International Health

Low- and Middle-Income Countries (LMIC) disproportionately bear the high burden of injuries, with 90% of all deaths due to injury occurring in these countries. In India, data on pre-hospital care of the injured is either absent or incomplete. The Bloomberg Philanthropies Global Road Safety Program is a five-year (2010- 2015) project implemented by a consortium of partners to improve road safety in 10 LMICs. The risk factors being addressed in India are reduction of drink driving and increasing helmet use. Up to 16 months of data from two large hospitals in Hyderabad (population 8 million) were retrospectively reviewed to examine the burden of road traffic injuries. Unfortunately, key information on the following was incomplete: alcohol use; location and activity of patient at the time of injury; nature of collision; vehicle in which patient was traveling; striking vehicle and type of road user. Information on the presence of safety equipment like helmet and seatbelt, and occurrence of prehospital care was uniformly absent. To overcome the information gap, round-the-clock injury surveillance was established in July 2013 in Hyderabad and in June 2014 in Visakhapatnam.

Objective

To describe the challenges and lessons learned in establishing road traffic injury surveillance in two large government teaching hospitals in two States of South India, with solutions that eventually helped streamline the process.

Livestock diseases in most developing countries are often widely distributed. The wide distribution of diseases often renders whole countries ineligible to participate in international trade of meat and meat products. These trade restrictions serve as a continuous primary source of revenue loss. The World Organisation for Animal Health (OIE) now promotes establishment of disease free zones to lessen the impact of trade restrictions. These “islands” of disease freedom not only serve as a first step in total disease freedom, but for many countries they also serve as a beacon of hope to ever returning to international trade. The selection of a region within a country to be designated as a disease free zone is likely to be based more on the fact that a particular region is yet to experience cases of a given disease than it is on the nation’s Veterinary department ability to keep the region disease free. As such, geographical regions that seem to have inherent protection against disease incursions usually due to geospatial features such as mountains, rivers, remoteness etc. serve as the best candidates for creation of disease free zones. Because the process of disease free zone creation is slow, it is important to ensure that disease surveillance is these regions is enhanced so that disease control authorities may serve as agile responders to disease incursions. This current presentation outlines the creation of a Provincial Epidemiological and Information Centre (PEIC) in Zambia’s Luapula province. This is only the second epidemiosurveillance centre in the country. Luapula province in the northern part of Zambia being one of only 3 provinces out of a total of 10 provinces that are free of theilleriosis in Zambia 2 has the potential of being Zambia’s largest disease free zone. The challenges as well as lessons learnt from setting up this epidemiosurveillance centre are presented.

Objective

This presentation outlines the steps and challenges involved in setting up a regional epidemio-surveillance centre in a resource constrained setting. While this Zambian experience is unique, the challenges encountered are typical of most developing countries and therefore the lessons learned can be applied to much of the developing world.

Integrated Disease Surveillance and Response (IDSR) is a strategy conceived and adopted by the World Health Organization Regional Office for Africa in 1998. The goal of IDSR is to support PHSS in Africa and enhance efficiency and communication across all levels of the national public health system. IDSR emphasizes the commitment of the revised International Health Regulations [IHR (2005)] to strengthen and maintain core capacities to detect, assess, report, and respond to public health events of international concern.

In February 2014, the Sudan Federal Ministry of Health (FMoH), requested an assessment of PHS with attention to PHSS integration opportunities and enhancing their ability to meet IHR (2005) requirements. A WHO Regional Office for the Eastern Mediterranean (WHO/EMRO) team of consultants performed this mission in collaboration with the FMoH.

Objective

This presentation aims to discuss the need and share the results from an international, multi-disciplinary mission to assess public health surveillance (PHS) in Sudan and develop a plan of action (PoA) to strengthen PHS through integration. We will present the findings of the mission and the resulting PoA developed for Public Health Surveillance Strengthening (PHSS) designed to rapidly detect, report and respond to infectious diseases and establish sustainable, integrated One Health concepts.

Fever is a top cause of morbidity in all age groups in Bangladesh and often classified as fever of unknown origin (FUO) in absence of any pathognomonic sign. Bangladesh with its long monsoon, frequent flooding, stagnant water, high temperature, humidity and largest density of animal and human population serves as an ideal place for zoonotic transmission of Leptospira.

Objective

To evaluate the necessity of a coordinated leptospira surveillance in Bangladesh through a systematic review.

Two major heat waves occurred in France in July 2015. A first episode characterized by early onset, intensity, large geographical coverage and duration occurred between 29th of June 8th of July. A second episode less intense was localized on the South-East of the country from 15th to 23rd of July.

The French heat warning system has been operating by InVS since 2004 as part of the French National Heat Wave Plan. Warnings are based on meteorological forecasts and on real-time follow-up of specific health indicators to support decision-making. The evolutions in emergency health care facilities during the July heat waves are presented.

Objective

To present the evolution of heat-related pathologies during heat waves occurring in July 2015 in France

In December 2013, an emergence of chikungunya was observed in the French Caribbean region. Starting on the Saint-Martin island, the epidemic of chikungunya spread in Martinique on December 2013. The first cases were then observed in Guadeloupe in December 2013 and in January 2014 in the French Guyana. A specific surveillance system has been implemented based on a sentinel general practitioners’ network enabling the estimation of the number of cases clinically suggestive. Severity of this arbovirus is assessed using the number of hospitalized cases. The syndromic surveillance system SurSaUD, based on the daily collection of two complementary morbidity data sources, is also implemented in these territories and has contributed to the surveillance of this outbreak.

Objective

Description of the temporal pattern of the chikungunya epidemic and the characteristics of patients in the French overseas territories of Americas using the French syndromic surveillance system SurSaUD.

 

In India the range and burden of infectious diseases is enormous. To address this burden effectively, an estimate of the burden of infectious diseases is essential. The present study aims to analyze data from the Integrated Disease Surveillance Project (ISDP) to estimate the rates of selected infectious diseases in the state of Maharashtra in comparison to the rest of India.

Objective

The present study aims to analyze data from the Integrated Disease Surveillance Project (ISDP) to estimate the rates of selected infectious diseases in the state of Maharashtra in comparison to the rest of India.

Deterioration of socio-economic conditions in Ukraine created a threat of the spread of communicable diseases, including vaccine preventable diseases. Children in Ukraine routinely receive two doses of the measles-mumps-rubella (MMR) vaccine according to the national immunization schedule. Measles is targeted for elimination in Ukraine. But now Ukraine crisis carries significant public health risk and requires changing tactics of surveillance and epidemiological control against measles.

Objective

To estimate the current measles situation in the Kharkiv oblast (eastern region of Ukraine) and to develop ways of improving the surveillance and control of measles in elimination phase during the crisis in Ukraine.

A major drawback in disability prevention and rehabilitation in Sri Lanka is the lack of complete, accurate and timely data. National disability surveys conducted as a part of the decennial census lack complete and scientifically accurate information. Further, Sri Lanka has no established disability surveillance system. This review was conducted to explore the national disability data and to develop a methodology for the establishment of a disability surveillance system in Sri Lanka.

Objective

To review the national disability statistics and to develop a methodology for the establishment of a national disability surveillance system in Sri Lanka.

Ascariasis is one of the most common intestinal nematode infections caused by Ascaris lumbricoides, especially in the tropics and subtropics where warm, wet climates favor year-round transmission of infection. Humans become infected by ingesting infective ascaris eggs in contaminated food, water or from hands that have become faecally contaminated and can cause reduced physical fitness, growth retardation, and respiratory and gastrointestinal problems. The highest morbidity is found in children, especially in those with a high worm burden. To identify high risk areas for intervention, it is necessary to understand the effects of climatic, environmental and socio-demographic conditions on A. lumbricoides infection. In Sri Lanka, although ascariasis was the commonest intestinal parasitic infection among children, information about associated factors and current health impact is insufficient. Therefore, this study was designed to develop and pilot an Ascariasis surveillance system among children in Sri Lanka.

Objective

Designing, developing and Piloting an Ascariasis surveillance system of children to determine factors associated with their variations in Sri Lanka.