scholarly journals Introducing risk inequality metrics in tuberculosis policy development

2018 ◽  
Author(s):  
M. Gabriela M. Gomes ◽  
Juliane F. Oliveira ◽  
Adelmo Bertolde ◽  
Tuan Anh Nguyen ◽  
Ethel L. Maciel ◽  
...  
Keyword(s):  
Policy Development ◽  
Data Interpretation ◽  
World Health ◽  
Individual Risk ◽  
Control Programs ◽  
Force Of Infection ◽  
Cohort Selection ◽  
National Tuberculosis ◽  
Health Organization ◽  
And Control

Global stakeholders including the World Health Organization rely on predictive models for developing strategies and setting targets for tuberculosis care and control programs. Failure to account for variation in individual risk leads to substantial biases that impair data interpretation and policy decisions1,2. Anticipated impediments to estimating heterogeneity for each parameter are discouraging despite considerable technical progress in recent years. Here we identify acquisition of infection as the single process where heterogeneity most fundamentally impacts model outputs, due to cohort selection imposed by dynamic forces of infection. Individuals with higher risk of acquiring infection are predominantly affected by the pathogen, leaving the unaffected pool with those whose intrinsic risk is lower. This causes susceptibility pools to attain average risks which are lower under higher forces of infection. Interventions that modify the force of infection change the strength of selection, and therefore alter average risks in the pools which feed further incidence. Inability to account for these dynamics is what makes homogenous models unsuitable. We introduce concrete metrics to approximate risk inequality in tuberculosis, demonstrate their utility in mathematical models, and pack the information into a risk inequality coefficient which can be calculated and reported by national tuberculosis programs for use in policy development and modeling.

scholarly journals Assessing Insecticide Resistance in Adult Mosquitoes: Perspectives on Current Methods

2020 ◽  
Vol 14 ◽  
pp. 117863022095279
Author(s):  
Stephanie L Richards ◽  
Brian D Byrd ◽  
Michael H Reiskind ◽  
Avian V White
Keyword(s):  
Insecticide Resistance ◽  
Training Programs ◽  
Data Interpretation ◽  
Control Measures ◽  
World Health ◽  
Control Programs ◽  
Global Issue ◽  
Control And Prevention ◽  
Health Organization ◽  
Level Training

Mosquito insecticide resistance (IR) is a growing global issue that must be addressed to protect public health. Vector control programs (VCPs) should regularly monitor local mosquito populations for IR and plan control measures accordingly. In some cases, state/federal resources financially support this testing with expertise and/or training programs. Standardization of methods (eg, Centers for Disease Control and Prevention bottle bioassay, World Health Organization tube testing, dose-mortality bioassay) for monitoring IR must be prioritized. One solution is regional hubs of IR monitoring at the state or other level. Training programs on methodology and interpretation of results should be developed and routinely offered to local VCPs conducting IR testing in mosquitoes. Here, current methods for assessing mosquito IR are discussed and insights into a variety of questions from VCPs are considered. It is critical that methods for IR monitoring and data interpretation are standardized through routine training, with the goal of evidence-driven decision making to improve control of mosquitoes and mosquito-borne disease.

Health Lessons Learned from the Recent Earthquakes and Tsunami in Asia

2007 ◽  
Vol 22 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Claude de Ville de Goyet
Keyword(s):  
Disease Surveillance ◽  
Lessons Learned ◽  
World Health ◽  
Material Support ◽  
Control Programs ◽  
Needs Assessments ◽  
Life Saving ◽  
Health Organization ◽  
Recent Earthquakes ◽  
And Control

AbstractThe evaluations following the Tsunami that affected 12 countries (December 2004) and the earthquakes in Bam, Iran (2003), and in Pakistan (2005) offered valuable lessons for public health preparedness against all types of risks (natural, complex, or technological) in all countries (regardless their level of development).The lessons learned, needs assessments, effectiveness of external life-saving assistance, disease surveillance and control, as well as donations management, were reviewed.Although hundreds of surveys or studies were conducted, the needs assessments were partial and uncoordinated. The findings often were not shared by individual agencies.The evaluations in each of the three disasters point to some additional issues:1. Foreign mobile hospitals rarely arrived in time for immediate trauma care. Existing international guidelines for the use of field hospitals often were ignored and must be updated and promoted. Local and neighboring facilities are best at providing immediate, life-saving care;2. Occassionally, the risk of epidemics was grossly overestimated by the agencies and the mass media. Surveillance and improved routine control programs work without resorting to costly, improvised immunization campaigns of doubtless value. Improving or re-establishing water and sanitation must be the first priority;3. Health donations were not always appropriate, nor did they follow the World Health Organization guidelines. The costly destruction of inappropriate donations was a recurrent problem; and4. Medical volunteers from within the affected country were abounding, but did not benefit from the external logistical and material support. The international community should provide logistical and material support before sending expatriate teams that are unfamiliar with the area and its health problems.Investing in the preparedness of the national health services and communities should become a priority for disaster-prone countries and those assisting them in their development.

scholarly journals Core Components for Infection Prevention and Control Programs: A World Health Organization Network Report

2010 ◽  
Vol 31 (9) ◽  
pp. 948-950 ◽  
Author(s):  
Wing Hong Seto ◽  
Fernando Otaíza ◽  
Carmen L. Pessoa-Silva ◽  
Keyword(s):  
World Health Organization ◽  
Prevention And Control ◽  
Infection Prevention ◽  
World Health ◽  
Infection Prevention And Control ◽  
Healthcare Facilities ◽  
Control Programs ◽  
Core Components ◽  
Health Organization ◽  
And Control

Under the leadership of the World Health Organization (WHO), the core components necessary for national and local infection prevention and control programs are identified. These components were determined by a network of international experts who are representatives from WHO regional offices and relevant WHO programs. The respective roles of the national authorities and the local healthcare facilities are delineated.

Non-Communicable Diseases and Global Health Politics

2019 ◽  
pp. 626-659
Author(s):  
Roger Magnusson
Keyword(s):  
Respiratory Diseases ◽  
Communicable Diseases ◽  
World Health ◽  
Global Response ◽  
Non Communicable Diseases ◽  
Health Politics ◽  
Chronic Respiratory Diseases ◽  
Health Organization ◽  
High Level ◽  
And Control

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, chronic respiratory diseases, and diabetes, are responsible for around 70 percent of global deaths each year. This chapter describes how NCDs have become prevalent and critically evaluates global efforts to address NCDs and their risk factors, with a particular focus on the World Health Organization (WHO) and United Nations (UN) system. It explores the factors that have prevented those addressing NCDs from achieving access to resources and a priority commensurate with their impact on people’s lives. The chapter evaluates the global response to NCDs both prior to and since the UN High-Level Meeting on Prevention and Control of Non-communicable Diseases, held in 2011, and considers opportunities for strengthening that response in future.

Effectiveness of a New Fluoride Varnish for Caries Prevention In Pre-School Children

2013 ◽  
Vol 38 (1) ◽  
pp. 7-12 ◽  
Author(s):  
V Pitchika ◽  
C Kokel ◽  
J Andreeva ◽  
A Crispin ◽  
R Hickel ◽  
...  
Keyword(s):  
Economic Status ◽  
Model Potential ◽  
World Health ◽  
Fluoride Varnish ◽  
Control Group ◽  
Carious Lesions ◽  
Health Organization ◽  
And Control ◽  
Caries Lesions ◽  
Initial Statistical Analysis

Objective: To investigate the effectiveness of a new fluoride varnish (Clinpro White Varnish, 3M Espe, Seefeld, Germany) with regard to the caries incidence within a 2-year period. Study design: A non-randomized sample of 400 children from the Kyffhäuser district (Thuringia, Germany) was divided into a fluoride group (FG, biannual application of fluoride varnish) and control group (CG, no intervention). (Non-)cavitated caries lesions were recorded using World Health Organization (WHO) and Universal Visual Scoring System (UniViSS) criteria. Parents were given questionnaires to gather information about their socio-economic status (SES). Non-parametric methods and binomial logistic regression were used for data analysis. Results: There was a significant increase in caries incidence in both groups. The number of non-cavitated carious lesions was significantly lower in the FG (mean 2.2; sd 2.3) compared with the CG (mean 2.9; sd 1.9). Initial statistical analysis revealed that fluoride varnish might prevent non-cavitated carious lesions. When including SES as a confounder into regression model, potential preventive effect was lost. Conclusions: This study underlines the importance of the multi-factorial etiology of caries and illustrates that the effectiveness of biannual fluoride varnish application was evident in non-cavitated carious lesions only.

scholarly journals Impact of External Quality Assurance on the Quality of Xpert MTB/RIF Testing in Viet Nam

2018 ◽  
Vol 57 (3) ◽  
Author(s):  
Vidyanidhi Gumma ◽  
Kyle DeGruy ◽  
Davara Bennett ◽  
Thanh Nguyen Thi Kim ◽  
Heidi Albert ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Positive Impact ◽  
Production Capacity ◽  
Control Program ◽  
External Quality Assurance ◽  
World Health ◽  
External Quality ◽  
National Tuberculosis ◽  
Control And Prevention ◽  
Health Organization

ABSTRACT Following the endorsement of the Xpert MTB/RIF assay (Cepheid, Sunnyvale, CA, USA) by the World Health Organization (WHO) in 2010, Viet Nam’s National Tuberculosis Control Program (NTP) began using GeneXpert instruments in NTP laboratories. In 2013, Viet Nam’s NTP implemented an Xpert MTB/RIF external quality assurance (EQA) program in collaboration with the U.S. Centers for Disease Control and Prevention (CDC) and the Foundation for Innovative New Diagnostics (FIND). Proficiency-testing (PT) panels comprising five dried tube specimens (DTS) were sent to participating sites approximately twice a year from October 2013 to July 2016. The number of enrolled laboratories increased from 22 to 39 during the study period. Testing accuracy was assessed by comparing reported and expected results; percentage scores were assigned; and feedback reports were provided to sites. On-site evaluation (OSE) was conducted for underperforming laboratories. The results from the first five rounds demonstrate the positive impact of PT and targeted OSE visits on testing quality. On average, for every additional round of feedback, the odds of achieving PT scores of ≥80% increased 2.04-fold (95% confidence interval, 1.39- to 3.00-fold). Future work will include scaling up PT to all sites and maintaining the performance of participating laboratories while developing local panel production capacity.

scholarly journals A Scoping Review of Policies Related to the Prevention and Control of Overweight and Obesity in Africa

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4028
Author(s):  
Theodosia Adom ◽  
Anniza De Villiers ◽  
Thandi Puoane ◽  
André Pascal Kengne
Keyword(s):  
Scoping Review ◽  
Population Level ◽  
Overweight And Obesity ◽  
World Health ◽  
Environmental Drivers ◽  
African Countries ◽  
Food Industries ◽  
Nutrition And Diet ◽  
Health Organization ◽  
And Control

To address the issue of obesity, the World Health Organization (WHO) recommends a set of comprehensive programmes aimed at changing the obesogenic environments to provide opportunities for healthy food options and increased physical activity in the school, home, and at the population level. The objectives of this study were to examine the nature and range of policies related to overweight and obesity prevention in Africa, and to assess how they align with international guidelines. An existing methodological framework was adapted for this scoping review. A search of publicly available national documents on overweight/obesity, general health, and non-communicable diseases (NCDs) was undertaken from relevant websites, including WHO, ministries, and Google Scholar. Additional requests were sent to key contacts at relevant ministries about existing policy documents. The documents were reviewed, and the policies were categorised, using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The framework categorises the environmental drivers of obesity into four domains (physical, economic, legislative, and socio-cultural) and two scales: macro (national, regional, sectors, food industries, media, etc.) and micro (household, institutional, and community). This review included documents from 41 African countries. The policy initiatives to prevent overweight/obesity target the school, family and community settings, and macro environments, and broadly align with global recommendations. The NCD documents were in the majority, with only two on obesity. The majority of the documents detailed strategies and key interventions on unhealthy diets and physical inactivity. The physical, legislative, and sociocultural domains were largely featured, with less emphasis on the economic domain. Additionally, nutrition- and diet-related policies were in the majority. Overlaps and interactions of policies were observed in the application of the ANGELO framework. This study has provided information on national policies and programmes in Africa and can be useful as a first point of call for policymakers. The overlapping and interaction in the initiatives demonstrate the importance of multi-sectoral partnerships in providing supportive environments for healthy behaviours.

scholarly journals Myelodysplastic syndrome: classification and prognostic systems

2011 ◽  
pp. 25-33
Author(s):  
Rosangela Invernizzi ◽  
Agnese Filocco
Keyword(s):  
Clinical Information ◽  
Scoring Systems ◽  
Classification Systems ◽  
World Health ◽  
Individual Risk ◽  
Information Classification ◽  
Definition Of ◽  
Health Organization ◽  
The Individual ◽  
Prognostic Scoring Systems

Myelodysplastic syndromes (MDS) are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO) classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.

scholarly journals Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: A qualitative study

2021 ◽  
Author(s):  
Angela Kwartemaa Acheampong ◽  
Lillian Akorfa Ohene ◽  
Isabella Naana Akyaa Asante ◽  
Josephine Kyei ◽  
Gladys Dzansi ◽  
...  
Keyword(s):  
Health Policy ◽  
Staff Development ◽  
Policy Development ◽  
National Policy ◽  
World Health ◽  
Health Coverage ◽  
Policy Reforms ◽  
Individual Interviews ◽  
Health Organization ◽  
Nurses And Midwives

Abstract Background: The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana.Methods: A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures. Results: Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raisedConclusion: The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.

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