Spatial factors for COVID-19 associated community deaths in an urban area of Lusaka, Zambia: an observational study

We retrospectively analyzed spatial factors for coronavirus disease 2019 (COVID-19)-associated community deaths i.e., brought-in-dead (BID) in Lusaka, Zambia, between March and July 2020. A total of 127 cases of BID with geocoordinate data of their houses were identified during the study period. Median interquartile range (IQR) of the age of these cases was 49 (34-70) years old, and 47 cases (37.0%) were elderly individuals over 60 years old. Seventy-five cases (75%) of BID were identified in July 2020, when the total number of cases and deaths was largest in Zambia. Among those whose information regarding their underlying medical condition was available, hypertension was most common (22.9%, 8/35). Among Lusaka's 94 townships, the numbers (median, IQR) of cases were significantly larger in those characterized as unplanned residential areas compared to planned areas (1.0, 0.0-4.0 vs 0.0, 0.0-1.0; p=0.030). The proportion of individuals who require more than 30 minutes to obtain water was correlated with a larger number of BID cases per 105 population in each township (rho=0.28, p=0.006). The number of BID cases was larger in unplanned residential areas, which highlighted the importance of targeted public health interventions specifically to those areas to reduce the total number of COVID-19 associated community deaths in Lusaka. Brought-in-dead surveillance might be beneficial in monitoring epidemic conditions of COVID-19 in such high-risk areas. Furthermore, inadequate access to water, sanitation, and hygiene (WASH) might be associated with such distinct geographical distributions of COVID-19 associated community deaths in Lusaka, Zambia.

Cost-Effectiveness of HCV Core Antigen versus PCR for Monitoring Treatment Response in DAAS-Treated Egyptian Patients

PCR is currently the non-debatable proof for diagnosis of HCV infection as well as conclusion of treatment outcomes. HCV core antigen (HCVcAg) testing is a neglected, less expensive and less time consuming test that's presumed to achieve the same aims. The aim of this study is to find the cost-effectiveness of HCV core antigen testing in the monitoring of treatment response as an alternative to the gold-standard PCR test

Health workers with good self-perceived competency have lower actual competency levels on HIS in Eastern Ethiopia: A cross-sectional study

Introduction: Utilization of health information is critical to meeting service performance goals and for making informed decisions. However, in resource limited countries, health data is rarely used in decisions around program improvements. This study aimed to assess the determinants of competency levels for health workers who utilized data from health information systems in Eastern Ethiopia. Methods:A cross-sectional study was carried out from April -May 2021 at selected public health facilities in the Dire Dawacityand Harar regions. A total of 129 health professionals were included in the study and simple random sampling techniques were used to select health facilities. Data was collected using face-to-face interviews and competency levels were measured using a tool adapted from the Performance of Routine Information Systems Management (PRISM) framework. STATA version 16 was used for data analysis. A linear regression model was applied to determine the linear relationship between self-perceived competency and the actual competency levels of the healthcare workers.Adjusted beta (ß) along with a 95% confidence interval (CI) was used to measure the strength of the association with a p-value < 0.05. Results:The overall mean for the actual competency levels of health workers who utilized data was 20.45 [95% CI: 16.71, 24.19]. Being head of a hospital/health center (ß: 19.24, 95% CI: 4.42, 34.06), perusing HIS training (ß: 14.38, 95% CI: 6.10, 22.67) and good perceived competency to perform RHIS tasks (ß: -12.96, 95% CI: -25.49, -0.43) were significantly associated with actual competency levels.Conclusion:The Health workers with high perceivedcompetency levels were found to have actual competency levels that were low. Health information systemfocused trainings were found to be positively associated with actual competency levels and being a hospital or health center head was found to be associated negatively to the actual competency levels of health workers. This research has found that providing health information system training for health workers could prove to be beneficial. There is also a need for initiatives aimed at enhancing competency in order to improve the health information systems related competency levels and data use.[Ethiop. J. Health Dev. 2022;36(SI-1)]

A review of the framework and strategy for disability and rehabilitation services in South Africa

Background: Rehabilitation is imperative for the successful integration of persons with disabilities into their social environments. The Framework and strategy for disability and rehabilitation services (FSDR) in South Africa, 2015-2020.was developed to strengthen access to rehabilitation services and ensure the inclusion of persons with disabilities in all aspects of community life. Despite the FSDR being commissioned, access to rehabilitation is a challenge for persons with disabilities and further compounded in rural communities. Objective: The study aimed to describe the barriers and facilitators that influenced the process of development, implementation and monitoring of the FSDR. Method: This qualitative study employed a single case study design. Data was collected through document analysis and in-depth interviews utilising the Walt & Gilson policy analysis framework that outlines the context, content, actors and process of policy development and implementation. In-depth interviews were conducted with twelve key informants (N=12) who were selected purposively for the study. Data obtained from the in-depth interviews were analysed using inductive thematic analysis. Results: We found many factors that influenced the implementation of the framework. Actor dynamics, insufficient resources, the rushed process, poor record-keeping, inappropriate leadership, negative attitudes of staff members and the insufficient monitoring impeded the successful implementation of the framework. While positive attitude, mentorship and support amongst the task team facilitated the implementation process, albeit with challenges. Conclusion: There is a need to address implementation gaps so that the FSDR is responsive to the current rehabilitation needs of persons with disabilities in South Africa. Contribution: This study may inform future disability policy, and can be used as a tool to advocate for the rights for persons with disabilities

Kenya nutrition monitoring and evaluation

Kenya is facing a triple burden of malnutrition in the form of under nutrition, micronutrient deficiencies and over-nutrition. The Ministry of Health in collaboration with stakeholders developed the Kenya Nutrition Action Plan (KNAP) 2018-2022. The overarching objective of the plan is accelerating and scaling up efforts towards the elimination of malnutrition in Kenya in line with Kenya's Vision 2030 and Sustainable Development Goals (SDGs) with focus on specific achievements by 2022. The action plan is organized into three category focus areas namely; Nutrition-specific and Nutrition-sensitive Interventions and, Enabling Environment. The Kenya Nutrition Monitoring and Evaluation Framework 2018-2022 has been developed to align with the needs of the Kenya Nutrition Action Plan 2018-2022. A review of the Nutrition Monitoring and Evaluation Framework 2013 and other relevant documents was conducted to inform the development of this framework. The development was conducted through a consultative process involving deliberations by task teams, stakeholder consultations, and online survey and review and validation workshops. The rationale of this framework is to ensure continuous tracking of progress, document lessons learned and replicate best practices of nutrition interventions as outlined in the KNAP 2018-2022. It highlights the goal and the objectives and the guiding principles which are expected to ensure a systematic implementation of the monitoring and evaluation framework. The framework describes the basic principles of Monitoring, Evaluation, Accountability and Learning (MEAL) the sources of nutrition information and data analysis and reporting. In addition, the Nutrition Information System monitoring toolkit repository comprising of a variety of guidelines, training packages, tools for data collection and guidance on data analysis and reporting for different sources of information has been developed to provide ease of accessibility to these tools and documents. The framework also covers the Common Results and Accountability Framework (CRAF) for the 19 Key Result Areas (KRAs) and elaborates the process of Monitoring, Evaluation, Accountability and Learning. The key result areas are categorized into nutrition specific, nutrition sensitive and enabling environment with their indicators, definitions, thresholds, means of verification, frequency of reporting and operational research to be conducted. The indicators will be measured and reported through existing systems such as Kenya Health Information System (KHIS), the National Drought Management Authority (NDMA) early warning system, program reports and population-based surveys. Reporting and communication of results will adhere to standard guidelines and use effective communication channels to ensure improved uptake of findings. Evaluation and operational research will be implemented to provide evidence for informing programme decisions that lead to effective coverage of interventions. Finally, accountability will be mainstreamed to ensure service providers or duty bearers are accountable for resources and results. Learning and application of best practices will contribute to adaptation of approaches that are known to produce results. The actualization of the M&E Framework will help build a chain of evidence that will provide the metrics of change. The burden of proof lies with the various stakeholders whose responsibility is to demonstrate that the commitment made in the KNAP 2018-2022 shall indeed be realized and that there is evidence to back up the claim of progress. The implementation strategy therefore shall be driven by human resource development and system readiness and funding mechanisms that will boost M&E human resource and systems at National and County levels

Gestational Trophoblastic diseases: alternatives to biological monitoring in under-resourced settings (Two clinical observations)

Gestational trophoblastic disease (GTD) is a condition requiring regular monitoring of hormone human chorionic gonadotropin (HCG). The semi-quantitative method presented here is an alternative for monitoring in under-equipped environments. The illustration made from two clinical cases of GTD that we have followed shows that this method can be used in under-equipped settings and where the quantitative dosage is unavailable

Aluminium Monitoring in Occupational Health : a Mini Review

Aluminium (Al) is a commonly encountered metal that has proven deleterious health outcomes; including neurological; respiratory and other systemic effects. There is growing awareness of the need to identify workers who have an increased burden of Al in order to avoid further exposure and to institute remedial action as appropriate. This need requires accurate identification of such workers. This paper examines the metabolism of Al with the aim of suggesting effective biomonitoring methods

Paludisme sur les Hautes Terres Centrales de Madagascar : strategies de lutte

Le present article presente le paludisme sur les Hautes Terres Centrales de Madagascar et les strategies pour ameliorer les composantes du programme national de lutte contre le paludisme. Pour la prise en charge du patient suspect d'acces palustre; l'utilisation des bandelettes de diagnostic rapide; la prise en charge precoce a domicile par la chloroquine pre-emballee et les reflexions sur les nouvelles combinaisons therapeutiques a base d'artemisinine sont discutees. Pour les mesures de prevention; l'alternance des pulverisations intra domiciliaires ciblees et generalisees dans la lutte antivectorielle; l' utilisation de moustiquaires impregnees d'insecticides; le passage au traitement preventif intermittent pour les groupes a risque; l'amelioration du systeme de surveillance et d'alerte epidemique par l'utilisation de la methode de Lot Quality Assurance Sampling pour l'investigation epidemiologique en cas de depassement du seuil d'alerte et la mise a disposition des bandelettes de diagnostic rapide sont etudies

Contribution a la mise en place d'une surveillance epidemiologique des meningites purulentes dans le service de pediatrie du CHU de Cocody

Les meningites purulentes sont des affections dont la gravite est universellement reconnue- Elles ont ete a la base d'epidemies meurtrieres dans les pays frontaliers du nord de la cote d'ivoire. Ce sont des maladies qui surviennent a n'importe age mais chez l'enfant elles entrainent une mortalite elevee et surtout des sequelles redoutables. Aussi constituent-elles un probleme majeur de sante publique. Pour lutter contre ces maladies; le service de surveillance epidemiologique de l'INHP en collaboration avec le ministere de la sante publique a elabore es 1997 un protocole pour la mise en place d'un systeme d'alerte precoce (SAS) dans les districts sanitaires de nord. Mais ces derniers temps le service de surveillance a decide d'elargir cette surveillance a d'autres zones. C'est donc dans le souci d'apporter notre contribution a I'installation d'un systeme de surveillance des meningites purulentes dans un hopital de reference que nous avons conduit une etude dans le service de pediatrie du CHU de cocody. Il s'agit d'uns etude prospective sur une periode de six mois (fev 2002 a aout 2002). Durant cette periode nous avons effectue au quotidien un suivi epidemio-clinique et bacteriologique de tout nouveau cas de meningites purulentes dans le service ainsi qu'un sondage d'opinion au niveau du personnel medical sur la notion de surveillance epidemiologique. NOS RESULTATS SONT LES SUIVANTS: 1- Nous avons effectivement constate qu'il n'existe pas de cadre formalise de surveillance epidemiologique des meningites purulentes dans le service de pediatrie. Ce constat est le meme dans le service de bacteriologie de l'IPCI. 2- il n'existe qu'une certaine collaboration entre ces deux services qui doivent pourtant beneficier d'une parfaite complementarite. 3-Les enfants de moins d'un an payent un lourd tribut aux meningites purulentes. 4-Les germes causals sont l'haemophilus inflenzae b et le pneumocoque. Au total notre etude ressort ta necessite de la mise en place d'un systeme de surveillance epidemiologique dans le service de pediatrie de CHU de cocody ainsi que l'introduction du vaccin contre l'haemophilus inflenzae b dans le P.E.V

La surveillance epidemiologique; mode d'emploi

L'objet de cette note pedagogique est de rappeler l'importance de la surveillance epidemiologique pour les systemes de sante et les grands principes qui lui permettent d'etre utile. Certaines attitudes inadequates; generalement non formulees mais sous jacentes sont ensuite enoncees et discutees

Zimbabwe's environmental dilemma : balancing resource inequities

One of the most controversial issues in post-independence Zimbabwe is how the country can tackle the land question in a way that will only address the gross wrongs of the past but also leave its relatively well-developed commercial agricultural sector intact. Indeed; the cautiousness of the Zimbabwe government in developing its land policy and implementing a major land reform programme is as much a result of the Lancaster House Constitution. The message of this book is unequivocal: land redistribution is the only way by which the country can move into the path of sustainable development. Without major reform; it is argued;the spectre of ecological disaster will continue to loom over the country. There is more to benefit than to lose in a major land reform exercise aimed at resolving the conflict over resources which characterises the present situation