scholarly journals Signatures of Cholera Outbreak during the Yemeni Civil War, 2016–2019

Author(s):  
Ryan B. Simpson ◽  
Sofia Babool ◽  
Maia C. Tarnas ◽  
Paulina M. Kaminski ◽  
Meghan A. Hartwick ◽  
...  

The Global Task Force on Cholera Control (GTFCC) created a strategy for early outbreak detection, hotspot identification, and resource mobilization coordination in response to the Yemeni cholera epidemic. This strategy requires a systematic approach for defining and classifying outbreak signatures, or the profile of an epidemic curve and its features. We used publicly available data to quantify outbreak features of the ongoing cholera epidemic in Yemen and clustered governorates using an adaptive time series methodology. We characterized outbreak signatures and identified clusters using a weekly time series of cholera rates in 20 Yemeni governorates and nationally from 4 September 2016 through 29 December 2019 as reported by the World Health Organization (WHO). We quantified critical points and periods using Kolmogorov–Zurbenko adaptive filter methodology. We assigned governorates into six clusters sharing similar outbreak signatures, according to similarities in critical points, critical periods, and the magnitude of peak rates. We identified four national outbreak waves beginning on 12 September 2016, 6 March 2017, 28 May 2018, and 28 January 2019. Among six identified clusters, we classified a core regional hotspot in Sana’a, Sana’a City, and Al-Hudaydah—the expected origin of the national outbreak. The five additional clusters differed in Wave 2 and Wave 3 peak frequency, timing, magnitude, and geographic location. As of 29 December 2019, no governorates had returned to pre-Wave 1 levels. The detected similarity in outbreak signatures suggests potentially shared environmental and human-made drivers of infection; the heterogeneity in outbreak signatures implies the potential traveling waves outwards from the core regional hotspot that could be governed by factors that deserve further investigation.

2016 ◽  
Vol 86 (5-6) ◽  
pp. 242-248 ◽  
Author(s):  
Genc Burazeri ◽  
Jolanda Hyska ◽  
Iris Mone ◽  
Enver Roshi

Abstract.Aim: To assess the association of breakfast skipping with overweight and obesity among children in Albania, a post-communist country in the Western Balkans, which is undergoing a long and difficult political and socioeconomic transition towards a market-oriented economy. Methods: A nationwide cross-sectional study was carried out in Albania in 2013 including a representative sample of 5810 children aged 7.0 – 9.9 years (49.5% girls aged 8.4 ± 0.6 years and 51.5% boys aged 8.5 ± 0.6 years; overall response rate: 97%). Children were measured for height and weight, and body mass index (BMI) calculated. Cut-off BMI values of the World Health Organization (WHO) and the International Obesity Task Force (IOTF) were used to define overweight and obesity in children. Demographic data were also collected. Results: Upon adjustment for age, sex, and place of residence, breakfast skipping was positively related to obesity (WHO criteria: OR = 1.5, 95% CI = 1.3–1.9; IOTF criteria: OR = 1.9, 95% CI = 1.4–2.5), but not overweight (OR = 1.1, 95% CI = 0.9–1.3 and OR = 1.1, 95% CI = 0.9–1.4, respectively). Furthermore, breakfast skipping was associated with a higher BMI (multivariable-adjusted OR = 1.05, 95% CI = 1.02–1.07). Conclusions: Our findings point to a strong and consistent positive relationship between breakfast skipping and obesity, but not overweight, among children in this transitional southeastern European population. Future studies in Albania and other transitional settings should prospectively examine the causal role of breakfast skipping in the development of overweight and obesity.


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatma Saleh ◽  
Jovin Kitau ◽  
Flemming Konradsen ◽  
Leonard E. G. Mboera ◽  
Karin L. Schiøler

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.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Zheng Li ◽  
Cynthia Jones ◽  
Girum S. Ejigu ◽  
Nisha George ◽  
Amanda L. Geller ◽  
...  

Abstract Background Three months after the first reported cases, COVID-19 had spread to nearly 90% of World Health Organization (WHO) member states and only 24 countries had not reported cases as of 30 March 2020. This analysis aimed to 1) assess characteristics, capability to detect and monitor COVID-19, and disease control measures in these 24 countries, 2) understand potential factors for the reported delayed COVID-19 introduction, and 3) identify gaps and opportunities for outbreak preparedness, particularly in low and middle-income countries (LMICs). We collected and analyzed publicly available information on country characteristics, COVID-19 testing, influenza surveillance, border measures, and preparedness activities in these countries. We also assessed the association between the temporal spread of COVID-19 in all countries with reported cases with globalization indicator and geographic location. Results Temporal spreading of COVID-19 was strongly associated with countries’ globalization indicator and geographic location. Most of the 24 countries with delayed COVID-19 introduction were LMICs; 88% were small island or landlocked developing countries. As of 30 March 2020, only 38% of these countries reported in-country COVID-19 testing capability, and 71% reported conducting influenza surveillance during the past year. All had implemented two or more border measures, (e.g., travel restrictions and border closures) and multiple preparedness activities (e.g., national preparedness plans and school closing). Conclusions Limited testing capacity suggests that most of the 24 delayed countries may have lacked the capability to detect and identify cases early through sentinel and case-based surveillance. Low global connectedness, geographic isolation, and border measures were common among these countries and may have contributed to the delayed introduction of COVID-19 into these countries. This paper contributes to identifying opportunities for pandemic preparedness, such as increasing disease detection, surveillance, and international collaborations. As the global situation continues to evolve, it is essential for countries to improve and prioritize their capacities to rapidly prevent, detect, and respond, not only for COVID-19, but also for future outbreaks.


Author(s):  
Tudor Lucian Pop ◽  
Dana Maniu ◽  
Daniela Rajka ◽  
Cecilia Lazea ◽  
Gabriel Cismaru ◽  
...  

Introduction: During the last three decades, there has been an excess weight epidemic due to changes in nutrition and lifestyle. Few data on the prevalence of overweight and obesity in children in Romania were published, without a single study representative at the national level. There are reports on the higher level of overweight and obesity in urban areas compared to rural ones. This study aimed to estimate the prevalence of underweight, overweight, obesity and severe obesity in children enrolled in schools from the urban area. Material and methods: For this cross-sectional study, children from 177 schools from the urban area of five counties from the northwestern part of Romania were included after the parents signed written informed consent. Anthropometric data were recorded (weight, height) based on World Health Organization (WHO) recommendations and Body-Mass-Index (BMI), and the z-score for BMI were calculated. The nutritional status was estimated using three reference criteria: WHO, International Obesity Task Force (IOTC) and the Center for Disease Control and Prevention (CDC). Results: We analyzed data of 21,650 children (48.19% boys) age between 7 and 18 years. The prevalence of overweight was 13.8%, 16.2% and 20.3%, of obesity was 10.7%, 10.0% and 5.7% and of severe obesity was 5.1%, 1.2% and 1.6% (using WHO, CDC and IOTF cut-offs). Underweight was present in 5.2% (WHO), 6% (CDC) and 2.6% (IOTF). The highest prevalence of overweight (including obesity) was found in children aged 10 years, and the lowest in adolescents at 18 years. Boys have a higher prevalence of excess weight than girls. Using IOTF cut-offs, the prevalence of obesity and severe obesity was lower than using WHO criteria. Conclusions: The prevalence of overweight (including obesity) in children from the urban area of Western Romania was recorded at alarming levels, higher in boys and at the pre-puberty ages. There are significant differences based on the reference system used. It is important to correctly choose the reference for the definition of overweight and obesity to have the correct estimation of the target for public health measures.


2021 ◽  
Vol 8 (2) ◽  
pp. 136-142
Author(s):  
Agnes M. Varghese ◽  
Misaki N. Natsuaki

In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Among the massive shutdowns that occurred across the United States in response, all K-12 schools in California closed to protect the health of students. However, such a closure and its resulting consequences were associated with a host of negative mental health implications for youth. Furthermore, many of these youth may not have had adequate resources to tackle issues impacting their psyche in this unprecedented time. Social and emotional learning (SEL), a method in which children can acquire the knowledge and skills to understand and manage emotions, has a proven track record of positive social, emotional, educational, and career consequences. The California Department of Education should convene a task force to develop guidelines for local school districts that provide all K-12 students in the state with effective SEL to assist them in mental health recovery from the pandemic.


Author(s):  
Jakob Tarp ◽  
Juel Jarani ◽  
Florian Muca ◽  
Andi Spahi ◽  
Anders Grøntved

Abstract Background The extent of the obesity epidemic among youth is an important public health statistic which provides an indication of the future burden of non-communicable diseases. Many developing countries, including Albania, do not have systematic and repeated monitoring systems in operation. Methods The Balkan Survey of Inactivity in Children study is a population-based cross-sectional survey including Albanian children living in the four Balkan nation-states of Albania, Kosovo, FYR Macedonia and Montenegro. In total, 19,850 children from 49 schools were approached. The LMS method was used to provide body mass index (BMI), height, weight and waist circumference reference centiles for boys and girls. The World Health Organisation (WHO) and International Obesity Task Force (IOTF) age- and sex-specific BMI cut-points were applied to evaluate adiposity levels. Results A sample of 18,460 participants aged 6–16 years old was available for creation of the BMI for age and sex reference centiles. The prevalence of overweight (including obesity) in the full sample was 21% (95% CI: 20%–21%) according to IOTF cut-off points and 28% (95% CI: 28%–29%) at WHO cut-off points. Overweight/obesity levels where higher in boys than in girls irrespective of the cut-off points applied (p<0.001). Noticeable between-country differences were observed with a prevalence of overweight/obesity of 40% (95% CI: 38%–42%) in Montenegro but only 20% (95% CI: 19%–21%) in Kosovo (WHO cut-off points). Conclusions Overweight/obesity is highly prevalent in Albanian children and adolescents. The apparent sex and country differences may inform public health actions.


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