International Health

Disease surveillance particularly surveillance for communicable diseases is essential in identifying cases and preventing the occurrence of an outbreak. Surveillance can also contribute to reducing the size of an outbreak. In order to achieve these, surveillance activities must include all possible sites for case detection. The lack of established mechanisms to provide feedback to the surveillance system at all such points can cause a failure of the surveillance system. These are extremely relevant particularly in the current outbreak of Ebola in some parts of the West African Sub Region. Ghana, like many countries has established surveillance systems for specific diseases. Currently, 44 diseases/public health events including Ebola are under surveillance as part of an Integrated Disease Surveillance and Response (IDSR) system. Although the Ministry of Health (MOH) exercises authority over issues of health, the operation of policies and practices on disease surveillance is by the Ghana Health Service (GHS), an agency of the MOH despite the existence of other agencies such as the teaching hospitals.

Objective

To describe Ghana’s disease surveillance system operation and the potential challenges in the light of the Ebola outbreak in West Africa

Regional disease surveillance as well as data transparency and sharing are the global trend for mitigating the threat of infectious diseases. The WHO has already played a leading role in FluNet (http:// www.who.int/influenza/gisrs_laboratory/flunet/en/ ) and DenguNet (http://www.who.int/csr/disease/dengue/denguenet/en/). However, the enterovirus-related infections which caused a high disease burden for pre-school children in South-East Asian regions over the last two decades still lack a comprehensive surveillance system in the region [1]. If the spreading pattern and a possible alert mechanism can be identified and set up, it will be beneficial for controlling hand, foot and mouth disease (HFMD) epidemics in East Asia. In some research findings, the transmission of HFMD was correlated with temperature, relative humidity, wind speed, precipitation, population density and the periods in which schools were open [2]. A delayed temporal trend was also found with the increase in latitude [3,4] . In this study, we tried to apply publicly available weekly surveillance data in Japan, Taiwan and Singapore to evaluate the spatio-temporal evolution of HFMD epidemics and how the weather conditions affect the HFMD epidemics.

Objective

Enterovirus epidemics, especially affecting young children, have occurred in South-East Asia every year. If the epidemic periods are inter-correlated among different areas, early warning signals could be issued to prevent or reduce the severity of the later epidemics in other areas. In this study, we integrated the available surveillance and weather data in East Asia to elucidate possible spatio-temporal correlations and weather conditions among different areas from low to high latitude.

Influenza poses a global health threat. The disease affects all ages, often with variable clinical features.

Abidjan, where this study took place, has a long rainy season April-July with a shorter less intense rainy season October-November. Temperatures vary very little during the year. In temperate areas, children and adults aged >=65 years are risk groups. In these countries the seasonality of influenza is clearly defined, with seasonal epidemics in cold weather periods. But in the tropics, the risk groups of influenza are not as well defined. Also, the dynamics of influenza transmission and climatological parameters that influence it are specific to the tropical region and not as thoroughly studied.

Objective

This study aims to determine the epidemiological and clinical profiles of influenza infections related to different strains and the effect of climatological parameters on the temporal distribution of the disease for the prediction.

Stillbirth is an unfortunate event in a woman life which remains uncounted in developing countries, thus, seldom caught attention until recently. Among 3.2 million stillbirths globally, 98% occurs in LMICs with majority in South Asia, and 75% of those are preventable. Globally, it counts as equal to neonatal deaths and is not mentioned in MGDs, global charters and programs priority. Besides immense information gap, it is mostly not part of vital registration system. Mostly, the data for stillbirths is mostly collected in demographic surveys, clinical studies or retrospective records, underestimating the counts. Besides, lack of optimal national vital registration system, Pakistan has highest rate of stillbirth. Hence, to collect prospective data, efforts are made by Department of Paediatrics of Aga Khan University to maintain a Demographic & Health Surveillance System (DHSS) at Karachi to provide more robust data over years.

Objective

To describe characteristic of stillbirth in a diverse population in Karachi health and demographic surveillance system.

Biosurveillance Portal (BSP) is a web-based enterprise environment that is aimed to facilitate international collaboration, communication, and information-sharing in support of the detection, management, and mitigation of biological events in Korea. In Oct 2013, Republic of Korea (ROK) Ministry of National Defense has made the project agreement with United States (US) Department of Defense Joint Program Executive Office of Chemical and Biological Defense to develop Biosurveillance Portal which will provide tools and capabilities to facilitate timely identification and detection of biological events to minimize operational impacts on ROK-US Forces. As a part of this project, Armed Forces Medical Command (AFMC) undertook the initiative to develop the Military Active Realtime Syndromic Surveillance system.

Objective

This presentation aims to elaborate our experiences from initiating a syndromic surveillance system as a part of current biosurveillance developments in Korea. We developed Military Active Realtime Syndromic Surveillance (MARSS) system with data from all of 19 Korean military hospitals as a part of the US-ROK joint Biosurveillance Project.

In 1969, the Twenty-Second World Health Assembly revised and consolidated the International Sanitary Regulations into what is known today as the International Health Regulations (IHR). The IHR promote a global collaboration to prepare for, respond to, and prevent the spread of infectious disease and other public health threats. In 2005, the IHR was once again reviewed and expanded to address the increasing threat of emerging infectious disease due to globalization and urbanization. 195 State Parties agreed to adopt and implement IHR (2005); however, as of May 2013, over 100 of these States still had not yet met the eight core capacities outlined in the IHR (2005). In February 2014, the Obama administration launched the Global Health Security Agenda with the aim of moving toward a world safe and secure from infectious disease threats. The Global Health Security Agenda offers a path forward to support countries in achieving the core capacities of the IHR. APHL proposes leveraging the distributed structure of the US managed Laboratory Response Network for Biological Threats Preparedness (LRN-B) to develop the core capacity of laboratory testing and to fulfill the laboratory strengthening component of the Global Health Security Agenda. The LRN supports five of the eight core capacities and could serve as a model for State Parties lacking resources and an implementation plan. The LRN, founded in 1999 by Centers for Disease Control and Prevention (CDC), Federal Bureau of Investigation (FBI) and the Association of Public Health Laboratories (APHL), is a specialized network of laboratories that are capable of an all-hazard response to a variety public health threats. Leveraging LRN assets internationally would provide a standardized approach toward IHR (2005) implementation and ensure a global collaboration to defend against public health threats.

Objective

To promote the Laboratory Response Network (LRN) as a model that supports global health initiatives, strengthens worldwide laboratory systems, and advances international partnerships to prepare for and respond to infectious disease threats.

Reduction in HIV transmission needs continuous, comprehensive and effective communication channels to disseminate messages that will sustain efforts to motivate adolescents to engage in a range of options to reduce the risk of HIV infection. Life skills education, an integral part of school-based AIDS programs that include sexual and reproductive health information, has been a timely prevention effort in schools.1 This has proven to be an effective method in delaying the onset of sexual intercourse, and among sexually experienced youth, in increasing the use of condoms and decreasing the number of sexual partners. Life skills are behaviors that enable individuals to adapt to and deal effectively with the demands and challenges of life. The life skills approach is an interactive, educational methodology that not only focuses on transmitting knowledge but also aims at shaping attitudes and developing interpersonal skills. The main goal of the life skills approach is to enhance young people’s ability to take responsibility for making healthier choices, resisting negative pressures, and avoiding risk behaviors. Limited studies have been done on assessing life skills of adolescents in schools. Findings from this study will provide baseline for programmatic scale up.

Objective

To assess the predictors of life-skills-based HIV/AIDS education on sexual behaviour among secondary school students in South West, Nigeria.

 

Cancers are among the leading causes of deaths globally. In subSaharan Africa, cancer-related deaths have been projected to increase significantly in the next few decades. Information on cancer is essential in planning and implementing cancer control and prevention activities. Registration and follow-up of cancer cases to estimate survival are useful tools in cancer control programmes. In Ghana, despite the existence of a national cancer prevention and control strategy, not much attention has been given to the problem. Cancer survival has been found to be poor in most developing countries due to late reporting. While late reporting may be a significant factor in cancer survival, the ability of clinical and community health staff to follow-up on cases can help and provide accurate information on cancer survival.

Objective

To identify challenges to community-based surveillance and follow up of breast cancer cases in Ghana.

 

About 60% of Nairobi residents live in slums with higher poverty, population density prevalence diseases and lower health access than the city average. Some residents own livestock or in are in contact with its products. Most slums dwellers work outside slums. Thus, health surveillance in slum area is vital because of potential disease outbreaks and spread. Yet, little is known on practice/challenges of health surveillance in resource-limited slums.

Objective

Disseminate field lessons from a zoonotic disease study nested on the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study investigates the emergence and introduction of zoonoses in urban areas

 

The costs of addressing specific needs to improve surveillance systems in sub-Saharan Africa are often unknown. For centuries meningococcal meningitis epidemics have occurred every few years in the Sahelian and sub-sahel regions of Africa also referred to as the “African meningitis belt”. A serogroup A meningococcal conjugate vaccine, MenAfriVac®, was licensed in 2009 and introduced in phases through mass immunization campaigns for all 1-29 year olds. The long term health impact of MenAfriVac® can only be determined if strong disease surveillance is in place. The objective was to estimate the costs and assess the performance of meningitis surveillance in Chad to determine resources needed for implementing a district casebased surveillance strategy.

Objective T

his presentation shares findings of a cost and performance evaluation of the meningitis surveillance system in Chad. We will also present methods used to design an operational standard for meningitis surveillance in Chad and a cost extrapolation model for other meningitis affected countries in sub-Saharan Africa.