scholarly journals Zika Pregnancy Surveillance: Transforming Data into Educational and Clinical Tools

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Kara Polen ◽  
Titilope Oduyebo ◽  
Jazmyn Moore ◽  
Sascha Ellinton ◽  
Regina Simeone ◽  
...  
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Surveillance System ◽  
Healthcare Providers ◽  
Surveillance Data ◽  
Clinical Settings ◽  
Educational Materials ◽  
The Us ◽  
Clinical Tools ◽  
The Impact

ObjectiveTo describe how Zika virus (Zika) surveillance data informs and improves testing guidance, clinical evaluation and management of pregnant women and infants with possible Zika infectionIntroductionLittle was known about the maternal and fetal/infant effects of Zika infection before the 2015 outbreak in the Americas, which made it challenging for public health practitioners and clinicians to care for pregnant women and infants exposed to Zika. In 2016, CDC implemented a rapid surveillance system, the US Zika Pregnancy and Infant Registry, to collect information about the impact of Zika infection during pregnancy and inform the CDC response and clinical guidance. In partnership with state, tribal, local, and territorial health departments, CDC disseminated information from this surveillance system, which served as the foundation for educational materials and clinical tools for healthcare providers.MethodsThroughout the Zika response, CDC worked closely with health officers, epidemiologists, and clinical partners to seek expert input on the interpretation of emerging data and the evaluation and management of these vulnerable populations. In response to requests from clinical and public health partners, CDC created targeted educational materials and tools to facilitate the implementation of clinical guidance. These materials equipped healthcare providers with the information needed to care for pregnant women and infants with Zika infection. Examples of products developed included: 1) screening tools to identify pregnant women for whom testing is indicated; 2) an interactive web tool to assist with implementation and interpretation of Zika testing guidance (Pregnancy and Zika Testing Widget); 3) patient counseling scripts; and 4) videos to explain critical clinical concepts (e.g., measurement of infant head circumference). These tools were informally pre-tested with the target audiences prior to dissemination, specifically to assess usefulness in clinical settings. CDC disseminated these tools through the CDC website and through comprehensive outreach (e.g., webinars, calls, email alerts) to various audiences. Additionally, several professional organizations incorporated these tools into regular communication with their membership.ResultsThe US Zika Pregnancy and Infant Registry is currently monitoring infants from approximately 7,300 pregnancies in the US states and territories with laboratory evidence of Zika. Surveillance data provided valuable information, including clues toward the pattern of defects and other neurologic disabilities associated with congenital Zika infection, estimates of the risks associated with congenital infection, and timeframes of greatest risk during pregnancy, to help clinicians counsel pregnant patients with potential Zika exposure. CDC used these data to inform their clinical tools, particularly in pretest counseling materials and educational factsheets for healthcare providers to use with pregnant women with potential Zika exposure.After informal testing among healthcare providers, the tools received positive feedback regarding usefulness and applicability in clinical settings. Collectively, CDC’s Zika clinical tools were downloaded more than 300,000 times from CDC’s website. The Pregnancy and Zika Testing Widget was accessed and followed to an endpoint (e.g., Zika testing recommended) more than 17,000 times, with more than 75% of users self-identifying as clinicians.ConclusionsRapid implementation of Zika surveillance captured evolving data about the impact of Zika on pregnant women and their infants. These data informed the development of clinical tools for healthcare providers caring for and counseling patients with Zika exposure. These tools ensured pregnant women and infants were adequately monitored during the Zika outbreak. Health education materials and clinical tools based on surveillance data should be considered in future emergency responses, particularly when knowledge is rapidly evolving.ReferencesCDC Zika Pregnancy Website: https://www.cdc.gov/pregnancy/zika/materials/index.html 

scholarly journals Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Comparison Group ◽  
Intervention Group ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Percentage Points ◽  
Reporting Rates ◽  
The Impact

Abstract Background: Infectious diseases remain one of the greatest threats to public health globally. Effective public health surveillance systems are therefore needed to provide timely and accurate information for early detection and response. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The completeness of reporting increased significantly after the training by 17 percentage points (from 45% to 62%) for the intervention group compared to 3 percentage points (49% to 52%) for the comparison group. Timeliness of reporting increased significantly by 21 percentage points (from 30% to 51%) for the intervention group compared to 7 percentage points (from 31% to 38%) for the comparison group. Major challenges identified for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers being given other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

scholarly journals Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Comparison Group ◽  
Transition Period ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Percentage Points ◽  
Reporting Rates ◽  
The Impact

Abstract Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45% to 62%, i.e. by 17 percentage points (95% CI 16.14 -17.86) compared to an increase from 49% to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23 -3.77). The timeliness of reporting increased from 30% to 51%, i.e. by 21 percentage points (95% CI 20.16 - 21.84) for the intervention group, compared to an increase from 31% to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

scholarly journals Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Comparison Group ◽  
Transition Period ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Percentage Points ◽  
Reporting Rates ◽  
The Impact

Abstract Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45% to 62%, i.e. by 17 percentage points (95% CI 16.14 - 17.86) compared to an increase from 49% to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23-3.77). The timeliness of reporting increased from 30% to 51%, i.e. by 21 percentage points (95% CI 20.16 - 21.84) for the intervention group, compared to an increase from 31% to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

scholarly journals Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

2019 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Intervention Group ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Control Group ◽  
Percentage Points ◽  
Reporting Rates ◽  
The Impact

Abstract Background Infectious diseases remain one of the greatest threats to public health globally. Effective public health surveillance systems are therefore needed to provide timely and accurate information for early detection and response. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2(DHIS2). As part of Global Health Security Agenda(GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates.Methods From February to May 2017, we analysed surveillance data for 13 intervention and 13 control counties. An intervention county was defined as one that had received a refresher training on DHIS2 while a control county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. A Likert scale was used to grade the challenges.Results The completeness of reporting increased after the training by 17 percentage points (from 45% to 62%) for the intervention group compared to 3 percentage points (49% to 52%) for the control group. Timeliness of reporting increased by 21 percentage points (from 30% to 51%) for the intervention group compared to 7 percentage points (from 31% to 38%) for the control group. Major challenges identified for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers being given other competing tasks.Conclusions Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

scholarly journals CAREGIVING SURVEILLANCE AT THE CDC: PAST, PRESENT, AND FUTURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S188-S188
Author(s):  
Valerie J Edwards ◽  
C Grace Whiting
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Healthy Aging ◽  
National Level ◽  
Public Health Problem ◽  
Population Based ◽  
Surveillance Data ◽  
Public Health Issue ◽  
Behavioral Risk ◽  
The Impact

Abstract As the U.S. population ages, caregiving has emerged as an important public health issue affecting an increasing proportion of American families. In 2015, an estimated 17.7 million people provided assistance to family members and friends. Although caregiving can have positive aspects, many studies have found that caregivers report more health difficulties than non-caregivers. The importance of population-based information is central to public health’s ability to respond effectively to this growing public health problem. The Alzheimer’s Disease and Healthy Aging Program at the Centers for Disease Control and Prevention (CDC) has made surveillance of caregivers a priority area. To this end, the development and use of a caregiving module for the Behavioral Risk Factor Surveillance System (BRFSS) was undertaken. The BRFSS is one of the largest telephone-based health surveillance system in the world, and collects information from the public across a broad range of health topics. This platform therefore provides a unique opportunity to capture health status data from caregivers as well as the option of comparing caregivers to non-caregivers. The Caregiver Module consists of 9 questions that address the characteristics of care and the type of assistance provided. The objective of this symposium is to describe the development of the current caregiving module (Dr. Bouldin), present relevant findings from the previous three years of surveillance data (Drs. Edwards and Taylor), and to discuss future directions for caregiver surveillance and CDC-developed resources to facilitate date utilization (Dr. McGuire). The discussant will describe the impact and status of national-level surveillance data

scholarly journals Guidelines for Pregnancy Management During the COVID-19 Pandemic: A Public Health Conundrum

2020 ◽  
Vol 17 (21) ◽  
pp. 8277
Author(s):  
Caroline Benski ◽  
Daria Di Filippo ◽  
Gianmarco Taraschi ◽  
Michael R. Reich
Keyword(s):  
Public Health ◽  
At Risk ◽  
Maternal Health ◽  
Pregnant Women ◽  
Royal College ◽  
Health Workers ◽  
Healthcare Providers ◽  
Management Guidelines ◽  
Limited Knowledge ◽  
The Impact

Pregnant women seem to be at risk for developing complications from COVID-19. Given the limited knowledge about the impact of COVID-19 on pregnancy, management guidelines are fundamental. Our aim was to examine the obstetrics guidelines released from December 2019 to April 2020 to compare their recommendations and to assess how useful they could be to maternal health workers. We reviewed 11 guidelines on obstetrics management, assessing four domains: (1) timeliness: the time between the declaration of pandemics by WHO and a guideline release and update; (2) accessibility: the readiness to access a guideline by searching it on a common browser; (3) completeness: the amount of foundational topics covered; and (4) consistency: the agreement among different guidelines. In terms of timeliness, the Royal College of Obstetricians and Gynaecologists (RCOG) was the first organization to release their recommendation. Only four guidelines were accessible with one click, while only 6/11 guidelines covered more than 80% of the 30 foundational topics we identified. For consistency, the study highlights the existence of 10 points of conflict among the recommendations. The present research revealed a lack of uniformity and consistency, resulting in potentially challenging decisions for healthcare providers.

scholarly journals Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

2020 ◽  
Author(s):  
Ian Njeru ◽  
David Kareko ◽  
Ngina Kisangau ◽  
Daniel Langat ◽  
Nzisa Liku ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Comparison Group ◽  
Transition Period ◽  
Health Surveillance ◽  
Surveillance Data ◽  
Percentage Points ◽  
Reporting Rates ◽  
The Impact

Abstract Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45% to 62%, i.e. by 17 percentage points (95% CI 16.14 -17.86) compared to an increase from 49% to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23 -3.77). The timeliness of reporting increased from 30% to 51%, i.e. by 21 percentage points (95% CI 20.16 - 21.84) for the intervention group, compared to an increase from 31% to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

scholarly journals Evaluation of Measles Surveillance Systems in Ginnir District, Bale Zone, Southeast Ethiopia: A Concurrent Embedded Mixed Quantitative/Qualitative Study 

2020 ◽  
Author(s):  
Falaho Sani ◽  
Mohammed Hasen ◽  
Mohammed Seid ◽  
Nuriya Umer
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Surveillance System ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Health Facilities ◽  
Surveillance Data ◽  
Surveillance Systems ◽  
Southeast Ethiopia ◽  
Bale Zone

Abstract Background: Public health surveillance systems should be evaluated periodically to ensure that the problems of public health importance are being monitored efficiently and effectively. Despite the widespread measles outbreak in Ginnir district of Bale zone in 2019, evaluation of measles surveillance system has not been conducted. Therefore, we evaluated the performance of measles surveillance system and its key attributes in Ginnir district, Southeast Ethiopia.Methods: We conducted a concurrent embedded mixed quantitative/qualitative study in August 2019 among 15 health facilities/study units in Ginnir district. Health facilities are selected using lottery method. The qualitative study involved purposively selected 15 key informants. Data were collected using semi-structured questionnaire adapted from Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems through face-to-face interview and record review. The quantitative findings were analyzed using Microsoft Excel 2016 and summarized by frequency and proportion. The qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings.Results: The structure of surveillance data flow was from the community to the respective upper level. Emergency preparedness and response plan was available only at the district level. Completeness of weekly report was 95%, while timeliness was 87%. No regular analysis and interpretations of surveillance data, and the supportive supervision and feedback system was weak. The participation and willingness of surveillance stakeholders in implementation of the system was good. The surveillance system was found to be useful, easy to implement, representative and can accommodate and adapt to changing conditions. Report documentation and quality of data was poor at lower level health facilities. Stability of the system has been challenged by shortage of budget and logistics, staff turnover and lack of update trainings.Conclusions: The surveillance system was acceptable, useful, simple, flexible and representative. Data quality, timeliness and stability of the system were attributes that require improvement. The overall performance of measles surveillance system in the district was poor. Hence, regular analysis of data, preparation and dissemination of epidemiological bulletin, capacity building and regular supervision and feedback are recommended to enhance performance of the system.

scholarly journals Barriers to hospital electronic public health reporting and implications for the COVID-19 pandemic

2020 ◽  
Vol 27 (8) ◽  
pp. 1306-1309
Author(s):  
A Jay Holmgren ◽  
Nate C Apathy ◽  
Julia Adler-Milstein
Keyword(s):  
Public Health ◽  
Surveillance Data ◽  
Electronic Data ◽  
American Hospital ◽  
American Hospital Association ◽  
Public Health Agencies ◽  
Hospital Referral ◽  
Health Agencies ◽  
The Impact ◽  
To Receive

Abstract We sought to identify barriers to hospital reporting of electronic surveillance data to local, state, and federal public health agencies and the impact on areas projected to be overwhelmed by the COVID-19 pandemic. Using 2018 American Hospital Association data, we identified barriers to surveillance data reporting and combined this with data on the projected impact of the COVID-19 pandemic on hospital capacity at the hospital referral region level. Our results find the most common barrier was public health agencies lacked the capacity to electronically receive data, with 41.2% of all hospitals reporting it. We also identified 31 hospital referral regions in the top quartile of projected bed capacity needed for COVID-19 patients in which over half of hospitals in the area reported that the relevant public health agency was unable to receive electronic data. Public health agencies’ inability to receive electronic data is the most prominent hospital-reported barrier to effective syndromic surveillance. This reflects the policy commitment of investing in information technology for hospitals without a concomitant investment in IT infrastructure for state and local public health agencies.

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