scholarly journals Estimating burden of foodborne diseases where public health impact is higher and data scarcer: a study in four African countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
B Desta
Keyword(s):  
International Development ◽  
Disease Surveillance ◽  
Large Scale ◽  
Diarrheal Disease ◽  
Risk Mitigation ◽  
Surveillance Systems ◽  
Foodborne Disease ◽  
Political Commitment ◽  
African Countries ◽  
Main Challenge

Abstract Low and middle-income countries, in particular from Africa, bear the highest burden of foodborne disease (FBD). However, because research and disease surveillance data from Africa are limited, previous burden estimates are subject to uncertainty. The main challenge to estimating burden of FBD in Africa is lack of data, where factors ranging from lack of capacity to lack of political commitment, and a focus on priority diseases, limit existing surveillance systems. To address this, we are working with Ethiopia, Mozambique, Nigeria, and Tanzania, to estimate the burden of, and strengthen surveillance systems for, FBD in Africa. We are conducting a population survey (to estimate incidence and distribution of diarrhea in the community), a systematic literature review (to estimate proportions of diarrheal disease caused by different agents), and an active review of available FBD reports (to estimate the extent of under-reporting in existing surveillance). Together, these findings will provide more accurate estimates of the burden of FBD for African countries. Lessons from this large-scale project can be extrapolated to other countries and regions where the burden is high but data are scarce. We highlight applying leadership attributes, including delegation of duties, setting milestones, regular meetings, transparency, and risk mitigation plans. The leading role of experts in this project helps to reduce hurdles. We have also adapted existing data collection tools for use across our diverse African study populations. We are engaging stakeholders who will use our research outputs, by involving them at all stages of the project. This integrated Knowledge Translation approach is translatable to other settings. These studies are part of FOCAL (Foodborne Disease Epidemiology, Surveillance, and Control in African LMIC), a multi-partner, multi-study project co-funded by the Bill and Melinda Gates Foundation and the United Kingdom's Department for International Development.

Using novel methodologies to support burden of disease estimates

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Hald
Keyword(s):  
International Development ◽  
Traditional Approach ◽  
Source Population ◽  
Surveillance Systems ◽  
Data Generation ◽  
Time Data ◽  
African Countries ◽  
Indirect Measure ◽  
True Incidence ◽  
Laboratory Capacity

Abstract A challenge to estimating burden of diarrheal diseases, particularly in LMICs, where laboratory capacity and surveillance systems are limited, is obtaining valid estimates of etiology proportions of cases. A commonly used method is systematic review of studies reporting pathogen isolation in diarrhea cases. However, studies often differ in design, source population, timeframe, and pathogens included, hampering extrapolation to the target population. In a study co-funded by the Bill and Melinda Gates Foundation and the UK Department for International Development, we explore a novel approach for estimating diarrhea etiology proportions in urban and rural populations in four African countries. We analyse sewage samples using short-read next-generation sequencing (NGS) to determine abundance of genes that can be mapped to specific bacterial genera, providing an estimate of the relative abundance of specific pathogens in each sample. In parallel to collecting sewage samples, a questionnaire-based population survey will estimate diarrheal incidence. By combining results, pathogen-specific incidence will be estimated and compared with incidence estimates from the traditional approach. The application NGS to human sewage has great potential for surveillance of foodborne infections, particularly in resource-poor settings where laboratory capacity for bacterial isolation is limited. First, NGS is a one method takes all approach, as it is based on detection of RNA/DNA, a language common across pathogens. Second, it is culture independent, allowing for real-time data generation and standardized sharing. Finally, few samples are needed to survey large populations for several pathogens at the same time. Thus, surveillance based on NGS of sewage may prove to be an indirect measure of incidence. Although it will not provide an estimate for the true incidence in the population, it will increase our understanding of the burden and as such be a proxy and novel way of ranking diseases.

scholarly journals The Surveillance for Enteric Fever in Asia Project (SEAP), Severe Typhoid Fever Surveillance in Africa (SETA), Surveillance of Enteric Fever in India (SEFI), and Strategic Typhoid Alliance Across Africa and Asia (STRATAA) Population-based Enteric Fever Studies: A Review of Methodological Similarities and Differences

2020 ◽  
Vol 71 (Supplement_2) ◽  
pp. S102-S110 ◽  
Author(s):  
Megan E Carey ◽  
William R MacWright ◽  
Justin Im ◽  
James E Meiring ◽  
Malick M Gibani ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Large Scale ◽  
Enteric Fever ◽  
Low Cost ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Physician Practices ◽  
Surveillance Studies ◽  
Salmonella Infections

Abstract Building on previous multicountry surveillance studies of typhoid and others salmonelloses such as the Diseases of the Most Impoverished program and the Typhoid Surveillance in Africa Project, several ongoing blood culture surveillance studies are generating important data about incidence, severity, transmission, and clinical features of invasive Salmonella infections in sub-Saharan Africa and South Asia. These studies are also characterizing drug resistance patterns in their respective study sites. Each study answers a different set of research questions and employs slightly different methodologies, and the geographies under surveillance differ in size, population density, physician practices, access to healthcare facilities, and access to microbiologically safe water and improved sanitation. These differences in part reflect the heterogeneity of the epidemiology of invasive salmonellosis globally, and thus enable generation of data that are useful to policymakers in decision-making for the introduction of typhoid conjugate vaccines (TCVs). Moreover, each study is evaluating the large-scale deployment of TCVs, and may ultimately be used to assess post-introduction vaccine impact. The data generated by these studies will also be used to refine global disease burden estimates. It is important to ensure that lessons learned from these studies not only inform vaccination policy, but also are incorporated into sustainable, low-cost, integrated vaccine-preventable disease surveillance systems.

scholarly journals Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa

2019 ◽  
Vol 4 (4) ◽  
pp. e001427 ◽  
Author(s):  
Ibrahima Socé Fall ◽  
Soatiana Rajatonirina ◽  
Ali Ahmed Yahaya ◽  
Yoti Zabulon ◽  
Peter Nsubuga ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Rapid Assessment ◽  
Scale Up ◽  
Current Status ◽  
Surveillance Systems ◽  
African Region ◽  
African Countries ◽  
Monthly Bulletin ◽  
Surveillance And Response ◽  
Event Based

In 1998, the WHO African region adopted a strategy called Integrated Disease Surveillance and Response (IDSR). Here, we present the current status of IDSR implementation; and provide some future perspectives for enhancing the IDSR strategy in Africa.In 2017, we used two data sources to compile information on the status of IDSR implementation: a pretested rapid assessment questionnaire sent out biannually to all countries and quarterly compilation of data for two IDSR key performance indicators (KPI). The first KPI measures country IDSR performance and the second KPI tracks the number of countries that the WHO secretariat supports to scale up IDSR. The KPI data for 2017 were compared with a retrospective baseline for 2014.By December 2017, 44 of 47 African countries (94%) were implementing IDSR. Of the 44 countries implementing IDSR, 40 (85%) had initiated IDSR training at subnational level; 32 (68%) had commenced community-based surveillance; 35 (74%) had event-based surveillance; 33 (70%) had electronic IDSR; and 32 (68%) had a weekly/monthly bulletin for sharing IDSR data. Thirty-two countries (68%) had achieved the timeliness and completeness threshold of at least 80% of the reporting units. However, only 12 countries (26%) had the desired target of at least 90% IDSR implementation coverage at the peripheral level.After 20 years of implementing IDSR, there are major achievements in the indicator-based surveillance systems. However, major gaps were identified in event-based surveillance. All African countries should enhance IDSR everywhere.

scholarly journals Global Impact and Implications of Covid-19: Call for Multi-Dimensional Perspectives towards Sustainable Solutions

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Teddie O. Rahube
Keyword(s):  
Disease Surveillance ◽  
Specific Treatment ◽  
Disease Outbreaks ◽  
Developed Countries ◽  
Viral Disease ◽  
Health Impact ◽  
Late Response ◽  
Surveillance Systems ◽  
African Countries ◽  
Sustainable Solutions

The COVID-19 pandemic poses an enormous challenge, and it is evidently presenting itself as one of the greatest threats to humanity. The aim of this paper is to review the current state of the COVID-19 pandemic, the global health impact and implications of COVID-19 relative to other recent viral disease outbreaks and antimicrobial resistance (AMR), with the aim to propose the implementation of sustainable solutions. The magnitude of COVID-19 deaths is incomparable to other coronaviruses (CoVs) disease outbreaks experienced in recent history. The high number of deaths observed in developed countries compared to developing countries may have been triggered by the late response/preparedness to the pandemic rather than by the socio-economic statuses. CoVs will remain a serious health threat to humanity due to absence of vaccines and anti-viral treatments. The absence of specific treatment regimens also lead to heavy reliance on chemical disinfectants and could significantly contribute to the rise in AMR, further raising some important questions surrounding hygiene, microbes, ecosystem health and human diseases. The CEASE approach, comprising of five key elements; Communication, Education, Advocacy, Socialization, and Experimentation is proposed for implementation at a global level. CEASE approach is critical especially for African countries and can be used to further explore opportunities that can lead to improvements in sanitation, access to clean water, health care, education and infectious disease surveillance systems.

scholarly journals COVID-19 Crisis in Africa: Revisiting the Contributing Factors

2021 ◽  
Vol 1 (1) ◽  
pp. 64-67
Author(s):  
Ugochukwu A Eze ◽  
Kingsley I Ndoh ◽  
Kehinde K Kanmodi
Keyword(s):  
Disease Surveillance ◽  
Democratic Republic Of Congo ◽  
The United States ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Contributing Factors ◽  
African Countries ◽  
The World ◽  
Control And Prevention ◽  
Sub Saharan

Abstract The COVID-19 pandemic has been a major threat to people and healthcare systems around the world. Each region of the world has had unique factors such as culture, demographics, socioeconomic and the political landscape that has either fueled or mitigated the severity of the pandemic. For example, the 2021 Indian Kumbh Mela festival fueled a devastating wave of the pandemic in India. Similarly, the pandemic in the United States has in part been fueled an epidemic of disinformation that led to a growing number of anti-vaxxers, and those who are opposed to COVID-19 prevention guidelines set by agencies like the Centers for Disease Control and Prevention. In Africa, burial practices in Liberia and the Democratic Republic of Congo once fueled the Ebola epidemic. Likewise, in the context of COVID-19, there are factors that are unique to Africa that may have either fueled or mitigated the severity of the pandemic. The anti-COVID-19 measures in many African countries significantly affected household income without commensurate deployment of palliative measures to cushion the effect. Fortunately, the pandemic has run a relatively milder course in sub-Saharan Africa—defying earlier devastating projections. Therefore, to be prepared for the next pandemic, African governments must involve critical stakeholders such as religious and traditional leaders, strengthen current disease surveillance systems and invest in systems that encourage private investments in local vaccine manufacturing.

scholarly journals Strengthening foodborne diseases surveillance in the WHO African region: An essential need for disease control and food safety assurance

2012 ◽  
Vol 12 (52) ◽  
pp. 6336-6353
Author(s):  
P Mensah ◽  
◽  
L Mwamakamba ◽  
S Kariuki ◽  
MC Fonkoua ◽  
...  
Keyword(s):  
Food Safety ◽  
Disease Surveillance ◽  
Research Training ◽  
Resistant Bacteria ◽  
Foodborne Diseases ◽  
Surveillance Systems ◽  
Foodborne Disease ◽  
African Region ◽  
Chemical Contaminants ◽  
Use Of Resources

Several devastating outbreaks of foodborne diseases have been reported in the African region including acute aflatoxicosis in Kenya in 2004 and bromide poisoning in Angola in 2007. There are concerns about transmission of multiple antibiotic resistant bacteria and pesticide residues in foods. The globalization of the food trade which could increase the spread of food contaminants internationally is an emerging issue. The new International Health Regulations (IHR) (2005) cover events of international importance including contaminated food and outbreaks of foodborne disease. The IHR (2005) and other international as well as regional agreements require Member States to strengthen surveillance systems including surveillance for foodborne diseases. WHO has been supporting countries to strengthen foodborne disease surveillance since 2003. This paper reports on the work of WHO and partners in the area of foodborne disease surveillance, the challenges and opportunities and provides perspectives for the area of its work. The paper shows that laboratory-based surveillance is the preferred system for foodborne disease surveillance since it allows early detection of outbreak strains and identification of risk factors with laboratory services as the cornerstone. Foodborne disease surveillance has been included in the revised Integrated Disease Surveillance and Response (IDSR) Strategy and there are guidelines for use by countries. WHO in collaboration with partners, especially the Global Food Infections Network (GFN), has been supporting countries to strengthen national analytical capacity for foodborne disease surveillance and research. Training for countries to detect, control and prevent foodborne and other enteric infections from farm to table has been conducted. The training for microbiologists and epidemiologists from public health, veterinary and food sectors involved in isolation, identification and typing of Salmonella sp, Campylobacter sp., Vibrio cholerae, Vibrio sp. and Shigella from human and food samples have been carried out. Research into specific topics in microbiology and chemical contaminants has been conducted. Three institutions in Cameroun, Mali and Nigeria have been designated as centres of excellence for chemical contaminants. Despite these significant achievements, a number of challenges remain. Most food safety programmes and food safety systems remain fragmented resulting in duplication of efforts and inefficient use of resources; and most laboratories in the African Region are poorly resourced. In countries where facilities exist, there is underutilization and lack of synergy among laboratories. Countries should, therefore, conduct audits of existing laboratories to determine their strengths and weaknesses and strategize as appropriate. It is also imperative to continue to strengthen partnerships and forge new ones and increase resources for food safety, in general, and for foodborne disease surveillance, in particular, and continue capacity building, both human and institutional.

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