Strengthening Of Surveillance System Research Articles

Opportunities to strengthen respiratory virus surveillance systems in Australia: lessons learned from the COVID-19 response.

Disease surveillance data was critical in supporting public health decisions throughout the coronavirus disease 2019 (COVID-19) pandemic. At the same time, the unprecedented circumstances of the pandemic revealed many shortcomings of surveillance systems for viral respiratory pathogens. Strengthening of surveillance systems was identified as a priority for the recently established Australian Centre for Disease Control, which represents a critical opportunity to review pre-pandemic and pandemic surveillance practices, and to decide on future priorities, during both pandemic and inter-pandemic periods. On 20 October 2022, we ran a workshop with experts from the academic and government sectors who had contributed to the COVID-19 response in Australia on 'The role of surveillance in epidemic response', at the University of New South Wales, Sydney, Australia. Following the workshop, we developed five recommendations to strengthen respiratory virus surveillance systems in Australia, which we present here. Our recommendations are not intended to be exhaustive. We instead chose to focus on data types that are highly valuable yet typically overlooked by surveillance planners. Three of the recommendations focus on data collection activities that support the monitoring and prediction of disease impact and the effectiveness of interventions (what to measure) and two focus on surveillance methods and capabilities (how to measure). Implementation of our recommendations would enable more robust, timely, and impactful epidemic analysis.

EVALUATION OF MONITORING HYPERTENSION CASE BASED ON NINE SURVEILLANCE ATTRIBUTES IN JOMBANG DISTRICT HEALTH OFFICE IN 2018

Hypertension is still a global problem, therefore, even affecting the citizens of Indonesia. Among 10 most common diseases in Jombang regency, hypertension was ranked second in 2017. One of the efforts in overcoming hypertension was by monitoring hypertension cases through Noncommunicable Diseases (NCD) surveillance system strengthening. However, the completeness of the MSS hypertension reports in Jombang region was low.The purpose of this study was to evaluate the monitoring of hypertension cases based on surveillance attributes in the Jombang District Health Office throughout 2018. This study was conducted using the qualitative evaluation method. The research subject was NCD surveillance, specifically in monitoring hypertension cases in the Jombang District Health Office. The determination of the informants used purposive sampling. The research informants consist of NCD officers in Jombang District Health Office, and NCD officers in 2 selected primary healthcare centers. The data collection technique used interview guidelines and document observation where data analysis was performed descriptively. The results show in the assessment of surveillance attributes of simplicity, acceptability, positive predictive value, data quality, and stability the results were low. While, flexibility, sensitivity, representativeness, and timeliness cannot be assessed. The conclusion was that the assessment of the surveillance attributes was quite good, but there are still obstacles in its implementation, namely incomplete reports, no attendance records, and so on. This study suggests to implement attendance records in each unit allowing the reported data to be used for planning in preventing hypertension.Keywords: evaluation, hypertention, surveillance attribute.

Distribution and Molecular Characterization of Escherichia coli Harboring mcr Genes Isolated from Slaughtered Pigs in Thailand.

The resistance of Enterobacteriaceae to colistin mediated by plasmid-borne mobile mcr genes is an emerging public health concern. This study aimed to explore the distribution and characteristics of Escherichia coli isolates harboring mcr genes from slaughtered pigs in Thailand from 2014 to 2015. A total of 779 E. coli isolates were assessed, of which 61 (7.8%) were found to carry mcr genes, including mcr-1, mcr-3, mcr-6, mcr-7, mcr-8, and mcr-9, together with co-occurrences of mcr-1+mcr-3, mcr-1+mcr-9, and mcr-3+mcr-6+mcr-7. In these mcr-harboring E. coli isolates, mcr-1 (40.9%) and mcr-9 (32.8%) were predominant. Colistin resistance was mainly mediated by the mcr-1 gene, whereas intermediate resistance was noted in isolates that harbored mcr-9, mcr-6, mcr-7, and mcr-8 genes. Most E. coli isolates harboring mcr genes were susceptible to third-generation cephalosporins and all of these isolates were susceptible to carbapenems. Clermont phylotyping demonstrated that mcr-harboring isolates mainly belonged to phylogroup A (44.3%), followed by phylogroups B1 (34.4%), D (14.8%), and B2 (6.6%). Multilocus sequence typing revealed that 25 sequence types (STs) were assigned to 45 mcr-harboring E. coli isolates, whereas the remaining 16 isolates were novel STs. The mcr-1 and mcr-9 genes were mostly predominant in ST101 and ST8900, respectively. This study provides a comprehensive insight into the prevalence and diversity of mcr-harboring E. coli isolates obtained from slaughtered pigs across Thailand. Strengthening of surveillance systems by the government for controlling and preventing mcr dissemination from animals to humans or vice versa is urgently needed. No clinical trial registration number.

Prospects and strategies for malaria elimination in the Greater Mekong Sub-region: a qualitative study

BackgroundAs malaria elimination becomes a goal in malaria-endemic nations, questions of feasibility become critical. This article explores the potential challenges associated with this goal and future strategies for malaria elimination in the Greater Mekong Sub-region.MethodsThirty-two semi-structured interviews were conducted with policy makers (n = 17) and principal investigators (n = 15) selected based on their involvement in malaria prevention, control and elimination in the GMS. Interviews were audio-recorded and transcribed for qualitative content (thematic) analysis using QSR NVivo.ResultsAll respondents described current malaria control and elimination strategies, such as case detection and management, prevention and strengthening of surveillance systems as critical and of equal priority. Aware of the emergence of multi-drug resistance in the GMS, researchers and policy makers outlined the need for additional elimination tools. As opposed to a centralized strategy, more targeted and tailored approaches to elimination were recommended. These included targeting endemic areas, consideration for local epidemiology and malaria species, and strengthening the peripheral health system. A decline in malaria transmission could lead to complacency amongst funders and policy makers resulting in a reduction or discontinuation of support for malaria elimination. Strong commitment of policymakers combined with strict monitoring and supervision by funders were considered pivotal to successful elimination programmes.ConclusionAgainst a backdrop of increasing anti-malarial resistance and decreasing choices of anti-malarial regimens, policy makers and researchers stressed the urgency of finding new malaria elimination strategies. There was consensus that multi-pronged strategies and approaches are needed, that no single potential tool/strategy can be appropriate to all settings. Hence there is a need to customize malaria control and elimination strategies based on the better surveillance data.

Descriptive Analysis of Malaria Surveillance System Data, Yemen, 2011-2015

Background: Malaria remains one of the most serious health problems in Yemen where 68% of population is living in malaria risk areas. An Integrated Malaria Surveillance System (IMSS) was introduced in 2009 to improve reporting. Objective: To describe the epidemiology of malaria and identify groups at risk. Methods: Data for 2011-2015 was obtained from the National Malaria Control Program (NMCP). According to the NMCP Guidelines, confirmed malaria case is defined as a case that is positive by microscopy or rapid test. We calculated incidence rate (IR) by age group, sex, type of plasmodium, seasonality and population at risk using projections from the 2014 Central Statistical Organization data. Results: Although the overall malaria IR dropped from 11/1000 in 2011 to 5 in 2015, the IR among < 5 children increased from 8 to 15/1000 and the percentage of confirmed cases increased from 0.64% to 0.83%. Among pregnant women, the IR increased from 4/1000 in 2011 to 6 in 2014 but decreased to 2 in 2015. Two thirds of malaria cases were reported among males and from the coastal governorates. Plasmodium Falciparum accounted for 99% of cases. Conclusions: Despite IR dropped from 2011 to 2015, such drop might not reflect improvement in control and prevention measures, but could reflects underreporting due to political instability, war situation and poor access to health facilities. Proper targeting especially of coastal areas by insecticide treated bed nets and indoor residual spraying is necessary. Strengthening of surveillance system for high-risk groups i.e. <5 children and pregnant women is recommended. A qualitative research should investigate reasons behind the predominance of malaria among males. Further IMSS evaluation is recommended. [iproc 2018;4(1):e10637]

Neurocritical Care in Developing Countries

Neurocritical illness heavily burdens the developing world. In spite of a lack of resources for population-based health in most developing countries, there is an increasing demand for resource-intense strategies for acute neurological care. Factors including rising individual incomes in emerging economies, need for neurointensive care in humanitarian emergencies, growth of private hospitals, the rising burden of noncommunicable disease, and the practice of neurocritical care by specialists outside of neurology are discussed. Possible steps to improve the global practice of neurocritical care include: (1) emphasis on prevention of neurocritical illness through traffic safety and adequate outpatient treatment; (2) standardization of training requirements and skill sets; (3) guidelines on cost-effective measures including medications, equipment, and devices; (4) strengthening of surveillance systems and registries for both noncommunicable and communicable neurological diseases; (5) expanded use of teleneurology; (6) educational exchanges of neurointensive health care workers; and (7) monitoring of neurological intensive care unit death rates due to nosocomial infections, neurological disease, and other causes. A summary of reported mortality rates among neurocritically ill patients in African countries in recent years is provided as an illustrative example.

DART – the German strategy to fight antimicrobial resistance. Report on history and current state1

Abstract This report outlines the German strategy to fight antimicrobial resistance consisting of ten objectives: strengthening of surveillance systems on antibiotic resistance and antibiotic consumption, systematic feedback of data on antibiotic resistance and antibiotic consumption, promoting the use of guidelines to ensure the diagnosis, promotion of training, further education and training of health professionals, pharmacists, and natural scientists, national and international cooperation, promotion of assessment measures in human medicine, promotion of knowledge transfer in the field of antibiotic resistance, as well as networking and strengthening of science in the field of antibiotic resistance. The proposed draft legislation and questions concerning sustainable maintenance of good laboratory practice and the corresponding means are addressed.