scholarly journals Simulation exercises and after action reviews – analysis of outputs during 2016–2019 to strengthen global health emergency preparedness and response

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Frederik Anton Copper ◽  
Landry Ndriko Mayigane ◽  
Yingxin Pei ◽  
Denis Charles ◽  
Thanh Nam Nguyen ◽  
...  

Abstract Background Under the International Health Regulations (2005) [IHR (2005)] Monitoring and Evaluation Framework, after action reviews (AAR) and simulation exercises (SimEx) are two critical components which measure the functionality of a country’s health emergency preparedness and response under a “real-life” event or simulated situation. The objective of this study was to describe the AAR and SimEx supported by the World Health Organization (WHO) globally in 2016–2019. Methods In 2016–2019, WHO supported 63 AAR and 117 SimEx, of which 42 (66.7%) AAR reports and 56 (47.9%) SimEx reports were available. We extracted key information from these reports and created two central databases for AAR and SimEx, respectively. We conducted descriptive analysis and linked the findings according to the 13 IHR (2005) core capacities. Results Among the 42 AAR and 56 SimEx available reports, AAR and SimEx were most commonly conducted in the WHO African Region (AAR: n = 32, 76.2%; SimEx: n = 32, 52.5%). The most common public health events reviewed or tested in AAR and SimEx, respectively, were epidemics and pandemics (AAR: n = 38, 90.5%; SimEx: n = 46, 82.1%). For AAR, 10 (76.9%) of the 13 IHR core capacities were reviewed at least once, with no AAR conducted for food safety, chemical events, and radiation emergencies, among the reports available. For SimEx, all 13 (100.0%) IHR capacities were tested at least once. For AAR, the most commonly reviewed IHR core capacities were health services provision (n = 41, 97.6%), risk communication (n = 39, 92.9%), national health emergency framework (n = 39, 92.9%), surveillance (n = 37, 88.1%) and laboratory (n = 35, 83.3%). For SimEx, the most commonly tested IHR core capacity were national health emergency framework (n = 56, 91.1%), followed by risk communication (n = 48, 85.7%), IHR coordination and national IHR focal point functions (n = 45, 80.4%), surveillance (n = 31, 55.4%), and health service provision (n = 29, 51.8%). For AAR, the median timeframe between the end of the event and AAR was 125 days (range = 25–399 days). Conclusions WHO has recently published guidance for the planning, execution, and follow-up of AAR and SimEx. Through the guidance and the simplified reporting format provided, we hope to see more countries conduct AAR and SimEx and standardization in their methodology, practice, reporting and follow-up.

1991 ◽  
Vol 6 (2) ◽  
pp. 271-278
Author(s):  
Maniza S. Zaman ◽  
Sandro Calvani

AbstractThe World Health Organization, Panafrican Centre for Emergency Preparedness and Response (WHO/EPR) was established in 1988, and officially opened in March 1989, as a practical and functional response to the identified need for a regional institution to deal effectively with the health and related consequences of both natural and man-made disasters. The principal objective of the Centre is to aid member countries in the prevention and/or reduction of the adverse health effects of disasters, be they direct or indirect, by strengthening national capacities for disaster preparedness and response. The WHO has reoriented its disaster operations unit to incorporate preparedness activities, particularly within an overall developmental framework which is crucial for reducing losses, both human and material, in the event of a disaster. In keeping with this focus, the Centre has defined its goals and activities: development of national disaster preparedness programs; training of national and international personnel in health emergency preparedness and response; production and dissemination of technical publications on disaster preparedness and management; undertaking risk assessment missions; and executing relevant research projects.


2020 ◽  
Author(s):  
Weisi Liu

BACKGROUND It can be seen that the occurrence of disease in the destination is closely related to the health of travelers. The public urgently needs a localized disease status retrieval tool. Mini App is an application that can be used without downloading and installing. Users can scan or search from WeChat to open the application. It’s the most popular way for Chinese people to use it. OBJECTIVE This study aims to explore the feasibility of establishing disease risk communication platform system in the era of artificial intelligence and big data, to provide suggestions for disease control workers and the public to establish an information-based data platform for efficient communication, and to provide practical and scientific basis for the implementation of accurate communication strategy of risk communication. METHODS The data of authoritative portal websites and authoritative websites in related fields were collected and integrated into a practical destination disease information platform suitable for the public. The data source includes World Health Organization, National Health Commission of the people's Republic of China, China Center for Disease Control and prevention, CDC of the United States, ECDC of Europe, portal of Hong Kong Health Protection Center, etc. RESULTS A total of 946 pieces of information were collected from the National Health Commission of the people's Republic of China (300), CDC (370), World Health Organization (170), Covid-19 guidelines (79) and Canada tourism network-- travel.gc.ca (27). The number of searches was 1134. CONCLUSIONS This small program conforms to the current new media data age, people's habits, directly facing the public, let the public understand the disease situation of the tourism destination, and obtain authoritative prevention and control guidelines; it provides information and convenience for the public, and has a good practical application prospect.


2014 ◽  
Vol 29 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Hilarie Cranmer ◽  
Jennifer L. Chan ◽  
Stephanie Kayden ◽  
Altaf Musani ◽  
Philippe E. Gasquet ◽  
...  

AbstractThe need to provide a professionalization process for the humanitarian workforce is well established. Current competency-based curricula provided by existing academically affiliated training centers in North America, the United Kingdom, and the European Union provide a route toward certification. Simulation exercises followed by timely evaluation is one way to mimic the field deployment process, test knowledge of core competences, and ensure that a competent workforce can manage the inevitable emergencies and crises they will face. Through a 2011 field-based exercise that simulated a humanitarian crisis, delivered under the auspices of the World Health Organization (WHO), a competency-based framework and evaluation tool is demonstrated as a model for future training and evaluation of humanitarian providers.CranmerH, ChanJ, KaydenS, MusaniA, GasquetP, WalkerP, BurkleF, JohnsonK. Development of an evaluation framework suitable for assessing humanitarian workforce competencies during crisis simulation exercises. Prehosp Disaster Med. 2014;29(1):1-6.


2020 ◽  
Vol 32 (2 (Supp)) ◽  
pp. 281-287
Author(s):  
Praveen Madala ◽  
Senthilnathan Subramaniam

Background: World Health Organization (WHO), China Country Office informed cases of pneumonia of unknown aetiology detected in Wuhan City, Hubei Province of China. On 7th January 2020, Chinese authorities identified a new strain of Coronavirus as the causative agent for the disease. By 1st April 2020, the disease since its first detection in China has spread to over 200 countries/territories leading to a total of 823626 confirmed cases and 40598 deaths. WHO declared the novel Coronavirus outbreak as a Pandemic on 11 March 2020 and named the 2019 novel Coronavirus as COVID-19. As the screening of these suspects in ships is a challenging and novel one, the present study was aimed at identifying the proper and systematic way of screening of these suspects.  Screening if done systematically aids in early diagnosis of the COVID-19 suspects and if coupled with pre-arrival preparedness through e-mail follow up helps in proper planning. Proper risk communication can help in alleviating the fears of the stakeholders and public. Aims & Objectives: The primary objective of this study was to screen the COVID-19 suspect cases systematically in the vessels and the secondary objectives were to identify any gaps in the process of collection, transport and receipt of results of samples of COVID-19 Suspect cases, know the process of risk communication & to share the experience to other seaports for duplication. Materials & Methods: Screening was done for all the crew by the Investigators with proper Personal Protective Equipment (PPE) on the Bridge (Navigation Deck) of the vessel mainly for recording the temperature and eliciting other signs & symptoms of COVID -19. It was then followed by sending the samples of the two COVID-19 suspects for testing to the Government approved laboratory in a systematic way. Risk communication was also done to all the stakeholders and media in a well-coordinated manner at the earliest to update them on the facts and to prevent false communication. Results: Pre-arrival preparedness through screening of pre-arrival documents and systematic approach adopted for screening of the COVID-19 suspects led to early diagnosis of the suspects. Samples were collected as per protocol and sent for testing to the laboratory and reports of the same were obtained without any much constraints through proper liaison with Tamilnadu State Health team. Risk communication to the stakeholders and media prevented panic among the public and stakeholders. Conclusions: Pre-arrival e-mail follow-up and arrangements like coordination meeting with the stakeholders led to proper planning. Systematic screening and proper liaison with State Health team helped in the early diagnosis of the suspects. Proper and early risk communication to the stakeholders and media prevents panic, facilitates good support and prevents communication of maleficious information to the public.


Crisis ◽  
2003 ◽  
Vol 24 (2) ◽  
pp. 73-78 ◽  
Author(s):  
Yves Sarfati ◽  
Blandine Bouchaud ◽  
Marie-Christine Hardy-Baylé

Summary: The cathartic effect of suicide is traditionally defined as the existence of a rapid, significant, and spontaneous decrease in the depressive symptoms of suicide attempters after the act. This study was designed to investigate short-term variations, following a suicide attempt by self-poisoning, of a number of other variables identified as suicidal risk factors: hopelessness, impulsivity, personality traits, and quality of life. Patients hospitalized less than 24 hours after a deliberate (moderate) overdose were presented with the Montgomery-Asberg Depression and Impulsivity Rating Scales, Hopelessness scale, MMPI and World Health Organization's Quality of Life questionnaire (abbreviated versions). They were also asked to complete the same scales and questionnaires 8 days after discharge. The study involved 39 patients, the average interval between initial and follow-up assessment being 13.5 days. All the scores improved significantly, with the exception of quality of life and three out of the eight personality traits. This finding emphasizes the fact that improvement is not limited to depressive symptoms and enables us to identify the relative importance of each studied variable as a risk factor for attempted suicide. The limitations of the study are discussed as well as in particular the nongeneralizability of the sample and setting.


2018 ◽  
Vol 2 (1) ◽  
pp. 49
Author(s):  
Enis Uruci

Exposure prevention is the primary strategy to reduce the risk of occupational bloodborne pathogen infections in healthcare workers (HCW). HCWs should be made aware of the medicolegal and clinical relevance of reporting an exposure, and have ready access to expert consultants to receive appropriate counselling, treatment and follow-up. Vaccination against hepatitis B virus (HBV), and demonstration of immunisation before employment are strongly recommended. HCWs with postvaccinal anti-HBs levels, 1-2 months after vaccine completion, .or=10 mIU/mL are considered as responders. Responders are protected against HBV infection: booster doses of vaccine or periodic antibody concentration testing are not recommended. Alternative strategies to overcome non-response should be adopted. Isolated anti-HBc positive HCWs should be tested for anti-HBcIgM and HBV-DNA: if negative, anti-HBs response to vaccination can distinguish between infection (anti-HBs .or=50 mIU/ml 30 days after 1st vaccination: anamnestic response) and false positive results(anti-HBs .or=10 mUI/ml 30 days after 3rd vaccination: primary response); true positive subjects have resistance to re-infection. and do not need vaccination The management of an occupational exposure to HBV differs according to the susceptibility of the exposed HCW and the serostatus of the source. When indicated, post-exposure prophylaxis with HBV vaccine, hepatitis B immunoglobulin or both must be started as soon as possible (within 1-7 days). In the absence of prophylaxis against hepatitis C virus (HCV) infection, follow-up management of HCV exposures depends on whether antiviral treatment during the acute phase is chosen. Test the HCW for HCV-Ab at baseline and after 6 months; up to 12 for HIV-HCV co-infected sources. If treatment is recommended, perform ALT (amino alanine transferase) activity at baseline and monthly for 4 months after exposure, and qualitative HCV-RNA when an increase is detected. Introduction Bloodborne pathogens such as hepatitis B (HBV) and C virus (HCV) represent an important hazard for healthcare workers (HCWs) (1). In the general population, HCV prevalence varies geographically from about 0.5% in northern countries to 2% in Mediterranean countries, with some 5 million chronic carriers estimated in Europe; while HBV prevalence ranges from 0.3% to 3%. The World Health Organization (WHO) estimates that each year in Europe 304 000 HCWs are exposed to at least one percutaneous injury with a sharp object contaminated with HBV, 149 000 are exposed to HCV and 22 000 to HIV. The probability of acquiring a bloodborne infection following an occupational exposure has been estimated to be on average.


2021 ◽  
pp. 097206342199498
Author(s):  
Rajesh Kumar

Background: Since independence, life expectancy has increased substantially in India, but the goal of health-for-all has not been achieved yet. Hence, National Rural Health Mission was launched in 2005, and several strategies were implemented to strengthen the health system. Impact evaluation of the mission was done to learn lessons for future health planning. Materials and Methods: Logical evaluation framework was used to examine input, output and impact indicators systematically using time series data from Health Management Information System, National Family Health Surveys, National Sample Surveys and Sample Registration Scheme. Findings: After launch of the mission, fund allocation has increased nearly five times. The number of auxiliary nurse midwives has doubled, and the number of nurses has trebled. The number of accredited social health activists has increased to about one million. Institutional deliveries have increased from 38.7% in 2005–2006 to 78.9% in 2015–2016. Full immunisation coverage has increased from 43.5% to 62%. Oral rehydration solution (ORS) use in childhood diarrhoea has increased from 26% to 51%. Infant mortality rate has declined from 58 in 2005 to 33 per 1,000 live births in 2017 and maternal mortality ratio has also registered a decline from 254 in 2004–2006 to 122/100000 live births in 2015–2017. However, out-of-pocket health expenditure continues to be fairly high (69.3% of the total expenditure on health). Conclusions: Though National Health Mission has made a significant impact, the goal of universal care coverage is not yet fully achieved. Hence, capacity of health system needs to be trebled by a substantial increase in fund allocation.


Author(s):  
Katja Bender ◽  
Eilís Perez ◽  
Mihaela Chirica ◽  
Julia Onken ◽  
Johannes Kahn ◽  
...  

Abstract Purpose High-grade astrocytoma with piloid features (HGAP) is a recently described brain tumor entity defined by a specific DNA methylation profile. HGAP has been proposed to be integrated in the upcoming World Health Organization classification of central nervous system tumors expected in 2021. In this series, we present the first single-center experience with this new entity. Methods During 2017 and 2020, six HGAP were identified. Clinical course, surgical procedure, histopathology, genome-wide DNA methylation analysis, imaging, and adjuvant therapy were collected. Results Tumors were localized in the brain stem (n = 1), cerebellar peduncle (n = 1), diencephalon (n = 1), mesencephalon (n = 1), cerebrum (n = 1) and the thoracic spinal cord (n = 2). The lesions typically presented as T1w hypo- to isointense and T2w hyperintense with inhomogeneous contrast enhancement on MRI. All patients underwent initial surgical intervention. Three patients received adjuvant radiochemotherapy, and one patient adjuvant radiotherapy alone. Four patients died of disease, with an overall survival of 1.8, 9.1, 14.8 and 18.1 months. One patient was alive at the time of last follow-up, 14.6 months after surgery, and one patient was lost to follow-up. Apart from one tumor, the lesions did not present with high grade histology, however patients showed poor clinical outcomes. Conclusions Here, we provide detailed clinical, neuroradiological, histological, and molecular pathological information which might aid in clinical decision making until larger case series are published. With the exception of one case, the tumors did not present with high-grade histology but patients still showed short intervals between diagnosis and tumor progression or death even after extensive multimodal therapy.


2020 ◽  
Vol 58 (12) ◽  
pp. 2025-2035
Author(s):  
María Sol Ruiz ◽  
María Belén Sánchez ◽  
Yuly Masiel Vera Contreras ◽  
Evangelina Agrielo ◽  
Marta Alonso ◽  
...  

AbstractObjectivesThe quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.MethodsThe laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.ResultsOur field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.ConclusionsIn conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.


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