Health Surveillance Research Articles

Gambaran Surveilans Kesehatan Ibu dan Anak (KIA) sebagai Upaya Mengurangi Angka Kematian Ibu dan Anak di Kota Palembang

Maternal and Child Health (MCH) surveillance plays a critical role in reducing maternal and infant mortality rates in Palembang City. This study aims to provide a comprehensive overview of the implementation of MCH surveillance at the Padang Selasa Health Center in Palembang, focusing on the health conditions of mothers and children from 2022 to 2024. Using secondary data from annual and monthly reports, the study found that anemia and Chronic Energy Deficiency (KEK) in pregnant women remain significant health concerns. Furthermore, while the exclusive breastfeeding program and Vitamin A distribution showed positive outcomes, immunization coverage has declined in 2024, highlighting potential gaps in access and outreach. The study emphasizes the need for improved healthcare access, more effective nutritional education for pregnant women, and enhancements in the distribution and awareness of immunization programs to reduce maternal and child health risks.

Assessment of occupational hazards, health effects, and personal protective equipment usage among motorcycle food delivery riders in Thailand: a cross-sectional survey

BackgroundMotorcycle Food Delivery Riders (MFDRs) play a vital role in the online food delivery industry, yet their prolonged time on the road exposes them to numerous occupational hazards, health risks, making them more vulnerable than both regular motorcyclists and the general population. The study aimed to investigate the working conditions, occupational hazards, health issues, use of personal protective equipment (PPE), and the association between occupational hazards and health effects among Thai MFDRs.MethodsA cross-sectional study was conducted from November 2021 to mid-February 2022 in Chiang Mai, Thailand, using an anonymous self-reported survey. A total of 709 MFDRs participated in the survey. Data were collected on background information, job characteristics, occupational hazards, health issues, and the use of PPE over the previous six months. The data were analyzed using a multivariable logistic regression model.ResultsMost MFDRs are frequently exposed to physical hazards, including heat and sunlight (91.6%), as well as chemical hazards such as exhaust smoke (90.1%) and particulate matter (PM) (86.1%). Most MFDRs reported suffering from musculoskeletal disorders (62.1%) and eyes-related problems (45.1%). The most common problems were shoulder pain (39.2%), neck pain (38.1%), and burning eyes (33.3%). Multivariable logistic regression analysis indicates that biomechanical hazards are significantly associated with musculoskeletal disorders (MSDs) (p < 0.05), while psychological hazards significantly associated with headaches, insomnia, and feeling depressed (p < 0.05). Additionally, physical hazards such as sunlight and heat, noise, and whole-body vibrations, are also significantly associated with headaches, flu-like symptoms, and insomnia (p < 0.05). The most worn PPE by the participants were helmets (99.72%), long-leg pants (99.72%), masks (99.29%), and thermal jackets (98.17%).ConclusionsThe high prevalence of occupational hazards and health issues among MFDRs is worrisome. It is critical for platform companies and health sectors to introduce effective protective measures for workers, including establishing health surveillance, and supplying PPE.

Viral load dynamics among adults receiving HIV care in rural North-Eastern South Africa, 2015–2020: insights from a population-based record linkage study

IntroductionThe Joint United Nations Programme on HIV/AIDS set ambitious-but-reachable targets to have 95% of HIV-positive people diagnosed, 95% on ART, and 95% virally suppressed by 2030. To address the latter, post-2016, South Africa’s HIV treatment guidelines aimed to deliver maximal and durable viral load (VL) suppression through extensive antiretroviral therapy (ART) scale-up. Yet, standard suppression one-off measurement conceals viral response trajectories with high onward transmission potential for HIV patients on lifelong treatment. We investigated the dynamics of periodic VL patterns and associated socio-demographic factors in rural north-eastern South Africa using data from adults receiving HIV care in healthcare facilities within the Agincourt Health and Demographic Surveillance System (HDSS).MethodsWe extracted two person-identified VL measurements collected 9-15 months apart per individual yearly between 2015 and 2020 from the Agincourt HDSS Hospital-Clinic-Linkage system for 7 493 HIV patients. Sankey diagrams were used to describe VL flows within and across the suppressed and unsuppressed statuses over each year. We classified temporal VL responses into four profiles: (i) Sustained suppression, (ii) achieved suppression, (iii) viral rebound, (iv) virologic failure. Additionally, mixed-effects multinomial logistic regression models were utilised to examine the odds of covariates factors for varied VL trajectories.ResultsThe proportion of individuals remaining virally suppressed increased steadily from 84% in 2015 to 86% in 2016, with the highest prevalence of 88% sustained for three consecutive years, from 2017 through 2019, and then dropped slightly in 2020 to 87%. However, 2-3% of initially virally suppressed rebounded annually, while ~5% experience treatment failure. The likelihood of achieving viral suppression was high among men, those aged 15-24 years and 25-34 years however, these groups were less likely to have sustained viral suppression and more likely to experience virologic failure and rebounding.ConclusionsTemporal VL metrics are needed to effectively track progress towards reaching high and sustained HIV suppression potential in HIV hyperendemic settings. Thus, optimising the assessment of targeted interventions and identification of left-behind groups such as those younger, men, unmarried and poorer HIV patients to improve individual and population health outcomes.

Differential rates of early gastric cancer in the urban and rural medical centers of Hangzhou, China.

This study aimed to compare gastric cancer (GC) and early gastric cancer (EGC) diagnosis rates between urban and rural, and to investigate potential reasons for the increased GC morbidity in rural areas. Patients who underwent endoscopy at rural and urban medical centers from 2019-2024 were included. We analyzed differences in patients' pre-endoscopic chief complaints and endoscopic diagnoses across the two areas. 32,613 patients from rural medical centers and 70,195 patients from urban centers were included. Significant differences in endoscopic diagnoses were found between the groups, with the EGC diagnosis rate being significantly lower in rural areas than in urban (10.19% vs. 27.19%). Rural patients were more likely to undergo endoscopy for abdominal pain, reflux, abdominal fullness, and melaena (RR = 1.340, 1.431, 1.106, and 1.231, respectively). Fewer rural patients underwent endoscopy due to lab abnormality, including Helicobacter pylori infection, elevated tumor markers, positive fecal occult blood tests, and anemia (RR = 0.591, 0.295, 0.251, and 0.400, respectively). Additionally, rural patients were significantly less likely to undergo endoscopy owing to health screening or surveillance for chronic atrophic gastritis (CAG) (RR = 0.362 and 0.527, respectively). The diagnosis rate of EGC is significantly lower in rural than in urban. Rural patients are more likely to seek endoscopy because they are symptomatic and are less likely to undergo endoscopy for health screening, surveillance for CAG, or lab abnormality. Enhanced health education and awareness programs in rural areas are needed to encourage proactive endoscopic screening and surveillance.

YOLO-Based Bacteria Detection and Identification: A Deep Learning Approach for Microbial Diagnosis

Abstract: This article describes the rapid detection and identification of bacteria using deep learning. Rapid and accurate detection and identification of bacterial strains is important not only for effective diagnosis and treatment in clinical settings, but also for public health surveillance and ensuring food safety. Traditional bacterial detection methods, some of which, such as culture-based techniques, are time- consuming and labor-intensive, limiting their applicability in high- throughput and real-time analysis. Machine learning algorithms using deep convolutional neural networks (CNNs) offer a promising alternative. Here, we present a deep learning-based approach combined with the Yolo algorithm for rapid and accurate detection of bacterial class identities. Our method is designed to analyze high-dimensional data in real time, achieving rapid identification with high accuracy. We used multi-class classification to identify Gram-positive and Gram- negative strains and differentiate between all tested bacterial strains. We propose a simple YOLO and CNN architecture and use a many- class bacterial isolation dataset for training and testing. We achieve a discrimination accuracy of about 86% with near real-time discrimination speed. Our results show that the processing time is significantly reduced compared to traditional methods, reducing the detection time to minutes. The proposed system provides a scalable solution that can be integrated into clinical and laboratory workflows and will be a valuable tool to improve patient outcomes and public health responses. Keywords: Bacteria, Rapid detection, Deep learning, CNN Traditional methods, YOLO classification, Image Processing

Wastewater-integrated pathogen surveillance dashboards enable real-time, transparent, and interpretable public health risk assessment and dissemination.

Timely pathogen surveillance and reporting is essential for effective public health guidance. Web dashboards have become a key tool for communicating public health information to stakeholders, health care workers, and the broader community. Over the SARS-CoV-2 pandemic, wastewater surveillance has increasingly been incorporated into public health workflows for outbreak monitoring and response, enabling community-representative and low-cost monitoring to supplement clinical surveillance. However, the methods used for visualization and dissemination of clinical and wastewater surveillance data differ across programs, and best practices are yet to be defined. In this work, we demonstrate data workflows and dashboards used to perform wastewater-based public health surveillance in tandem with clinical data across local and national scales, leveraging custom-built, reproducible, and open-source software. Using a centralized data aggregation and analysis hub approach, we establish multiple data pipelines for data storage, wrangling, and standardized analyses, and deploy custom-built web dashboards that allow for immediate public release. We find that our approach is effective across scales, computing architectures, and dissemination strategies, and provides an adaptable model to incorporate additional pathogens and epidemiological data.

Evaluating Population Normalization Methods Using Chemical Data for Wastewater-Based Epidemiology: Insights from a Site-Specific Case Study

Wastewater-based epidemiology (WBE) has been widely employed to track the spread of human pathogens; however, correlating wastewater data with clinical surveillance remains challenging due to population variability and environmental factors affecting wastewater composition. This study evaluated different SARS-CoV-2 normalization methods, comparing static population estimates with dynamic normalization based on common physicochemical parameters: chemical oxygen demand (COD), biochemical oxygen demand (BOD5), and ammonia (NH4-N). Wastewater samples were collected from four urban wastewater treatment plants (WWTPs) in northwestern Tuscany (Italy) from February 2021 to March 2023. The correlations between normalized viral loads and clinical COVID-19 cases were highest for static normalization (ρ = 0.405), followed closely by dynamic normalization using COD and BOD5 (ρ = 0.378 each). Normalization based on NH4-N was less effective. These findings suggest that chemical parameters, particularly COD and BOD5, offer a valid alternative for viral normalization when population estimates or flow rate measurements are unavailable. These parameters provide a cost-effective and practical approach for improving WBE reliability, particularly in resource-limited settings. Our results reinforce the importance of normalization in WBE to enhance its representativeness and applicability for public health surveillance.

Are new roles being established for occupational health nurses in the health surveillance of workers exposed to reprotoxic agents?

Real Decreto (RD) 665/1997, of May 12, transposed Council Directive 90/394/EEC, of June 28, 1990, on the protection of workers from the risks related to exposure to carcinogens at work and establishes the minimum provisions applicable to activities in which workers may be exposed to carcinogenic or mutagenic agents, with the aim of protecting them and preventing risks related to exposure (1). Since the approval of the aforementioned Directive, it has undergone several modifications that have led to successive updates of RD 665. The most recent one, in compliance with Directive (EU) 2022/431, incorporates protection against reprotoxic agents, agents that can have adverse effects on the sexual function and fertility of adults, as well as on the development of offspring (2). This update represents a significant step towards safer and healthier work environments but will require a joint effort from all occupational health professionals for its effective implementation.

Benefits and limitations of using innovative tools like detection dogs, thermal imaging and drones to increase wildlife carcass finds during health surveillance and management efforts

Recent awareness of the role of wildlife in the evolution of emerging zoonotic diseases emphasizes the needs to conduct surveillance for public health. Additionally, wildlife surveillance is motivated by animal health, conservation and biodiversity perspectives. Event-based wildlife surveillance involves studying mortality and investigating its causes. Carcass detection thus plays a key role in the surveillance of high-risk diseases. Many factors influence the degradation of a carcass, particularly environmental conditions, the biology and behavior of the species, and the role played by necrophagous insects and scavengers. Various tools and technologies have been tested over the years to improve wildlife carcass detection. Here, we review the main factors that influence carcass detectability and detection in wildlife surveillance and management, alongside the strengths and limitations of key innovative detection tools: detection dogs, drones and thermal imaging. We also list decision criteria to help wildlife surveillance managers and researchers understand and select the targeted search approaches most likely to optimize carcass encounter and recovery during disease outbreaks.

Brief organizational history of epidemiological surveillance at the IMSS

The Mexican Institute for Social Security (IMSS) has been an institution that has been forged over 80 years of existence, with contributions to the history of public health and epidemiological surveillance in Mexico; to do so, over the course of its institutional life, it has had to adapt to the contexts, realities, challenges and unforeseen events in terms of medical, sanitary and epidemiological care. In this sense, the Institute has modified its organizational structure on several occasions at managerial level, and, consequently, within the federal entities and in the medical care units. For this reason, this manuscript summarizes the main milestones and events that the Institute has experienced, focusing on its organic structure related to epidemiological surveillance; for example, the birth of the Epidemiological Surveillance and Contingency Support Coordination, as well as the Network of Laboratories for Epidemiological Surveillance and its growth, following a review mainly of the organization manuals of the Medical Benefits Administration and various institutional reports that are published annually, with many successes that have resulted from these changes and the alliances within the Institute, as well as the external ones that recall the strength and flexibility of the Institute's organizational structure.

Epidemiological surveillance at IMSS: a review of institutional successes

The Mexican Institute for Social Security (IMSS) has recently celebrated 8 decades of existence; its contribution to the processes of medical care, public health and epidemiological surveillance in Mexico have been among its cornerstones. This article presents some selected points of the history of the Institute's epidemiological surveillance, from its birth in the organic structure to the successes of identifying agents and responding to outbreaks, epidemics and pandemics that have been milestones in the modern history of our country, such as diseases preventable by vaccination, pathologies affecting the respiratory tract, as well as the gastrointestinal tract, vector-borne and sexually transmitted diseases that have been subject to sectoral epidemiological surveillance, not only in terms of epidemiological surveillance, but also as contributions of research. Finally, it is a brief recapitulation to know and understand the events that the Institute have experienced, i. e., where we come from, what has been achieved in order to understand where we are and what can be built and done in the future.

Global Trends and Action Items for the Prevention and Control of Emerging and Re-Emerging Infectious Diseases

In recent decades, the world has observed the emergence and re-emergence of a multitude of previously non-existent or re-emerging infectious diseases, for which there is a paucity of timely and effective preventative measures. The WHO has published a catalogue of priority pathogens that are likely to trigger future epidemics, with the objective of designing effective prophylactic and therapeutic interventions. The rationale behind these interventions is rooted in a comprehensive understanding of the aetiology, epidemiology, and pathogenesis of the target diseases. While it is imperative to acknowledge the pivotal role that evolutionary changes in pathogens play, it is equally important to recognise the influence of a multifaceted interplay of factors on the emergence and re-emergence of infectious diseases. These include changes in human populations, the vectors and reservoirs of exposure, and environmental changes. This review summarises the aetiology, epidemiology, and pathogenesis of the ten WHO priority diseases, as well as those with high epidemic potential that are already the focus of specific control programme initiatives, such as HIV/AIDS, tuberculosis, and malaria diseases. Furthermore, this review concentrated on the means of addressing these infections through public health surveillance and response systems. Such systems must be designed to rapidly detect unusual and unexpected disease patterns, track and share information in real time, and rapidly mobilise global responses, which are the most important ways to effectively contain transmission.

Metagenomic insights into correlation of microbiota and antibiotic resistance genes in the worker-pig-soil interface: A One Health surveillance on Chongming Island, China

Metagenomic insights into correlation of microbiota and antibiotic resistance genes in the worker-pig-soil interface: A One Health surveillance on Chongming Island, China

Refresher training in administering intradermal BCG-vaccine increased BCG-scarring rates in rural Guinea-Bissau.

A correct vaccination technique is important for developing BCG scars. Having a BCG scar is associated with lower mortality among BCG-vaccinated children. To compare BCG-scar prevalences among children vaccinated before and after refresher training in BCG vaccination technique. BCG-scar prevalence is assessed through a health and demographic surveillance system in rural Guinea-Bissau. In the context of a randomised trial, staff at health facilities in three regions (intervention area) received refresher training on BCG vaccination technique. In a fourth region (control area) no training was implemented. In logistic regression models, we compared scar prevalence among children vaccinated before and after the training. BCG-scar prevalence increased from 75% to 92% (odds ratio (OR)=4.19, 95%CI 2.92-6.01) in the intervention area and from 71% to 78% (OR=1.43, 95%CI 0.89-2.29) in the control area (p-value for same increase: <0.001). BCG scarring rates increased after training in vaccination technique.

Insights Into Cancer Awareness and Health Practices in Rural Kenya: A Cross-Sectional Study of Esophageal, Breast, Prostate, Cervical, and Colorectal Cancers.

In sub-Saharan Africa (SSA), there has been an epidemiologic transition from infectious diseases to noncommunicable diseases, including a projected doubling in incidence of cancer. Understanding the underlying factors driving this surge is crucial for designing effective strategies to mitigate the cancer burden. This study focuses on assessing knowledge, attitudes, screening practices, and health behaviors related to five most prevalent cancers in SSA: prostate, breast, cervical, esophageal, and colorectal-among a predominantly rural coastal population in Kenya. We used a cross-sectional study design targeting 1,500 adult respondents randomly selected from an existing community health and demographic surveillance system. Face-to-face interviewer-administered questionnaires were used to collect data. One thousand four hundred fifty-two adults participated in the final survey. Breast cancer awareness was highest (69.1%), while awareness of colorectal cancer was lowest (34.6%). Given a list of possible risk factors and symptoms, most respondents (>50%) could only recognize one to two per cancer type. Perceptions of survival from colorectal cancer were particularly pessimistic, with <70% recognizing early detection as a means to improve survival outcomes. In terms of cancer-associated risk factors, more men engaged in tobacco and alcohol use (20.5% and 22.4%, respectively). Additionally, fewer than 10% of eligible participants had ever undergone cancer screening. This study addresses a gap in population-level Knowledge, Attitudes, and Practices studies in rural SSA, offering insights crucial for cancer prevention, early detection, and treatment. The low awareness and knowledge levels and unhealthy behaviors emphasize a need for targeted educational campaigns at community level and enhanced understanding of barriers to uptake of screening if we are to effectively combat the growing cancer burden in this region.

Entamoebiasis in zoological non-human primates in the United Kingdom.

Entamoebiasis in zoological non-human primates in the United Kingdom.

Outbreak of Marburg Virus Disease, Equatorial Guinea, 2023.

In February 2023, the government of Equatorial Guinea declared an outbreak of Marburg virus disease. We describe the response structure and epidemiologic characteristics, including case-patient demographics, clinical manifestations, risk factors, and the serial interval and timing of symptom onset, treatment seeking, and recovery or death. We identified 16 laboratory-confirmed and 23 probable cases of Marburg virus disease in 5 districts and noted several unlinked chains of transmission and a case-fatality ratio of 90% (35/39 cases). Transmission was concentrated in family clusters and healthcare settings. The median serial interval was 18.5 days; most transmission occurred during late-stage disease. Rapid isolation of symptomatic case-patients is critical in preventing transmission and improving patient outcomes; community engagement and surveillance strengthening should be prioritized in emerging outbreaks. Further analysis of this outbreak and a One Health surveillance approach can help prevent and prepare for future potential spillover events.

Randomization to Introductory Letters Improves Completion of Public Health Surveillance Surveys After Hospitalization for Respiratory Viral Infections

Randomization to Introductory Letters Improves Completion of Public Health Surveillance Surveys After Hospitalization for Respiratory Viral Infections

Stability of antipsychotic biomarkers for wastewater-based epidemiology.

Stability of antipsychotic biomarkers for wastewater-based epidemiology.

Disparities in residential PM2.5 and disease burden across urban and peri-urban: A 2018-2019 multicenter on-site survey in China.

Disparities in residential PM2.5 and disease burden across urban and peri-urban: A 2018-2019 multicenter on-site survey in China.