Anthrax is a widely distributed endemic infection in Georgia, affecting nearly the entire country. Many of the human cases that are annually registered are agriculturally acquired. Anthrax remains a public health risk due to active, resistant soil foci. More than 2,000 anthrax affected areas are registered in the country; around 10% of them are active. Recent reports have indicated an increase in the number of human cases as a result of contact with the environment, this is hypothesized to be due to expansion of affected foci, and this has raised concerns of the disease spreading to new areas. The control of anthrax foci is one of the main goals of the public health and veterinary service’s in Georgia. A surveillance program of anthrax foci across pipeline constructions in Georgia has been ongoing since 2003. Field trips are conducted by National Center for Disease Control and Public Health mobile teams to investigate each possible affected area across pipeline constructions.
Public/Population Health
Health care reform and the use of electronic health record systems is dramatically changing the health care landscape creating both challenges and opportunities for public health. High adoption of health information technology among Minnesota’s health care providers has created an opportunity to advance e-health by collecting and using these data to improve population health. It has been demonstrated that interoperable clinical data repositories can serve surveillance needs to support both public health and clinical care. Additionally, health reform is fostering the need for the collection of data to manage population health, compare and share data locally and across states for care coordination, and monitor cohorts and attributed populations. This project will provide a critical understanding of the status, challenges, and opportunities for leveraging the substantial investment in health care data systems to better support public health prevention programs, epidemiology, and surveillance to improve population health, address health disparities, and advance health equity.
Objective
This project describes the informatics characteristics of clinical data repositories among Minnesota health systems and their opportunities and readiness to support public health practice. The focus of the study is the use of these data for public health prevention programs and surveillance, including the opportunities to address health disparities. We examine technical, organization, and process readiness of repositories in support of epidemiology and other key public health programs, and how these data can be used as a statewide public health resource.
Community health assessments are a foundation of public health practice and a prerequisite to achieving public health accreditation. Best practice dictates that CHAs must incorporate qualitative and quantitative data and utilize a number of indicators to create a detailed picture of a community’s health. Metrics may describe demographics, social and economic factors, health behaviors, health outcomes, and healthcare access and utilization. Commonly used indicators facilitate cross-jurisdiction comparisons and simplify decisionmaking. However, while many readily available indicators exist on a county level, few have been made available on the sub-county level. Syndromic surveillance messages, typically emergency room visit records, contain sub-county level data on patient residence, such as zip code or municipality. As hospitals progress towards meeting Stage 2 Meaningful Use requirements, transmission of syndromic surveillance data to public health entities will become standard. Analysis of emergency room visit data, either in aggregate or by specific syndromes, may be a valuable sub-county level indicator of community health status and access to care that can be standardized across jurisdictions.
Objective
To identify geographic clustering of elevated emergency room (ER) usage rates for incorporation into community health assessments (CHA) in suburban Cook County and to validate this metric as a potential sub-county level community health indicator.
Electronic data that could be used for global health surveillance are fragmented across diseases, organizations, and countries. This fragmentation frustrates efforts to analyze data and limits the amount of information available to guide disease control actions. In fields such as biology, semantic or knowledge-based methods are used extensively to integrate a wide range of electronically available data sources, thereby rapidly accelerating the pace of data analysis. Recognizing the potential of these semantic methods for global health surveillance, we have developed the Scalable Data Integration for Disease Surveillance (SDIDS) software platform. SDIDS is a knowledge-based system designed to enable the integration and analysis of data across multiple scales to support global health decision-making. A ‘proof of concept’ version of SDIDS is currently focused on data sources related to malaria surveillance in Uganda.
Objective
To develop a scalable software platform for integrating existing global health surveillance data and to implement the platform for malaria surveillance in Uganda.
Advanced cancer treatments and research have been helping reduce cancer mortality nationally and in Wisconsin. However, chronic health disparities in cancer remain a major public health concern as not all population subgroups have equal accesses to these healthcare benefits. Previous cancer studies showed that cancer health disparities persisted among racial populations had primarily focused on the entire state of Wisconsin. The southeastern region Wisconsin, the greater Milwaukee metropolitan area, is home to 83% of Wisconsin’s African American population, and includes one of the most segregated metropolitan areas in the United States. Because of this, better understanding of cancer trends in the southeastern Wisconsin region can assist in targeting a focal point to more effectively use resources to eliminate health disparities in Wisconsin.
Objective
To assesse health disparities in all-site cancer incidence and mortality rates, and stage of specific cancer diagnosis (female breast cancer and colorectal cancer) compared between African American and white populations of southeastern Wisconsin during 2007-2011.
Zoonoses account for over 70% of emerging infectious diseases in humans. In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola. The occurrence of a number of these zoonoses, and their spread to new areas, is related to globalization, environmental changes, and marginalization of populations. This phenomenon holds true for Latin American and the Caribbean countries (LAC), where 70% of the events public health emergencies reported to the WHO from 2007 to 2008 in the Americas were classified as zoonoses or communicable diseases common to humans and animals. Despite this record, there are no national or regional disease burden estimates in LAC for many zoonoses. To start filling this void, the Pan American Health Organization (PAHO) conducted a survey of LAC countries to collect information on priority emerging and endemic zoonoses, countries prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control.
Objective
To take the first step in identifying how American countries can strengthen their capacities to manage zoonoses risks by capturing information regarding their national zoonoses programs and priorities.
Wildfires occur annually in Oregon, and the health risks of wildfire smoke are well documented1. Before implementing syndromic surveillance through Oregon ESSENCE, assessing the health effects of wildfires in real time was very challenging. Summer 2015 marked the first wildfire season with 60 of 60 eligible Oregon emergency departments (EDs) reporting to ESSENCE. The Oregon ESSENCE team developed a wildfire surveillance pilot project with two local public health authorities (LPHAs) to determine their surveillance needs and practices and developed a training program to increase capacity to conduct surveillance at the local level. Following the training, one of the LPHAs integrated syndromic surveillance into its routine surveillance practices. Oregon ESSENCE also integrated the evaluation findings into the summer 2016 statewide wildfire surveillance plan.
Objective
To build capacity to conduct syndromic surveillance at the local level by leveraging a health surveillance need.
Syndromic surveillance systems are used by Public Health England (PHE) to detect changes in health care activity that are indicative of potential threats to public health. By providing early warning and situational awareness, these systems play a key role in supporting infectious disease surveillance programmes, decision making and supporting public health interventions. In order to improve the identification of unusual activity, we created new baselines to model seasonally expected activity in the absence of outbreaks or other incidents. Although historical data could be used to model seasonality, changes due to public health interventions or working practices affected comparability. Specific examples of these changes included a major change in the way telehealth services were provided in England and the rotavirus vaccination programme introduced in July 2013 that changed the seasonality of gastrointestinal consultations. Therefore, we needed to incorporate these temporal changes in our baselines.
Objective
To improve the ability of syndromic surveillance systems to detect unusual events.
Anthrax is endemic in the South Caucasus region. There is a lack of understanding of the regional epidemiology of the causative pathogen, Bacillus anthracis, and the trans-boundary factors related to its persistence.
Objective
The purpose of this study was to describe anthrax foci along the Georgia-Azerbaijan border and to describe control measures in identified areas.
Information and Communication Technology (ICT) can enhance public health surveillance (PHS) by facilitating the digital exchange of information. Electronic surveillance (e-Surveillance) is the use of electronic systems to empower the digitization of PHS functions of prevention, detection, and response. E-Surveillance maximizes compliance with the International Health Regulations (2005), enables efficient Integrated Disease Surveillance and Response, and empowers One Health.
In Africa, e-Health is hindered by donor-funded, short-term projects known as “pilotitus.” Proactive national leadership is required to establish a sustainable e-Surveillance program; an assessment and a strategic plan are the first steps.
Therefore, the One Health e-Surveillance Initiative (OHSI) was conceived and piloted by Public Health Practice, LLC (PHP) and the African Field Epidemiology Network (AFENET), with support by the Defense Threat Reduction Agency and the U.S. Centers for Disease Control and Prevention (CDC).
Objective
1) To establish One Health workgroups and conduct an e-Surveillance assessment to inform national strategic planning efforts in pilot countries. 2) To provide evidence for the African Surveillance Informatics Governance Board (ASIGB) to address its mission of establishing e-Surveillance.