scholarly journals Spatial distribution and temporal trends of leprosy in Uganda, 2012–2016: a retrospective analysis of public health surveillance data

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Freda Loy Aceng ◽  
Herman-Joseph Kawuma ◽  
Robert Majwala ◽  
Maureen Lamunu ◽  
Alex Riolexus Ario ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Census Data ◽  
Temporal Trends ◽  
Northern Region ◽  
Control Measures ◽  
Population Estimates ◽  
Case Detection ◽  
Detection Rates ◽  
Leprosy Case

Abstract Background Leprosy is a neglected disease that poses a significant challenge to public health in Uganda. The disease is endemic in Uganda, with 40% of the districts in the country affected in 2016, when 42 out of 112 districts notified the National Tuberculosis and Leprosy Program (NTLP) of at least one case of leprosy. We determined the spatial and temporal trends of leprosy in Uganda during 2012–2016 to inform control measures. Methods We analyzed quarterly leprosy case-finding data, reported from districts to the Uganda National Leprosy Surveillance system (managed by NTLP) during 2012–2016. We calculated new case detection by reporting district and administrative regions of treatment during this period. New case detection was defined as new leprosy cases diagnosed by the Uganda health services divided by regional population; population estimates were based on 2014 census data. We used logistic regression analysis in Epi-Info version 7.2.0 to determine temporal trends. Population estimates were based on 2014 census data. We used QGIS software to draw choropleth maps showing leprosy case detection rates, assumed to approximate the new case detection rates, per 100,000 population. Results During 2012–2016, there was 7% annual decrease in reported leprosy cases in Uganda each year (p = 0.0001), largely driven by declines in the eastern (14%/year, p = 0.0008) and central (11%/year, p = 0.03) regions. Declines in reported cases in the western (9%/year, p = 0.12) and northern (4%/year, p = 0.16) regions were not significant. The combined new case detection rates from 2012 to 2016 for the ten most-affected districts showed that 70% were from the northern region, 20% from the eastern, 10% from the western and 10% from the central regions. Conclusion There was a decreasing trend in leprosy new case detection in Uganda during 2012–2016; however, the declining trends were not consistent in all regions. The Northern region consistently identified more leprosy cases compared to the other regions. We recommend evaluation of the leprosy surveillance system to ascertain the leprosy situation.

scholarly journals Spatial patterns of leprosy in a hyperendemic state in Northern Brazil, 2001-2012

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Lorena Dias Monteiro ◽  
Francisco Rogerlândio Martins-Melo ◽  
Aline Lima Brito ◽  
Carlos Henrique Alencar ◽  
Jorg Heukelbach
Keyword(s):  
High Risk ◽  
Spatial Patterns ◽  
Detection Rate ◽  
Disease Risk ◽  
Late Diagnosis ◽  
Control Measures ◽  
Case Detection ◽  
Detection Rates ◽  
Case Detection Rate ◽  
Brazilian State

ABSTRACT OBJECTIVE To describe the spatial patterns of leprosy in the Brazilian state of Tocantins. METHODS This study was based on morbidity data obtained from the Sistema de Informações de Agravos de Notificação (SINAN – Brazilian Notifiable Diseases Information System), of the Ministry of Health. All new leprosy cases in individuals residing in the state of Tocantins, between 2001 and 2012, were included. In addition to the description of general disease indicators, a descriptive spatial analysis, empirical Bayesian analysis and spatial dependence analysis were performed by means of global and local Moran’s indexes. RESULTS A total of 14,542 new cases were recorded during the period under study. Based on the annual case detection rate, 77.0% of the municipalities were classified as hyperendemic (> 40 cases/100,000 inhabitants). Regarding the annual case detection rate in < 15 years-olds, 65.4% of the municipalities were hyperendemic (10.0 to 19.9 cases/100,000 inhabitants); 26.6% had a detection rate of grade 2 disability cases between 5.0 and 9.9 cases/100,000 inhabitants. There was a geographical overlap of clusters of municipalities with high detection rates in hyperendemic areas. Clusters with high disease risk (global Moran’s index: 0.51; p < 0.001), ongoing transmission (0.47; p < 0.001) and late diagnosis (0.44; p < 0.001) were identified mainly in the central-north and southwestern regions of Tocantins. CONCLUSIONS We identified high-risk clusters for transmission and late diagnosis of leprosy in the Brazilian state of Tocantins. Surveillance and control measures should be prioritized in these high-risk municipalities.

scholarly journals Trends in leprosy case detection in Rwanda, 1995–2011: analysis of 17 years of laboratory data

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Innocent Uwimana ◽  
Nestor Bizimungu ◽  
Fabrice Ingabire ◽  
Elyse Mukamukwiye ◽  
Odette Sharangabo ◽  
...  
Keyword(s):  
Prevalence Rate ◽  
Laboratory Data ◽  
Staining Technique ◽  
Control Programme ◽  
Reference Laboratory ◽  
Case Detection ◽  
Prevalence Rates ◽  
Detection Rates ◽  
Leprosy Case ◽  
Early Case

Background: Leprosy, or Hansen’s disease, is a chronic, infectious disease caused by Mycobacterium leprae. It remains one of the leading causes of deformity and physical disability.Objective: We analysed laboratory records to assess trends in prevalence rates and case detection rates (CDRs) in Rwanda. Methods: A retrospective review of detected leprosy cases from the records of the Rwanda National Reference Laboratory over a 17-year period (1995–2011) was conducted. Skin biopsy samples were analysed microscopically using Ziehl-Neelsen staining technique to identify M. leprae.Results: Cumulatively, 266 suspected cases were reported between 1995 and 2011. Of the suspected cases, 77 (28.9%) were laboratory confirmed as having leprosy. Among detected cases, 59 (76.6%) were men and 18 (23.4%) women. The male:female ratio was 3:1. There were 77 registered leprosy cases over the 17-year period of the study, and the prevalence rate was 0.005 per 10 000 population. A gradual decrease in the prevalence rate was observed from 0.015 per 10 000 population in 2003 to 0.003 per 10 000 population in 2010. From 1995 to 2011, the CDR did not exceed one per 10 000 population.Conclusion: This laboratory review demonstrates a declining trend in prevalence rates and CDR during the period of the study. Early case detection and a sustainable leprosy control programme remain the cornerstones of reducing the physical and socio-economic burden of leprosy in Rwanda.

COVID-19 situation in Honduras: lessons learned

2020 ◽  
Vol 128 (S2) ◽  
pp. S242-S250
Author(s):  
Itzel Fuentes ◽  
Karla Henriquez ◽  
Fausto Muñoz ◽  
Elsa Palou ◽  
Tito Alvarado ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Surveillance System ◽  
Public Health System ◽  
Emerging Diseases ◽  
Current Data ◽  
Lessons Learned ◽  
Control Measures ◽  
Epidemiological Surveillance ◽  
The Public

Introduction: Several emerging and re-emerging diseases in the last decade have shown the global weakness to detect and act in a timely manner in situations that threaten the health of the planet. Latin America has been vulnerable to outbreaks as a result of increased poverty, social inequity and the poor response capacity of the public health system. Objective: Describe the situation of COVID-19 in Honduras and the challenges it presents. Methodology: Analysis of the epidemiology and control strategies applied in the country to contain the spread of SARS-CoV-2, in the context of the social and economic reality until September 18, 2020. Results: Honduras ranks fifth in Central America in the number of tests performed; the cumulative incidence rate of cases is 7 105 per million inhabitants. The country has an accelerated growth in the percentage of positivity with intense community transmission. Some 63.4 % of cases are concentrated in the group 20-49 years old (43 624 cases); 15.2 % in adults 60+ (10 440 cases) and 7.5 % in children under 20 (5 133 cases). With a disjointed health system and a chronic and recurrent shortage of physical and human resources, the National Risk Management System (SINAGER), which includes the Ministry of Health (SESAL), implemented various strategies to reduce the spread of the virus. Some control measures were border closures, physical distancing and the use of masks were made mandatory by legislative decree. The serious impact on the weak national economy forced an intelligent opening coinciding with the rise of cases. Conclusions: Current data show that the age group most affected is adults between 20 and 49 years old. The country’s socioeconomic situation has been aggravated by the pandemic; the continuous rise in the number of cases, hospitalizations and deaths has collapsed the public health system leaving the majority of Hondurans in continuous vulnerability. Primary care clinics and mobile medical brigades have been implemented as a new way to contain the spread and impact of transmission. Several European countries and cities in the Americas have had to reverse the process of economic reopening when faced with successive waves of outbreaks. Honduras has demonstrated limited capacity to deal with catastrophic situations. The national epidemiological surveillance system and access to timely and quality diagnostic tests remain weak and fragmented. There is an urgent need to improve the health and surveillance system to guide strategic evidence-based decision making and to prevent future pandemics.

scholarly journals Evaluation of COVID-19 Surveillance Strategy in Ecuador

2020 ◽  
pp. 1-4
Author(s):  
Ricardo Cañizares Fuentes ◽  
Rubén Aroca ◽  
Miquel Blasco Carlos
Keyword(s):  
Public Health ◽  
South Korea ◽  
Diagnostic Tests ◽  
Bayes Theorem ◽  
Control Measures ◽  
Positive Case ◽  
Actual Behavior ◽  
Case Detection ◽  
Surveillance Strategy

ABSTRACT Objectives: Evaluate the relevance of the coronavirus disease 2019 (COVID-19) positive case detection policy or model implemented by the Ministry of Public Health (MPH) of Ecuador and to compare it with the experiences of other countries. Methods: Data contained the daily reports publicized by the MPH. The formulations were carried out under the Conditioned Probability modality applying Bayes’ Theorem. All the COVID-19 tests applied in relation to the confirmed cases per million inhabitants were considered to obtain their level of positivity, and compared with the experience of Iceland and South Korea. Results: The probability of detecting positive cases of COVID-19 in Ecuador was higher than Iceland and South Korea, because the diagnostic tests were aimed at symptomatic patients, without identifying asymptomatic or mild symptomatic, who play an important role in the transmission of the disease. In addition, many symptomatic patients were examined but will remain undiagnosed due to the unavailability of tests and the low quality of many of them. Conclusions: The daily reports on the behavior of the COVID-19 issued by the Ecuadorian government do not adequately represent the growth in the number of those infected each day, nor the actual behavior of the epidemic, affecting possible control measures.

scholarly journals Hambatan Penemuan Suspect TB Ditinjau dari Faktor Personal di Kabupaten Probolinggo Jawa Timur

2020 ◽  
Vol 8 (2) ◽  
pp. 118-123
Author(s):  
Ro'isah - Ayu ◽  
Anies Anies ◽  
M. Sakundarno Adi ◽  
Nurjazuli Nurjazuli
Keyword(s):  
Public Health ◽  
Public Health Problem ◽  
Phenomenological Approach ◽  
Structured Interview ◽  
Case Detection ◽  
Personal Factors ◽  
Social Phenomena ◽  
Detection Rates ◽  
The Third ◽  
The World

Tuberculosis (TB) is an infectious disease caused by Mycobacterium Tuberculosis that is still being current public health problem. There are about 9-11.1 people suffering from tuberculosis. Indonesia becomes the third highest TB burden in the world with TB case detection rates which is still under 70%. These hidden cases will spread in the community. One of the factors that causes the low case detection is the number of suspect findings. The purpose of this study was to identify obstacles of finding TB suspect in terms of personal factors in the TB association members in Probolinggo Regency. The method of this study is qualitative with a phenomenological approach to explore social phenomena, values, experiences of life about behavior of TB suspect  discovery. The informants were 20 cadres of TB Association members. The data was collected by structured interview. The data analyzing used content analysis. The results showed that the obstacles in finding suspect of TB Association members in terms of knowledge found that generally, the cadres already knew about TB but lack of sputum removal techniques knowledge. In terms of personality, there was already an opened communication that explained about TB to the community, however TB is still considered as a horrible thing to be declared. The community has no awareness and feel embarrassed to check their disease.

scholarly journals Towards NCD surveillance in Germany – diabetes as a paradigm

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Reitzle ◽  
R Paprott ◽  
C Heidemann ◽  
C Schmidt ◽  
J Baumert ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Surveillance System ◽  
Disease Incidence ◽  
Temporal Trends ◽  
Health Data ◽  
Data Sources ◽  
Extensive Literature ◽  
Effective Prevention ◽  
Shared Risk

Abstract Background Non-communicable diseases (NCD) are a major public health challenge in Germany and throughout the world. The epidemiology of diabetes, in particular type 2 diabetes, exemplifies the need for effective prevention and control. To support policy making with actionable evidence, the Robert Koch Institute (RKI) is developing a diabetes surveillance system for Germany serving as model for NCD surveillance. Methods First, we consented a conceptual framework and key indicators among experts and stakeholders based on an extensive literature review including national and international NCD surveillance systems. After prioritization of indicators applying a two-step Delphi method, we identified data sources for sustainable surveillance including data from nationwide RKI health surveys as well as external data such as claims or registry data. Lastly, in cooperation with stakeholders we developed first dissemination products. Results During concept phase, we identified 40 indicators ranging from risk factors, disease incidence and prevalence to quality of care, mortality and burden of disease. During implementation, suitable data sources and results on temporal trends have been obtained for a large part of the indicators. For dissemination we developed a website with interactive visualization of results supported by an explainer video on YouTube. Additionally, we prepared a printed diabetes report summarizing and interpreting key findings for a broader audience, including health politicians and public health researchers. Conclusions We demonstrated the feasibility of the systematic collection and analysis of health data to describe the disease and care situation of diabetes in Germany. The methodology and data sources of indicators can be transferred to further NCDs and shared risk factors are already depicted. Next steps are to close remaining data gaps and to advance dissemination products in collaboration with our stakeholder network tailored to their information needs. Key messages Considering available health data, we showed the feasibility of implementing a diabetes surveillance system for Germany providing reliable information on disease dynamics for various stakeholders. The knowledge on methodology and data sources gained establishing a diabetes surveillance system can be extended to other noncommunicable diseases.

scholarly journals Epidemiology and National Surveillance System for Foot and Mouth Disease in Cattle in Thailand during 2008–2019

2020 ◽  
Vol 7 (3) ◽  
pp. 99 ◽  
Author(s):  
Orapun Arjkumpa ◽  
Tedsak Yano ◽  
Rotchana Prakotcheo ◽  
Chalutwan Sansamur ◽  
Veerasak Punyapornwithaya
Keyword(s):  
Surveillance System ◽  
Temporal Trends ◽  
Foot And Mouth Disease ◽  
Vaccination Strategy ◽  
Control Program ◽  
Mouth Disease ◽  
Control Measures ◽  
Surveillance Program ◽  
National Surveillance ◽  
Foot And Mouth

Foot and mouth disease (FMD) is a prominent transboundary disease that threatens livestock production and can disrupt the trade in animals and animal products at both regional and international levels. The aims of this study were: (1) to analyze the distribution of FMD in Thailand during the period of 2008 to 2019, (2) to outline a national surveillance approach, and (3) to identify the existing knowledge gap that is associated with this disease in relation to cattle production. We analyzed FMD outbreak data in order to determine the existing spatial and temporal trends and reviewed relevant publications and official documents that helped us outline a national surveillance program. There were 1209 FMD outbreaks in cattle farms during the study period. FMD outbreaks occurred every year throughout the study period in several regions. Notably, FMD serotype O and A were considered the predominant types. The FMD National Strategic Plan (2008–2015) and the national FMD control program (2016–2023) have been implemented in order to control this disease. The surveillance approach employed by livestock authorities included both active and passive surveillance techniques. The vaccination program was applied to herds of cattle 2–3 times per year. Additionally, numerous control measures have been implemented across the country. We have identified the need for a study on the assessment of an applicable surveillance program, the evaluation of an appropriate vaccination strategy and an assessment of the effectiveness of a measured control policy. In conclusion, this study provided much needed knowledge on the epidemiology of FMD outbreaks across Thailand from 2008 to 2019. Additionally, we identified the need for future studies to address the existing knowledge gaps. The findings from this study may also be useful for livestock authorities and stakeholders to establish an enhanced control strategy and to implement an effective surveillance system that would control and eradicate FMD throughout the country.

Modelling In-Patient Bed Usage Behaviour in a Department of Geriatric Medicine

1993 ◽  
Vol 32 (01) ◽  
pp. 79-81 ◽  
Author(s):  
P. Millard ◽  
S. McClean
Keyword(s):  
Census Data ◽  
Geriatric Medicine ◽  
Temporal Trends ◽  
Exponential Model ◽  
Bed Occupancy ◽  
Lengths Of Stay ◽  
Geriatric Hospital ◽  
Using Data ◽  
Acute Patients

Abstract:The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients.Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.

scholarly journals Predictors of historical change in drug treatment coverage among people who inject drugs in 90 large metropolitan areas in the USA, 1993–2007

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Barbara Tempalski ◽  
Leslie D. Williams ◽  
Brooke S. West ◽  
Hannah L. F. Cooper ◽  
Stephanie Beane ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Treatment ◽  
Resource Availability ◽  
People Who Inject Drugs ◽  
Census Data ◽  
Poverty Rate ◽  
Community Action ◽  
Historical Change ◽  
Treatment Coverage ◽  
Over Time

Abstract Background Adequate access to effective treatment and medication assisted therapies for opioid dependence has led to improved antiretroviral therapy adherence and decreases in morbidity among people who inject drugs (PWID), and can also address a broad range of social and public health problems. However, even with the success of syringe service programs and opioid substitution programs in European countries (and others) the US remains historically low in terms of coverage and access with regard to these programs. This manuscript investigates predictors of historical change in drug treatment coverage for PWID in 90 US metropolitan statistical areas (MSAs) during 1993–2007, a period in which, overall coverage did not change. Methods Drug treatment coverage was measured as the number of PWID in drug treatment, as calculated by treatment entry and census data, divided by numbers of PWID in each MSA. Variables suggested by the Theory of Community Action (i.e., need, resource availability, institutional opposition, organized support, and service symbiosis) were analyzed using mixed-effects multivariate models within dependent variables lagged in time to study predictors of later change in coverage. Results Mean coverage was low in 1993 (6.7%; SD 3.7), and did not increase by 2007 (6.4%; SD 4.5). Multivariate results indicate that increases in baseline unemployment rate (β = 0.312; pseudo-p < 0.0002) predict significantly higher treatment coverage; baseline poverty rate (β = − 0.486; pseudo-p < 0.0001), and baseline size of public health and social work workforce (β = 0.425; pseudo-p < 0.0001) were predictors of later mean coverage levels, and baseline HIV prevalence among PWID predicted variation in treatment coverage trajectories over time (baseline HIV * Time: β = 0.039; pseudo-p < 0.001). Finally, increases in black/white poverty disparity from baseline predicted significantly higher treatment coverage in MSAs (β = 1.269; pseudo-p < 0.0001). Conclusions While harm reduction programs have historically been contested and difficult to implement in many US communities, and despite efforts to increase treatment coverage for PWID, coverage has not increased. Contrary to our hypothesis, epidemiologic need, seems not to be associated with change in treatment coverage over time. Resource availability and institutional opposition are important predictors of change over time in coverage. These findings suggest that new ways have to be found to increase drug treatment coverage in spite of economic changes and belt-tightening policy changes that will make this difficult.

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