Pub Date : 2021-01-01DOI: 10.1080/23779497.2021.1929387
Sivan Yegnanarayana Iyer Saraswathy
ABSTRACT Introduction: Addressing social determinants of health (SDH) from a global health security perspective is important especially in low and middle income countries. Socioeconomic status, cultural, political and behavioural factors influence health and disease of the people. This paper seeks to describe how government programmes and other initiatives are expected to play an important role in addressing SDH and thereby improving health of the people. The analysis addresses both health and social policy issues. Context and Aim: The study assumes importance in view of India moving towards strengthening health and social security of its people through several policy-driven initiatives. Methods: This analysis classifies the 100 plus programmes launched by the Government of India into health, education, nutrition, social security, etc., and compares available indicators (2000–2018) Findings: The initiatives of the Government of India are expected to improve health and social security of its people, with focus on addressing health as well as social inequity. One of the programmes (Swachh Bharat Mission – clean India mission) has helped in avoiding 300,000 child deaths. Official survey results are not available for all indicators. Innovative contribution to policy, practice and/or research: Analysis of Government of India’s policy-driven programmes and other initiatives with focus on livelihood improvement indicate that they are contributing to ensure health and social security; and are worth replicating in similar settings.
{"title":"Global Health Security: Addressing Social Determinants of Health through programmes and other initiatives","authors":"Sivan Yegnanarayana Iyer Saraswathy","doi":"10.1080/23779497.2021.1929387","DOIUrl":"https://doi.org/10.1080/23779497.2021.1929387","url":null,"abstract":"ABSTRACT Introduction: Addressing social determinants of health (SDH) from a global health security perspective is important especially in low and middle income countries. Socioeconomic status, cultural, political and behavioural factors influence health and disease of the people. This paper seeks to describe how government programmes and other initiatives are expected to play an important role in addressing SDH and thereby improving health of the people. The analysis addresses both health and social policy issues. Context and Aim: The study assumes importance in view of India moving towards strengthening health and social security of its people through several policy-driven initiatives. Methods: This analysis classifies the 100 plus programmes launched by the Government of India into health, education, nutrition, social security, etc., and compares available indicators (2000–2018) Findings: The initiatives of the Government of India are expected to improve health and social security of its people, with focus on addressing health as well as social inequity. One of the programmes (Swachh Bharat Mission – clean India mission) has helped in avoiding 300,000 child deaths. Official survey results are not available for all indicators. Innovative contribution to policy, practice and/or research: Analysis of Government of India’s policy-driven programmes and other initiatives with focus on livelihood improvement indicate that they are contributing to ensure health and social security; and are worth replicating in similar settings.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"2013 1","pages":"38 - 48"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78595830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/23779497.2020.1848444
S. Balajee, S. Salyer, B. Greene-Cramer, Mahmoud M. Sadek, A. Mounts
ABSTRACT Event-based surveillance (EBS) is the organised approach to the detection and reporting of ‘signals,’ defined as information that may represent events of public health importance, often through channels outside of routine surveillance systems. Signals can be designed to detect patterns of disease, such as clusters of similar illness in a community, or clusters of disease or death in animals. Signals can also include single cases of suspected high-priority events such a patient with viral haemorrhagic fever. EBS can be a key component of an effective early warning system, which enables countries to be better prepared for endemic and pandemic illness outbreaks. EBS uses an all-hazards approach that includes the principles of One Health. This review covers the concept and process of EBS, different sources for EBS data, and methods to obtain information from these sources. This overview will aid countries in implementing this important form of surveillance.
{"title":"The practice of event-based surveillance: concept and methods","authors":"S. Balajee, S. Salyer, B. Greene-Cramer, Mahmoud M. Sadek, A. Mounts","doi":"10.1080/23779497.2020.1848444","DOIUrl":"https://doi.org/10.1080/23779497.2020.1848444","url":null,"abstract":"ABSTRACT Event-based surveillance (EBS) is the organised approach to the detection and reporting of ‘signals,’ defined as information that may represent events of public health importance, often through channels outside of routine surveillance systems. Signals can be designed to detect patterns of disease, such as clusters of similar illness in a community, or clusters of disease or death in animals. Signals can also include single cases of suspected high-priority events such a patient with viral haemorrhagic fever. EBS can be a key component of an effective early warning system, which enables countries to be better prepared for endemic and pandemic illness outbreaks. EBS uses an all-hazards approach that includes the principles of One Health. This review covers the concept and process of EBS, different sources for EBS data, and methods to obtain information from these sources. This overview will aid countries in implementing this important form of surveillance.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"16 1","pages":"1 - 9"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81772593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/23779497.2021.1939760
Sang Ngoc Nguyen, C. Van Dang, Tham Thi Tran
ABSTRACT Hand, foot, and mouth disease (HFMD) is a public health issue in Haiphong, as it is in Vietnam overall. In 2011, a large outbreak of HFMD in Vietnam resulted in 113,121 children seeking medical attention, of whom 170 died. According to a Vietnam General Department of Preventive Medicine report in 2012, HFMD has the 2nd highest incidence of pediatric disease among 10 common diseases. There were 157,654 cases, of which 45 patients died, ranking 3rd among Vietnamese children’s causes of death. In 2017, HFMD broke out again in Haiphong. Haiphong Children’s Hospital (HCH) is the only hospital in Haiphong to examine and treat HFMD for children. This study aims to describe the clinical characteristics of HFMD seen in HCH and review the results of disease control efforts in 2017. A retrospective descriptive study. Clinical data were obtained by reviewing the patients’ case records from January 2017 through December 2017 in HCH. There were 2610 patients admitted to HCH in 2017. Most patients were under 3 years old (94.8%). The disease prevalence increased from April 1st through September 30th. Common symptoms were: fever (99%), mouth ulcers, sore throat (96.4%), rash on hand and foot (64.4%), startle (33.9%). Diagnosis mainly was clinical-grade 2a (79.8%). PCR was performed in 526 patients with grade 2b, 3, 4, and 218 cases (41.4%) were positive with EV71. Most of the cases’ prognosis was excellent, with 99.3% of cases cured and no deaths. Despite stringent measures taken in kindergartens, it is clear that HFMD is currently a public health problem in Vietnam. It is a highly contagious infectious disease, including several potential complications, and results in a number of cases leading to death. The disease is a particular cause of concern, especially when HFMD cases can overload already crowded hospitals. A high degree of vigilance should be maintained over the disease and its consequences.
{"title":"Surveillance and outbreak response of hand - foot - mouth disease in Haiphong Children’s Hospital, Vietnam","authors":"Sang Ngoc Nguyen, C. Van Dang, Tham Thi Tran","doi":"10.1080/23779497.2021.1939760","DOIUrl":"https://doi.org/10.1080/23779497.2021.1939760","url":null,"abstract":"ABSTRACT Hand, foot, and mouth disease (HFMD) is a public health issue in Haiphong, as it is in Vietnam overall. In 2011, a large outbreak of HFMD in Vietnam resulted in 113,121 children seeking medical attention, of whom 170 died. According to a Vietnam General Department of Preventive Medicine report in 2012, HFMD has the 2nd highest incidence of pediatric disease among 10 common diseases. There were 157,654 cases, of which 45 patients died, ranking 3rd among Vietnamese children’s causes of death. In 2017, HFMD broke out again in Haiphong. Haiphong Children’s Hospital (HCH) is the only hospital in Haiphong to examine and treat HFMD for children. This study aims to describe the clinical characteristics of HFMD seen in HCH and review the results of disease control efforts in 2017. A retrospective descriptive study. Clinical data were obtained by reviewing the patients’ case records from January 2017 through December 2017 in HCH. There were 2610 patients admitted to HCH in 2017. Most patients were under 3 years old (94.8%). The disease prevalence increased from April 1st through September 30th. Common symptoms were: fever (99%), mouth ulcers, sore throat (96.4%), rash on hand and foot (64.4%), startle (33.9%). Diagnosis mainly was clinical-grade 2a (79.8%). PCR was performed in 526 patients with grade 2b, 3, 4, and 218 cases (41.4%) were positive with EV71. Most of the cases’ prognosis was excellent, with 99.3% of cases cured and no deaths. Despite stringent measures taken in kindergartens, it is clear that HFMD is currently a public health problem in Vietnam. It is a highly contagious infectious disease, including several potential complications, and results in a number of cases leading to death. The disease is a particular cause of concern, especially when HFMD cases can overload already crowded hospitals. A high degree of vigilance should be maintained over the disease and its consequences.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"30 1","pages":"49 - 56"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90743836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.1080/23779497.2021.1927796
J. Kizilhan, F. Steger
ABSTRACT The number of potential Islamist perpetrators and supporters has been rising worldwide since the beginning of ISIS in 2014. Despite its military defeat in 2017, ISIS remains a serious threat. How come that numerous people join ISIS and allow the organisation to motivate them to participate in cruel and inhuman acts, such as mass-killings, within a very short period of time? This article offers socio-psychological explanations, such as processes like dehumanisation and role distance and the perception of a collective humiliation as well as structural and personal violence in the Middle East to answer this question. In connection to that, the authors argue that ISIS targetly addresses the psychological needs resulting from the social and political contexts in which the recruits live by having construced a distinct totalitarian ideology based on a very selective reading of religious narratives from Islam. Identifying religious elements from Islam as means for a particular purpose and not as the actual focus, the authors emphasise that ISIS has not lived another version of Islam but constructed a distinct ideology, which becomes manifest in strong internal social hierarchies, the genocide of minority groups and a dissemination of this mentality which is independent of a centralised organisation. Future studies must examine these observations and focus on the questions whether this mentality spread by ISIS changes the societies from which people are recruited and, if so, in which way this change becomes evident.
{"title":"The socialpsychology of Islamist terror – interdisciplinary perspectives on violence and ISIS totalitarian structures","authors":"J. Kizilhan, F. Steger","doi":"10.1080/23779497.2021.1927796","DOIUrl":"https://doi.org/10.1080/23779497.2021.1927796","url":null,"abstract":"ABSTRACT The number of potential Islamist perpetrators and supporters has been rising worldwide since the beginning of ISIS in 2014. Despite its military defeat in 2017, ISIS remains a serious threat. How come that numerous people join ISIS and allow the organisation to motivate them to participate in cruel and inhuman acts, such as mass-killings, within a very short period of time? This article offers socio-psychological explanations, such as processes like dehumanisation and role distance and the perception of a collective humiliation as well as structural and personal violence in the Middle East to answer this question. In connection to that, the authors argue that ISIS targetly addresses the psychological needs resulting from the social and political contexts in which the recruits live by having construced a distinct totalitarian ideology based on a very selective reading of religious narratives from Islam. Identifying religious elements from Islam as means for a particular purpose and not as the actual focus, the authors emphasise that ISIS has not lived another version of Islam but constructed a distinct ideology, which becomes manifest in strong internal social hierarchies, the genocide of minority groups and a dissemination of this mentality which is independent of a centralised organisation. Future studies must examine these observations and focus on the questions whether this mentality spread by ISIS changes the societies from which people are recruited and, if so, in which way this change becomes evident.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"12 1","pages":"26 - 37"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82008772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1814162
A. Kimball, A. Jumaan
ABSTRACT Introduction: In March 2015 a Saudi-led coalition began an air campaign and ground offensive in Yemen. The conflict has resulted in at least 100,000 people killed and 3.2 million people internally displaced. Over the last 29 months of the war, the Yemen Relief and Reconstruction Foundation (YRRF), working through an informal network of indigenous volunteers, has successfully provided food, clothing, medicine and water filters to areas under siege. Context: Asymmetric warfare complicates humanitarian assistance. YRRF succeeds through an informal network: hundreds of Yemeni volunteers negotiating passage through competing armed checkpoints focussed on concrete, lifesaving action. Method: A case-study report about a local, informal, Yemeni-led relief organisation supported by remote financing and training. Findings: YRRF has succeeded in delivering food and clothing to more than 20,000 families, distributing more than 1200 water filters to remote villages and internally displaced families and medicine to five cancer centres. Innovative contribution: Yemen has multiple combatants within its territory, with competing systems for aid distribution and healthcare delivery. YRRF has developed an efficient and cost-effective technique for managing those complex environments while delivering care to fragile, and often displaced, populations in a war zone. Dynamic networks: local volunteers, working with local leaders, understanding culutral aspects, in country office, staying aploitical and meeting the needs of the population are key.
{"title":"Yemen: the challenge of delivering aid in an active conflict zone","authors":"A. Kimball, A. Jumaan","doi":"10.1080/23779497.2020.1814162","DOIUrl":"https://doi.org/10.1080/23779497.2020.1814162","url":null,"abstract":"ABSTRACT Introduction: In March 2015 a Saudi-led coalition began an air campaign and ground offensive in Yemen. The conflict has resulted in at least 100,000 people killed and 3.2 million people internally displaced. Over the last 29 months of the war, the Yemen Relief and Reconstruction Foundation (YRRF), working through an informal network of indigenous volunteers, has successfully provided food, clothing, medicine and water filters to areas under siege. Context: Asymmetric warfare complicates humanitarian assistance. YRRF succeeds through an informal network: hundreds of Yemeni volunteers negotiating passage through competing armed checkpoints focussed on concrete, lifesaving action. Method: A case-study report about a local, informal, Yemeni-led relief organisation supported by remote financing and training. Findings: YRRF has succeeded in delivering food and clothing to more than 20,000 families, distributing more than 1200 water filters to remote villages and internally displaced families and medicine to five cancer centres. Innovative contribution: Yemen has multiple combatants within its territory, with competing systems for aid distribution and healthcare delivery. YRRF has developed an efficient and cost-effective technique for managing those complex environments while delivering care to fragile, and often displaced, populations in a war zone. Dynamic networks: local volunteers, working with local leaders, understanding culutral aspects, in country office, staying aploitical and meeting the needs of the population are key.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"122 1","pages":"65 - 70"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79465346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1865182
R. Bernard, Gemma Bowsher, R. Sullivan
ABSTRACT Cyber-attacks against hospitals, medical devices, and healthcare entities are becoming increasingly common; simultaneously, physical attacks against hospitals and healthcare entities are increasing. The purpose of this article is to explore the threat to healthcare from cyber-attacks. We undertake qualitative analysis of current and past cyber-attacks on healthcare system and look at these in the context of the increase in non-traditional threats. We conclude that there is a current and systemic threat to the healthcare sector from cyber-attacks by nation state and criminal groups, which is not currently being addressed in a systematic manner. Finally, we conclude that further discussion on key issues such as legislation and regulatory frameworks needs to take place at both a policy and practitioner level.
{"title":"Cyber security and the unexplored threat to global health: a call for global norms","authors":"R. Bernard, Gemma Bowsher, R. Sullivan","doi":"10.1080/23779497.2020.1865182","DOIUrl":"https://doi.org/10.1080/23779497.2020.1865182","url":null,"abstract":"ABSTRACT Cyber-attacks against hospitals, medical devices, and healthcare entities are becoming increasingly common; simultaneously, physical attacks against hospitals and healthcare entities are increasing. The purpose of this article is to explore the threat to healthcare from cyber-attacks. We undertake qualitative analysis of current and past cyber-attacks on healthcare system and look at these in the context of the increase in non-traditional threats. We conclude that there is a current and systemic threat to the healthcare sector from cyber-attacks by nation state and criminal groups, which is not currently being addressed in a systematic manner. Finally, we conclude that further discussion on key issues such as legislation and regulatory frameworks needs to take place at both a policy and practitioner level.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"60 1","pages":"134 - 141"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91047843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1832903
A. Kruglanski, R. Gunaratna, Molly Ellenberg, A. Speckhard
ABSTRACT Despite the world’s overwhelming preoccupation with the COVID-19 pandemic, the threat of international and domestic terrorism is not in decline according to available indicators. The angst that the pandemic induced in millions of people, and the incapacitation of major functions and institutions of world’s societies are exploited by both jihadist and far-right terror organisations for the spread of conspiracy theories aimed to fuel hate against their alleged nemeses, the encouragement of easy attacks against vulnerable targets, and the spread of bedlam and confusion intended to bring down governments and promote the terrorists’ agenda. In this paper, we illustrate and discuss terrorism trends manifest during the COVID-19 pandemic and consider the threat these trends pose to the world’s security.
{"title":"Terrorism in time of the pandemic: exploiting mayhem","authors":"A. Kruglanski, R. Gunaratna, Molly Ellenberg, A. Speckhard","doi":"10.1080/23779497.2020.1832903","DOIUrl":"https://doi.org/10.1080/23779497.2020.1832903","url":null,"abstract":"ABSTRACT Despite the world’s overwhelming preoccupation with the COVID-19 pandemic, the threat of international and domestic terrorism is not in decline according to available indicators. The angst that the pandemic induced in millions of people, and the incapacitation of major functions and institutions of world’s societies are exploited by both jihadist and far-right terror organisations for the spread of conspiracy theories aimed to fuel hate against their alleged nemeses, the encouragement of easy attacks against vulnerable targets, and the spread of bedlam and confusion intended to bring down governments and promote the terrorists’ agenda. In this paper, we illustrate and discuss terrorism trends manifest during the COVID-19 pandemic and consider the threat these trends pose to the world’s security.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"7 1","pages":"121 - 132"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80615405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1007/978-3-030-23491-1
{"title":"Global Health Security: Recognizing Vulnerabilities, Creating Opportunities","authors":"","doi":"10.1007/978-3-030-23491-1","DOIUrl":"https://doi.org/10.1007/978-3-030-23491-1","url":null,"abstract":"","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72942763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1823869
N. Noreen, Dil Saima, Naveed Irum, R. Asghar, Asad Ullah Faiz, N. Mohiuddin, M. Ali Khan, N. Ullah Khan, F. Khudaidad, Fawad Khalid Khan
ABSTRACT Pakistan has been experiencing a continuous rise in the incidence of Crimean Congo Haemorrhagic Fever (CCHF). Sporadic cases of CCHF are reported from rural areas of Punjab, Azad Jammu Kashmir and Khyber Pakhtunkhwa and neighbouring Afghanistan where cattle herding is common. The objective of this paper was to describe the epidemiology of CCHF. A descriptive study was carried out in the CCHF isolation ward in Islamabad in a tertiary care hospital from February to November 2018. Using a standardised case definition, all patients admitted in the isolation ward with clinical evidence of CCHF were included in the study. After taking the informed consent, data were collected on demographic factors, history of animal contact, tick-bite history, co-morbidity, laboratory results and treatment outcome. Data were analysed as per time, place and person. During the study period, 40 suspected CCHF patients were admitted in the isolation ward, 32 (80%) males were affected. Mean age of the cases was 33.5 years (range 13–70 years). Most affected 17 (42.5%) age group was 20–29 years. Animal contact history was found in Thirty-seven (92.5%) of cases and 28 (70%) with tick bites. Most of the cases, 26 (65%), were reported from July to August. Forty patients in this study were tested by Real Time Polymerase Chain Reaction (PCR), 20 (50%) were positive, out of which 6(30%) expired. Majority of the positive patients were animal handlers by occupation (37.5%). Proper personal protective equipment was available. The reference laboratory facility was not available for immediate investigations was sent to National Institute of Health for confirmation. The overall results show the important risk factors for CCHF a history of tick bites, high-risk occupations and having contact with livestock. Public health measures should focus on preventing tick bites, increasing awareness of CCHF signs and symptoms, timely investigation, and treatment to reduce mortality. Our analyses recommend the government to set up isolation units in all major hospitals, and proper surveillance system.
巴基斯坦克里米亚刚果出血热(CCHF)的发病率持续上升。据报告，旁遮普邦、阿扎德查谟克什米尔和开伯尔普赫图赫瓦省以及邻近的阿富汗农村地区发生了散发的CCHF病例，这些地区的畜牧业很普遍。本文的目的是描述CCHF的流行病学。2018年2月至11月在伊斯兰堡一家三级保健医院的CCHF隔离病房进行了一项描述性研究。采用标准化病例定义，所有有临床证据的隔离病房住院患者均被纳入研究。填写知情同意书后，收集人口统计学因素、动物接触史、蜱叮咬史、合并症、实验室结果和治疗结果等数据。数据按时间、地点和人员进行分析。研究期间隔离病房收治疑似CCHF患者40例，男性32例(80%)。病例平均年龄33.5岁(13-70岁)。最受影响的17岁(42.5%)年龄组为20-29岁。37例(92.5%)有动物接触史，28例(70%)有蜱叮咬史。大多数病例为26例(65%)，报告时间为7 - 8月。本研究对40例患者进行实时聚合酶链反应(Real Time Polymerase Chain Reaction, PCR)检测，20例(50%)阳性，其中6例(30%)过期。按职业分类，阳性患者以动物饲养员为主(37.5%)。有适当的个人防护装备。参考实验室设施无法立即进行调查，已送往国立卫生研究院进行确认。总体结果表明，蜱叮咬史、高危职业和与牲畜接触是CCHF的重要危险因素。公共卫生措施应侧重于预防蜱叮咬，提高对CCHF体征和症状的认识，及时调查和治疗以降低死亡率。我们的分析建议政府在所有主要医院设立隔离病房，并建立适当的监测系统。
{"title":"‘Characterisation of suspected Crimean-Congo Haemorrhagic Fever (CCHF) cases in a public sector hospital Islamabad’","authors":"N. Noreen, Dil Saima, Naveed Irum, R. Asghar, Asad Ullah Faiz, N. Mohiuddin, M. Ali Khan, N. Ullah Khan, F. Khudaidad, Fawad Khalid Khan","doi":"10.1080/23779497.2020.1823869","DOIUrl":"https://doi.org/10.1080/23779497.2020.1823869","url":null,"abstract":"ABSTRACT Pakistan has been experiencing a continuous rise in the incidence of Crimean Congo Haemorrhagic Fever (CCHF). Sporadic cases of CCHF are reported from rural areas of Punjab, Azad Jammu Kashmir and Khyber Pakhtunkhwa and neighbouring Afghanistan where cattle herding is common. The objective of this paper was to describe the epidemiology of CCHF. A descriptive study was carried out in the CCHF isolation ward in Islamabad in a tertiary care hospital from February to November 2018. Using a standardised case definition, all patients admitted in the isolation ward with clinical evidence of CCHF were included in the study. After taking the informed consent, data were collected on demographic factors, history of animal contact, tick-bite history, co-morbidity, laboratory results and treatment outcome. Data were analysed as per time, place and person. During the study period, 40 suspected CCHF patients were admitted in the isolation ward, 32 (80%) males were affected. Mean age of the cases was 33.5 years (range 13–70 years). Most affected 17 (42.5%) age group was 20–29 years. Animal contact history was found in Thirty-seven (92.5%) of cases and 28 (70%) with tick bites. Most of the cases, 26 (65%), were reported from July to August. Forty patients in this study were tested by Real Time Polymerase Chain Reaction (PCR), 20 (50%) were positive, out of which 6(30%) expired. Majority of the positive patients were animal handlers by occupation (37.5%). Proper personal protective equipment was available. The reference laboratory facility was not available for immediate investigations was sent to National Institute of Health for confirmation. The overall results show the important risk factors for CCHF a history of tick bites, high-risk occupations and having contact with livestock. Public health measures should focus on preventing tick bites, increasing awareness of CCHF signs and symptoms, timely investigation, and treatment to reduce mortality. Our analyses recommend the government to set up isolation units in all major hospitals, and proper surveillance system.","PeriodicalId":32212,"journal":{"name":"Global Security Health Science and Policy","volume":"94 1","pages":"85 - 92"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91075743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1080/23779497.2020.1786431
S. Otsu, H. Do, Tuan Anh Ha, Tu H. Ngo, Q. D. Tran, O. Condell, T. Le, N. D. Ngu, Thanh V. Hoang, T. Q. Dang, P. D. Tran, P. T. T. Tran, Anh T. Lai, Masaya Kato, Cindy H. Chiu
ABSTRACT In our inter-connected world, health-care professionals are the first line of defence to identify emerging diseases and public health events for rapid response. In Vietnam, event-based surveillance (EBS), critical for the early detection of emerging disease outbreaks and acute public health events, has been limited to media-based EBS until recently. In 2017–2018, the Ministry of Health of Vietnam, in collaboration with the World Health Organisation and the US Centres for Disease Control and Prevention, designed, implemented, and evaluated a hospital EBS demonstration pilot in six hospitals in two provinces in Vietnam. After the 9-month implementation period, we conducted a logbook review, eight interviews, and six focus group discussions with hospital and preventive medicine staff, and conducted thematic and descriptive analysis. During the implementation period, 11 signals were reported and confirmed as true events. Of the 11 signals, majority (N = 8, 72.7%) were detected in ICU, followed by the outpatient department (N = 2, 18.2%). The most common signal were clusters of food poisoning (N = 4, 36.4%). All (100%) signals were reported, risk-assessed, and responded to within 24 hours of signal detection. The hospital and preventive medicine staff reported that one of the main benefits of the pilot was their improved mutual relationship. This pilot formalised hospital event-based surveillance through a legal framework, standard operating procedures, a formal feedback mechanism to hospitals to facilitate a two-way conversation, and providing additional training and continued sensitisation. Most importantly, it fostered a trusting relationship between the curative medicine and public health sectors, marking an important step towards advancing the national event-based surveillance system in Vietnam.
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