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 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.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

scholarly journals Laboratory capacity of Greek hospitals for diagnosis of salmonellosis and surveillance systems’ performance in the years of economic crisis, 2010–2016

2018 ◽  
Vol 147 ◽  
Author(s):  
K. Mellou ◽  
E. Saranti-Papasaranti ◽  
G. Mandilara ◽  
T. Georgakopoulou
Keyword(s):  
Public Hospitals ◽  
Geographical Region ◽  
Reference Laboratory ◽  
Laboratory System ◽  
Surveillance Systems ◽  
National Reference Laboratory ◽  
Notification System ◽  
National Reference ◽  
Laboratory Capacity ◽  
Mandatory Notification

AbstractAusterity might have affected the capacity of public hospitals in Greece to diagnose salmonellosis (laboratory capacity) over the period 2010–2016, as well as the performance of the existing surveillance systems. The scope of this paper is to present data on laboratory capacity over these years, as well as the results of a two-source capture-recapture study (data from Mandatory Notification System and National Reference Laboratory System for Salmonella). The main findings were that: (a) laboratory capacity was high and steady besides the financial crisis, (b) the estimated number of laboratory-confirmed cases (n = 6017, 95% CI 5892–6142) resulted in an incidence rate (7.9 cases/100 000 population) almost twice than that reported by the two systems Mandatory Notification System (MNS); 4.1 and National Reference Laboratory System (NRLS); 4.5 cases/100 000 population, (c) underreporting was high for both systems (MNS; 47.5% and NRLS; 42.8%) and (d) differences by geographical region, size and type of hospital were identified. We suggest that (a) specific interventions are needed to increase completeness of the systems by type of hospital and geographical region, (b) record linkage can help in estimating the disease burden in a more valid way than each system separately and (c) a common electronic database in order to feed one system to the other could significantly increase completeness of both systems.

scholarly journals Estimating true incidence of O157 and non-O157 Shiga toxin-producingEscherichia coliillness in Germany based on notification data of haemolytic uraemic syndrome

2016 ◽  
Vol 144 (15) ◽  
pp. 3305-3315 ◽  
Author(s):  
A. KUEHNE ◽  
M. BOUWKNEGT ◽  
A. HAVELAAR ◽  
A. GILSDORF ◽  
P. HOYER ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Monte Carlo ◽  
Monte Carlo Simulations ◽  
Shiga Toxin ◽  
Haemolytic Uraemic Syndrome ◽  
Credible Interval ◽  
Annual Incidence ◽  
Surveillance Systems ◽  
True Incidence ◽  
Notification Data

SUMMARYShiga toxin-producingEscherichia coli(STEC) is an important cause of gastroenteritis (GE) and haemolytic uraemic syndrome (HUS). Incidence of STEC illness is largely underestimated in notification data, particularly of serogroups other than O157 (‘non-O157’). Using HUS national notification data (2008–2012, excluding 2011), we modelled true annual incidence of STEC illness in Germany separately for O157 and non-O157 STEC, taking into account the groups’ different probabilities of causing bloody diarrhoea and HUS, and the resulting difference in their under-ascertainment. Uncertainty of input parameters was evaluated by stochastic Monte Carlo simulations. Median annual incidence (per 100 000 population) of STEC-associated HUS and STEC-GE was estimated at 0·11 [95% credible interval (CrI) 0·08-0·20], and 35 (95% CrI 12-145), respectively. German notification data underestimated STEC-associated HUS and STEC-GE incidences by factors of 1·8 and 32·3, respectively. Non-O157 STEC accounted for 81% of all STEC-GE, 51% of all bloody STEC-GE and 32% of all STEC-associated HUS cases. Non-O157 serogroups dominate incidence of STEC-GE and contribute significantly to STEC-associated HUS in Germany. This might apply to many other countries considering European surveillance data on HUS. Non-O157 STEC should be considered in parallel with STEC O157 when searching aetiology in patients with GE or HUS, and accounted for in modern surveillance systems.

Corruption, Transparency, and E-Government

2011 ◽  
pp. 271-282
Author(s):  
Herwig Ostermann ◽  
Roland Staudinger
Keyword(s):  
International Development ◽  
Historical Perspective ◽  
Capital Inflows ◽  
Private Capital ◽  
African Countries ◽  
Political Issue ◽  
Transparency International ◽  
Economic Progress ◽  
Red Tape ◽  
The Cost

Regarded from a historical perspective, the appearance of corruption is not a new phenomenon at all. It can be traced back to the ancient civilizations of China, Egypt, Greece, India, Israel, and Rome, which all provide evidence of widespread illegality and corruption. In spite of its long history, corruption increasingly became a political issue in the 1990s: corruption scandals contributed substantially to the resignation of governments in Ecuador, Brazil, India, and Italy and unsettled well-established ruling parties in Japan and Mexico (Lash, 2004; Sen, 1999). According to Sen (1999), “the prevalence of corruption is rightly regarded as one of the major stumbling blocks in the path to successful economic progress, for example in many Asian and African countries” (p. 275). Dudley (2000) estimates that 30% of the money spent annually for international development loans are diverted from productive pursuits because of corruption. Additionally, countries perceived as being corrupt suffer from lower (private) capital inflows, as foreign investors are deterred by corruption and its associated phenomena, which include bureaucratic red tape, mismanagement and the lack of secure property rights (Transparency International (TI), 2004). Overall, the cost of corruption represents 5% of the volume of total global output or more than 1.5 trillion dollars a year according to “rough, but conservative” World Bank estimates (United Nations, 2003c). Table 1 aims to illustrate the scale of political corruption by presenting estimates of the funds allegedly embezzled by 10 notorious (but not necessarily the most corrupt) leaders of the last 20 years.

scholarly journals West Nile virus transmission: results from the integrated surveillance system in Italy, 2008 to 2015

2016 ◽  
Vol 21 (37) ◽  
Author(s):  
Caterina Rizzo ◽  
Christian Napoli ◽  
Giulietta Venturi ◽  
Simonetta Pupella ◽  
Letizia Lombardini ◽  
...  
Keyword(s):  
West Nile Virus ◽  
Data Exchange ◽  
Virus Disease ◽  
Virus Transmission ◽  
Geographic Area ◽  
Activity Period ◽  
Surveillance Systems ◽  
Time Data ◽  
West Nile ◽  
West Nile Virus Transmission

In Italy a national Plan for the surveillance of imported and autochthonous human vector-borne diseases (chikungunya, dengue, Zika virus disease and West Nile virus (WNV) disease) that integrates human and veterinary (animals and vectors) surveillance, is issued and revised annually according with the observed epidemiological changes. Here we describe results of the WNV integrated veterinary and human surveillance systems in Italy from 2008 to 2015. A real time data exchange protocol is in place between the surveillance systems to rapidly identify occurrence of human and animal cases and to define and update the map of affected areas i.e. provinces during the vector activity period from June to October. WNV continues to cause severe illnesses in Italy during every transmission season, albeit cases are sporadic and the epidemiology varies by virus lineage and geographic area. The integration of surveillance activities and a multidisciplinary approach made it possible and have been fundamental in supporting implementation of and/or strengthening preventive measures aimed at reducing the risk of transmission of WNV trough blood, tissues and organ donation and to implementing further measures for vector control.

scholarly journals Fast Transient Detection as a Prototypical “Big Data” Problem

2011 ◽  
Vol 7 (S285) ◽  
pp. 340-341
Author(s):  
Dayton L. Jones ◽  
Kiri Wagstaff ◽  
David Thompson ◽  
Larry D'Addario ◽  
Robert Navarro ◽  
...  
Keyword(s):  
Big Data ◽  
Large Scale ◽  
High Time Resolution ◽  
Data Generation ◽  
Time Data ◽  
Transient Detection ◽  
Data Archiving ◽  
Large Scale Data ◽  
Data Problem ◽  
Scale Data

AbstractThe detection of fast (< 1 second) transient signals requires a challenging balance between the need to examine vast quantities of high time-resolution data and the impracticality of storing all the data for later analysis. This is the epitome of a “big data” issue—far more data will be produced by next generation-astronomy facilities than can be analyzed, distributed, or archived using traditional methods. JPL is developing technologies to deal with “big data” problems from initial data generation through real-time data triage algorithms to large-scale data archiving and mining. Although most current work is focused on the needs of large radio arrays, the technologies involved are widely applicable in other areas.

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

scholarly journals Local Public Health Surveillance of Heroin-Related Morbidity and Mortality, Orange County, Florida, 2010-2014

2017 ◽  
Vol 132 (1_suppl) ◽  
pp. 80S-87S ◽  
Author(s):  
Toni-Marie L. Hudson ◽  
Benjamin G. Klekamp ◽  
Sarah D. Matthews
Keyword(s):  
Orange County ◽  
The United States ◽  
Data Availability ◽  
Data Sources ◽  
Morbidity And Mortality ◽  
Medical Examiner ◽  
Surveillance Systems ◽  
Time Data ◽  
Mortality And Morbidity ◽  
Ed Visits

Objectives: Heroin-related deaths have increased substantially in the past 10 years in the United States, particularly in Florida. Our objectives were to measure heroin-related morbidity and mortality rates in Orange County, Florida, and to assess trends in those rates during 2010-2014. Methods: We used 3 heroin surveillance methods, based on data from the Florida Medical Examiner, the Florida Agency for Health Care Administration (AHCA), and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics–Florida (ESSENCE-FL). We conducted descriptive and geographic spatial analyses of all 3 data sets, determined heroin-related mortality and morbidity (emergency department [ED] visit) rates, and compared the timeliness of data availability from the 3 data sources. Results: Heroin-related deaths in Orange County increased by 590%, from 10 in 2010 to 69 in 2014. Heroin-related ED visits during the same period increased 12-fold (from 13 to 154) and 6-fold (from 49 to 307) when based on AHCA and ESSENCE-FL data, respectively. ESSENCE-FL identified 140% more heroin-related visits than did AHCA. Spatial analysis found geographic clustering of heroin-related morbidity and mortality. Hospitals facing the greatest burden of heroin-related ED visits were close to communities with the highest crude heroin-related ED visit rates. Of the 3 data sources, ESSENCE-FL provided the timeliest data availability. Conclusions: These 3 data sources can be considered acceptable surveillance systems for monitoring heroin-related events in Orange County. The timely availability of data from ESSENCE-FL makes it the most useful source for obtaining near–real-time data about the heroin epidemic, potentially leading to improved identification of populations most in need of interventions to reduce morbidity and mortality.

scholarly journals Social Protection of the Poor in Africa

2012 ◽  
Vol 4 ◽  
pp. 89-94
Author(s):  
Olabanji Akinola
Keyword(s):  
International Development ◽  
Social Protection ◽  
Conditional Cash Transfers ◽  
Successful Implementation ◽  
Government Officials ◽  
African Countries ◽  
Chronic Poverty ◽  
The Past ◽  
The Individual ◽  
New Phenomena

Conditional cash Transfers (CCTS) in the past decade have become attractive as social protection programmes for reducing chronic poverty and vulnerabilities in poor African households. however, the adoption of CCTS in african countries overlooks and neglects the individual and different programme contexts required for successful implementation of the programmes. This negligence can impede the achievement of programme objectives as well as their sustainability owing to prevailing socio-political together with economic development constraints. This policy brief thus advocates for greater consideration by government officials and their international development partners of the needs of individual countries in the design and implementation of ccT programmes in africa. While various social protection programmes exist in one (un)conditional form or the other in countries like Ghana, Nigeria, Ethiopia, South Africa, Zambia, Egypt, and Uganda amongst others, the introduction of CCTS as social protection programmes is a relatively new phenomena and therefore throws up some challenges. The challenges they present should therefore be seen as part of a learning process rather than reasons to avoid attempting to implement them successfully.

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