Priority Areas For Surveillance Research Articles

Epidemiological profile, spatial patterns and priority areas for surveillance and control of leishmaniasis in Brazilian border strip, 2009–2017

Leishmaniasis represents a major neglected public health problem and the control measures have not been successful in Brazil. Recent studies have shown leishmaniasis importance to Brazilian border zones which reinforces the need to investigate its spread in those regions. This study aimed to analyze epidemiologic profile and its spatial distribution or aggregation process in both tegumentary and visceral leishmaniasis in the Brazilian border strip from 2009 to 2017. This is an ecological study of the epidemiological profile and spatial patterns encompassing municipalities in the Brazilian border strip. The presence of spatial autocorrelation and determination of priority areas for disease control were performed using global (Moran I) and local (LISA) Moran spatial techniques. The annual mean coefficients of tegumentary and visceral leishmaniasis were 29.8 and 0.6 by 100,000 inhabitants in the border strip, respectively. The indigenous population rates of leishmaniasis in the border zone appears to be higher than in the rest of the country (cutaneous changed from 33.2% to 6.6% and visceral rising from 1.0% to 17.5%) in the period. The most affected municipalities were located in the North and Central arches of the border zone. The results can subsidize the development of more targeted and effective strategies that can contribute to the surveillance and control of leishmaniasis in border zones, as the provision of epidemiological and spatial data on the disease. For better control of the disease, we recommend and emphasize the need to integrate public health policies of neighboring countries.

Identification of priority areas for surveillance of cutaneous leishmaniasis using spatial analysis approaches in Southeastern Brazil

BackgroundCutaneous leishmaniasis (CL) is an important public health problem in Brazil and in several tropical regions of the world. In the Americas, Brazil is the country with the highest number of registered cases. In Brazil, the state of Minas Gerais has the highest number of cases in the southeastern region. In the present study, we used spatial analysis in the State of Minas Gerais to identify municipalities of priority during a nine-year period (2007–2015), which might be used to guide surveillance and control measures.MethodsAn ecological study with spatial analysis of autochthonous cases of CL was performed in the state of Minas Gerais between 2007 and 2015. We calculated incidence rates, used Empirical Bayesian smoothing for each municipality, and divided the analyses into three-year intervals. In order to analyze the existence of spatial autocorrelation, and to define priority areas, Moran’s Global Index and Local Indicators of Spatial Association (LISA) were used.ResultsThe mean incidence rate for the entire state was 6.1/100,000 inhabitants. For Minas Gerais, analysis of CL cases over time revealed a successive increase of indicated mesoregions with high priority municipalities. Eight of the designated mesoregions contained municipalities classified as high priority areas in any of the three evaluated trienniums, and four mesoregions had high priority municipalities throughout the entire investigation.ConclusionsWithin the southeastern region of Brazil, Minas Gerais State stands out, with highest CL incidence rates. Using spatial analysis, we identified an increasing numbers of cases in the municipalities classified as high priority areas in different mesoregions of the state. This information might be of value to direct surveillance and control measures against CL and to understand the dynamics of the expansion of CL in Minas Gerais. Similar approaches might be used to map CL in other regions throughout Brazil, or in any other country, where national notification and control programs exist.

Running the Numbers

Parents of adolescents, health care professionals, teachers, school administrators, and community organizations are all concerned about health risk behaviors among adolescents. Use of alcohol, tobacco, and other drugs, lack of physical activity, sexual risk-taking, and behaviors that put students at risk for injuries have been identified by the Centers for Disease Control and Prevention (CDC) as priority areas for surveillance and intervention for adolescents. These behaviors represent significant preventable causes of morbidity and mortality for adolescents [1]. In addition to compromising the current health status of young people, risk behaviors initiated during adolescence result in adverse health consequences in adulthood and in significant social and financial costs [2]

Priority areas for surveillance and prevention of avian influenza during the water-bird migration season in Pakistan

Avian influenza viruses may be introduced into domestic poultry through migratory wild birds, particularly from Pakistan, which is situated across the migratory Indus flyway and holds more than 225 wetlands. To answer the question which areas should be given priority in surveillance and prevention with respect to notifiable avian influenza during the migratory season, a subset of Asian waterbird census data was reviewed. The dataset contains 535 local sites and available counts of waterbirds reported from 1987 to 2007. However, as the majority of the sites are not counted regularly gaps in data matrix appeared. The coordinates of 270 known sites completely fitted the administrative boundaries of the country. These coordinates were geo-processed with polygons of water-bodies and a raster map of predicted poultry density. Pixels representing the estimated number of poultry per km2 were found within a 3 to 9 km range of the census sites (or water-bodies) in their proximity. The coordinates were also used to map the maximum reported counts of waterbirds and local clusters of under-sampled sites. A retrospective case-series analysis of previous outbreaks (2006-2008) of influenza A virus, subtype H5N1 was performed, which revealed that 64% of outbreaks, reported to Office International des Epizooties, the World Organization for Animal Health, occurred during the migratory period. This paper highlights the potential use and limitations of the Asian waterbirds census data in the context of avian influenza. The proposed methodology may be used to prioritize districts for surveillance and economize prevention measures provided better data are generated in future.

Hospital-wide surveillance: Perspective for the practitioner

Hospitals with limited resources need to develop priorities and might consider directing their surveillance efforts in the critical care areas. Once surveillance in these areas has been completed, the practitioner can focus attention on other areas of the hospital, including in-service activities. The preliminary report of the CDC's study of the efficacy of nosocomial infection control (SENIC study) showed a direct correlation between the level of in-service activities and subsequent infection rates. In conclusion, goals for a cost effective surveillance system program should reflect (1) priority areas for surveillance, (2) decision as to what information needs reporting, and (3) effective utilization of data to direct preventive efforts and outbreak investigation.