scholarly journals Twenty years of integrated disease surveillance and response in Sub-Saharan Africa: challenges and opportunities for effective management of infectious disease epidemics

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Irene R. Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Sharadhuli I. Kimera ◽  
...  
Keyword(s):  
Big Data ◽  
Disease Surveillance ◽  
Primary Source ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Quality Analysis ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan

Abstract Introduction This systematic review aimed to analyse the performance of the Integrated Disease Surveillance and Response (IDSR) strategy in Sub-Saharan Africa (SSA) and how its implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources. Methods HINARI, PubMed, and advanced Google Scholar databases were searched for eligible articles. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Results A total of 1,809 articles were identified and screened at two stages. Forty-five studies met the inclusion criteria, of which 35 were country-specific, seven covered the SSA region, and three covered 3–4 countries. Twenty-six studies assessed the IDSR core functions, 43 the support functions, while 24 addressed both functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The routine Health Management Information System (HMIS), which collects data from health care facilities, has remained the primary source of IDSR data. However, the system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation, and lack of integration of data from other sources. Under-use of advanced and big data analytical technologies in performing disease surveillance and relating multiple indicators minimises the optimisation of clinical and practice evidence-based decision-making. Conclusions This review indicates that most countries in SSA rely mainly on traditional indicator-based disease surveillance utilising data from healthcare facilities with limited use of data from other sources. It is high time that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate other sources of health information to provide support to effective detection and prompt response to public health threats.

scholarly journals Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

2020 ◽  
Author(s):  
Irene Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Leonard E.G. Mboera ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Information ◽  
Disease Surveillance ◽  
Sub Saharan Africa ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan ◽  
Disease Epidemics

Abstract Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: A search for eligible articles was done through HINARI, PubMed, and advanced Google Scholar databases. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. Using the key search descriptors, 1,809 articles were identified and screened at two stages and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions while 42 studies assessed the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilized and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

scholarly journals Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

2020 ◽  
Author(s):  
Irene Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Leonard E.G. Mboera ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Information ◽  
Disease Surveillance ◽  
Sub Saharan Africa ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan ◽  
Disease Epidemics

Abstract Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: Three databases were searched for eligible articles: HINARI, PubMed, and advanced Google Scholar databases. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. A total of 1,809 articles were identified using key descriptors and screened at two stages, and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region, and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions, while 42 studies evaluated the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements, mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilised and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

scholarly journals Assessment of the core and support functions of the integrated disease surveillance and response system in Zanzibar, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatma Saleh ◽  
Jovin Kitau ◽  
Flemming Konradsen ◽  
Leonard E. G. Mboera ◽  
Karin L. Schiøler
Keyword(s):  
Infectious Disease ◽  
Early Detection ◽  
Disease Surveillance ◽  
Health Facilities ◽  
Outbreak Detection ◽  
World Health ◽  
Support Functions ◽  
The Core ◽  
Surveillance And Response ◽  
Facility Level

Abstract Background Disease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determine its capacity for early detection of and response to infectious disease outbreaks. Methods This cross-sectional descriptive study involved 10 districts of Zanzibar and 45 public and private health facilities. A mixed-methods approach was used to collect data. This included document review, observations and interviews with surveillance personnel using a modified World Health Organization generic questionnaire for assessing national disease surveillance systems. Results The performance of the IDSR system in Zanzibar was suboptimal particularly with respect to early detection of epidemics. Weak laboratory capacity at all levels greatly hampered detection and confirmation of cases and outbreaks. None of the health facilities or laboratories could confirm all priority infectious diseases outlined in the Zanzibar IDSR guidelines. Data reporting was weakest at facility level, while data analysis was inadequate at all levels (facility, district and national). The performance of epidemic preparedness and response was generally unsatisfactory despite availability of rapid response teams and budget lines for epidemics in each district. The support functions (supervision, training, laboratory, communication and coordination, human resources, logistic support) were inadequate particularly at the facility level. Conclusions The IDSR system in Zanzibar is weak and inadequate for early detection and response to infectious disease epidemics. The performance of both core and support functions are hampered by several factors including inadequate human and material resources as well as lack of motivation for IDSR implementation within the healthcare delivery system. In the face of emerging epidemics, strengthening of the IDSR system, including allocation of adequate resources, should be a priority in order to safeguard human health and economic stability across the archipelago of Zanzibar.

scholarly journals PO 8581 ZOONOTIC VIRAL ANTIGENS SURVEILLANCE IN HEALTHY POPULATIONS LIVING IN LAMBARÉNÉ, GABON

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A58.2-A58
Author(s):  
Emmanuel Bache ◽  
Marguerite M Loembe ◽  
Selidji T Agnandji
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Vaccine Trial ◽  
Viral Rna ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Rt Pcr ◽  
Zoonotic Infections ◽  
Viral Antigens ◽  
Sub Saharan

BackgroundWorldwide, viral zoonotic infections such as filoviruses, flaviviruses, nairoviruses and arenaviruses cause self-limiting to severe diseases. They are endemic in sub-Saharan Africa, causing sporadic outbreaks warranting the development of sustainable surveillance systems. In Gabon, Ebola outbreaks occurred from 1994 to 2002 causing 214 human cases and 150 deaths, while Dengue, Zika and Chikungunya virus outbreaks occurred between 2007 and 2010. Beyond these outbreaks, little is known about the epidemiology. Recently, in collaboration with the Japanese government, the Research and Health Ministries of Gabon supported the implementation of a biosecurity level-3 (BSL-3) laboratory at CERMEL in Lambaréné as a zoonotic disease surveillance unit. Start-off involved antigen detection and characterisation of circulating antibodies to targeted viral antigens in healthy populations. This study reports data from healthy participants (18–50 years) in a phase I rVSV-ZEBOV-GP Ebola vaccine trial.MethodsHundred-six (106) baseline samples were screened for Ebola, Dengue (serotypes) 1–4 and Chikungunya viral RNA by RT-PCR on serum. IgG ELISA on plasma was used to identify antibodies against: Zaire-Ebola-(EBOV-GP and EBOV-VP40), Marburg-(MARV-GP and MARV-VP40), Crimean Congo Haemorrhagic Fever-(CCHFV-GP), Lasa-(LASV-GPC and LASV-NP), Yellow Fever-(YFV-NS1), West-Nile-(WNV-NS1), Zika virus-(ZIKV-NS1), Chikungunya-(CHIKV-VLP) and Dengue-(DENV1-NS1,DENV2-NS1,DENV3-NS1,DENV4-NS1) virus antigens.ResultsNo viral RNA was isolated by RT-PCR in 106 samples. About 9% (10/106), 3% (3/106), 6% (6/106), 24% (25/106), 51% (54/106), 38% (40/106) and 36% (38/106) participants were seropositive for antibodies specific to EBOV-GP, MARV-GP, CCHFV-GP, YFV-NS1, WNV-NS1, ZIKV-NS1 and CHIKV-VLP, respectively. Twelve percent (12%; 13/106) of participants possessed antibodies specific to Zika, Chikungunya and Dengue 1–4 antigens. Six percent (6%; 6/106) of participants were seropositive for EBOV-GP and CCHFV-GP.ConclusionWe found antibodies to viral zoonotic infections among our healthy volunteers. Further assays, including neutralisation assays are being performed to ascertain the specificity of the antibodies. These findings, once confirmed, will provide insights into disease surveillance, vaccine trial designs, evaluation of post-vaccine immune responses, variability in adverse events and overall disease transmission patterns.

scholarly journals The Establishment and Diversification of Epidemic-Associated Serogroup W Meningococcus in the African Meningitis Belt, 1994 to 2012

mSphere ◽  
2016 ◽  
Vol 1 (6) ◽  
Author(s):  
Adam C. Retchless ◽  
Fang Hu ◽  
Abdoul-Salam Ouédraogo ◽  
Seydou Diarra ◽  
Kristen Knipe ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Meningococcal Disease ◽  
Disease Surveillance ◽  
Bloodstream Infections ◽  
Rapid Identification ◽  
Sub Saharan Africa ◽  
Common Cause ◽  
Content Type ◽  
Meningitis Belt ◽  
Sub Saharan

ABSTRACT Meningococcal disease (meningitis and bloodstream infections) threatens millions of people across the meningitis belt of sub-Saharan Africa. A vaccine introduced in 2010 protects against Africa’s then-most common cause of meningococcal disease, N. meningitidis serogroup A. However, other serogroups continue to cause epidemics in the region—including serogroup W. The rapid identification of strains that have been associated with prior outbreaks can improve the assessment of outbreak risk and enable timely preparation of public health responses, including vaccination. Phylogenetic analysis of newly sequenced serogroup W strains isolated from 1994 to 2012 identified two groups of strains linked to large epidemics in Burkina Faso, one being descended from a strain that caused an outbreak during the Hajj pilgrimage in 2000. We find that applying whole-genome sequencing to meningococcal disease surveillance collections improves the discrimination among strains, even within a single nation-wide epidemic, which can be used to better understand pathogen spread. Epidemics of invasive meningococcal disease (IMD) caused by meningococcal serogroup A have been eliminated from the sub-Saharan African so-called “meningitis belt” by the meningococcal A conjugate vaccine (MACV), and yet, other serogroups continue to cause epidemics. Neisseria meningitidis serogroup W remains a major cause of disease in the region, with most isolates belonging to clonal complex 11 (CC11). Here, the genetic variation within and between epidemic-associated strains was assessed by sequencing the genomes of 92 N. meningitidis serogroup W isolates collected between 1994 and 2012 from both sporadic and epidemic IMD cases, 85 being from selected meningitis belt countries. The sequenced isolates belonged to either CC175 (n = 9) or CC11 (n = 83). The CC11 N. meningitidis serogroup W isolates belonged to a single lineage comprising four major phylogenetic subclades. Separate CC11 N. meningitidis serogroup W subclades were associated with the 2002 and 2012 Burkina Faso epidemics. The subclade associated with the 2012 epidemic included isolates found in Burkina Faso and Mali during 2011 and 2012, which descended from a strain very similar to the Hajj (Islamic pilgrimage to Mecca)-related Saudi Arabian outbreak strain from 2000. The phylogeny of isolates from 2012 reflected their geographic origin within Burkina Faso, with isolates from the Malian border region being closely related to the isolates from Mali. Evidence of ongoing evolution, international transmission, and strain replacement stresses the importance of maintaining N. meningitidis surveillance in Africa following the MACV implementation. IMPORTANCE Meningococcal disease (meningitis and bloodstream infections) threatens millions of people across the meningitis belt of sub-Saharan Africa. A vaccine introduced in 2010 protects against Africa’s then-most common cause of meningococcal disease, N. meningitidis serogroup A. However, other serogroups continue to cause epidemics in the region—including serogroup W. The rapid identification of strains that have been associated with prior outbreaks can improve the assessment of outbreak risk and enable timely preparation of public health responses, including vaccination. Phylogenetic analysis of newly sequenced serogroup W strains isolated from 1994 to 2012 identified two groups of strains linked to large epidemics in Burkina Faso, one being descended from a strain that caused an outbreak during the Hajj pilgrimage in 2000. We find that applying whole-genome sequencing to meningococcal disease surveillance collections improves the discrimination among strains, even within a single nation-wide epidemic, which can be used to better understand pathogen spread.

scholarly journals Planning universal accessibility to public health care in sub-Saharan Africa

2020 ◽  
Vol 117 (50) ◽  
pp. 31760-31769
Author(s):  
Giacomo Falchetta ◽  
Ahmed T. Hammad ◽  
Soheil Shayegh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Public Health Care ◽  
Care Services ◽  
Universal Accessibility ◽  
Care Facilities ◽  
Sub Saharan

Achieving universal health care coverage—a key target of the United Nations Sustainable Development Goal number 3—requires accessibility to health care services for all. Currently, in sub-Saharan Africa, at least one-sixth of the population lives more than 2 h away from a public hospital, and one in eight people is no less than 1 h away from the nearest health center. We combine high-resolution data on the location of different typologies of public health care facilities [J. Maina et al., Sci. Data 6, 134 (2019)] with population distribution maps and terrain-specific accessibility algorithms to develop a multiobjective geographic information system framework for assessing the optimal allocation of new health care facilities and assessing hospitals expansion requirements. The proposed methodology ensures universal accessibility to public health care services within prespecified travel times while guaranteeing sufficient available hospital beds. Our analysis suggests that to meet commonly accepted universal health care accessibility targets, sub-Saharan African countries will need to build ∼6,200 new facilities by 2030. We also estimate that about 2.5 million new hospital beds need to be allocated between new facilities and ∼1,100 existing structures that require expansion or densification. Optimized location, type, and capacity of each facility can be explored in an interactive dashboard. Our methodology and the results of our analysis can inform local policy makers in their assessment and prioritization of health care infrastructure. This is particularly relevant to tackle health care accessibility inequality, which is not only prominent within and between countries of sub-Saharan Africa but also, relative to the level of service provided by health care facilities.

scholarly journals Les petits exploitants agricoles à l’école inclusive : cas de l’apprentissage collectif par la vidéo et la radio sur la post-récolte du riz local au Bénin

2021 ◽  
Vol 15 (4) ◽  
pp. 1678-1697
Author(s):  
Espérance Zossou ◽  
Seth Graham-Acquaah ◽  
John Manful ◽  
Simplice D. Vodouhe ◽  
Rigobert C. Tossou
Keyword(s):  
Smallholder Farmers ◽  
Laboratory Data ◽  
Innovation System ◽  
Collective Learning ◽  
Sub Saharan Africa ◽  
Quality Analysis ◽  
Afrique Subsaharienne ◽  
Sub Saharan ◽  
Student’S T ◽  
The Impact

En Afrique subsaharienne, les petits exploitants agricoles ruraux ont difficilement accès aux connaissances et informations actualisées afin d’améliorer leur revenu. Pour renforcer l’apprentissage collectif au sein des acteurs des chaînes de valeur du riz local blanc et étuvé, la vidéo et la radio ont été utilisées de façon participative. La présente étude visait à comprendre l’influence de cet apprentissage collectif sur (i) le changement des pratiques des transformations et (ii) la qualité du riz local. Des interviews et suivis hebdomadaires ont été réalisés entre 2009 et 2018 au sud et nord du Bénin auprès de 240 transformateurs choisis aléatoirement. Des échantillons de riz ont été également collectés pour des analyses de qualité au laboratoire. L’analyse des données a été faite avec les tests t de Student, Wilcoxon, ANOVA, et le modèle de régression de Poisson. Les résultats ont montré une amélioration des pratiques de 14% ; 23% et 58% respectivement dans les villages contrôles, radio et vidéo. Dans le processus d’amélioration des pratiques, les transformateurs ont renforcé leur créativité en développant des technologies appropriées à leur environnement ; ce qui a eu un impact positif sur les qualités physiques et de cuisson du riz. Dans un contexte de pauvreté, d’insécurité alimentaire, de ruralité et d’analphabétisme, l’apprentissage collectif par la vidéo et la radio locale se révèle être une opportunité pour le renforcement du système d’innovation agricole.   English title: Smallholder farmers at inclusive school: Lessons learnt from collective  learning through video and radio on local rice processing in Benin In sub-Saharan Africa, rural smallholder farmers have limited access to timely and up-to-date knowledge and information to improve their incomes. To strengthen collective learning among rice sector’ stakeholders, videos and radio were participatory used. This study aims to assess the impact of this collective learning on (i) changing rice processors practices and (ii) the quality of local rice. Interviews and weekly follow-ups were conducted between 2009 and 2018 in southern and northern Benin with 240 randomly selected rice processors. Rice samples were also collected for quality analysis in the laboratory. Data analysis was done with Student's t-tests, Wilcoxon, one-way ANOVA, and the Poisson regression model. The results showed an improvement in rice processors practices of 14%; 23% and 58% respectively in control, video and radio villages. During the improvement of their practices, rice processors have increased their creativity by developing appropriate technologies to their environment; and this has positively impact on the physical and cooking qualities of the rice. In a context of poverty, food insecurity, rurality and illiteracy, collective learning through video and radio seems to be an opportunity to strengthen the agricultural innovation system, and a booster for change through adoption and adaptation of innovation.

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