Adapting the Structured Operational Research Training Initiative (SORT IT) for high-income countries.

SORT IT (Structured Operational Research Training InitiaTive) is a successful capacity building programme started 10 years ago to develop operational research skills in low- and middle-income countries. Public Health England (PHE) aims to embed a culture of research in front-line staff, and SORT IT has been adapted to train frontline health protection professionals at PHE North West (PHE NW) to collate, analyse and interpret routinely collected data for evidence-informed decision-making. Six participants from the PHE NW Health Protection team were selected to attend a two-module course in Liverpool, UK, in May and in November 2018. Five participants finished the course with completed papers on characteristics and burden of influenza-like illness in elderly care homes (two papers), use of dried blood spots for blood-borne virus screening in prisons, uptake of meningococcal ACWY (groups A, C, W-135 and Y) vaccine in schoolchildren and fires in waste management sites. The SORT IT course led to 1) new evidence being produced to inform health protection practice, and 2) agreement within PHE NW to continue SORT IT with two courses per year, and 3) showed how a research capacity building initiative for low- and middle-income countries that combines 'learning with doing' can be adapted and used in a high-income country.

SORT IT (Structured Operational Research Training InitiaTive) est un programme fructueux de renforcement des capacités qui a démarré il y a 10 ans afin de développer des compétences en recherche opérationnelle dans les pays à revenu faible et moyen. Public Health England (PHE) vise à incorporer une culture de recherche au sein du personnel de première ligne. SORT IT a été adapté afin de former les professionnels de protection de la santé de première ligne à PHE-North West (PHE-NW) pour compiler, analyser et interpréter les données recueillies en routine en vue de prises de décisions basées sur des preuves. Six participants de l'équipe de PHE-NW Health Protection ont été choisis pour participer à un cours de deux modules à Liverpool, Royaume-Uni, en mai 2018 et en novembre 2018 respectivement. Cinq participants ont terminé le cours avec des articles achevés sur les caractéristiques et le fardeau des syndromes grippaux dans les maisons de retraite (deux articles), l'utilisation de gouttes de sang séché pour le dépistage des virus transmis par le sang dans les prisons, la couverture du vaccin anti-méningococcique ACWY (groupes A, C, W-135 and Y) chez les écoliers et les incendies dans les dépôts d'ordures. Les résultats et l'impact de cette approche incluent 1) la production de nouvelles preuves visant à informer les pratiques de protection de la santé ; 2) un accord au sein de PHE-NW pour poursuivre SORT IT avec deux cours par an ; et 3) la démonstration de la manière dont une initiative de renforcement des capacités de recherche destinée aux pays à revenu faible et moyen, qui combine « l'apprentissage par la pratique ¼, peut être adaptée et utilisée dans un pays à haut revenu.

El programa SORT IT (por Structured Operational Research Training InitiaTive) es una iniciativa eficaz de fortalecimiento de la capacidad, orientada a crear competencias en investigación operativa en los países de ingresos bajos y medianos, que se inició hace 10 años. La finalidad del organismo inglés de salud pública (PHE, por Public Health England) consiste en incorporar la cultura de la investigación en la práctica del personal de primera línea; el programa SORT IT se adaptó con miras a capacitar a los profesionales que prestan directamente la protección de la salud en el PHE-NW (noroccidente) para recopilar, analizar e interpretar los datos recogidos de manera sistemática y fundamentar así la adopción de decisiones basadas en la evidencia. Se escogieron seis participantes del equipo de protección de salud del PHE-NW para que asistieran a un curso en dos módulos en Liverpool, RU, en mayo del 2018 y noviembre del 2018. Cinco de los participantes terminaron el curso con la elaboración de artículos sobre las características y la carga de morbilidad por síndrome gripal en los hogares de ancianos (dos artículos), la utilización en las prisiones de muestras de manchas de sangre seca para el tamizaje de los virus de transmisión sanguínea, la aceptación de la vacuna ACWY (grupos A, C, W-135 and Y) contra el meningococo en los niños de edad escolar y los incendios en los centros de gestión de desechos. Los resultados y el impacto de esta iniciativa fueron los siguientes 1) se obtuvo nueva evidencia para fundamentar las prácticas de la protección de la salud; 2) se acordó continuar el programa SORT IT en el PHE-NW con dos cursos por año; y 3) se demostró cómo se puede adaptar una iniciativa de fortalecimiento de la capacidad en investigación dirigida a países de ingresos bajos y medianos, que asocia "aprender con hacer" para utilizarla en un país de ingresos altos.

Prevalence of recreational drug use reported by men who have sex with men attending sexual health clinics in Manchester, UK.

Recreational drug use (RDU) has been reported to be disproportionately higher in men who have sex with men (MSM) when compared to their heterosexual counterparts. To identify RDU, links to risky sexual practices and infections for MSM attending three sexual health clinics across Manchester, United Kingdom, a retrospective case note review was conducted using a random powered sample of service users attending three sites during 2014. Three hundred and fifty-seven case notes were reviewed across three sites. Eighteen per cent of service users reported any type of RDU. Use of at least one of the three drugs associated with chemsex (crystal methamphetamine, mephedrone, gamma hydroxybutyrate/gamma butyrolactone) was reported by 3.6%. A statistically significant difference was identified between non-drug users and any-drug users reporting: group sex (odds ratio [OR] 5.88, p = 0.013), condomless receptive anal intercourse (CRAI) (OR 2.77, p = 0.003) and condomless oral intercourse (OR 2.52, p = 0.016). A statistically significant difference was identified between chemsex-related drug user and non-drug user groups reporting: group sex (OR 13.05, p = 0.023), CRAI (OR 3.69, p = 0.029) and condomless insertive anal intercourse (OR 1.27, p = 0.039). There was also a statistically higher incidence of gonorrhoea infection in chemsex-related drug use compared with those not using drugs (p = 0.002, OR 6.88). This study identifies that substance use is common in MSM attending sexual health clinics in Manchester. High-risk sexual practices and certain sexually transmitted infections are more common in MSM reporting RDU.

Development and testing of models of tuberculosis contact tracing in rural southern Africa.

SETTING: A regional hospital in rural Swaziland. OBJECTIVES: To evaluate a hospital-based contact screening programme and test approaches to improve its effectiveness. DESIGN: An evaluation and quality improvement study of tuberculosis (TB) contact tracing services. RESULTS: Hospital-based TB contact tracing led to screening of 157 (24%) of 658 contacts; of these, 4 (2.5%) were diagnosed with TB. Of 68 contacts eligible for human immunodeficiency virus (HIV) testing and counselling, 45 (66%) were tested and 7/45 (16%) were identified as HIV-positive. Twelve (50%) of 24 screened contacts aged <5 years were provided isoniazid prophylaxis. Three enhanced models of TB contact tracing were piloted to screen contacts in the community. Although some enhanced models screened large numbers of contacts, no contacts were diagnosed with TB. CONCLUSION: Contact tracing of household members conducted in TB clinics within hospital settings is effective in high-burden, low-income settings, and can be provided using current resources. Enhanced household contact tracing models that followed up contacts in the community were not found to be effective. Additional resources would be required to provide household TB contact tracing in the community.

Diabetic retinopathy equity profile in a multi-ethnic, deprived population in Northern England.

PURPOSE: Equity profiles are an established public health tool used to systematically identify and address inequity within health and health services. Our aim was to conduct an equity profile to identify inequity in eye health across Leeds and Bradford. This paper presents results of findings for diabetic retinopathy in Bradford and Airedale. METHODS: A variety of routine health data were included and sub-analysed by measures of equity, including age, sex, ethnicity, and deprivation to identify inequity in eye health and healthcare. The Spearman Rank Correlation Coefficient was used to determine the association between variables. RESULTS: The prevalence of diagnosed diabetes in Bradford and Airedale district is 6.6% compared to 4.3% in nearby Leeds and 5.1% nationally. The age-standardised prevalence of diagnosed diabetic retinopathy within Bradford and Airedale is 2.21% (95% CI 1.54-2.26%), with a disproportionately high prevalence of disease in the Pakistani population and the most deprived parts of the population. There was a poorer uptake of diabetic retinopathy screening in more deprived parts of the district and the proportions with a higher rate of referral to ophthalmology following the screening in Black and Minority Ethnic populations compared with the white population (13.2% vs 6.9%). Uptake of secondary care outpatient appointments is much lower in more deprived populations. CONCLUSION: Inequalities are inherent in diabetic retinopathy prevalence, diagnosis, and treatment. The reasons for these inequities are multi-factorial and further investigation of reasons for poor uptake of services is required. Addressing the inequalities in eye health and healthcare requires cross-organisational collaboration.