Investigating outbreaks: Practical guidance in the Indian scenario.

The new International Health Regulations, 2005, which came into force in 2007, establish a national focal point in each country to manage public health emergencies of international concern, including outbreaks. Investigating outbreaks is a challenging task. Often, pressure from decision-makers to hasten investigation may preclude proper evidence-based conclusions. Furthermore, the task of outbreak investigation is given to senior staff, who have limited time for field activities. The classical 10-step approach includes 4 main stages of (i) confirmation of the presence of the outbreak and of diagnosis using laboratory tests, (ii) generation of hypotheses regarding causation using descriptive epidemiology findings, (iii) hypothesis-testing using analytical epidemiology techniques, and (iv) institution of prevention measures. Peer-review at all stages of the investigation and reporting is the keystone of the quality assurance process. It is important to build capacity for outbreak investigation. Two Field Epidemiology Training Programmes in India are trying to do this. In these programmes, epidemiologists-intraining take a lead in investigating outbreaks, while learning the ropes, with full technical support from the faculty. This training should spawn a culture of generating and using evidence for decision-making in the context of public health, and help strengthen health systems even beyond the domain of outbreaks.

Enteroparasitosis en comunidames de la etnia yukpa del estado zulia / Enteroparasitosis in yukpas ethnic communities of Zulia State

El objetivo de la presente investigación fue determinar la prevalencia de las parasitosis intestinales en dos comunidades indígenas de la Sierra de Perijá, Estado Zulia: los pobladores de Santa Ana de Wasana y los de Kasmera. Se les dió instrucción para la adecuada recolección de la muestra fecal, obteniéndose un total, entre las dos comunidades de 70 muestras de heces, mediante métodos coproparasitológicos del examen directo, coloración temporal con lugol y por concentración (formol-etil acetato). Se encontró una alta prevalencia de enteroparasitosis en ambas comunidades; las especies de enteroparásitos más frecuentes en Santa Ana de Wasama y Kasmera fueron: Ascaris lumbricoides (36.6 por ciento y 62.1 por ciento), Trichuris trichiura (31.7 por ciento y 44.8 por ciento) y Entamoeba histolytica (26.8 por ciento y 37.9 por ciento respectivamente). Se evidenció un alto poliparasitismo en ambas comunidades