Implementation Of Public Health Measures Research Articles

Buruli ulcer, tuberculosis and leprosy: Exploring the One Health dimensions of three most prevalent mycobacterial diseases: A narrative review.

The literature review was conducted using the online databases PubMed, Scopus, ProQuest and Google Scholar, reviewing articles that were written in English in the last 15 years. Grey literature, published by intergovernmental agencies, was also reviewed. For the pathogen of Buruli ulcer, evidence suggests possums as a possible animal reservoir and thus having an active role in disease transmission to humans. Cattle and some wildlife species are deemed as established animal reservoirs for tuberculosis pathogens, with a non-negligible proportion of infections in humans being of zoonotic origin. Armadillos constitute an established animal reservoir for leprosy pathogens with the transmission of the disease from armadillos to humans being deemed possible. Lentic environments, soil and other aquatic sources may represent further abiotic reservoirs for viable Buruli ulcer and leprosy pathogens infecting humans. Ongoing investigation and implementation of public health measures, targeting (sapro)zoonotic transmission can be found in all three diseases. Buruli ulcer, tuberculosis and leprosy exhibit important yet still poorly understood One Health aspects. Despite the microbiological affinity of the respective causative mycobacteria, considerable differences in their animal reservoirs, potential environmental sources and modes of zoonotic transmission are being observed. Whether these differences reflect actual variations between these diseases or rather knowledge gaps remains unclear. For improved disease control, further investigation of zoonotic aspects of all three diseases and formulation of One Health relevant interventions is urgently needed.

Burden of Vaccine-Preventable Diseases in People Living with HIV.

Vaccine-preventable diseases (VPDs) pose a serious public health concern for people living with HIV (PLH). PLH experience a delayed and weakened response to many vaccines available, compared to the general population. Lower seroconversion rates, along with a decreased efficacy and durability of vaccines, increases the susceptibility of PLH to VPDs. Vaccination guidelines specifically targeting this population have been modified to overcome these challenges. However, vaccine uptake remains suboptimal due to multiple barriers, highlighting the need for further studies and the additional implementation of public health measures specifically tailored to PLH.

Incidence of Cryptosporidium: A Neglected Parasite in Immunocompetent Adults in Swabi

Objective: To highlight the increasing incidence of Cryptosporidium in immunocompetent adults and the resultant altered epidemiology. Methodology: This study was conducted over a period of one year, from 1st January 2023 to 1st of January, 2024 at Microbiology Laboratory MTI- GKMC/BKMC, Swabi. Modified Ziehl Neelsen staining was performed on the received stool samples from patients presenting with wide range of symptoms associated with Irritable Bowel Syndrome (IBS). Abdominal pain, recurrent episodes of diarrhea and weight loss were the main symptoms. Modified ZN stain being one of the most reliable, quick and cost effective methods for the detection of cysts of Cryptosporidium using 40X and oil immersion lens was used for diagnosis. Results: A total of 62 samples were received from immunocompetent patients in the said period out of which 34% were positive for the oocysts of Cryptosporidium species. Out of a total of 21 positive samples 62% were males and 38% were females. The age range of the patients spanned between 20 to 60 years. Conclusion: Knowing this high incidence 34% of Cryptosporidium spp. in the healthy adults, necessitates to prioritize steps for the prevention of this infection by implementation of public health measures.

A holistic view of human rights and its application in the context of infectious disease pandemics

Under the new coronavirus epidemic, the implementation of public health measures has generated some resistance in countries around the world. The essence of examining the human rights claims of those who oppose the epidemic is that they have a too narrow understanding of individual human rights and ignore the obligation implications of human rights itself. From the historical point of view, health and epidemic prevention is the objective necessity of the survival and development of human society; From the ethical point of view, the joint fight against the epidemic is the moral obligation of the coordinated development of individuals and society. From the normative point of view, the management of infectious diseases is the basic consensus established by many international conventions. To correct the narrow understanding of individual human rights concept, the global human rights concept should be established in pandemic governance, and the concept of human health community should be shaped in the pandemic convention to build governance consensus, implement the same health concept to clarify the scope of governance, implement the principle of common but differentiated responsibilities, and strengthen the participation of individuals and communities in public health governance to improve governance paths. To shape a more reasonable and effective pandemic governance order.

Implementation of lockdown, quarantine, and isolation measures in the context of COVID-19 among internally displaced persons in Burkina Faso: a qualitative study

BackgroundThe triple political, security, and health crisis in Burkina Faso has impacted the lives of Burkinabè people, resulting in massive internal displacement. These internally displaced persons (IDPs) are very vulnerable to epidemic diseases, which was exacerbated by the recent COVID-19 pandemic., The implementation of public health measures to curb the spread of COVID-19 represented a major concern among IDPs. The objective of this study was to document knowledge, difficulties, adjustments, and challenges faced by IDPs and humanitarian authorities/actors during implementation of lockdown, quarantine, and isolation measures in response to COVID-19.MethodsThe study was conducted in Burkina Faso, in the north-central region Kaya, a commune which hosts the largest number of IDPs in the country. Qualitative research using semi-structured interviews collected discursive data from 18 authorities and/or humanitarian actors and 29 IDPs in June 2021. The transcribed interviews were coded with N’vivo 11 software and analyzed thematically.ResultsAlthough respondents had a good knowledge of lockdown, isolation, and quarantine measures, the difference between these three concepts was not easily understood by either authorities/humanitarian actors or IDPs. Communication was one of the biggest challenges for humanitarian actors. The difficulties encountered by IDPs were economic (lack of financial resources), infrastructural (limited housing), and socio-cultural in the application of lockdown, isolation, and quarantine measures. As for adjustment measures, the health authorities developed a strategy for isolation and quarantine for the management of positive and suspected cases. The IDPs mentioned their commitment to compliance and awareness of lockdown measures as the main adjustment.ConclusionAlthough there were no known cases of COVID-19 among the IDPs at the time of the study, tailored response plans were developed to facilitate the application of these measures in emergencies. The involvement of IDPs in the communication and sensitization process was necessary to facilitate their adherence to these different measures.

Factors influencing the likelihood of accessing healthcare during the COVID-19 pandemic in Ireland: lessons for the future

Background Implementation of public health measures during the first wave of the coronavirus disease (COVID-19) pandemic, including travel restrictions and physical distancing, may have impacted population behaviour in seeking medical care. Identifying barriers to accessing healthcare is important, especially for vulnerable groups. Methods Data were collected through a nationally representative cross-sectional telephone survey during the first period of easing of COVID-19 restrictions in May and June 2020. Secondary data analysis of the dataset was carried out to examine the factors influencing the likelihood of individuals avoiding General Practitioner (G.P.) and hospital-based care. Poisson regression analyses were conducted to estimate risk ratios with robust variance estimation of the association between selected demographic and self-reported health factors and the risk of avoiding G.P. and hospital-based healthcare. Results Of the 969 participants, 152 (15.7%) deliberately avoided contacting their G.P. about non COVID-19 related concerns while 81 (8.4%) reported avoiding hospitals. Three groups, women (Rate Ratio (RR): 1.75, 95% Confidence Interval (CI): 1.28 – 2.40), individuals who reported experiencing an adverse life event within the last 3 months (RR: 1.79, 95% CI: 1.33 – 2.40), and those at an increased risk of infection (RR: 1.65, 95% CI: 1.06 – 2.58) were more likely to avoid contact with their G.P. Individuals at a higher risk of avoiding hospital-based care were those aged 50 – 59 years (RR: 2.27, 95% CI: 1.03 – 4.98) and 70 years+ (RR: 2.73, 95% CI: 1.24 – 6.01), individuals at an increased risk of infection (RR: 2.07, 95% CI: 1.20 – 3.56), smokers (RR: 1.68, 95% CI: 1.02 – 2.77) and those who agreed they were “likely to catch COVID-19” (RR: 2.80, 95% CI: 1.25 – 6.25). Conclusion These findings highlight the importance of public health awareness and education regarding accessing healthcare during a pandemic and should be considered in future pandemic preparedness.

Childhood vision impairment and blindness in West Africa: public health measures and implications for systemic health.

Childhood blindness is an issue of global health impact, affecting approximately 2 million children worldwide. Vision 2020 and the United Nations Sustainable Development Goals previously identified childhood blindness as a key issue in the twentieth century, and while public health measures are underway, the precise etiologies and management require ongoing investigation and care, particularly within resource-limited settings such as sub-Saharan Africa. We systematically reviewed the literature on childhood blindness in West Africa to identify the anatomic classification and etiologies, particularly those causes of childhood blindness with systemic health implications. Treatable causes included cataract, refractive error, and corneal disease. Systemic etiologies identified included measles, rubella, vitamin A deficiency, and Ebola virus disease. While prior public health measures including vitamin A supplementation and vaccination programs have been deployed in most countries with reported data, multiple studies reported preventable or reversible etiologies of blindness and vision impairment. Ongoing research is necessary to standardize reporting for anatomies and/or etiologies of childhood blindness to determine the necessity of further development and implementation of public health measures that would ameliorate childhood blindness and vision impairment.

Trends in blood pressure changes and hypertension prevalence in Australian adults before and during the COVID-19 pandemic.

Efforts to limit the impact of the coronavirus disease (COVID-19) pandemic led to the implementation of public health measures and reallocation of health resources. To investigate trends in blood pressure (BP), hypertension and BMI in the Australian population during the COVID-19 pandemic, data from publicly accessible health stations were analyzed. Average BP and BMI measured by the SiSU Health Station network in Australia in over 1.6 million health screenings were compared between the years 2018 and 2021. Additionally, paired trajectories for BP and BMI development before and during the COVID-19 pandemic were calculated. Comparisons between pre-COVID years and post-COVID years of 2018versus 2020, 2019versus 2020, 2018versus 2021, and 2019versus 2021 showed increases in average adjusted systolic BP of 2.0, 1.7, 2.6, and 2.3mmHg, respectively. Paired analysis of longitudinal data showed an overall increase in the trajectory of systolic BP of 3.2mmHg between pre- and post-COVID years. The prevalence of hypertension in users of the health stations increased by approximately 25% in the years 2020-2021. Similar trends were seen for BMI. Data from public Australian health stations indicated a strong trend toward higher BP during the COVID-19 pandemic. At the population level, BP increments have been shown to markedly increase cardiovascular disease risk. Anti-pandemic measures need to be carefully evaluated in terms of secondary public health effects and health support systems extended to effectively target cardiovascular risk.

Canadian Covid-19 pandemic public health mitigation measures at the province level

The Covid-19 pandemic has prompted governments across the world to enforce a range of public health interventions. We introduce the Covid-19 Policy Response Canadian tracker (CPRCT) database that tracks and records implemented public health measures in every province and territory in Canada. The implementations are recorded on a four-level ordinal scale (0–3) for three domains, (Schools, Work, and Other), capturing differences in degree of response. The data-set allows the exploration of the effects of public health mitigation on the spread of Covid-19, as well as provides a near-real-time record in an accessible format that is useful for a diverse range of modeling and research questions.

Factors associated with the use of medicines and self-medication during the COVID-19 pandemic in 12 Latin American countries

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has triggered a rise in the global phenomenon of self-medication. The use of medicines with unsubstantiated claims of benefit for the prevention and/or treatment of infected people has been widely adopted. ObjectiveTo determine the factors associated with the use of medicines and self-medication by Latin American populations during the COVID-19 pandemic. MethodsThis analytical cross-sectional study was conducted via an analysis of secondary data collected from 8777 responses from 12 Latin American countries obtained from a survey on the use of medicines and self-medication during the pandemic. ResultsRespondents who reported using Paracetamol, Ibuprofen, or antibiotics (ABx) disclosed this as self-medication in 26.9%, 16.6%, and 9.7% of cases respectively. In our multivariate analysis, significant associations were found between: self-medication by individual choice and the use of Hydroxychloroquine, ABx, or non-steroidal anti-inflammatory drugs (NSAIDs) (p = 0.026, = 0.003, and <0.001 respectively); self-medication on the recommendation of a family member, with ABx, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, and <0.001 respectively); and self-medication on the recommendation of another person, with Chloroquine, Hydroxychloroquine, Azithromycin, Penicillin, other ABx, Warfarin, Ivermectin, Paracetamol, Ibuprofen, or other NSAIDs (p <0.001, <0.001, <0.001, = 0.001, <0.001, <0.001, = 0.004, <0.001, <0.001, and <0.001 respectively). ConclusionThere was a significantly high prevalence of self-medication in our Latin American study population, including the use of medicines not recommended for COVID-19 treatment and/or prevention. The implementation of public health measures aimed at combating the worrying COVID-19 infodemic is essential to prevent this ongoing issue and its associated negative impacts on both current public health and future medication efficacy. This is especially important in the case of ABx due to the threat of a future antimicrobial resistance pandemic.

A mathematical model of Marburg virus disease outbreaks and the potential role of vaccination in control

BackgroundMarburg virus disease is an acute haemorrhagic fever caused by Marburg virus. Marburg virus is zoonotic, maintained in nature in Egyptian fruit bats, with occasional spillover infections into humans and nonhuman primates. Although rare, sporadic cases and outbreaks occur in Africa, usually associated with exposure to bats in mines or caves, and sometimes with secondary human-to-human transmission. Outbreaks outside of Africa have also occurred due to importation of infected monkeys. Although all previous Marburg virus disease outbreaks have been brought under control without vaccination, there is nevertheless the potential for large outbreaks when implementation of public health measures is not possible or breaks down. Vaccines could thus be an important additional tool, and development of several candidate vaccines is under way.MethodsWe developed a branching process model of Marburg virus transmission and investigated the potential effects of several prophylactic and reactive vaccination strategies in settings driven primarily by multiple spillover events as well as human-to-human transmission. Linelist data from the 15 outbreaks up until 2022, as well as an Approximate Bayesian Computational framework, were used to inform the model parameters.ResultsOur results show a low basic reproduction number which varied across outbreaks, from 0.5 [95% CI 0.05–1.8] to 1.2 [95% CI 1.0–1.9] but a high case fatality ratio. Of six vaccination strategies explored, the two prophylactic strategies (mass and targeted vaccination of high-risk groups), as well as a combination of ring and targeted vaccination, were generally most effective, with a probability of potential outbreaks being terminated within 1 year of 0.90 (95% CI 0.90–0.91), 0.89 (95% CI 0.88–0.90), and 0.88 (95% CI 0.87–0.89) compared with 0.68 (0.67–0.69) for no vaccination, especially if the outbreak is driven by zoonotic spillovers and the vaccination campaign initiated as soon as possible after onset of the first case.ConclusionsOur study shows that various vaccination strategies can be effective in helping to control outbreaks of MVD, with the best approach varying with the particular epidemiologic circumstances of each outbreak.

COVID-19 Regional Safety Assessment Using Evaluation Based on Distance from Average Solution (EDAS) Method

The process of assessing the safety and risk level of a particular region or area in respect to the COVID-19 pandemic is known as COVID-19 Regional Safety Assessment. It involves analyzing various factors, such as the number of active cases, testing and reporting capabilities, vaccination rates, healthcare system capacity, implementation of public health measures, travel restrictions, presence of variants of concern, and localized outbreaks. A complete evaluation of regional safety is necessary for public health professionals, legislators, and residents to successfully prevent the spread of COVID-19 and protect public health and wellbeing. Authorities may identify areas of concern, distribute resources wisely, and put targeted measures in place to restrict the virus's spread by performing a thorough examination. In order to restrict the virus's spread and protect the health and welfare of communities, it is crucial for guiding decision-making processes, identifying problem areas, and effectively allocating resources. The research carried out through regional safety assessments advances our knowledge of the pandemic, guides public health initiatives, and encourages the use of evidence-based decision-making in order to effectively battle COVID-19. Distance from Average Solution-Based Evaluation (EDAS)The evaluation based on distance from the average solution approach assesses the efficacy or quality of individual solutions or data points by comparing each solution or data point to the average or mean solution. This approach is commonly employed in various fields, including optimization, data analysis, and decision-making.In this evaluation method, the average solution serves as a reference point or baseline. It is crucial to remember that the evaluation's specific context and goals may influence the choice of the average solution and distance metric. Additionally, other evaluation criteria or metrics may be employed in conjunction with the distance-based evaluation to obtain a more comprehensive assessment of the solutions. China, Denmark, Germany, Hong Kong, Hungary, Israel, Australia, Austria, Canada, and Efficiency of the government, monitoring and detection, and quarantine Emergency Preparedness, regional resilience, and healthcare readiness .Ranking of the nation based on the Covid-19 Regional Safety Assessment survey. Hungary is shown as occupying the last slot, whereas China is listed as occupying the first spot. It has been noted that China has a significant influence on COVID-19.

‘Communism is the virus. COVID-19 is how it spreads’: partisan epistemology and the medical freedom movement

The COVID-19 pandemic saw the implementation of public health measures that caused significant disruption to daily life. Consequently, these measures were met with widespread resistance. It was argued that this resistance was driven by anti-scientific attitudes, as individuals refused to comply with mask mandates and lockdowns, and later resisted vaccination efforts. This article asks whether this is an accurate characterisation of those challenging efforts to combat the COVID-19 pandemic. To address this question, this article draws on fieldwork at medical freedom rallies. These rallies were explicitly organised to challenge policies aimed at containing the spread of COVID-19. The primary finding is that rather than being a conflict between pro- and anti-scientific forces, the conflict instead largely stemmed from who can properly lay claim to the mantle of science. Attendees questioned the legitimacy of the science justifying limitations on their personal liberty and suggested that extra-scientific concerns such as a desire for political control had compromised the objectivity of public health experts. This work contributes to ongoing debates concerning institutional trust and the role of expertise in democratic governance.

Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic - a cross-sectional analysis based on the international PRICOV-19 study in Austria

BackgroundThe SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for “virtual” health or “distance” treatments. This paper aimed to assess the use of video consultations, the up-to-dateness of practice websites, and the views of GPs on whether eHealth is a positive aspect for the future of their practices in publicly -funded primary healthcare facilities in Austria.MethodsThe cross-sectional online questionnaire, part of the PRICOV-19 study, was conducted from December 2020 until July 2021. We randomly recruited 176 GP practices across Austria. Descriptive statistics as well as binary logistic regression models were applied to examine the associations between telemedicine use and practice factors.ResultsCompared with before the pandemic (3.8%), 7.6% of publicly funded GP practices have been using video consultations since the pandemic. In line with this, 93.9% of the practices had no increase in video consultation use. Fewer than half (44.3%) had an up-to-date webpage, and 27.8% assumed that the pandemic might have been a positive driver for eHealth in their practices. Positive associations with video consultation use could be found in practices with fewer patients aged 70 years and over than the average and more patients with chronic diseases than the average.ConclusionThe use of video consultations in general practice and the readiness for other telemedicine approaches are both very low in Austria. Austria has to urgently follow the example of countries with a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper payment system, patient inclusion, and support with regard to administrative and organizational aspects, no substantial change will occur in spite of an increase in need due to the pandemic and changes in the patient population.

The potential of resilience indicators to anticipate infectious disease outbreaks, a systematic review and guide.

To reduce the consequences of infectious disease outbreaks, the timely implementation of public health measures is crucial. Currently used early-warning systems are highly context-dependent and require a long phase of model building. A proposed solution to anticipate the onset or termination of an outbreak is the use of so-called resilience indicators. These indicators are based on the generic theory of critical slowing down and require only incidence time series. Here we assess the potential for this approach to contribute to outbreak anticipation. We systematically reviewed studies that used resilience indicators to predict outbreaks or terminations of epidemics. We identified 37 studies meeting the inclusion criteria: 21 using simulated data and 16 real-world data. 36 out of 37 studies detected significant signs of critical slowing down before a critical transition (i.e., the onset or end of an outbreak), with a highly variable sensitivity (i.e., the proportion of true positive outbreak warnings) ranging from 0.03 to 1 and a lead time ranging from 10 days to 68 months. Challenges include low resolution and limited length of time series, a too rapid increase in cases, and strong seasonal patterns which may hamper the sensitivity of resilience indicators. Alternative types of data, such as Google searches or social media data, have the potential to improve predictions in some cases. Resilience indicators may be useful when the risk of disease outbreaks is changing gradually. This may happen, for instance, when pathogens become increasingly adapted to an environment or evolve gradually to escape immunity. High-resolution monitoring is needed to reach sufficient sensitivity. If those conditions are met, resilience indicators could help improve the current practice of prediction, facilitating timely outbreak response. We provide a step-by-step guide on the use of resilience indicators in infectious disease epidemiology, and guidance on the relevant situations to use this approach.

Variation in the stringency of COVID-19 public health measures on self-reported health, stress, and overall wellbeing in Canada

Evidence is building regarding the association between government implemented public health measures aimed at combating COVID-19 and their impacts on health. This study investigated the relationship between the stringency of public health measures implemented in Canada and self-reported mental health, physical health, stress, and wellbeing among a random sample of 6647 Canadians 18 years of age and older. The analysis was based on self-reported health data from the Canadian Perspectives on Environmental Noise Survey. This data was combined with the Oxford COVID-19 Government Response Tracker database, which included overall stringency index (SI), and four of its sub-components, i.e., school and business closures, restrictions on gatherings, and stay at home policies. Adjusted multivariate logistic regression models indicated that the magnitude of the overall SI was associated with higher or lower odds of reporting worse physical health, mental health, stress and/or overall wellbeing, depending on the measure evaluated. Similarly, policy directed at the four sub-components had varying impacts on the odds of reporting worse health, depending on the sub-component, the strength of the policy restriction, and the health outcome evaluated. The association between the strength of the public health measures and self-reported health, and how this may inform future policy, is discussed.

Human biomonitoring of inorganic elements in a representative sample of the general population from Cape Verde: Results from the PERVEMAC-II study

Inorganic elements such as heavy metals and other potentially toxic elements are frequently detected in humans. The aim of the present study was to analyze the blood concentrations of 49 inorganic elements in a cohort of 401 subjects from Cape Verde. The study was performed in the frame of the Pesticide Residues in Vegetables of the Macaronesia project (PERVEMAC-II). Concentration of inorganic elements, including elements in the ATSDR's priority pollutant list and rare earth elements (RREs) were measured by ICP-MS in the whole blood of participants. A total of 20 out of 49 elements (40.8%) were detected in ≥20% of participants. Arsenic, copper, mercury, lead, selenium, strontium and zinc were detected in ≥99% of samples. Among the REEs, 7 showed detection frequencies above 20%. The median number of different elements detected was 15. In the present series, 77.0, 99.2 and 33.4% of the participants showed values of arsenic, mercury and lead higher than Reference Values 95%. These percentages were much higher than those reported in similar studies. Niobium and tantalum showed the highest median concentrations: 1.35 and 1.34 ng/mL, suggesting an environmental source of these valuable REEs in Cape Verde. Age appeared as the most important factor influencing the blood levels of inorganic elements. Lifestyle had an effect on the concentration of some of these elements. Those subjects whose water source was pond water had significantly higher arsenic levels. The concentration of ∑REEs was significantly higher among individuals who purchase their food in supermarkets (P = 0.013). These variables are of relevance since they can be controlled individually to reduce exposure to these contaminants. Our results may be useful for the implementation of public health measures by the competent authorities.

Features of Mpox infection: The analysis of the data submitted to the ID-IRI network

BackgroundMpox is a rare zoonotic disease caused by the Mpox virus. On May 21, 2022, WHO announced the emergence of confirmed Mpox cases in countries outside the endemic areas in Central and West Africa. MethodsThis multicentre study was performed through the Infectious Diseases International Research Initiative network. Nineteen collaborating centres in 16 countries participated in the study. Consecutive cases with positive Mpoxv-DNA results by the polymerase chain reaction test were included in the study. ResultsThe mean age of 647 patients included in the study was 34.5.98.6% of cases were males, 95.3% were homosexual-bisexual, and 92.2% had a history of sexual contact. History of smallpox vaccination was present in 3.4% of cases. The median incubation period was 7.0 days. The most common symptoms and signs were rashes in 99.5%, lymphadenopathy in 65.1%, and fever in 54.9%. HIV infection was present in 93.8% of cases, and 17.8% were followed up in the hospital for further treatment. In the two weeks before the rash, prodromal symptoms occurred in 52.8% of cases. The incubation period was 3.5 days shorter in HIV-infected Mpox cases with CD4 count <200/μL, we disclosed the presence of lymphadenopathy, a characteristic finding for Mpox, accompanied the disease to a lesser extent in cases with smallpox vaccination. ConclusionsMpox disseminates globally, not just in the endemic areas. Knowledge of clinical features, disease transmission kinetics, and rapid and effective implementation of public health measures are paramount, as reflected by our findings in this study.

Development of a Syndromic Molecular Diagnostic Assay for Tick-Borne Pathogens Using Barcoded Magnetic Bead Technology.

Infectious disease diagnostics often depend on costly serological testing with poor sensitivity, low specificity, and long turnaround time. Here, we demonstrate proof of the principle for simultaneous detection of two tick-borne pathogens from a single test sample using barcoded magnetic bead technology on the BioCode 2500 system. Specific primer sets complementary to the conserved genes of Anaplasma phagocytophilum and Borrelia burgdorferi were used in PCR amplification of the target, followed by the hybridization of the resulting biotinylated PCR products with specific probes tethered to the barcoded magnetic beads for simultaneous detection, using a fluorophore with high quantum yield. The assay has an extremely high signal to background ratio, with a limit of detection (LOD) of 2.81 50% tissue culture infection dose (TCID50)/mL and 1 CFU/mL for A. phagocytophilum and B. burgdorferi, respectively. The observed LOD for gene blocks was 1.8 copies/reaction for both the pathogens. The assay demonstrated 100% positive and negative agreement on performance evaluation using patient specimens and blood samples spiked with 1 × LOD of pathogen stock. No cross-reactivity was observed with other related tick-borne pathogens and genomic DNA of human, cattle, and canine origin. The assay can be upgraded to a sensitive and cost-effective multiplex diagnostic approach that can simultaneously detect multiple clinically important tick-borne pathogens in a single sample with a short turnaround time. IMPORTANCE The low pathogen load in the tick-borne disease test samples and the lack of highly sensitive multiplex diagnostic approaches have impacted diagnosis during clinical testing and limited surveillance studies to gauge prior insight about the prevalence of tick-borne infections in a geographical area. This article demonstrates proof of the principle for simultaneous detection of two important tick-borne pathogens from a single test sample using digital barcoded magnetic bead technology. Using a fluorophore of high quantum yield, the diagnostic approach showed high sensitivity and specificity. The LOD was 1.8 genome copies per reaction for both A. phagocytophilum and B. burgdorferi. The assay can be upgraded for the detection of all clinically important tick-borne pathogens from a single patient sample with high sensitivity and specificity. The assay can provide a diagnostic answer to the clinician in a short turnaround time to facilitate speedy therapeutic intervention to infected patients and implement public health measures to prevent community spread.

Test-Trace strategy for disease control and management: South Africa’s control measures to contain the spread of COVID-19

This chapter provides a critical examination of South Africa’s COVID-19 testing and contact tracing response, including emerging successes and weaknesses. Lessons emerging from South Africa’s COVID-19 testing and contact tracing strategy highlight the importance of rapid roll-out of community screening and testing across the country, robust implementation of public health measures, and leveraging existing healthcare services such as the deployment of existing Community Health Workers. The absence of a standardised national information system to support contact tracing efforts, long turnaround times and backlogs in testing, and low uptake of digital solutions such as the COVIDConnect and COVID Alert Apps, were noted as some of the challenges of the process. New considerations to take into account in planning for any future outbreaks include ways to enhance intersectoral approaches and integrate with other community surveillance systems, how to rationalise health workforce redistribution during surge periods by prioritising cases, and the use of technology solutions to manage data.