Japan by Two National Surveillance Systems: The National Epidemiological Surveillance of Infectious Diseases and Japan Nosocomial Infections Surveillance.

The Ministry of Health, Labour and Welfare (MHLW) of Japan has conducted two national surveillance systems for approximately 20 years to monitor antimicrobial resistance (AMR) in bacteria: the National Epidemiological Surveillance of Infectious Diseases (NESID) and the Japan Nosocomial Infections Surveillance (JANIS). Data accumulated for 20 years by these two surveillance systems have helped depict the epidemiology of the representative AMR bacteria in Japan chronologically. The epidemiology of methicillin-resistant Staphylococcus aureus teaches us that once AMR bacteria have established their high endemicity, controlling such AMR bacteria requires time and is challenging. On the other hand, the epidemiology that multidrug-resistant Acinetobacter sp. exhibits when a strict containment policy for AMR bacteria was introduced in the early phase of its emergence and spread reveals that it is possible to control it. Detailed epidemiology provided by these two different national surveillance systems in Japan enabled us to set up the goal for controlling each AMR bacteria at the hospital level to the prefecture/national level. It is the public health authorities’ responsibility to maintain a good surveillance system for AMR bacteria and share the data and findings with healthcare professionals and academicians.

Invasive Bacterial Vaccine-Preventable Disease Surveillance: Successes and Lessons Learned in Bangladesh for a Sustainable Path Forward.

We have made considerable progress in setting and scaling up surveillance systems to drive evidence-based policy decisions, but the recent epidemics highlight that current systems are not optimally designed. Good surveillance systems should be coordinated, comprehensive, and adaptive. They should generate data in real time for immediate analysis and intervention, whether for endemic diseases or potential epidemics. Such systems are especially needed in low-resource settings where disease burden is the highest, but tracking systems are the weakest here due to competing priorities and constraints on available resources. In this article, using the examples of 3 large, and mostly successful, infectious disease surveillance studies in Bangladesh, we identify 2 core limitations—the pathogen bias and the vaccine bias—in the way current surveillance programs are designed for low-resource settings. We highlight the strengths of the current Global Invasive Bacterial Vaccine Preventable Disease Surveillance Network of the World Health Organization and present case studies from Bangladesh to illustrate how this surveillance platform can be leveraged to overcome its limitations. Finally, we propose a set of criteria for building a comprehensive infectious disease surveillance system with the hope of encouraging current systems to use the limited resources as optimally as possible to generate the maximum amount of knowledge.

Evaluation of the combination of rapid diagnostic tests and microscopy for imported malaria surveillance in Anhui Province, China

Background: In the Anhui Province, China, efforts to interrupt the local malaria transmission were successful, with no endemic cases reported since 2014. Contrastingly, imported malaria cases are still being reported, indicating a disease reintroduction risk after years of elimination. A good surveillance system is key for avoiding the risk, detecting imported cases and possible cases associated with local transmission early. Therefore, rapid diagnostic tests (RDTs) were combined with microscopy to strengthen malaria surveillance in the province. Herein, we aimed to evaluate the efficacy of this surveillance strategy.Methods: We conducted a retrospective study using malaria surveillance data from January 2016 to June 2020. Epidemiological characteristics and diagnostic information were analysed using descriptive and comparative statistics. The diagnostic performance of the combined toolbox (Wondfo RDTs plus microscopy) was evaluated based on its sensitivity, specificity, positive and negative predictive values, and Cohen's kappa coefficient, using real-time polymerase chain reaction as the gold standard.Results: The combined toolbox displayed a higher overall sensitivity for malaria cases than that of microscopy alone (93.74% vs 89.37%; padj <0.05), which could detect 94.65%, 88.16%, 95.00%, and 100.00% of Plasmodium falciparum, P. ovale, P. vivax, and P. malariae infections, respectively. In clinical practice, Wondfo RDTs ability to detect P. falciparum infections was better than that of microscopy (97.55% vs 89.67%, padj < 0.05). In contrast, microscopy displayed a higher specificity than that of Wondfo RDTs (81.82% vs 63.28%, p adj <0.05). Moreover, the consistency between microscopy and the gold standard results was also better than that of RDTs (Kappa value:0.669 vs 0.596).Conclusions: The combination of microscopy and RDTs is an effective strategy for malaria surveillance because it possibly detected more P. falciparum infections due to the introduction of RDTs. In contrast, microscopy is complementary to some limitations related to the use of RDTs in field practice. Thus, monitoring malaria cases in non-endemic areas may require employing more than one diagnostic tool in surveillance strategies. Moreover, further understanding of the advantages and disadvantages of different detection methods is necessary for applying optimum combinations in field settings.

Female garment workers' understandings of sexually transmitted infections in selected low to middle-income countries: A systematic review

Objective: This study reviewed the current state of knowledge of female garment workers' (FGWs) personal understandings and their experiences of their human immunodeficiency virus (HIV) experiences in selected low to middle-income countries (LMIC).Methods: Relevant literature on FGWs health on sexually transmitted infections (STIs) and HIV within selected LMIC published between 1988 and 2020 carried out, and a systematic review search technique used, utilizing the PRISMA protocol. Significant and relevant information from selected articles obtained and presented existing literature in the method of new outcomes as well as critically interpret existing outcomes. The themes and keywords were examined in the abstract and title of literature extracted using the aforementioned search engines.Results: Major causes of HIV vulnerability of FGWs are poverty (low wages), gender inequality, drug abuse, multiple sex partners, lack of knowledge on STIs/HIV, low use of condoms, and rape violence found in selected LMIC.Conclusion: For empowering FGWs, health education/workplace intervention is crucial, comprising prevention of sexual harassment, workplace violence (WPV), and intimate partner violence (IPV) related training by government sectors, non-government organizations (NGOs), and civil society. A good surveillance system on key populations, including FGWs, and a good public health system in every country is the key and acts very fast for prevention of STIs and HIV on FGWs and contribute to guide policymakers and researchers and improve FGWs health in LIMC.

A Serious Public Health Concern for India due to Newly Discovered Virus (COVID-19): Early Detection of all Possible Cases is the Only Way to Combat

Background: It is well known that India is having a massive population (around 130 crores) after China. So, it's more likely to be similar or more positive cases of corona among Indians. However, we are following the ways of social distancing and all possible ways to weaken the corona outbreak. But, India needs a good monitoring and surveillance system to tackle this problem otherwise it may become a serious public health problem. Objectives: This study has done to understand the severity of corona in India and its states and to device a tool based on symptoms suggested by the World Health Organization on the corona. Methods: We have utilized data extracted through the Ministry of Health &amp; Family Welfare, GoI from 30th Jan to 26th March 2020. We have estimated the case fatality rate and cured rate to understand the severity of the newly discovered virus (COVID-19). Results: Out of 694 confirmed corona cases, 47 were foreigners and 647 Indians. Our study found that the case fatality rate due to COVID-19 was 23.1 per 1000 persons in India while the people who were still hospitalized under isolation wards were about 91 percent. The cure rate was estimated at around 64.8 per 1000 persons. Conclusions: Looking at the recovery rate, we may think about the severity of corona among Indians. We can reduce the chances of rapidly increasing corona cases through good monitoring and surveillance system. It is recommended that Government should not only focus on testing the passengers arriving at the airport but also test as much as possible cases based on the symptoms of corona in all the districts so that an actual number of cases can be estimated.

Strengthening District Health Teams Capacity in Surveillance Systems and Response to Public Health Threats in Western Uganda through Field Epidemiology Training Program (FETP)

Aim: To strengthen the District Capacity in surveillance for effective detection, Reporting and Response to Public Health threats. Background: The overall aim of a good surveillance system is to strengthen the capacity of a Health system through training of health personnel who can conduct effective surveillance activities. A good surveillance system is achieved through improved use of complete and timely health information to detect changes in time to institute a rapid response to the suspected outbreak of Public Health events. This assessment followed a 3-month Field Epidemiology Training program undertaken by the investigator who applied the acquired knowledge and skills in completion of the assessment. Study Design: It was a descriptive cross-sectional, institutional based epidemiological investigation conducted at district level and Health Centre 1V in Kabarole from 15th December 2019-March 2020. eReports were retrieved from DHIS-2 for epidemiological weeks 44 in 2019 to week 3 in 2020. Data analysis: Micro soft word excel program was used to determine the reporting rates, epidemic disease trends and construction of malaria channel. SWOT analysis was done to identify poor HMIS reporting as the lead surveillance quality challenge and route cause analysis done to determine underlying causes. Results: Weekly reports analyzed were from a total of 53 Health facilities and one Health Centre four for malaria channel construction. Of the 53 functional Health facilities assessed in the district, the average reporting Timeliness was 32% and Completeness at 63% from week 44 in 2019 to week 3 in 2020. This finding shows that the district was not achieving the 80% Timeliness and 80% Completeness national target. The poor reporting situation implies that the district may not detect an emerging Public Health Event and respond in time. Poor reporting rate was linked to knowledge gap among reporting staff in completion of the newly revised HMIS tools and lack of support supervision. The analyzed data revealed that the district had increased dysentery, measles and typhoid fever cases. The dysentery and typhoid fever cases had reached and surpassed the Alert and Action thresh hold levels however there was no reported death from these diseases. Further inquiry revealed that Typhoid fever was being diagnosed using WIDAL test as opposed to WHO recommendation of stool or blood culture. The noted typhoid fever outbreak in the district was therefore being based on wrong laboratory tests hence regarded by the researcher as speculative. Findings on malaria channel revealed a normal and expected trend of malaria in Kabarole district in 2020. Conclusion: knowledge and skills from FETP-training enabled the investigator to establish the fact that the district’s surveillance system was less sensitive in detecting Public Health events for a quick response. Intensified targeted support supervision and mentorships of all health workers on reporting could help improve the districts surveillance system.

Disease Surveillance System of Bangladesh: Combating Public Health Emergencies

Disease Surveillance System of Bangladesh: Combating Public Health Emergencies

Evaluation of Animal Rabies Surveillance System, Ekiti State, Nigeria, 2012-2017

Evaluation of Animal Rabies Surveillance System, Ekiti State, Nigeria, 2012-2017

Hybridization of Genetic Algorithm and Neural Network on Predicting Dengue Outbreak

In Malaysia, prediction of dengue outbreak becomes crucial because this infectious disease remains one of the main health issues in the country. Malaysia has a good surveillance system but there are still insufficient findings on suitable model to predict future outbreaks. While there are previous studies on dengue prediction models, some of these models still have constraints in finding good parameter with high accuracy. The aim of this paper is to propose a more promising model for predicting dengue outbreak by using a hybrid model based on genetic algorithm for the determination of weight in neural network model. Several model architectures were designed and the parameters adjusted to achieve optimal prediction performance. A sample comprising dengue and rainfall data of Kuala Selangor in Selangor, Malaysia collected from State Health Department of Selangor and Malaysian Meteorological Department was used in a case study to evaluate the proposed model. The performance of the overall architecture was analyzed and the result showed that architecture III performed significantly better than other architectures and it is therefore proposed as a useful approach in the problem of time series prediction of dengue outbreak.

From malaria control to elimination in South Africa: The researchers’ perspectives

BackgroundGlobal decline in malaria episodes over the past decade gave rise to a debate to target malaria elimination in eligible countries. However, investigation regarding researchers’ perspectives on barriers and facilitating factors to effective implementation of a malaria elimination policy in South Africa (SA) is lacking.AimThe aim of this study was to investigate the malaria researchers’ knowledge, understandings, perceived roles, and their perspectives on the factors influencing implementation of a malaria elimination policy in SA.SettingParticipants were drawn from the researchers who fulfilled the eligibility criteria as per the protocol, and the criteria were not setting-specific.MethodsThe study was a descriptive cross-sectional survey conducted through an emailed self-administered semi-structured questionnaire amongst malaria researchers who met the set selection criteria and signed informed consent.ResultsMost (92.3%) participants knew about SA’s malaria elimination policy, but only 45.8% had fully read it. The majority held a strong view that SA’s 2018 elimination target was not realistic, citing that the policy had neither been properly adapted to the country’s operational setting nor sufficiently disseminated to all relevant healthcare workers. Key concerns raised were lack of new tools, resources, and capacity to fight malaria; poor cross-border collaborations; overreliance on partners to implement; poor community involvement; and poor surveillance.ConclusionMalaria elimination is a noble idea, with sharp divisions. However, there is a general agreement that elimination requires: (a) strong cross-border initiatives; (b) deployment of adequate resources; (c) sustainable multistakeholder support and collaboration; (d) good surveillance systems; and (e) availability and use of all effective intervention tools.

Safety surveillance in haemophilia and allied disorders

The introduction of clotting factor concentrates has transformed the lives of persons with inherited bleeding disorders. With the use of prophylactic treatment, it is now possible to prevent bleeding in these individuals. The early concentrates were contaminated with the HIV and hepatitis C viruses (HCV) and resulted in major morbidity and mortality in the recipients. Current products are much safer, especially in terms of infectious agents, but other adverse events such as alloantibodies (inhibitors), allergic reactions and thrombotic risks remain of concern. Approximately 30% of previously untreated patients with severe haemophilia A develop inhibitors, making this the most important issue in haemophilia care today. Recently, it was suggested that one of the most commonly used concentrates was associated with a higher inhibitor risk, but this was not supported by the evidence from all studies. Good safety surveillance systems are essential for all diseases and products but are particularly so in the group of individuals with inherited bleeding disorders treated with clotting factor concentrates who have suffered disproportionately from the adverse effects of their treatment. National and multinational systems are now in place to allow reporting of adverse events in patients with inherited bleeding disorders. All clinicians treating individuals with inherited bleeding disorders should prospectively report adverse events to treatment even if they are believed to be common and well recognized.

대기 산란 계수 비율 기반의 밝기변환과 지역적 히스토그램 평활화를 이용한 실시간 안개 제거 방법

Images taken from outdoor are degraded quality by fog or haze, etc. In this paper, we propose a method that provides the visibility improved images through fog or haze removal. We proposed haze removal method that uses brightness transform based on atmospheric scatter coefficient rate with local histogram equalization. To calculate the transmission rate that indicate fog rate in original image, we use atmospheric scatter coefficient rate based on quadratic equations about haze model. And primary brightness transformed image can be obtained by using the obtained transmission rate. Also we use local histogram equalization with proposed brightness transform for effectively image visibility enhancement. Unlike existing methods, our method can process real-time with stable and effect image visibility enhancement. Proposed method use only the luminance images processed by good performance surveillance systems because it represents the real-time processing is required, black-box, digital camera and multimedia equipment is applicable. Also because it shows good performance only with the luminance images processed, Surveillance systems, black boxes, digital cameras, and multimedia devices etc, that require real-time processing can be applied.

Lessons learnt from 20 years surveillance of malaria drug resistance prior to the policy change in Burkina Faso.

The history of drug resistance to the previous antimalarial drugs, and the potential for resistance to evolve to Artemisinin-based combination therapies, demonstrates the necessity to set-up a good surveillance system in order to provide early warning of the development of resistance. Here we report a review summarizing the history of the surveillance of drug resistance that led to the policy change in Burkina Faso. The first Plasmodium falciparum Chloroquine-Resistance strain identified in Burkina Faso was detected by an in vitro test carried out in Koudougou in 1983. Nevertheless, no further cases were reported until 1987, suggesting that resistant strains had been circulating at a low prevalence before the beginning of the systematic surveillance system from 1984. We observed a marked increase of Chloroquine-Resistance in 2002-2003 probably due to the length of follow-up as the follow-up duration was 7 or 14 days before 2002 and 28 days from 2002 onwards. Therefore, pre-2002 studies have probably under-estimated the real prevalence of Chloroquine-Resistance by not detecting the late recrudescence. With a rate of 8.2% treatment failure reported in 2003, Sulfadoxine-Pyrimethamine was still efficacious for the treatment of uncomplicated malaria in Burkina Faso but this rate might rapidly increase as the result of its spreading from neighboring countries and due to its current use for both the Intermittent Preventive Treatment in pregnant women and Seasonal Malaria Chemoprophylaxis. The current strategy for the surveillance of the Artemisinin-based combination treatments resistance should build on lessons learnt under the previous period of 20 years surveillance of Chloroquine and Sulfadoxine-Pyrimethamine resistance (1994-2004). The most important aspect being to extend the number of sentinel sites so that data would be less patchy and could help understanding the dynamic of the resistance.

Are surveillance response systems enough to effectively combat and contain the Ebola outbreak?

The epidemic of the Ebola virus infection in West Africa in 2014 has become a worldwide concern. Due to the nature of the disease, which has an extremely high mortality potential, this outbreak has received much attention from researchers and public health workers. An article entitled "Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries," published in the journal Infectious Diseases of Poverty in August 2014, concluded that a good surveillance system to monitor disease transmission dynamics is essential and needs to be implemented to combat the outbreak. Issues regarding the limitation of the passive surveillance system have been raised by Professor Viroj Wiwanitkit, who emphasizes the need for an active disease detection system such as mass screening in this letter to editor. The different function between passive and active surveillance system in combating the disease outbreak has been agreed upon by Ernest Tambo et al. There have also been discussions between Wiwanitkit and Tambo et al. on the following issues: (i) the extreme resource limitations in outbreak areas, (ii) new technology to improve the available systems. Further recommendations echoed in this letter to editor by Wiwanitkit, who outlined the research priorities on the development of appropriate combined disease monitoring systems and good policy to allocate available tools and technology in resource-limited settings for epidemic scenarios. The journal’s editor, Professor Xiao-Nong Zhou, has therefore collated all parts of these discussions between authors in this letter to editor paper, in order to further promote research on a combined active and passive system to combat the present extending Ebola outbreak.Electronic supplementary materialThe online version of this article (doi:10.1186/2049-9957-4-7) contains supplementary material, which is available to authorized users.

An Effective Approach to Track Levels of Influenza-A (H1N1) Pandemic in India Using Twitter

India is one of the fasted economies in the world, having the second largest population. Communicable diseases in the 21st century remain a major public health threat due to the globalization. The emergence of new diseases and the reappearance of older infectious disease cause great impact towards public health. It is very important to monitor this disease early and take a rapid decision to overcome the damage. In this paper, we suggest an approach based on tweets using Twitter to make a good surveillance system. We examine important issues related to 2015 H1N1 pandemic in India like symptoms, prevention steps and availability of medicine. Our study focused on different parameters to find the relevant information towards Influenza-A (H1N1) and the public general awareness towards it. Our analysis shows the use of twitter may allow the detection of disease outbreaks through analysis of data generated by social media.

A postmarket surveillance benchmarking exercise.

Monitoring device performance after a product has been launched is a critical aspect of maintaining product safety. Not only is it the right thing to do, but our regulators expect that it’s done. • FDA 21 CFR 822 discusses monitoring and evaluation of product performance data. • The medical device risk management standard ISO 14971 requires that manufacturers establish, document, and maintain a system to collect post-production quality information and act on that information. • MEDDEV 2.12-1 specifically discusses the guideline that product incidents shall be monitored against established trigger levels based on risk documentation, and expects a manufacturer to submit a report to the competent authorities when those expected thresholds are exceeded. A good postmarket surveillance system can inform a company of emerging issues before they lead to patient harm, or even prevent exposure of potentially brand-damaging problems. In an effort to benchmark practices at several medical device companies, a survey was sent out in September 2013 asking questions regarding their systems to monitor and act upon postmarket data. This article summarizes those findings.