scholarly journals Pathology and Telepathology Methods in the Child Health and Mortality Prevention Surveillance Network

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S322-S332 ◽  
Author(s):  
Roosecelis B Martines ◽  
Jana M Ritter ◽  
Joy Gary ◽  
Wun-Ju Shieh ◽  
Jaume Ordi ◽  
...  
Keyword(s):  
Child Health ◽  
Lessons Learned ◽  
Molecular Testing ◽  
Surveillance Network ◽  
Pathology Laboratory ◽  
Pathologic Evaluation ◽  
Control And Prevention ◽  
Central Pathology ◽  
Image Archives ◽  
Health And Mortality

Abstract This manuscript describes the Child Health and Mortality Prevention Surveillance (CHAMPS) network approach to pathologic evaluation of minimally invasive tissue sampling (MITS) specimens, including guidelines for histopathologic examination and further diagnostics with special stains, immunohistochemistry, and molecular testing, as performed at the CHAMPS Central Pathology Laboratory (CPL) at the Centers for Disease Control and Prevention, as well as techniques for virtual discussion of these cases (telepathology) with CHAMPS surveillance locations. Based on review of MITS from the early phase of CHAMPS, the CPL has developed standardized histopathology-based algorithms for achieving diagnoses from MITS and telepathology procedures in conjunction with the CHAMPS sites, with the use of whole slide scanners and digital image archives, for maximizing concurrence and knowledge sharing between site and CPL pathologists. These algorithms and procedures, along with lessons learned from initial implementation of these approaches, guide pathologists at the CPL and CHAMPS sites through standardized diagnostics of MITS cases, and allow for productive, real-time case discussions and consultations.

scholarly journals Standardization of Minimally Invasive Tissue Sampling Specimen Collection and Pathology Training for the Child Health and Mortality Prevention Surveillance Network

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S302-S310 ◽  
Author(s):  
Natalia Rakislova ◽  
Fabiola Fernandes ◽  
Lucilia Lovane ◽  
Luisa Jamisse ◽  
Paola Castillo ◽  
...  
Keyword(s):  
Child Health ◽  
Minimally Invasive ◽  
Training Program ◽  
Tissue Sampling ◽  
Surveillance Network ◽  
Staff Members ◽  
Specimen Collection ◽  
Death Investigation ◽  
Health And Mortality

Abstract Background Minimally invasive tissue sampling (MITS) is a simplified postmortem examination technique that has shown to be an adequate approach for cause of death investigation in low-resource settings. It requires relatively low level of infrastructures and can be performed by health professionals with no background in pathology. A training program has been developed for the Child Health and Mortality Prevention Surveillance (CHAMPS) network to guarantee standardization of specimen collection techniques, procedures, and laboratory methods. Methods The training program has included assessment of the site capacities and training on a standardized protocol of MITS sampling and histological processing. The project has also introduced a program of training for trainers for the personnel from Mozambique. To guarantee the adequacy of the procedure in each site, a trainer accompanied the local teams when the activities started. Training outcomes were assessed by evaluating the quality of the samples obtained and the quality of the slides produced locally. Results Between June 2016 and October 2018, the laboratories of 7 sites (Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa) have been evaluated and upgraded. Training has been delivered to 63 staff members from all sites. More than 600 MITS procedures have been performed. The quantity of tissue obtained in the MITS by the local teams was sufficient or abundant in 73%, and 87% of the slides were considered as technically acceptable or excellent. Conclusions Satisfactory standardization of MITS and histology procedures has been achieved across all CHAMPS sites through organized capacity-building plans.

scholarly journals Health and Demographic Surveillance Systems Within the Child Health and Mortality Prevention Surveillance Network

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S274-S279 ◽  
Author(s):  
Solveig A Cunningham ◽  
Nida I Shaikh ◽  
Ariel Nhacolo ◽  
Pratima L Raghunathan ◽  
Karen Kotloff ◽  
...  
Keyword(s):  
Child Health ◽  
Sierra Leone ◽  
Causes Of Death ◽  
Demographic Data ◽  
Surveillance Systems ◽  
Surveillance Network ◽  
Laboratory Methods ◽  
Child Deaths ◽  
Demographic Surveillance Systems ◽  
Health And Mortality

Abstract Health and demographic surveillance systems (HDSSs) provide a foundation for characterizing and defining priorities and strategies for improving population health. The Child Health and Mortality Prevention Surveillance (CHAMPS) project aims to inform policy to prevent child deaths through generating causes of death from surveillance data combined with innovative diagnostic and laboratory methods. Six of the 7 sites that constitute the CHAMPS network have active HDSSs: Mozambique, Mali, Ethiopia, Kenya, Bangladesh, and South Africa; the seventh, in Sierra Leone, is in the early planning stages. This article describes the network of CHAMPS HDSSs and their role in the CHAMPS project. To generate actionable health and demographic data to prevent child deaths, the network depends on reliable demographic surveillance, and the HDSSs play this crucial role.

scholarly journals Development and Implementation of Multiplex TaqMan Array Cards for Specimen Testing at Child Health and Mortality Prevention Surveillance Site Laboratories

2019 ◽  
Vol 69 (Supplement_4) ◽  
pp. S311-S321 ◽  
Author(s):  
Maureen H Diaz ◽  
Jessica L Waller ◽  
M Jordan Theodore ◽  
Nishi Patel ◽  
Bernard J Wolff ◽  
...  
Keyword(s):  
Child Health ◽  
Data Management ◽  
Real Time ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Molecular Testing ◽  
Acid Extraction ◽  
Infectious Disease Diagnostics ◽  
Taqman Array ◽  
Health And Mortality

Abstract Child Health and Mortality Prevention Surveillance (CHAMPS) laboratories are employing a variety of laboratory methods to identify infectious agents contributing to deaths of children <5 years old and stillbirths in sub-Saharan Africa and South Asia. In support of this long-term objective, our team developed TaqMan Array Cards (TACs) for testing postmortem specimens (blood, cerebrospinal fluid, lung tissue, respiratory tract swabs, and rectal swabs) for >100 real-time polymerase chain reaction (PCR) targets in total (30–45 per card depending on configuration). Multipathogen panels were configured by syndrome and customized to include pathogens of significance in young children within the regions where CHAMPS is conducted, including bacteria (57 targets covering 30 genera), viruses (48 targets covering 40 viruses), parasites (8 targets covering 8 organisms), and fungi (3 targets covering 3 organisms). The development and application of multiplex real-time PCR reactions to the TAC microfluidic platform increased the number of targets in each panel while maintaining assay efficiency and replicates for heightened sensitivity. These advances represent a substantial improvement in the utility of this technology for infectious disease diagnostics and surveillance. We optimized all aspects of the CHAMPS molecular laboratory testing workflow including nucleic acid extraction, quality assurance, and data management to ensure comprehensive molecular testing of specimens and high-quality data. Here we describe the development and implementation of multiplex TACs and associated laboratory protocols for specimen processing, testing, and data management at CHAMPS site laboratories.

HIV digital vaccine strategy: An application of blockchain technology in preventing the spread of HIV (Preprint)

2019 ◽  
Author(s):  
Jia Liu ◽  
Zhe Wang ◽  
Dingyong Sun ◽  
Xiying Wang
Keyword(s):  
High Risk ◽  
Vaccine Strategy ◽  
Surveillance Network ◽  
High Risk Sexual Behavior ◽  
Blockchain Technology ◽  
Control And Prevention ◽  
Heavy Burden ◽  
Promising Solution ◽  
Susceptible Populations ◽  
And Control

UNSTRUCTURED The HIV epidemic imposes a heavy burden on societal development. Presently, the protection of susceptible populations is the most feasible method for eliminating the spread of HIV. Governments and other relevant industries are actively attempting to solve the problem. In view of the unavailability of biological vaccines, the best measures that can currently be applied are identification of HIV-infected persons and provision of treatment and behavioral intervention. This paper proposes a HIV digital vaccine strategy based on blockchain technology. In the proposed strategy, a decentralized surveillance network is jointly constructed using HIV high-risk individuals as application nodes and accredited testing agencies as authentication nodes. Following testing at the authentication nodes, the results are uploaded to the blockchain, which results in HIV high-risk individuals being able to determine the HIV infection status of each other in a convenient, anonymous, and credible manner. This reduces the occurrence of high-risk sexual behavior and effectively protects susceptible populations. The proposed strategy is a promising solution to prevent the spread of HIV. The performance of the decentralized surveillance network may lead to the restructuring of current government-funded infectious disease prevention and control modes that are centered on centers for disease control and prevention and hospitals to introduce revolutionary changes in public health systems globally.

scholarly journals Community-based molecular and serological surveillance of subclinical malaria in Myanmar

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Katherine O’Flaherty ◽  
Win Han Oo ◽  
Sophie G. Zaloumis ◽  
Julia C. Cutts ◽  
Kyaw Zayar Aung ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Quantitative Polymerase Chain Reaction ◽  
Dried Blood Spots ◽  
Molecular Testing ◽  
Sample Collection ◽  
Malaria Surveillance ◽  
Surveillance Network ◽  
Targeted Interventions ◽  
Residual Malaria Transmission ◽  
Serological Surveillance

Abstract Background In the Greater Mekong Subregion (GMS), current malaria surveillance strategies rely on a network of village health volunteers (VHVs) reporting the results of rapid diagnostic tests (RDTs), known to miss many asymptomatic infections. Integration of more sensitive diagnostic molecular and serological measures into the VHV network may improve surveillance of residual malaria transmission in hard-to-reach areas in the region and inform targeted interventions and elimination responses. However, data on residual malaria transmission that would be captured by these measures in the VHV-led testing and treatment surveillance network in the GMS is unknown. Methods A total of 114 VHVs were trained to collect dried blood spots from villagers undergoing routine RDTs as part of VHV-led active and passive case detection from April 2015 to June 2016. Samples were subjected to molecular testing (quantitative polymerase chain reaction [qPCR]) to determine Plasmodium falciparum and P. vivax infection and serological testing (against P. falciparum and P. vivax antigens) to determine exposure to P. falciparum and P. vivax. Results Over 15 months, 114 VHVs performed 32,194 RDTs and collected samples for molecular (n = 13,157) and serological (n = 14,128) testing. The prevalence of molecular-detectable P. falciparum and P. vivax infection was 3.2% compared to the 0.16% prevalence of Plasmodium spp. by RDT, highlighting the large burden of infections undetected by standard surveillance. Peaks in anti-P. falciparum, but not P. vivax, merozoite IgG seroprevalence coincided with seasonal P. falciparum transmission peaks, even in those with no molecularly detectable parasites. At the individual level, antibody seropositivity was associated with reduced odds of contemporaneous P. falciparum (OR for PfCSP 0.51 [95%CI 0.35, 0.76], p = 0.001, PfAMA1 0.70 [95%CI 0.52, 0.93], p = 0.01, and PfMSP2 0.81 [95%CI 0.61, 1.08], p = 0.15), but not P. vivax infection (OR PvAMA1 1.02 [95%CI 0.73, 1.43], p = 0.89) indicating a potential role of immunity in protection against molecular-detectable P. falciparum parasitaemia. Conclusions We demonstrated that integration and implementation of sample collection for molecular and serological surveillance into networks of VHV servicing hard-to-reach populations in the GMS is feasible, can capture significant levels of ongoing undetected seasonal malaria transmission and has the potential to supplement current routine RDT testing. Improving malaria surveillance by advancing the integration of molecular and serological techniques, through centralised testing approaches or novel point-of-contact tests, will advance progress, and tracking, towards malaria elimination goals in the GMS.

scholarly journals Molecular characterization of carbapenem-resistant Acinetobacter species in an Irish university hospital: predominance of Acinetobacter genomic species 3

2009 ◽  
Vol 58 (2) ◽  
pp. 209-216 ◽  
Author(s):  
T. W. Boo ◽  
F. Walsh ◽  
B. Crowley
Keyword(s):  
Antimicrobial Agents ◽  
Carbapenem Resistance ◽  
Control Measures ◽  
University Hospital ◽  
Pathology Laboratory ◽  
Acinetobacter Species ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Genomic Species ◽  
Central Pathology

A 30 month prospective study of Acinetobacter species encountered in the Central Pathology Laboratory of St James's Hospital, Dublin, Ireland, was conducted to investigate the prevalence and molecular epidemiology of carbapenem resistance in such isolates. Acinetobacter genomic species 3 (AG3) was found to be the predominant Acinetobacter species (45/114, 39 %) in our institution. A total of 11 % of all Acinetobacter species (12/114) and 22 % of AG3 isolates (10/45) were carbapenem resistant. Carbapenem resistance was mediated by Ambler class D β-lactamase OXA-23 in all 12 isolates, with insertion sequence ISAba1 found upstream of bla OXA-23. ISAba1 was also found upstream of bla ADC-25, which encodes the enzyme AmpC, in an Acinetobacter baumannii isolate, and upstream of the aminoglycoside-acetyltransferase-encoding gene aacC2 in three AG3 isolates. Inter-species plasmidic transfer was most likely involved in the emergence and spread of bla OXA-23 among the Acinetobacter isolates within our institution. The emergence of carbapenem resistance was associated not only with prior carbapenem use but also with the use of other antimicrobial agents, most notably β-lactam/β-lactamase-inhibitor combinations. The study demonstrated the emerging trend of carbapenem resistance in the wider context of the Acinetobacter genus, and reiterated the paramount importance of the prudent use of antimicrobial agents, stringent infection control measures and resistance surveillance of pathogens.

Developing key performance indicators for a tertiary children’s hospital network

2018 ◽  
Vol 42 (5) ◽  
pp. 491 ◽  
Author(s):  
Christopher Elliot ◽  
Cheryl Mcullagh ◽  
Michael Brydon ◽  
Karen Zwi
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Performance Indicators ◽  
Strategic Plan ◽  
Key Performance Indicators ◽  
Lessons Learned ◽  
Process Measures ◽  
Children's Hospital ◽  
Child Health Outcomes ◽  
Priority Populations

Objective The aim of this study is to describe the experience of developing key performance indicators (KPIs) for Sydney Children’s Hospital Network (SCHN), the largest paediatric healthcare entity in Australia. Methods Beginning with a published methodology, the process of developing KPIs involved five phases: (1) identification of potential KPIs referencing the organisational strategic plan and pre-existing internal and external documents; (2) consolidation into a pragmatic set; (3) analysis of potential KPIs against selection criteria; (4) mapping these back against the strategic plan and management structure; and (5) presentation to key stakeholders to ensure suitability and traction. Consistent with the strategic plan, a subset of indicators was selected to address quality of care for children from priority populations. Results A pragmatic list of 60 mandated and 50 potential KPIs was created from the 328 new and 397 existing potentially relevant KPIs generated by the executive team. Of these, 20 KPIs were selected as the most important; 65% were process measures. The majority of mandated KPIs were process measures. Of the KPIs selected to highlight inequities, there were proportionately more outcome measures (44% outcome, 27% process). Less than one-third could currently be measured by the organisation and were thus aspirational. Conclusion Developing a KPI suite requires substantial time, effort and organisational courage. A structured approach to performance measurement and improvement is needed to ensure a balanced suite of KPIs that can be expected to drive an organisation to improve child health outcomes. Future directions for SCHN include a systematic approach to implementation beyond the mandated KPIs, including KPIs that reflect equity and improved outcomes for priority populations, development of meaningful measures for the aspirational KPIs, adding structure KPIs and measurement of changes in child health outcomes related to the development of this KPI process. What is known about the topic? Health services are increasingly required to demonstrate accountability through KPIs. There is a body of literature on both theoretical frameworks for measuring performance and a long list of possible measures, however developing a meaningful suite of KPIs remains a significant challenge for individual organisations. What does this paper add? This paper describes lessons learned from the practical, pragmatic application of a published methodology to develop a suite of KPIs for the largest paediatric healthcare entity in Australia. It provides a select list of the highest-level KPIs selected by the organisation to stimulate further discussion among similar organisations in relation to KPI selection and implementation. What are the implications for practitioners? Developing and implementing a suite of meaningful KPIs for a large organisation requires courage, an understanding of health informatics, stakeholder engagement, stamina and pragmatism. The process we describe can be replicated and/or modified as needed, with discussion of key lessons learned to help practitioners plan ahead.

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