Infectious Disease

Because the dynamics and severity of influenza in the US vary each season, yearly estimates of disease burden in the population are essential to evaluate interventions and allocate resources. The CDC uses data from a national health-care based surveillance system and mathematical models to estimate the overall burden of disease in the general population. Over the past decade, crowd-sourced syndromic surveillance systems have emerged as a digital data source that collects health-related information in near real-time. These systems complement traditional surveillance systems by capturing individuals who do not seek medical care and allowing for a longitudinal view of illness burden. However, because not all participants report every week and participants are more likely to report when ill, the number of weekly reports is temporally and spatially inconsistent and the estimates of disease burden and incidence may be biased. In this study, we use data from Flu Near You (FNY), a participatory surveillance system based in the US and Canada1, to estimate and compare Influenza-like Illness (ILI) ARs using different approaches to adjust for reporting biases in participatory surveillance data.

Objective:

To estimate and compare influenza attack rates (AR) in the United States (US) using different approaches to adjust for reporting biases in participatory syndromic surveillance data.

Vietnam initiated the HSS system in 1994 in selected provinces with high HIV burden. The surveillance has two components: monitor HIV sero-prevalence and risk behaviors among key population including PWID. However, no VL data were collected among HIV infected people. In 2016, Vietnam piloted an added component of VL testing to the existing HSS system. The purpose was to test the feasibility of adding VL testing to the HSS so that VL data among PWID would be available. The pilot was conducted in two provinces in southern Vietnam-Ho Chi Minh City and Long An. It was expected that adding the VL testing to the existing HSS would also save resources and help monitor HIV viral transmission among PWID in the community regardless if they are currently on anti-retroviral therapy (ART).

Objective:

To share Vietnam's experiences piloting the integration of viral load (VL) testing into the national HIV sentinel surveillance (HSS) system to better understand the level of HIV viral transmission among people who inject drugs (PWID).

Cryptosporidiosis is a diarrheal disease caused by microscopic parasite Cryptosporidium. Modes of transmission include eating undercooked food contaminated with the parasite, swallowing something that has come into contact with human or animal feces, or swallowing pool water contaminated with the parasite. The disease is clinically manifested usually with chronic diarrhea and abdominal cramps. It is found to be more prevalent in immunocompromised patients like HIV and AIDS. Cryptosporidiosis usually causes potentially life-threatening disease in people with AIDS.

Objective:

To demonstrate the demographic and clinical distribution of reported Cryptosporidiosis cases in Houston, Texas, from 2013-2016

Nigeria is the only polio endemic country in Africa. Four (4) WPV1 cases were confirmed in 2013 after two years of silence. Nigeria has a strong polio programme characterized by innovative and forward driven strategies, despite several challenges of which surveillance is one of the driving forces. Near perfect surveillance core indicators reported over the past twelve (12) months across certain states and Local Government Areas (LGAs) were issues of concern, given security challenges among others. In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.

Objective:

In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.

Knowledge of one’s HIV serostatus helps improve quality of life for those who test positive and decreases the risk of HIV transmission. WHO recommends that all participants in HIV prevalence surveys be provided access to their test results, especially those who test HIV positive. Anonymous Vietnam HIV sentinel surveillance (HSS), implemented since 1994, focuses on people who inject drugs (PWID), female sex workers (FSW), and men who have sex with men (MSM). According to national guidelines, the HIV testing algorithm for surveillance purposes was based on two tests whereas the diagnostic algorithm for individuals was based on three tests. Thus, surveillance test results could not be returned to participants who were instead encouraged to learn their HIV serostatus by testing at public confirmatory testing sites. In 2015, a three-test strategy was applied as part of HSS so that test results could be returned to participants.

Objective:

To describe the implementation and preliminary results of returning HIV test results to participants in Vietnam HIV sentinel surveillance.

HIV surveillance in Vietnam is comprised of different surveillance systems including the HIV sentinel surveillance (HSS). The HSS is an annual, multi-site survey to monitor HIV sero-prevalence and risk behaviors among key populations. In 2015, the Vietnam Administration on HIV/AIDS Control (VAAC) installed the Epi Info Cloud Data Analytics (ECDA), a free web-based analytical and visualization program developed by the Centers for Disease Control and Prevention (CDC) to serve as an information management system for HIV surveillance. Until 2016, provincial surveys, recorded on paper, were computerized and submitted to VAAC, which was responsible for merging individual provincial datasets to form a national HSS dataset. Feedback on HSS issues were provided to provinces 3 to 6 months after survey conclusion. With the use of tablets for field data collection in 2017, provincial survey data were recorded electronically and transferred to VAAC at the end of each survey day, thus enabling instant updating of the national 2017 HSS dataset on daily basis. Upon availability of the national HSS dataset on VAAC’s server, ECDA enhanced wider access and prompt analysis for staff at all levels (figure 1). This abstract describes the use of ECDA, together with tablet-based data collection to improve management, quality and use of surveillance data.

Objective:

To use Epi Info Cloud Data Analytics (ECDA) to improve the management, quality and utilization of the Vietnam National HIV Surveillance data.

HIV testing remains the mainstay of optimal HIV care and is pivotal to control and prevention of the disease, however efforts to attain optimal testing levels have been undermined by low HIV testing especially in developing countries. Botswana in response, amended its Public Health Act in September 2013 but the effect of this action on facility based HIV testing rates has not been evaluated.

Objective:

We aimed to assess the effect of the amended Public Health act of 2013 on facility-based HIV testing in Princess Marina Hospital.

ILINet is a CDC program that has been used for years for influenza-like illness (ILI) surveillance, using a network of outpatient providers who volunteer to track and report weekly the number of visits due to ILI and the total number of visits to their practice. Pennsylvania has a network of 95 providers and urgent care clinics that submit data to ILINet. However, ongoing challenges in recruiting and retaining providers, and inconsistent weekly reporting are barriers to receiving accurate, representative, and timely ILI surveillance data year-round. Syndromic surveillance data have been used to enhance outpatient ILI surveillance in a number of jurisdictions, including Pennsylvania. At present, 156 hospitals, or 90% of all Pennsylvania hospitals with emergency departments (EDs), send chief complaint and other information on their ED visits to the Department of Health’s (PADOH) syndromic surveillance system. PADOH evaluated the consistency and reliability of ILI syndromic data as compared to ILINet data, to confirm that syndromic data were suitable for use in ILINet.

Objective:

Discuss use of syndromic surveillance as a source for the state’s ILI/Influenza surveillance Discuss reliability of syndromic data and methods to address problems caused by data outliers and inconsistencies.

HIV and AIDS is not a new problem to global community and human civilization. Though much efforts had been taken yet its devastating effects can be seen in many areas like human productivity, public health, human rights etc. Nepal is experiencing a concentrated epidemic of HIV with prevalence at, or over, 5 percent in certain high-risk groups, such as intravenous drug users (IDUs), MSM, FSW, and migrant laborers in India who go to cities such as Mumbai. The possibility of transmission of HIV infection from these high-risk groups to the general population is a serious health concern. Nepal’s vulnerability to HIV has increased because of several factors including poverty coupled with the lack of employment opportunities, large-scale migration and ten years of conflict. IBBS survey conducted in 2008 in mid-Terai regions reported the prevalence of HIV among seasonal migrants who had sexual contact with female sex workers in India was 2.6% which indicates unsafe sex being one of the major factors of HIV transmission among the seasonal migrants. Similar study conducted among seasonal migrants reported that only 62% used condom during sex with sex worker and HIV infection was found only on those who visited Mumbai (6.1%) and had sex with sex workers without using condom. Seasonal migration for income generation in Mid-Terai part of Nepal is present since the time immemorial. People migrate to India generally to Bihar, Punjab, Uttaranchal, Maharashtra, Uttar Pradesh, Delhi states. Risk of HIV transmission among the seasonal migrants is very high. Separated from their spouses and adrift from social bindings, many to these migrants exercise unsafe sexual practices. Regular monitoring and health assistance to this population is lacking, especially in the case of those who migrate to neighboring countries like India, compared to those who receive authorized permission to work in other countries.

Objective:

The objective was to assess the risk of HIV infection among the seasonal labour migrants of Nepal.