scholarly journals How health systems approached respiratory viral pandemics over time: a systematic review

2020 ◽  
Vol 5 (12) ◽  
pp. e003677
Author(s):  
Fidelia Cascini ◽  
Ilda Hoxhaj ◽  
Drieda Zaçe ◽  
Margherita Ferranti ◽  
Maria Luisa Di Pietro ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Healthcare System ◽  
Viral Infections ◽  
Healthcare Systems ◽  
Evidence Based ◽  
Effective Response ◽  
Influenza A H1n1 ◽  
Pertinent Data ◽  
Respiratory Viral Infections

BackgroundSeveral healthcare systems facing respiratory viral infections outbreaks, like COVID-19, have not been prepared to manage them. Public health mitigation solutions ranging from isolation of infected or suspected cases to implementation of national lockdowns have proven their effectiveness for the outbreak’s control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review to identify healthcare systems interventions, experiences and recommendations that have been used to manage different respiratory viral infections outbreaks in the past.MethodsPubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until 17 April 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full texts were read and pertinent data were extracted. When applicable, quality assessment was conducted for the included articles. We performed a narrative synthesis of each implemented public health approaches.ResultsWe included a total of 24 articles addressing the public health approaches implemented for respiratory viral infections outbreaks for COVID-19, influenza A H1N1, MERS and severe acute respiratory syndrome . The identified approaches are ascribable to two main categories: healthcare system strategies and healthcare provider interventions. The key components of an effective response on respiratory viral outbreaks included the implementation of evidence-based contextual policies, intrahospital management actions, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans.ConclusionThe identified healthcare system strategies applied worldwide to face epidemics or pandemics are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond.

scholarly journals Healthcare systems strategies to manage pandemics transition phases: a systematic review

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Cascini ◽  
I Hoxhaj ◽  
D Zaçe ◽  
M Ferranti ◽  
W Ricciardi ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Knowledge Base ◽  
Local Level ◽  
Healthcare Systems ◽  
Evidence Based ◽  
Systems Management ◽  
Useful Knowledge ◽  
Influenza A H1n1 ◽  
Pertinent Data

Abstract Background Several countries facing the COVID-19 pandemic were not prepared to manage it. Public health mitigation strategies, ranging from isolation of infected cases to implementation of national lockdowns, proved their effectiveness for the outbreaks control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review, identifying healthcare systems approaches, experiences and recommendations used to manage COVID-19 and other epidemics. Methods PubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until April 17th, 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full-texts were read and pertinent data were extracted. We performed a narrative analysis of each implemented strategy. Results We included a total of 24 articles addressing the public health strategies implemented for respiratory viral infections outbreaks as COVID-19, influenza A H1N1, MERS and SARS. The identified strategies are ascribable to two main categories: healthcare systems management at a national level and healthcare providers strategies at a local level. The key components of the transition strategies regarded the implementation of evidence-based contextual policies, intrahospital management approaches, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans. Conclusions The identified healthcare systems strategies applied worldwide to face epidemics or pandemics, are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond. Key messages Healthcare systems strategies that can be implemented to manage pandemics/epidemics transition phases are a useful knowledge base to inform policy makers about the most effective solutions to adopt. The evidence reporting the healthcare systems management of respiratory viruses epidemics/pandemics, show the lack of a common and shared approach and more evidence-based research is needed.

scholarly journals COVID-19 public health measures: a reduction in hospital admissions for COPD exacerbations

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-216083
Author(s):  
Jing Yuan Tan ◽  
Edwin Philip Conceicao ◽  
Liang En Wee ◽  
Xiang Ying Jean Sim ◽  
Indumathi Venkatachalam
Keyword(s):  
Public Health ◽  
Clinical Outcomes ◽  
Hospital Admissions ◽  
Viral Infections ◽  
Significant Morbidity ◽  
Common Cause ◽  
Copd Exacerbations ◽  
Health Measures ◽  
Acute Exacerbations ◽  
Respiratory Viral Infections

Hospitalisations for acute exacerbations of COPD (AECOPD) carry significant morbidity and mortality. Respiratory viral infections (RVIs) are the most common cause of AECOPD and are associated with worse clinical outcomes. During the COVID-19 pandemic, public health measures, such as social distancing and universal masking, were originally implemented to reduce transmission of SARS-CoV-2; these public health measures were subsequently also observed to reduce transmission of other common circulating RVIs. In this study, we report a significant and sustained decrease in hospital admissions for all AECOPD as well as RVI-associated AECOPD, which coincided with the introduction of public health measures during the COVID-19 pandemic.

scholarly journals Are Community Acquired Respiratory Viral Infections an Underestimated Burden in Hematology Patients?

2019 ◽  
Vol 7 (11) ◽  
pp. 521 ◽  
Author(s):  
Popescu ◽  
Ursache ◽  
Feketea ◽  
Bocsan ◽  
Jimbu ◽  
...  
Keyword(s):  
Hematological Malignancies ◽  
Viral Infections ◽  
Treatment Options ◽  
Published Data ◽  
Evidence Based ◽  
Respiratory Viral Infection ◽  
Improve Outcome ◽  
Diagnosis And Management ◽  
Respiratory Viral Infections ◽  
Evidence Based Guidelines

Despite a plethora of studies demonstrating significant morbidity and mortality due to community-acquired respiratory viral (CRV) infections in intensively treated hematology patients, and despite the availability of evidence-based guidelines for the diagnosis and management of respiratory viral infections in this setting, there is no uniform inclusion of respiratory viral infection management in the clinical hematology routine. Nevertheless, timely diagnosis and systematic management of CRV infections in intensively treated hematology patients has a demonstrated potential to significantly improve outcome. We have briefly summarized the recently published data on CRV infection epidemiology, as well as guidelines on the diagnosis and management of CRV infections in patients intensively treated for hematological malignancies. We have also assessed available treatment options, as well as mentioned novel agents currently in development.

NATIONAL GUIDELINES FOR HIGH-COST DRUGS IN BRAZIL: ACHIEVEMENTS AND CONSTRAINTS OF AN INNOVATIVE NATIONAL EVIDENCE-BASED PUBLIC HEALTH POLICY

2013 ◽  
Vol 29 (2) ◽  
pp. 198-206 ◽  
Author(s):  
Paulo D. Picon ◽  
Alberto Beltrame ◽  
David Banta
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Healthcare System ◽  
Public Health Policy ◽  
Policy Making ◽  
Social Inequalities ◽  
Critical Issue ◽  
Public Healthcare ◽  
Evidence Based ◽  
National Guidelines

Introduction: The translation of best evidence into practice has become an important purpose of policy making in health care. In Brazil, a country of continental dimensions with widespread regional and social inequalities, the dissemination and use of the best-evidence in policy making is a critical issue for the healthcare system.Objectives: The main purpose of this study is to describe an evidence-based public health policy with special emphasis on guidelines creation for high-cost medicines. We also describe how that strategy was diffused to the judiciary system and to other parts of the healthcare system.Results: We present an 11-year follow-up of a national project for creating and updating guidelines for high-cost medicines in Brazil. A total of 109 national guidelines were published (new or updated versions) for 66 selected diseases, the first such effort in Brazilian history. The project influenced the Brazilian legislature, which has recently established a Federal Law requiring national guidelines for any new technology listed for payment by the Brazilian public healthcare system.Conclusion: We were able to involve many different stakeholders in a partnership between academia and policy makers, which made possible the widespread dissemination of the clinical practice guidelines. Problems and constraints were also encountered. This evolving public health strategy might be useful for other developing countries.

scholarly journals Concomitant Infections of Influenza A H1N1 and Disseminated Cryptococcosis in an HIV Seropositive Patient

2015 ◽  
Vol 7 (02) ◽  
pp. 134-136 ◽  
Author(s):  
Ankit Gupta ◽  
Malini R Capoor ◽  
Sonal Gupta ◽  
Harish Chand Sachdeva
Keyword(s):  
Pandemic Influenza ◽  
Influenza A ◽  
Unusual Case ◽  
Viral Infections ◽  
Dual Infection ◽  
Seropositive Patient ◽  
Seropositive Individual ◽  
Influenza A H1n1 ◽  
Respiratory Viral Infections ◽  
Hiv Seropositive

ABSTRACTRespiratory viral infections, especially influenza have a potential to form a fatal association with cryptococcosis in the setting of compromised immunity. Considering the lethality of these two infections, we report an unusual case of dual infection of pandemic influenza A H1N1 and disseminated cryptococcosis in an HIV seropositive individual.

scholarly journals Efficacy and safety of Anaferon for children and Anaferon for the prevention and treatment of influenza and other acute respiratory viral infections: systematic review and meta-analysis

2021 ◽  
Vol 5 (5) ◽  
pp. 335-347
Author(s):  
N.A. Geppe ◽  
◽  
A.L. Zaplatnikov ◽  
E.G. Kondyurina ◽  
O.I. Afanasieva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Therapeutic Efficacy ◽  
Disease Duration ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Acute Respiratory Infections ◽  
Efficacy And Safety ◽  
Prevention And Treatment ◽  
Respiratory Viral Infections

Aim: to evaluate the efficacy and safety of Anaferon and Anaferon for children for the prevention and treatment of of acute respiratory viral infections (ARVI)/influenza using meta-analysis. Patients and Methods: the meta-analysis included data from 11 randomized clinical trials (RCTs) involving 3079 patients aged 1 month to 69 years, of which: 1729 people were included in the meta-analysis of the preventive drugs efficacy, 1550 patients — in the meta-analysis of the therapeutic efficacy of Anaferon for children. The evaluation of the therapeutic efficacy was conducted according to the criteria "disease duration" and/or "fever duration", the evaluation of the preventive efficacy was conducted according to the criterion "the proportion of patients not falling ill with ARVI/influenza". The safety was evaluated taking into account the number of adverse events (AEs). Statistical methods included the exact Fisher criterion, the Student criterion, fixed and random effects models, the Z-test, the Cochrane-Mantel-Hensel criterion, Cochrane Q-statistics and the I2 coefficient, the Breslow-Day test, the calculation of relative risk (RR), odds ratios (OR) and their 95% confidence intervals (CI). Results: according to the criterion "the proportion of patients not falling ill with ARVI/influenza", the RR of Anaferon for children was 1.2 [95% CI 1.2; 1.3] with an OR of 2.2 [95% CI 1.7; 2.9], while for Anaferon, the RR was 6.7 [95% CI 3.8; 11.8] with an OR of 20.1 [95% CI 9.2; 44.0]. At the same time, the proportion of patients without ARVI/influenza during Anaferon intake exceeded that in the absence of preventive intervention by almost 8 times, and during Anaferon for children intake — 1.3 times vs. placebo. When evaluating the therapeutic effect of Anaferon for children, it was found that the average disease duration was 1.4 times shorter than during placebo intake, and was 4.71±2.53 days (p<0,001). The average fever duration was 2.19±1.21 days vs. 3.22±1.81 days during placebo intake (p<0,001). According to the criterion "disease duration", the weighted average effect value was 1.05 [95% CI 0.44; 1.67], according to the criterion "fever duration" — 0.97 [95% CI 0.61; 1.33] (p<0.001, p-value of the two-tailed Z-test; random effects model). The therapeutic efficacy of Anaferon for children did not depend on the etiology of ARVI, the symptoms, and the presence of comorbidity (asthma). The total number of AEs is similar to those in the comparison group. Conclusion: the conducted review and meta-analysis concerning the efficacy and safety of Anaferon and Anaferon for children for the treatment and prevention of ARVI/influenza allow us to conclude the following: 1) Anaferon for children is effective and safe for the treatment of influenza and other acute respiratory infections, regardless of the pathogen and the presence of comorbidity (asthma); 2) Anaferon and Anaferon for children are effective and safe for the prevention of acute respiratory infections/influenza, including patients with concomitant bronchopulmonary pathology and frequently ill children. KEYWORDS: ARVI, influenza, prevention, treatment, meta-analysis, Anaferon, Anaferon for children. FOR CITATION: Geppe N.A., Zaplatnikov A.L., Kondyurina E.G. et al. Efficacy and safety of Anaferon for children and Anaferon for the prevention and treatment of influenza and other acute respiratory viral infections: systematic review and meta-analysis. Russian Medical Inquiry. 2021;5(5):335–347 (in Russ.). DOI: 10.32364/2587-6821-2021-5-5-335-347.

scholarly journals Efficacy and safety of convalescent plasma for severe COVID-19 based on evidence in other severe respiratory viral infections: a systematic review and meta-analysis

2020 ◽  
Vol 192 (27) ◽  
pp. E745-E755 ◽  
Author(s):  
Niveditha Devasenapathy ◽  
Zhikang Ye ◽  
Mark Loeb ◽  
Fang Fang ◽  
Borna Tadayon Najafabadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Viral Infections ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Respiratory Viral Infections

Sustainability of healthcare systems

2020 ◽  
pp. 394-401
Author(s):  
Elena Azzolini ◽  
Mary Harney ◽  
Walter Ricciardi
Keyword(s):  
Public Health ◽  
Healthcare System ◽  
Healthcare Systems ◽  
System P

Having read this chapter, you should be able to: define the term ‘health sustainability’; understand the importance of health sustainability to public health; recognize opportunities and actions needed to obtain a sustainable healthcare system.

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