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Resource-limited Settings

Description

Electronic disease surveillance systems can be extremely valuable tools; however, a critical step in system implementation is collection of data. Without accurate and complete data, statistical anomalies that are detected hold little meaning. Many people who have established successful surveillance systems acknowledge the initial data collection process to be one of the most challenging aspects of system implementation. These challenges manifest from varying degrees of economical, infrastructural, environmental, cultural, and political factors. Although some factors are not controllable, selecting a suitable collection framework can mitigate many of these obstacles. JHU/APL, with support from the Armed Forces Health Surveillance Center, has developed a suite of tools, Suite for Automated Global bioSurveillance (SAGES), that is adaptable for a particular deployment’s environment and takes the above factors into account. These subsystems span communication systems such as telephone lines, mobile devices, internet applications, and desktop solutions--each has compelling advantages and disadvantages depending on the environment in which they are deployed. When these subsystems are appropriately configured and implemented, the data are collected with more accuracy and timeliness.

Objective

This paper describes the common challenges of data collection and presents a variety of adaptable frameworks that succeed in overcoming obstacles in applications of public health and electronic disease surveillance systems and/or processes, particularly in resource-limited settings.

Submitted by teresa.hamby@d… on
Description

Electronic disease surveillance systems can be extremely valuable tools; however, a critical step in system implementation is collection of data. Without accurate and complete data, statistical anomalies that are detected hold little meaning. Many people who have established successful surveillance systems acknowledge the initial data collection process to be one of the most challenging aspects of system implementation. These challenges manifest from varying degrees of economical, infrastructural, environmental, cultural, and political factors. Although some factors are not controllable, selecting a suitable collection framework can mitigate many of these obstacles. JHU/APL, with support from the Armed Forces Health Surveillance Center, has developed a suite of tools, Suite for Automated Global bioSurveillance, that is adaptable for a particular deployment’s environment and takes the above factors into account. These subsystems span communication systems such as telephone lines, mobile devices, internet applications, and desktop solutions - each has compelling advantages and disadvantages depending on the environment in which they are deployed. When these subsystems are appropriately configured and implemented, the data are collected with more accuracy and timeliness.

 

Objective

This paper describes the common challenges of data collection and presents a variety of adaptable frameworks that succeed in overcoming obstacles in applications of public health and electronic disease surveillance systems and/or processes, particularly in resource-limited settings.

Submitted by hparton on
Description

Emerging and re-emerging infectious diseases are a serious threat to global public health. The World Health Organization (WHO) has identified more than 1100 epidemic events worldwide in the last 5 years alone. Recently, the emergence of the novel 2009 influenza A (H1N1) virus and the SARS coronavirus has demonstrated how rapidly pathogens can spread worldwide. This infectious disease threat, combined with a concern over man-made biological or chemical events, spurred WHO to update their International Health Regulations (IHR) in 2005. The new 2005 IHR, a legally binding instrument for all 194 WHO member countries, significantly expanded the scope of reportable conditions, and are intended to help prevent and respond to global public health threats. SAGES aims to improve local public health surveillance and IHR compliance, with particular emphasis on resource-limited settings.

Objective

This paper describes the development of the Suite for Automated Global bioSurveillance (SAGES), a collection of freely available software tools intended to enhance electronic disease surveillance in resource-limited settings around the world.

Submitted by Magou on
Description

More than a decade ago, in collaboration with the U.S. Department of Defense, the Johns Hopkins University Applied Physics Laboratory (JHU/APL) developed the Electronic Surveillance System for the Early Notification of Community-based Epidemics (Enterprise ESSENCE), which is currently used by federal, state and local health authorities in the US. As emerging infections will most likely originate outside of the US (for example, SARS) the application of electronic biosurveillance is increasingly important in resource limited areas. In addition, such systems help governments respond to the recently modified International Health Regulations. Leveraging the experience gained in the development of Enterprise ESSENCE, JHU/APL has developed two freely available electronic biosurveillance systems suitable for use in resource-limited areas: Open ESSENCE (OE) and ESSENCE Desktop Edition (EDE).

 

Objective

This paper describes the development and early implementation of two freely available electronic biosurveillance software applications: OE, and EDE.

Submitted by hparton on
Description

Oregon Health Authority (OHA), in collaboration with the Johns Hopkins University Applied Physics Laboratory, recently implemented Oregon ESSENCE, an automated, electronic syndromic surveillance system. One way to strengthen syndromic surveillance is to include data from multiple sources. We are integrating data from emergency departments, state notifiable conditions and vital statistics, and the Oregon Poison Center (OPC). Implementing ESSENCE in Oregon provided the opportunity to automate poison center surveillance, which was previously done manually. In order to achieve this, OHA needed a daily data feed of OPC data to upload into Oregon ESSENCE servers. For OPC to do this directly, they would have incurred significant costs to develop the necessary electronic infrastructure to query and send the data; furthermore, OPC does not employ IT staff. OHA does not currently have funding available to support IT system interoperability with Oregon ESSENCE, so we sought a low-cost solution that would build upon existing systems that utilized the National Poison Data System (NPDS) web service.

Objective

Enhance Oregon ESSENCE by integrating data from the Oregon Poison Center (OPC) in a cost-effective manner.

Submitted by elamb on
Description

Mobile technology provides opportunities to monitor and improve health in areas of the world where resources are scarce. Poor infrastructure and the lack of access to medical services for millions have led to increased usage of mobile technology for health related purposes in recent years. As adoption has increased, so has its acceptance as a viable technology for health data collection. The ability to provide timely, accurate, and informed responses to emerging outbreaks of disease and other health threats makes mobile technology highly suitable for use in surveillance data collection activities and within the arena of global health informatics overall. The American Public Health Association defines global health informatics as the application of information and communication technologies to improve health in low-resource settings, which include the following: linking disparate sources of data together through natural language processing, use of mobile health technologies for disease surveillance, use of telemedicine to manage chronic disease, use of digital libraries to increase knowledge and awareness of public health events. 

 

Objective 

To present the prevailing global public health informatics landscape in developing countries highlighting current mobile system requirements and usage for disease surveillance and revealing gaps in the technology.

Submitted by elamb on
Description

The Biological Threat Reduction Program (BTRP) of the U.S. Defense Threat Reduction Agency (DTRA) delivers interventions to enhance surveillance of especially dangerous pathogens of both humans and animals within countries of the former Soviet Union. The program targets the different stages at which threats or their impact can be reduced, for example via i) the reduction of exposure to threats, or ii) measures for the containment of the threat. The program delivers training on surveillance-related subjects through regular events attended by representatives of the Ministry of Agriculture of Uzbekistan (UZ). This provides an opportunity to capture data and conduct simple interventions on specific subjects amenable to basic evaluation. Given the sensitive nature of pathogen-specific data, we focus on non-disease-specific interventions leading to the reduction of exposure to and release of any given hazard. Here we present an opportunistic approach for capturing data, at no additional cost, to assess i) baseline awareness of on-farm biosecurity measures among UZ veterinary officials and ii) the impact of training on their awareness of biosecurity. We also discuss the conceptual design of a study to assess on-farm biosecurity practices in UZ.

Objective

To describe approaches to the evaluation of surveillance-related efforts in resource-limited countries. Here we present an opportunistic approach to measure the success of efforts to improve on-farm biosecurity in Uzbekistan, leading to a reduction of generic threats to animal disease transmission.

Submitted by elamb on
Description

Electronic epi-biosurveillance presents an opportunity to provide real-time disease surveillance alerts from remote areas to central disease management units, to rapidly decrease reporting times for reportable diseases, and to enable appropriate response scenarios to be put in place in a timely manner. Over the past year, with the support of GEIS and Johns Hopkins Applied Physics Lab, we have piloted an electronic disease reporting system in four sites in the Cameroon military and evaluated these surveillance efforts, to understand how such infrastructure may impact this resource-limited setting.

Objective

Pilot and evaluate an electronic disease surveillance system in the Cameroon military and assess the capabilities of this system to fulfill reporting and early warning requirements.

Submitted by knowledge_repo… on
Description

Difficulties in timely acquisition and interpretation of accurate data on communicable diseases can impede outbreak detection and control. These limitations are of global importance: they contribute to avoidable morbidity, economic losses, and social disruption; and, in a globalized world, epidemics can spread rapidly to other susceptible populations.

SARS and the potential for an influenza pandemic highlighted the importance of global disease surveillance. Similarly, the World Health Organization’s newly implemented 2005 International Health Regulations require member countries to provide notification of emerging infectious diseases of potential global importance. The challenges arise when Ministries of Health (MoH) in resource-poor countries add these mandates to already over-burdened and under-funded surveillance systems. Appropriately adapted, electronic disease surveillance systems could provide the tools and approaches MOHs need to meet today’s surveillance challenges.

 

Objective

In this presentation we will discuss the concept of electronic disease surveillance in resource-poor settings, and the issues to be considered during system planning and implementation.

Submitted by elamb on
Description

The former Soviet Union (FSU)—through the Sanitary-Epidemiologic Service (SES)—developed an extensive system of disease surveillance that was effective, yet centrally planned in Moscow. Even after the fall of the FSU in 1991, most newly independent states maintained all or parts of the SES structure. However, even 15 years later, the loss of economic and technical assistance from Moscow has negatively impacted the effectiveness and efficiency of disease surveillance in these republics, including Armenia and Georgia. In 2005, Armenia and Georgia reported tuberculosis (TB) incidences of 71 and 83, respectively, per 100,000.

 

Objective

To enhance its effectiveness and efficiency, we evaluated TB surveillance in the FSU Republics of Armenia and Georgia.

Submitted by elamb on