Although numerous disease intelligence and surveillance systems exist, they are plagued with inaccurate or untimely data. We contend, furthermore, that it was this lack of data quality – and not
the lack of surveillance systems or networks – that prevented the global community from acting earlier in response to the Ebola outbreak in 2014–2016. The new field of ‘connected diagnostics’ is one solution to this concern, as it automates data collection directly from the diagnostic instruments to multiple levels of stakeholders for real-time decision-making and policy response.
This article details how the intervention of ‘connected diagnostics’ could solve the primary underlying failure in existing surveillance systems – the lack of accurate and timely data – to enable
difficult political decisions earlier. The use of connectivity solutions can enable critical health and operational data to empower the Africa CDC, regional hubs, and each country with a consistent
and automated data feed while still maintaining country privacy and controls.
Feasibility of an SMS intervention to deliver tuberculosis testing results in...SystemOne
Pre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by SMS is increasingly being considered as a solution, but there is limited information about its feasibility as a public health tool in low resourced settings. It was found that reporting Xpert results via automated SMS is technically feasible and results in approximately half of patients receiving their test results immediately. Additional research should be done to address process inefficiencies in order to maximize impact of this technology and link its successful utilization to improved patient outcomes.
GxAlert Papua New Guinea Case Study 072518SystemOne
GxAlert's use in Papua New Guinea for disease surveillance and response. Initially used for Tuberculosis response, device management and second-line drug forecasting and stockage.
Implementing rapid testing for tuberculosis in MozambiqueSystemOne
Using rapid molecular tests to diagnose tuberculosis increased case detection in Mozambique but posed logistical challenges. From 2012-2013, Xpert® MTB/RIF testing of smear-negative samples in four hospitals detected an additional 1081 tuberculosis cases, increasing detection by 69%. However, only 67% of patients diagnosed by Xpert® started treatment compared to 82% diagnosed by smear microscopy. Machine failures and lack of connectivity posed operational difficulties. While rapid diagnostics can improve tuberculosis control, more affordable platforms and strengthened treatment initiation are still needed.
Remote monitoring of XpertW MTB/RIF testing in Mozambique: results of program...SystemOne
This document describes the implementation of a remote monitoring system called GxAlert to monitor Xpert MTB/RIF testing in Mozambique. Five GeneXpert machines were installed at health centers in central Mozambique. GxAlert software was successfully installed on the GeneXpert computers to allow test results to be uploaded daily via the internet to a secure online database. Over 1200 positive tuberculosis tests were uploaded, generating 8000 SMS notifications to key individuals like clinicians and patients. While initial implementation was promising, ongoing issues around patient data privacy, interoperability with other systems, and data security need to be addressed.
SPATIAL CLUSTERING AND ANALYSIS ON HEPATITIS C VIRUS INFECTIONS IN EGYPT IJDKP
Lots of studies worldwide have been carried out to check out the prevalence of Hepatitis C Virus (HCV) in human populations. Spatial data analysis and clustering detection is a vital process in HCV monitoring to discover the area of high risk and to help involved decision makers to draw hypotheses about the cause of disease. Egypt is declared as one of the countries having the highest prevalence rate of HCV worldwide. The anomaly of the HCV infection’s distribution in Egypt allowed several researches to identify the reasons that contributed to such widespread of HCV in this country. One way that can help in identification of areas with highest diseases is to give a detailed knowledge about the geographical distribution of HCV in Egypt. To achieve that goal, Data mining analytical tools integrated with GIS can help to visualize the distribution. Thus, the main propose of this paper is to present a spatial distribution of HCV in Egypt using case data obtained from the Egyptian health institute National Hepatology Tropical Medicine Research Institute (NHTMR). The visualization of the spatial analysis distribution by means of GIS allows us to investigate statistical results that are easily interpreted by non-experts.
ONLINE FUZZY-LOGIC KNOWLEDGE WAREHOUSING AND MINING MODEL FOR THE DIAGNOSIS A...ijcsity
This document presents a model for an online fuzzy-logic knowledge warehousing and mining system for diagnosing and treating HIV/AIDS. The system would store patient data and medical knowledge about HIV/AIDS. It uses fuzzy logic and data mining to predict HIV/AIDS status, monitor patient health over time, and determine recommended treatment plans. The system was tested on real patient data from a hospital in Nigeria. It aims to provide an efficient way to diagnose, treat, and monitor people living with HIV/AIDS.
Syndromic surveillance utilizes clinical and non-clinical data sources to monitor disease outbreaks. This document discusses two studies that investigated using ambulatory electronic health record (EHR) data for electronic syndromic surveillance (ESS). The first study examined EHR data from outpatient clinics in New York City during the 2009 H1N1 influenza outbreak and found that ambulatory data provided useful information to public health officials for assessing the outbreak in real-time. The second study looked at ambulatory clinic data associated with Kaiser Permanente in California during a 2009 gastrointestinal disease outbreak and found that officials were able to preemptively detect a potential outbreak based on a high number of stool tests ordered at outpatient facilities. Both studies illustrated the value
Feasibility of an SMS intervention to deliver tuberculosis testing results in...SystemOne
Pre-treatment loss to follow-up is common for patients diagnosed with tuberculosis (TB) in high-burden countries. Delivering test results by SMS is increasingly being considered as a solution, but there is limited information about its feasibility as a public health tool in low resourced settings. It was found that reporting Xpert results via automated SMS is technically feasible and results in approximately half of patients receiving their test results immediately. Additional research should be done to address process inefficiencies in order to maximize impact of this technology and link its successful utilization to improved patient outcomes.
GxAlert Papua New Guinea Case Study 072518SystemOne
GxAlert's use in Papua New Guinea for disease surveillance and response. Initially used for Tuberculosis response, device management and second-line drug forecasting and stockage.
Implementing rapid testing for tuberculosis in MozambiqueSystemOne
Using rapid molecular tests to diagnose tuberculosis increased case detection in Mozambique but posed logistical challenges. From 2012-2013, Xpert® MTB/RIF testing of smear-negative samples in four hospitals detected an additional 1081 tuberculosis cases, increasing detection by 69%. However, only 67% of patients diagnosed by Xpert® started treatment compared to 82% diagnosed by smear microscopy. Machine failures and lack of connectivity posed operational difficulties. While rapid diagnostics can improve tuberculosis control, more affordable platforms and strengthened treatment initiation are still needed.
Remote monitoring of XpertW MTB/RIF testing in Mozambique: results of program...SystemOne
This document describes the implementation of a remote monitoring system called GxAlert to monitor Xpert MTB/RIF testing in Mozambique. Five GeneXpert machines were installed at health centers in central Mozambique. GxAlert software was successfully installed on the GeneXpert computers to allow test results to be uploaded daily via the internet to a secure online database. Over 1200 positive tuberculosis tests were uploaded, generating 8000 SMS notifications to key individuals like clinicians and patients. While initial implementation was promising, ongoing issues around patient data privacy, interoperability with other systems, and data security need to be addressed.
SPATIAL CLUSTERING AND ANALYSIS ON HEPATITIS C VIRUS INFECTIONS IN EGYPT IJDKP
Lots of studies worldwide have been carried out to check out the prevalence of Hepatitis C Virus (HCV) in human populations. Spatial data analysis and clustering detection is a vital process in HCV monitoring to discover the area of high risk and to help involved decision makers to draw hypotheses about the cause of disease. Egypt is declared as one of the countries having the highest prevalence rate of HCV worldwide. The anomaly of the HCV infection’s distribution in Egypt allowed several researches to identify the reasons that contributed to such widespread of HCV in this country. One way that can help in identification of areas with highest diseases is to give a detailed knowledge about the geographical distribution of HCV in Egypt. To achieve that goal, Data mining analytical tools integrated with GIS can help to visualize the distribution. Thus, the main propose of this paper is to present a spatial distribution of HCV in Egypt using case data obtained from the Egyptian health institute National Hepatology Tropical Medicine Research Institute (NHTMR). The visualization of the spatial analysis distribution by means of GIS allows us to investigate statistical results that are easily interpreted by non-experts.
ONLINE FUZZY-LOGIC KNOWLEDGE WAREHOUSING AND MINING MODEL FOR THE DIAGNOSIS A...ijcsity
This document presents a model for an online fuzzy-logic knowledge warehousing and mining system for diagnosing and treating HIV/AIDS. The system would store patient data and medical knowledge about HIV/AIDS. It uses fuzzy logic and data mining to predict HIV/AIDS status, monitor patient health over time, and determine recommended treatment plans. The system was tested on real patient data from a hospital in Nigeria. It aims to provide an efficient way to diagnose, treat, and monitor people living with HIV/AIDS.
Syndromic surveillance utilizes clinical and non-clinical data sources to monitor disease outbreaks. This document discusses two studies that investigated using ambulatory electronic health record (EHR) data for electronic syndromic surveillance (ESS). The first study examined EHR data from outpatient clinics in New York City during the 2009 H1N1 influenza outbreak and found that ambulatory data provided useful information to public health officials for assessing the outbreak in real-time. The second study looked at ambulatory clinic data associated with Kaiser Permanente in California during a 2009 gastrointestinal disease outbreak and found that officials were able to preemptively detect a potential outbreak based on a high number of stool tests ordered at outpatient facilities. Both studies illustrated the value
Effective surveillance is critical for rabies elimination programs to detect outbreaks early, track disease spread, and judge program success. Traditional surveillance methods can be supplemented by innovative approaches like mobile phone reporting to shorten detection time. Surveillance data is needed on case numbers and distribution to target resources effectively. Maintaining surveillance is also important after a country achieves rabies-free status to detect any re-emergence of the disease. Synergistic investment across human and animal health sectors is needed to strengthen surveillance capacities for preparedness against infectious disease threats like rabies.
The document summarizes the use of electronic health records (EHRs) for syndromic surveillance, using the example of Zika virus. It discusses how EHRs can help improve reporting of outbreaks by recording patient information. While EHRs provide advantages like improved reporting efficiency and criterion validity of data, they also have limitations like the need for diagnostic and demographic accuracy. The document reviews literature on different surveillance systems and their use in various healthcare settings. It concludes by discussing opportunities for further research, such as including new diseases in surveillance systems and improving collaboration between public and private health sectors.
Two studies, PROUD and IPERGAY, found that PrEP with Truvada reduced the risk of HIV infection by 86% when taken correctly. PROUD studied 545 high-risk HIV-negative men who have sex with men taking daily PrEP, and found negligible increases in other STIs. IPERGAY studied 400 men using an on-demand dosing strategy before and after sex, and also found no HIV transmissions with correct use. The studies provide strong evidence that PrEP can significantly reduce HIV risk with few drawbacks when adherence is high.
This document discusses the importance of vaccine preventable disease (VPD) surveillance systems and provides details on setting up and monitoring different types of surveillance. It describes passive, sentinel, and active surveillance and compares their methods. Guidelines are provided for setting up each type of surveillance, including selecting reporting sites, collecting standardized case information, and monitoring the quality and timeliness of reporting. Methods for confirming vaccine preventable disease cases and preparing line lists and reports are also outlined.
This document summarizes the implementation and results of a routine HIV testing program called ACTS (Advise, Consent, Test, Support) across 10 community health centers in the Bronx over 10 years. Key findings:
1) HIV testing rates increased nearly threefold during the 2003-2007 ACTS pilot, from 8% tested in 2003 to 20% in 2007.
2) Testing rates were sustained or continued to increase with little ongoing support - 23% tested in 2008, 28% in 2011, 29% in 2012, and 28% in 2013.
3) 433 new HIV-positive patients were identified between 2006-2013, with 96% linked to care within 90 days, demonstrating the program's success
The document summarizes a term paper on public health surveillance in Nepal. It discusses the objectives, methodology, findings and conclusions of the paper. The key points are: public health surveillance involves ongoing collection and analysis of health data to guide public health practice; Nepal has integrated disease surveillance within its health management information system; and the country was commended for its efficient AFP surveillance and polio eradication efforts while still needing to address potential wild poliovirus circulation.
SM2015 is an ambitious project with the Ministry of Health and local support. This presentation outlines the design and activities around the data collection and analysis of the evaluation, as well as the results, conclusions, and future activities.
Epidemic Alert System: A Web-based Grassroots ModelIJECEIAES
This document summarizes research on web-based epidemic alert systems. It discusses how most current systems analyze large amounts of unstructured data from various online sources using complex algorithms, which can generate imprecise results given the lack of standards. The document then proposes a new grassroots web-based system that collects structured data directly from primary health centers, hospitals, and laboratories. This traditional approach uses threshold values based on percentiles to determine when an epidemic is triggered. If adopted, it could help standardize web-based disease surveillance.
This study analyzed data from the Utah Statewide Immunization Information System to identify missed opportunities for human papillomavirus (HPV) vaccination among females ages 11-26 between 2008-2012. Of 47,665 eligible clinical visits, there were 20,911 missed opportunities (43.87%) where another adolescent vaccine was given but not the HPV vaccine. Younger age, non-Hispanic ethnicity, and residence in a rural area were associated with higher rates of missed opportunities. Interventions targeted at providers serving groups with the most missed opportunities could help improve HPV vaccination coverage.
This document provides an overview of public health surveillance. It defines surveillance as the ongoing collection, analysis, and interpretation of health data to inform public health programs and actions. The document outlines the historical origins of surveillance dating back to ancient Greece. It describes various types of surveillance including community-level surveillance, routine reporting systems, active and passive surveillance, sentinel surveillance, and surveys. It also discusses the integrated disease surveillance program in India and how it aims to strengthen surveillance systems at the state and district levels.
Transforming the NHS through genomic and personalised medicine, pop up uni, 1...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
The Revised National Tuberculosis Control Programme (RNTCP) was launched in 1997 based on the WHO DOTS strategy, with a goal of covering the entire country by 2006. RNTCP implements the five components of DOTS - sustained political commitment, quality-assured diagnosis, standardized short-course treatment, uninterrupted drug supply, and standardized recording and reporting. Objectives include achieving at least 85% cure rate of infectious cases through DOTS and detecting at least 70% of estimated cases through quality sputum microscopy and case finding activities.
A study on the impact of data analytics in COVID-19 health care systemDr. C.V. Suresh Babu
Through the disperse of novel coronavirus illness globally, existence became considerably contrived. Data analytics have experienced powerful development over the past few years. As it happens, it’s exceptionally considerable to take advantage of data analytics to assist mankind in a prompt as well as factually precise method to forestall additionally restrain the advancement of the widespread, sustain gregarious balance and evaluate the influence of the widespread. The unforeseen significant number of coronavirus disease instances has disturbed medical care system in many economies furthermore eventuated in an insufficiency of dormitory in the hospices. For this reason, prognosticating quantity of coronavirus infection instances is indispensable for administrations to adopt the necessary measures. The count of coronavirus disease instances could be correctly anticipated by taking into account historical records of announced instances side by side few extraneous components that impact the disseminate of the COVID-19 . Hence, the principal aim out of this research is to contemporaneously consider historical data and the extraneous components. This paper explores how data analytics can play a role in health care especially in novel coronavirus illness.
This document provides an introduction to public health surveillance. It begins with an overview of public health surveillance and its role. It then outlines the key topics that will be covered, including defining surveillance, its goals and uses, the legal basis for surveillance in the US, different types of surveillance and the surveillance process. The document provides learning objectives and details each topic with definitions, examples and knowledge checks. The goal is to help participants understand what surveillance is, its purpose, how it is conducted and how the data is analyzed to support public health practice and policy.
India has a high tuberculosis (TB) burden, accounting for 21% of global TB incidence. In 2014, India had 2.2 million TB cases out of the global total of 9 million. The Revised National TB Control Programme (RNTCP) was launched in 1993 based on the WHO recommended DOTS strategy to address the failures of the previous National TB Control Programme (NTP). RNTCP aims to achieve an 85% cure rate among new sputum-positive patients and detect 70% of estimated new sputum-positive cases. It relies on quality-assured sputum smear microscopy, adequate drug supply, directly observed treatment, and systematic monitoring. However, the 2014 Joint TB Monitoring Mission report identified ongoing weaknesses including additional
Ethical Considerations for a Public Health Response Using Molecular HIV Surve...HopkinsCFAR
This document discusses a multi-stakeholder consultation regarding the ethical use of molecular HIV surveillance (MHS) data for public health purposes. MHS analyzes genetic sequences from HIV tests to identify clusters of individuals with closely related viruses, potentially indicating transmission relationships. While MHS could help target prevention, concerns include potential misinterpretation increasing criminalization risk. The consultation made recommendations in four areas: community education and engagement; examining laws/policies around data sharing; research on effectiveness and optimal implementation; and ensuring community input on policies. Addressing these issues is important as public health agencies expand use of this new surveillance approach.
There are an estimated 170 million people globally infected with hepatitis C virus (HCV), which poses a rising threat to healthcare systems. While some national governments and non-governmental organizations have accelerated efforts to improve HCV education, testing, and treatment, significant barriers remain. Effective disease surveillance is critical but data on chronic HCV prevalence is lacking in over half of countries surveyed. As awareness of HCV has increased, patient advocacy groups have played a leading role in shaping policy and pressuring governments to adopt more comprehensive national strategies. However, approaches to HCV still vary widely between countries.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Knolisandrai1k
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid ...
Effective surveillance is critical for rabies elimination programs to detect outbreaks early, track disease spread, and judge program success. Traditional surveillance methods can be supplemented by innovative approaches like mobile phone reporting to shorten detection time. Surveillance data is needed on case numbers and distribution to target resources effectively. Maintaining surveillance is also important after a country achieves rabies-free status to detect any re-emergence of the disease. Synergistic investment across human and animal health sectors is needed to strengthen surveillance capacities for preparedness against infectious disease threats like rabies.
The document summarizes the use of electronic health records (EHRs) for syndromic surveillance, using the example of Zika virus. It discusses how EHRs can help improve reporting of outbreaks by recording patient information. While EHRs provide advantages like improved reporting efficiency and criterion validity of data, they also have limitations like the need for diagnostic and demographic accuracy. The document reviews literature on different surveillance systems and their use in various healthcare settings. It concludes by discussing opportunities for further research, such as including new diseases in surveillance systems and improving collaboration between public and private health sectors.
Two studies, PROUD and IPERGAY, found that PrEP with Truvada reduced the risk of HIV infection by 86% when taken correctly. PROUD studied 545 high-risk HIV-negative men who have sex with men taking daily PrEP, and found negligible increases in other STIs. IPERGAY studied 400 men using an on-demand dosing strategy before and after sex, and also found no HIV transmissions with correct use. The studies provide strong evidence that PrEP can significantly reduce HIV risk with few drawbacks when adherence is high.
This document discusses the importance of vaccine preventable disease (VPD) surveillance systems and provides details on setting up and monitoring different types of surveillance. It describes passive, sentinel, and active surveillance and compares their methods. Guidelines are provided for setting up each type of surveillance, including selecting reporting sites, collecting standardized case information, and monitoring the quality and timeliness of reporting. Methods for confirming vaccine preventable disease cases and preparing line lists and reports are also outlined.
This document summarizes the implementation and results of a routine HIV testing program called ACTS (Advise, Consent, Test, Support) across 10 community health centers in the Bronx over 10 years. Key findings:
1) HIV testing rates increased nearly threefold during the 2003-2007 ACTS pilot, from 8% tested in 2003 to 20% in 2007.
2) Testing rates were sustained or continued to increase with little ongoing support - 23% tested in 2008, 28% in 2011, 29% in 2012, and 28% in 2013.
3) 433 new HIV-positive patients were identified between 2006-2013, with 96% linked to care within 90 days, demonstrating the program's success
The document summarizes a term paper on public health surveillance in Nepal. It discusses the objectives, methodology, findings and conclusions of the paper. The key points are: public health surveillance involves ongoing collection and analysis of health data to guide public health practice; Nepal has integrated disease surveillance within its health management information system; and the country was commended for its efficient AFP surveillance and polio eradication efforts while still needing to address potential wild poliovirus circulation.
SM2015 is an ambitious project with the Ministry of Health and local support. This presentation outlines the design and activities around the data collection and analysis of the evaluation, as well as the results, conclusions, and future activities.
Epidemic Alert System: A Web-based Grassroots ModelIJECEIAES
This document summarizes research on web-based epidemic alert systems. It discusses how most current systems analyze large amounts of unstructured data from various online sources using complex algorithms, which can generate imprecise results given the lack of standards. The document then proposes a new grassroots web-based system that collects structured data directly from primary health centers, hospitals, and laboratories. This traditional approach uses threshold values based on percentiles to determine when an epidemic is triggered. If adopted, it could help standardize web-based disease surveillance.
This study analyzed data from the Utah Statewide Immunization Information System to identify missed opportunities for human papillomavirus (HPV) vaccination among females ages 11-26 between 2008-2012. Of 47,665 eligible clinical visits, there were 20,911 missed opportunities (43.87%) where another adolescent vaccine was given but not the HPV vaccine. Younger age, non-Hispanic ethnicity, and residence in a rural area were associated with higher rates of missed opportunities. Interventions targeted at providers serving groups with the most missed opportunities could help improve HPV vaccination coverage.
This document provides an overview of public health surveillance. It defines surveillance as the ongoing collection, analysis, and interpretation of health data to inform public health programs and actions. The document outlines the historical origins of surveillance dating back to ancient Greece. It describes various types of surveillance including community-level surveillance, routine reporting systems, active and passive surveillance, sentinel surveillance, and surveys. It also discusses the integrated disease surveillance program in India and how it aims to strengthen surveillance systems at the state and district levels.
Transforming the NHS through genomic and personalised medicine, pop up uni, 1...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
The Revised National Tuberculosis Control Programme (RNTCP) was launched in 1997 based on the WHO DOTS strategy, with a goal of covering the entire country by 2006. RNTCP implements the five components of DOTS - sustained political commitment, quality-assured diagnosis, standardized short-course treatment, uninterrupted drug supply, and standardized recording and reporting. Objectives include achieving at least 85% cure rate of infectious cases through DOTS and detecting at least 70% of estimated cases through quality sputum microscopy and case finding activities.
A study on the impact of data analytics in COVID-19 health care systemDr. C.V. Suresh Babu
Through the disperse of novel coronavirus illness globally, existence became considerably contrived. Data analytics have experienced powerful development over the past few years. As it happens, it’s exceptionally considerable to take advantage of data analytics to assist mankind in a prompt as well as factually precise method to forestall additionally restrain the advancement of the widespread, sustain gregarious balance and evaluate the influence of the widespread. The unforeseen significant number of coronavirus disease instances has disturbed medical care system in many economies furthermore eventuated in an insufficiency of dormitory in the hospices. For this reason, prognosticating quantity of coronavirus infection instances is indispensable for administrations to adopt the necessary measures. The count of coronavirus disease instances could be correctly anticipated by taking into account historical records of announced instances side by side few extraneous components that impact the disseminate of the COVID-19 . Hence, the principal aim out of this research is to contemporaneously consider historical data and the extraneous components. This paper explores how data analytics can play a role in health care especially in novel coronavirus illness.
This document provides an introduction to public health surveillance. It begins with an overview of public health surveillance and its role. It then outlines the key topics that will be covered, including defining surveillance, its goals and uses, the legal basis for surveillance in the US, different types of surveillance and the surveillance process. The document provides learning objectives and details each topic with definitions, examples and knowledge checks. The goal is to help participants understand what surveillance is, its purpose, how it is conducted and how the data is analyzed to support public health practice and policy.
India has a high tuberculosis (TB) burden, accounting for 21% of global TB incidence. In 2014, India had 2.2 million TB cases out of the global total of 9 million. The Revised National TB Control Programme (RNTCP) was launched in 1993 based on the WHO recommended DOTS strategy to address the failures of the previous National TB Control Programme (NTP). RNTCP aims to achieve an 85% cure rate among new sputum-positive patients and detect 70% of estimated new sputum-positive cases. It relies on quality-assured sputum smear microscopy, adequate drug supply, directly observed treatment, and systematic monitoring. However, the 2014 Joint TB Monitoring Mission report identified ongoing weaknesses including additional
Ethical Considerations for a Public Health Response Using Molecular HIV Surve...HopkinsCFAR
This document discusses a multi-stakeholder consultation regarding the ethical use of molecular HIV surveillance (MHS) data for public health purposes. MHS analyzes genetic sequences from HIV tests to identify clusters of individuals with closely related viruses, potentially indicating transmission relationships. While MHS could help target prevention, concerns include potential misinterpretation increasing criminalization risk. The consultation made recommendations in four areas: community education and engagement; examining laws/policies around data sharing; research on effectiveness and optimal implementation; and ensuring community input on policies. Addressing these issues is important as public health agencies expand use of this new surveillance approach.
There are an estimated 170 million people globally infected with hepatitis C virus (HCV), which poses a rising threat to healthcare systems. While some national governments and non-governmental organizations have accelerated efforts to improve HCV education, testing, and treatment, significant barriers remain. Effective disease surveillance is critical but data on chronic HCV prevalence is lacking in over half of countries surveyed. As awareness of HCV has increased, patient advocacy groups have played a leading role in shaping policy and pressuring governments to adopt more comprehensive national strategies. However, approaches to HCV still vary widely between countries.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Knolisandrai1k
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid ...
Hiv vaccine market opportunity & clinical pipeline analysisKuicK Research
1) HIV/AIDS continues to be a major global public health challenge, with around 1.6 million deaths and 2.3 million new infections in 2012. An effective HIV vaccine is considered the best solution to ending the pandemic.
2) While treatment and prevention efforts have helped address illness and death from HIV/AIDS, it remains one of the leading infectious diseases worldwide, especially impacting developing countries. Close to 4 million people in India are currently infected.
3) Significant breakthroughs in HIV/AIDS prevention and treatment have been made in recent years, but an efficient vaccine is still needed, along with continued funding for medical research and new drug development.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Kno.docxdeanmtaylor1545
The document proposes a knowledge-based framework called HAIKU that uses ontologies, web services, and rules to improve surveillance of healthcare-associated infections. The framework focuses on consistently classifying infections like surgical site infections according to standards and guidelines. It uses the HAI ontology to group thousands of codes into a hierarchy of infection concepts and relationships. Statistical analysis and heuristics are used to define rules to improve detection of surgical site infection cases. The framework aims to use "e-triggers" identified through the ontology to better assess risk of postoperative infections for certain surgeries.
Malaria is still considered globally as a leading cause of morbidity with Nigeria carrying the highest burden of 19%. Coinfection of malaria and Human Immunodeficiency Virus (HIV) accelerate disease progression of HIV/AIDS subjects. This study investigated the prevalence and predictors of malaria among HIV infected subjects attending the antiretroviral therapy Clinic at Federal the Medical Centre, Keffi, Nigeria. After ethical clearance, 200 whole blood specimens were collected from patients who gave informed consent and completed a self-structured questionnaire. The specimens were examined for malarial parasite using rapid kits and microscopy. The overall prevalence of the infection was 78/200 (39.0%). The prevalence was higher in male (44.7%) than female (34.0%) subjects. Those subjects aged < 20 years (54.5), male gender (44.7%), non-formal education holders (61.5%), farmers (62.5%), stream water users (48.1%), those that lives in rural setting (43.6%), those that do not use Insecticides Treated Nets (ITNs) (39.4%) and swampy environment dwellers (41.7%) were identified predictors for malaria infection in the area. All the predictors studied did not show any statistically significant difference with the infection but some arithmetic difference exists (P > 0.05). The 39.0% prevalence of malaria in HIV infected subjects is a public health concern. Therefore, Public health surveillance and health education among HIV population should be advocated to help eradicate malaria comes 2030. Further study that will characterize the genes of the parasite should be carried out.
During the past 3 weeks, new major outbreaks of COVID-19 have been identified rapidly expanding in Europe, North America, Asia, and the Middle East. By March 16th, there were over 143 countries reporting cases. The WHO now characterizes COVID-19 as a pandemic. The WHO recommends countries take actions like contact tracing, promoting hygiene, preparing health systems, and postponing large gatherings. More research is still needed to understand transmission and develop treatments, but information sharing between scientists has increased global understanding of COVID-19.
The document discusses the ongoing Ebola outbreak in West Africa and the factors contributing to its severity. It argues that the high mortality rates are due not just to lack of staff and resources, but more fundamentally to lack of adequate health systems to effectively deploy them. In particular, it notes the lack of basic protective equipment, guidelines, and supportive care that could reduce unnecessary deaths. It calls for responses to both provide immediate aid and invest in building sustainable systems focused on quality, safety, effectiveness, and treating patients with dignity to restore lost trust and prevent future crises.
This review article discusses advanced HIV, which is defined as having a CD4 count less than 200 cells/uL or an AIDS-defining illness. Two groups present with advanced HIV - those who are ART-naive and those who are ART-experienced. While substantial progress has been made in treating HIV, diagnosis of advanced cases has stalled. Individuals diagnosed with advanced HIV have higher mortality rates than those diagnosed earlier, even after starting ART. Proper diagnosis of opportunistic infections like tuberculosis and cryptococcus is important for managing advanced HIV cases, but many patients remain undiagnosed. Earlier testing and treatment is needed to improve outcomes and prevent secondary HIV transmissions.
This document summarizes a study on factors influencing adherence to antiretroviral therapy (ART) among people living with HIV in Tanzania. The study analyzed data from 943 HIV-positive patients attending care and treatment centers in urban Dar es Salaam and rural Iringa regions of Tanzania. Adherence based on appointment keeping was 65% and based on patient self-reports of doses taken in the past month was 70-83%. Factors associated with better adherence included satisfaction with healthcare services, social support, knowledge of ART use, early presentation to care, and being on ART for over one year. Being in an urban area, using traditional medicine, experiencing side effects, and alcohol use were linked to poorer adherence
Patients from the urban Dar es Salaam region were less likely to be married, have social support, earn less than $150 USD per month, have lower education levels, receive pre-ART counseling, be on first-line ART, experience side effects, and be satisfied with clinic services compared to patients from the rural Iringa region. Patients from Dar es Salaam were more likely to pay less than $0.50 for transport to the clinic, delay registering at the clinic, and take additional medications for opportunistic infections. Adherence based on appointment keeping was higher in Dar es Salaam while adherence based on self-report was higher in Iringa.
Patients from the urban Dar es Salaam region were less likely to be married, have social support for medication reminders, earn less than $150 USD per month, have lower education levels, and consume alcohol compared to the rural Iringa region. Urban patients were also more likely to experience delays in registering for care, pay less for transportation to clinics, and take additional medications for opportunistic infections. Adherence based on appointment keeping was higher in the urban region, while adherence based on self-reported dosage in the past month was higher in the rural region. Factors associated with adherence differed between the urban and rural settings in Tanzania.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Efficient Investment in Health Information System for a Cost Effectiveness Ag...Global Risk Forum GRFDavos
GRF One Health Summit 2012, Davos: Presentation by Prof. Syed Mohamed Aljunid - Professor of Health Economics and Consultant Public Health Medicine - United Nations University
This document provides guidelines for conducting population-based surveys to measure national HIV prevalence. It outlines how to plan and implement a new national survey, incorporate HIV testing into existing surveys, and calculate a national HIV prevalence estimate by combining data from surveys and sentinel surveillance. Population-based surveys can provide more representative HIV prevalence data than sentinel surveillance alone. The guidelines aim to help countries obtain accurate national estimates by adjusting prevalence measures from different data sources and accounting for biases.
This document provides background information on HIV/AIDS and disease surveillance services. It discusses how HIV first emerged in the 1980s and has since spread globally. Disease surveillance involves the ongoing systematic collection and analysis of data to monitor disease spread and inform prevention and control efforts. The document then reviews studies on HIV prevalence in various countries and age groups. It also discusses theories relevant to disease surveillance and HIV control, including how education and awareness building can impact prevention efforts.
The HIV epidemic in Ethiopia remains heterogeneous, with urban areas, large cities, and areas near major transport corridors experiencing higher prevalence rates than rural areas. While national HIV prevalence has remained stable at around 1.5% according to surveys, prevalence is increasing slightly in some large urban areas. HIV incidence appears to have declined based on falling prevalence in younger age groups and ANC surveillance. AIDS-related mortality has also decreased sharply. Behavioral factors like high male circumcision rates and low rates of premarital and extramarital sex have helped keep prevalence low. However, HIV transmission within marriage represents a major source of new infections. The HIV response in Ethiopia has expanded treatment coverage significantly but prevention programs need to be strengthened,
Knowledge and attitude to human immunodeficiency virus post-exposure prophyla...BRNSSPublicationHubI
This study assessed the knowledge and attitudes of pharmacy, nursing, and medical students regarding HIV post-exposure prophylaxis (PEP) at a university in southeastern Nigeria. A survey was administered to 396 students across various levels. The results found poor overall knowledge of HIV PEP, with only 44.63% of nursing, 38.34% of medical, and 34.11% of pharmacy students demonstrating knowledge. However, attitudes were generally favorable, with over 60% of students from each program expressing positive attitudes toward HIV PEP. The study highlights the need for improved educational programs to enhance students' understanding and awareness of HIV PEP protocols.
WHO African Region - Africa marks six months on 14 August since COVID-19 was first detected on the continent. While the virus has raced through many other regions of the world, the pandemic’s evolution on the African continent has been different.
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
The papers for publication in The International Journal of Engineering& Science are selected through rigorous peer reviews to ensure originality, timeliness, relevance, and readability.
Similar to The Role of Connected Diagnostics in Strengthening Regional, National and Continental African Disease Surveillance (20)
GxAlert for Real-time Management and Strengthening of Remote GeneXpert Networ...SystemOne
Real-time monitoring of GeneXpert machines can contribute to reduced error rates and shorter turnaround
times for module replacement and can improve the overall
maintenance of the machines. Emails and SMS alerts can speed
up treatment initiation. The NTP now gets SMS alerts and emails for DR-TB patient enrollment; stockout and error (>5%) rates; critical module errors; and monthly MDR reports to ensure better
connections among diagnosis, enrollment, and treatment.
Racing for results: lessons learnt in improving the efficiency of HIV VL and ...SystemOne
This document discusses strategies for improving the efficiency of delivering HIV viral load and early infant diagnosis test results from laboratories to clinics. Traditional paper-based reporting systems can result in delays and lost results. Newer electronic and mobile health platforms show promise in reducing turnaround times, but also face challenges from limited infrastructure in low-resource settings. Specifically, laboratory information systems, SMS messaging, and SMS printers are being used to deliver results digitally, with some programs reporting up to 50% reductions in turnaround times. However, merely delivering results is not enough - systems also need to ensure results are received and acted upon to improve patient outcomes.
Bangladesh case study on how we implemented a connected diagnostics solution using GxAlert for infectious disease surveillance, TB program optimization and leveraging diagnostic data.
Diagnosing at Point of Care in South India: Coordination Work and Frictions SystemOne
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Surrogate endpoints in global health research: still searching for killer app...SystemOne
1. The document discusses the use of surrogate endpoints in global health research instead of long-term clinical outcomes. It provides examples where interventions improved surrogate endpoints but did not improve mortality, such as a TB diagnostic test and a WHO childbirth checklist in India.
2. It argues that surrogate endpoints alone are not sufficient and global health interventions need to strengthen entire health systems to improve outcomes. Researchers should map how an intervention fits in the care pathway and evaluate multiple endpoints along the pathway.
3. The authors propose using implementation research to understand how interventions can be optimized depending on context and to lower unrealistic expectations of what innovations can achieve when introduced into suboptimal systems.
Unsuccessful Xpert® MTB/RIF results: the Nigerian experienceSystemOne
The document discusses a study analyzing unsuccessful Xpert MTB/RIF test results in Nigeria between January and December 2015. Of over 52,000 tests conducted, 11% were unsuccessful, including 4.7% invalid results, 4.2% error results, and 2.1% with no result. Technical errors were the most frequent at 69%. Temperature-related errors peaked seasonally, while technical errors occurred uniformly. Improving adherence to standard operating procedures through training and supervision could help optimize Xpert performance.
1) The study assessed the impact of a digital reporting terminal called Aspect Reporter on reducing the time to deliver HIV viral load and early infant diagnostic results from centralized laboratories to remote clinics in Malawi.
2) Results showed that with digital reporting, 100% of results were delivered to clinics compared to 5% missing with paper reporting, and the average time to deliver results reduced from 22 days to just 1 day.
3) Across clinics, the time to deliver results using the digital reporter continued to improve over the 4 months of the study, going from an average of 8.1 days initially to just 0.6 days, representing a 95% reduction in turnaround time compared to the paper-based system.
The document discusses the role of diagnostics in preventing antimicrobial resistance (AMR). It notes that inappropriate antibiotic use is fueling the emergence of AMR globally and reducing treatment options. Currently 700,000 deaths per year are due to drug-resistant infections and this could rise to 10 million by 2050. Diagnostics can play a key role in optimizing antibiotic use, preserving new drugs, and enabling surveillance. The document outlines FIND's strategy to develop and promote rapid diagnostic tests to improve rational antibiotic use in low-resource settings and preserve antibiotics by enabling more targeted treatment.
GxAlert is a system that allows near real-time monitoring of GeneXpert machines and patient data in Uganda. It addresses challenges with the previous monthly data collection system by (1) regularly receiving weekly usage and test result data from sites, (2) automatically tracking cartridge inventory to aid planning, and (3) having the potential to automatically notify patients and clinicians of results. The next steps are expanding GxAlert nationwide, ensuring continuous internet, and directly messaging patients and clinicians.
This document summarizes the implementation of GxAlert, a system for real-time monitoring of GeneXpert machines and TB/HIV data, in Nigeria. It provides background on Nigeria's high TB and HIV burdens. It describes how over 280 of 377 GeneXpert sites have been connected to GxAlert. Expected benefits include real-time test results and resistance detection, early warnings on machine issues, and timely reporting. Challenges discussed include reluctance to share access, need for user guides and support. The next phase aims to sustain connectivity, integrate across systems, and connect additional diagnostics.
Effects of GeneXpert MTB/RIF Testing and GxAlert eHealth Platforms on MDR-TB ...SystemOne
This study evaluated the impact of GeneXpert MTB/RIF testing and the GxAlert eHealth platform on MDR-TB diagnosis and treatment initiation in Sofala Province, Mozambique. From 2012-2015, 22,543 GeneXpert tests were conducted, identifying 249 patients with rifampin-resistant TB. The number of MDR-TB patients diagnosed and treated increased over time. However, only 55.8% of rifampin-resistant patients were started on appropriate MDR-TB treatment. The GxAlert platform did not show a statistically significant improvement in linking patients to care, though it provided other benefits like remote monitoring of test results and machine performance.
The document describes improvements made to the Xpert MTB/RIF assay (Xpert) to create the new Xpert MTB/RIF Ultra assay (Ultra). Ultra showed an 8-fold lower limit of detection for Mycobacterium tuberculosis compared to Xpert. Ultra also improved detection of rifampin resistance, showing no false positives compared to two for Xpert. Testing on clinical samples found Ultra had higher sensitivity than Xpert, especially for smear-negative samples. The enhanced sensitivity of Ultra has the potential to significantly improve tuberculosis detection.
The Swaziland National Tuberculosis Program (NTP) implemented a new diagnostic device management platform called GxAlert to help manage their fleet of GeneXpert devices across 28 laboratories in the country. This was necessary to maximize the potential of the new diagnostics by allowing remote monitoring, error detection, targeted training, and data-driven decision making. With support from SystemOne and a skilled local NTP team, 15 laboratories were successfully connected to GxAlert in just 3 days, despite some initial challenges. GxAlert has since helped the NTP optimize inventory, monitor the drug resistance survey, and collect over 48,000 diagnostic results to improve patient care and understand disease trends.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Allopurinol, a uric acid synthesis inhibitor acts by inhibiting Xanthine oxidase competitively as well as non- competitively, Whereas Oxypurinol is a non-competitive inhibitor of xanthine oxidase.
Part III - Cumulative Grief: Learning how to honor the many losses that occur...bkling
Cumulative grief, also known as compounded grief, is grief that occurs more than once in a brief period of time. As a person with cancer, a caregiver or professional in this world, we are often met with confronting grief on a frequent basis. Learn about cumulative grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
Storyboard on Skin- Innovative Learning (M-pharm) 2nd sem. (Cosmetics)MuskanShingari
Skin is the largest organ of the human body, serving crucial functions that include protection, sensation, regulation, and synthesis. Structurally, it consists of three main layers: the epidermis, dermis, and hypodermis (subcutaneous layer).
1. **Epidermis**: The outermost layer primarily composed of epithelial cells called keratinocytes. It provides a protective barrier against environmental factors, pathogens, and UV radiation.
2. **Dermis**: Located beneath the epidermis, the dermis contains connective tissue, blood vessels, hair follicles, and sweat glands. It plays a vital role in supporting and nourishing the epidermis, regulating body temperature, and housing sensory receptors for touch, pressure, temperature, and pain.
3. **Hypodermis**: Also known as the subcutaneous layer, it consists of fat and connective tissue that anchors the skin to underlying structures like muscles and bones. It provides insulation, cushioning, and energy storage.
Skin performs essential functions such as regulating body temperature through sweat production and blood flow control, synthesizing vitamin D when exposed to sunlight, and serving as a sensory interface with the external environment.
Maintaining skin health is crucial for overall well-being, involving proper hygiene, hydration, protection from sun exposure, and avoiding harmful substances. Skin conditions and diseases range from minor irritations to chronic disorders, emphasizing the importance of regular care and medical attention when needed.
Storyboard on Acne-Innovative Learning-M. pharm. (2nd sem.) CosmeticsMuskanShingari
Acne is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells. It typically manifests as pimples, blackheads, or whiteheads, often on the face, chest, shoulders, or back. Acne can range from mild to severe and may cause emotional distress and scarring in some cases.
**Causes:**
1. **Excess Oil Production:** Hormonal changes during adolescence or certain times in adulthood can increase sebum (oil) production, leading to clogged pores.
2. **Clogged Pores:** When dead skin cells and oil block hair follicles, bacteria (usually Propionibacterium acnes) can thrive, causing inflammation and acne lesions.
3. **Hormonal Factors:** Fluctuations in hormone levels, such as during puberty, menstrual cycles, pregnancy, or certain medical conditions, can contribute to acne.
4. **Genetics:** A family history of acne can increase the likelihood of developing the condition.
**Types of Acne:**
- **Whiteheads:** Closed plugged pores.
- **Blackheads:** Open plugged pores with a dark surface.
- **Papules:** Small red, tender bumps.
- **Pustules:** Pimples with pus at their tips.
- **Nodules:** Large, solid, painful lumps beneath the surface.
- **Cysts:** Painful, pus-filled lumps beneath the surface that can cause scarring.
**Treatment:**
Treatment depends on the severity and type of acne but may include:
- **Topical Treatments:** Such as benzoyl peroxide, salicylic acid, or retinoids to reduce bacteria and unclog pores.
- **Oral Medications:** Antibiotics or oral contraceptives for hormonal acne.
- **Procedures:** Such as chemical peels, extraction of comedones, or light therapy for more severe cases.
**Prevention and Management:**
- **Cleanse:** Regularly wash skin with a gentle cleanser.
- **Moisturize:** Use non-comedogenic moisturizers to keep skin hydrated without clogging pores.
- **Avoid Irritants:** Such as harsh cosmetics or excessive scrubbing.
- **Sun Protection:** Use sunscreen to prevent exacerbation of acne scars and inflammation.
Acne treatment can take time, and consistency in skincare routines and treatments is crucial. Consulting a dermatologist can help tailor a treatment plan that suits individual needs and reduces the risk of scarring or long-term skin damage.
congenital GI disorders are very dangerous to child. it is also a leading cause for death of the child.
this congenital GI disorders includes cleft lip, cleft palate, hirchsprung's disease etc.
Understanding Atherosclerosis Causes, Symptoms, Complications, and Preventionrealmbeats0
Definition: Atherosclerosis is a condition characterized by the buildup of plaques, which are made up of fat, cholesterol, calcium, and other substances, in the walls of arteries. Over time, these plaques harden and narrow the arteries, restricting blood flow.
Importance: This condition is a major contributor to cardiovascular diseases, including coronary artery disease, carotid artery disease, and peripheral artery disease. Understanding atherosclerosis is crucial for preventing these serious health issues.
Overview: We will cover the aims and objectives of this presentation, delve into the signs and symptoms of atherosclerosis, discuss its complications, and explore preventive measures and lifestyle changes that can mitigate risk.
Aim: To provide a detailed understanding of atherosclerosis, encompassing its pathophysiology, risk factors, clinical manifestations, and strategies for prevention and management.
Purpose: The primary purpose of this presentation is to raise awareness about atherosclerosis, highlight its impact on public health, and educate individuals on how they can reduce their risk through lifestyle changes and medical interventions.
Educational Goals:
Explain the pathophysiology of atherosclerosis, including the processes of plaque formation and arterial hardening.
Identify the risk factors associated with atherosclerosis, such as high cholesterol, hypertension, smoking, diabetes, and sedentary lifestyle.
Discuss the clinical signs and symptoms that may indicate the presence of atherosclerosis.
Highlight the potential complications arising from untreated atherosclerosis, including heart attack, stroke, and peripheral artery disease.
Provide practical advice on preventive measures, including dietary recommendations, exercise guidelines, and the importance of regular medical check-ups.
A congenital heart defect is a problem with the structure of the heart that a child is born with.
Some congenital heart defects in children are simple and don't need treatment. Others are more complex. The child may need several surgeries done over a period of several years.
Phosphorus, is intensely sensitive to ‘other worlds’ and lacks the personal boundaries at every level. A Phosphorus personality is susceptible to all external impressions; light, sound, odour, touch, electrical changes, etc. Just like a match, he is easily excitable, anxious, fears being alone at twilight, ghosts, about future. Desires sympathy and has the tendency to kiss everyone who comes near him. An insane person with the exaggerated idea of one’s own importance.
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determines the success of a response. However, surveillance
systems are largely fragmented and lack input of timely,
accurate data.
Disease surveillance systems
Disease surveillance systems serve two key functions: first,
to provide an early warning system for potential threats and,
second, to provide a system to monitor diseases, trends, and
progress towards control and elimination strategies.9
Worldwide, different disease surveillance strategies and
systems have been adopted. Traditional systems typically
rely on a notification-based approach, whereby health care
providers regularly submit data to relevant health authorities
on a specified infectious disease within a specified territory.8
This requires passive reporting on disease information and,
although inexpensive, can result in sequential errors,
reflecting under- and over-reporting by health care providers
of diseases and cases. Active surveillance systems, on the
other hand, rely on proactive searches for cases with
established criteria, risk factors or events, but still require
manual data collection. By design, both of these strategies,
although employing structured reporting mechanisms, suffer
numerous challenges, including the lack of or inaccessibility
of real-time, quality data, under-reporting or delayed
reporting of cases and deaths,8
and complex management.10
Advancements such as the Internet have revolutionised how
disease data is collected and now, Web-based surveillance
systems such as Healthmap, allow automated and rapid
collection of large amounts of unstructured data from
electronic sources.10,11,12
However, even with advancements,
Web-based surveillance is still challenging, as the information
collected from diverse sources is not structured,12
has
uncertain and varying data quality, and may lead to
inaccurate interpretation and predictions.10
Disease surveillance in Africa
Africa has been plagued by numerous and recurring
epidemics over the past several decades. Not only do these
diseases share the ability to decimate entire towns and
villages, they also place enormous economic strain on
countries.13
Global estimates by the World Bank place the
annual global cost of a moderately severe to severe pandemic
at roughly $570 billion.14
Responses to many of these diseases
have been hampered by weak health care systems, lack of
policies that encourage integration and coordination within
countries and across borders, and the absence of accurate and
timely diagnostic data for decision-making.
When the WHO AFRO attempted to provide an inventory of
all epidemics reported in Africa between 1970 and 2016, the
effort was impeded by limited data, inconsistencies in
reporting of occurrences and magnitudes of outbreaks, and
variability in description of outbreak locations.15
The increasing burden of AMR threatens the effectiveness
and success of infectious disease treatment programmes.16
Africa is thought to contribute a large proportion of the
global AMR burden due to limited control and monitoring of
use of antibiotics and the high rates of communicable diseases
such as HIV and tuberculosis.17
However, the scarcity of data
coming from the region on AMR surveillance reflects the
absence of tools to collect valuable information, reliance on
passive reporting from centres and lack of training and
expertise needed for continuous monitoring and reporting.16
One review on the status of AMR in Africa found that recent
data on AMR was not available for 42.6% of African countries
and what was available were lacking in quality, even though
resistance to commonly prescribed antibiotics was very high
in the African continent.18
A review of 135 current antibiotic
prescribing guidelines also found that, in general, most do not
consider resistance patterns for highly prevalent infectious
syndromes such as community-acquired pneumonia and
urinary tract infections.19
This largely reflects the lack of
collection of accurate resistance data and limits our true
understanding of AMR burden.
The role of the Africa Centres for Disease
Control and Prevention in antimicrobial drug
resistance surveillance
To strengthen both regional and national health, the Africa
CDC and WHO AFRO are building a global health security
programme, focusing on rapid response surge teams, starting
at the Africa CDC and stemming out to the national public
health institutes (NPHIs). Five regional collaborating centres
(RCCs) hosted by Zambia, Kenya, Gabon, Nigeria and
Senegal, in addition to key NPHIs in those sub-regions, make
up the Africa CDC Regional Integrated Surveillance
Laboratory Network or RISLNET,20
with headquarters in
Ethiopia. The goal of this integrated system is to drive
networked, collaborative efforts to strengthen and improve
disease surveillance linked to laboratory confirmation, disease
preparedness and response. A further expected outcome of
the Africa CDC is the establishment of the Antimicrobial
Resistance and Surveillance Network or AMRSNET that will
standardise the approach to AMR surveillance and strive to
achieve quality data.20
In order for both of these efforts to
be fruitful, a data-sharing platform is needed which can
be leveraged across member states and disease areas to
strengthen the ability to collate, analyse and interpret the
generated data, and to respond appropriately.
Connected diagnostics in disease
surveillance
To ensure an effective response to a potential outbreak event,
timeliness is of paramount importance. This requires
surveillance, assessment and communication mechanisms to
be in place to increase awareness of management strategies,
and to facilitate their initiation in the early phases.21,22
When a
passive, paper-based surveillance system was implemented
in the public health sector in South Africa for health care-
associated infections, the main challenge was incomplete
data collection.23
Nurses felt that manual collection and
recording of data added to their workload, thus highlighting
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the need for systems that are able to automatically collect
data and communicate it to various levels of the health care
system. Interconnected diagnostic networks can address
these needs by facilitating the interactions between laboratory
confirmation, automated data collection, interpretation,
delivery of results and real-time monitoring of disease as
well as analysis. Also, by providing accurate and reliable
diagnostic information directly to the point of patient care,
more timely patient management and appropriate use of
antimicrobials can be facilitated.
Real-time reporting of laboratory-confirmed cases
A critical component of disease-specific surveillance and
early warning systems is their reliance on laboratory
confirmation of the disease. High-quality, reliable laboratory
detection has been emphasised by the Africa CDC as the
central component to rapid response.20
With the evolution of medical diagnostic instruments and
availability of digital health platforms in many African
countries, the tools for detection and response are already in
place and ready to be used and connected for surveillance. As
an example, the GeneXpert platform (Cepheid, Sunnyvale,
California, United States) is a molecular diagnostic tool
commonly used for tuberculosis and first-line drug resistance
detection, but also allows detection of a range of other
diseases including HIV, Hepatitis C virus, Ebola, Methicillin-
resistant Staphylococcus aureus and flu through the use of
pathogen-specific cartridges. The platform produces a wealth
of electronic diagnostic and operational data that can be
collected and transmitted in real-time, directly from the
instrument, utilising connectivity solutions such as the
GxAlert/Aspect platform (SystemOne, LLC, Springfield,
Massachusetts, United States) or C360 (Cepheid, Sunnyvale,
California, United States).24
In the context of tuberculosis, the
move towards connected diagnostic platforms has been
strongly recommended by the WHO in the latest Global
Laboratory Initiative guideline on connectivity and as part of
the End TB Strategy. The guideline indicates that all sites that
use WHO-recommended rapid tuberculosis diagnostics
should be transmitting results electronically to clinicians and
to information management systems, using data connectivity
solutions by no later than 2020.24
Currently, the existing GeneXpert footprint in Africa is
extensive; the WHO AFRO accounted for 42% of the global
GeneXpert module procurement in 2016 and almost 65%
of total cartridge procurement.25
By leveraging this existing
footprint, connected GeneXpert systems could shorten the
detection-response gap, reduce patient loss to follow-up and
facilitate early antimicrobial therapy and thus reducing
morbidity and mortality.26
Automated alerts and triggers
The paper-based systems still found in many nations today
have notoriously slow reporting cycles. Disease surveillance
in a NPHI may consist of manual tabulation of vital registries
and death certificates. These sources are of questionable
accuracy (e.g. cause of death listed as ‘fever’ instead of ‘Ebola
infection’) and typically tabulated on an annual or quarterly
basis, which is far too slow to identify an outbreak in progress
and prevent it from reaching critical mass.
Lack of knowledge regarding disease thresholds has also
been found to greatly restrict early identification of disease
outbreaks.27
Connectivity solutions can assist by providing
an in-built system to trigger automated electronic alerts
when reported cases of a specific disease exceed a predefined
threshold. This trigger could be sent to an epidemiologist for
specialist analysis or to field staff to verify the occurrence of
outbreaks and ensure that prompt control measures and case
findings are instituted. Setting these thresholds is a crucial
component to early warning and outbreak systems and needs
to be based on characteristics of the local disease.28
During
the 2014–2016 Ebola outbreak in West Africa, GeneXpert
devices located in mobile laboratories in Guinea and Sierra
Leone were interfaced to GxAlert to enable real-time
collection and management of diagnostic data. GxAlert
automatically reported Ebola-positive cases directly to the
laboratory directors in Conakry and Freetown via SMS and
email alerts to provide key decision-makers with accurate,
reliable and timely information to decrease the time needed
to coordinate a response.
Once the results from diagnostic instruments are digitised,
several patient-centred interventions also become immediately
possible:
• Faster treatment enrolment: Results can be transmitted in
real-time via SMS, email, online dashboard or connection
to another database (e.g. electronic patient record) for
faster treatment enrolment. In Malawi, SystemOne’s
Aspect platform is used to transmit HIV viral load results
from the central laboratory directly to the referring clinics
in real-time. Clinicians confirm receipt to acknowledge
that they are acting on the results.29
In the context of AMR,
the timely feedback of patient results supports clinicians
in providing prompt patient management and decision-
making on antibiotic use.30
• Immediate contact tracing: When results are tagged at the
laboratory with patient name, phone number and
address, this information can be transmitted immediately
(or after approval) to contact tracing teams to contain
outbreaks earlier. Training of staff to maintain
confidentiality is critical for the optimal operation of such
a system.
• Establishment of ‘sentinel sites’ for outbreak containment
and AMR surveillance: Diagnostic positives in
neighbouring countries can alert their national emergency
operations centres and the Africa CDC’s RCCs. By
connecting sentinel sites along borders or key points of
entry, neighbouring countries can better prevent
outbreaks from crossing their borders. Developing
capacity for AMR surveillance and data collection at
sentinel sites can help inform antibiotic prescription
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guidelines and infection control policies, inform
intervention needs and help develop an understanding
of emergence, transmission and dissemination of
pathogens.30
• Tagging and geo-locating sample transportation:
Connected, integrated sample transport will contribute
to solving the problem of sample loss, delays and
misplacement. Geo-tagging sample containers with
similar identifiers with patient source and point of origin
will rapidly improve the speed of sample access and
eliminate the administrative bottlenecks of tracing
missing samples.
Operational dashboards and interoperability
A further need of the Africa CDC is to link various
surveillance mechanisms to create a holistic, integrated
system. Connectivity solutions are not designed to replace
existing systems, but rather to feed them faster and
with more accuracy than manual collection with critical
data. Existing disease surveillance systems and laboratory
information systems (e.g. Global Antimicrobial Resistance
Surveillance System, Global Early Warning System, DISA,
District Health Management Information System-2) are
robust tools with well-established processes. What they
need most are better sources of timely and accurate data.
Connected diagnostics help these systems better fulfil their
designed purpose.
Even without complex laboratory information systems,
connectivity solutions provide an immediate subset of
structureddatathatissufficientforcoreactivities.Programme
managers, the Ministry of Health, the national reference
laboratory and other stakeholders can remotely monitor
reliable and accurate patient diagnostic data, rates of positive
cases, trends and geospatial information depending on their
different levels of access to operational dashboards. These
dashboards can provide some data analytic capabilities to
support interpretation and exploration of trends and
anomalies, and data can also be easily aggregated to multiple
levels of stakeholders for real-time decision-making and
response.
A bottom-up approach to continent-
wide antimicrobial resistance
surveillance
Building disease surveillance on connected diagnostics will
enable a coordinated response to potential public health
threats. In a scenario where a country has diagnostic
instruments connected to a system such as GxAlert or Aspect,
for example, digital copies of geo-located, disease-positive
cases are stored on a country-level database. Each country as
well as the Africa CDC RCCs and headquarters could have
access to their own operational dashboard based on the
permissions set by the Ministry of Health (Figure 1). This
type of system would serve the Africa CDC’s need for real-
time, geospatial reporting of quality results and enable them
to monitor de-identified results of importance, while still
preserving the country privacy and controls in place. It
would also serve to strengthen the coordinating and
supporting role for the RCC in specific sub-regions.
Automated escalations from the national to the RCC
level, based on certain thresholds, can initiate effective
coordination and allow cross-border surveillance (Table 1).
Significant value is obtained from the ability to receive
real-time statistics on disease burden, outbreaks, at-risk
populations and other epidemiological metrics for further
public health threats.
Confidentiality and privacy of
health information
The protection of both patient privacy and national
sovereignty are, naturally, strong concerns. The International
Health Regulations31
provide the legal framework and
political agreement needed to help the international
community prevent and respond to any potential cross-
border threats. However, in practice, creating an effective
mechanism for sharing this critical data in a transparent and
timely manner has been challenging. The advent of connected
diagnostics introduces a new opportunity. The technology is
capable of alerting all of the necessary organisations in
real-time. The Africa CDC has the mandate and the legal
underpinnings within the International Health Regulations
to work in concert with nations to negotiate what levels
of data access are acceptable and under what conditions
(Figure 1). The RCCs do not need to see details that identify
an individual patient and might not need to even see specific
results, but could be alerted if more than 10 positive Lassa
fever results (or plague or Ebola, etc.) occurred within a
single month. The alert may simply facilitate a conversation
between the RCC and the national emergency operations
centre about the cases to see if resources are needed. Although
a diagnostic result is not the same thing as a ‘positive patient’,
the information is close enough that for pathogens of public
Africa CDC
server
Regional Hub
RCC server
MoH server
Laboratory
NaƟonal LIS
Case management
Inventory system
Sample transport
DiagnosƟc
Instrument
Country Level
Local Laboratory
informaƟon
system(LIS)
Smart Router
Africa CDC, Africa Centres for Disease Control and Prevention; LIS, laboratory information
system; MoH, Ministry of Health; RCC, regional collaborating centre
FIGURE 1: Potential flow of information between national, regional and Africa
CDC. At each level, the server manages what information and triggering
conditions determine further reporting.
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health importance, the appearance of an unexpected number
of positive results warrants a conversation between the
public health bodies involved, at the minimum. The legal
framework supporting this has existed for some years. The
technology now exists to establish such a surveillance
network very affordably; for example, based on the
experience of installing and maintaining connectivity services
for more than 2100 Cepheid GeneXperts, Abbott m2000s,
Becton Dickinson MGITs, Alere PIMAs and Qs, and others by
SystemOne, Savics and the Foundation for Innovative New
Diagnostics (FIND), the cost to connect the entire continent of
Africa’s HIV viral load instruments is only around $5 M per
year (or $91 000 per African country). Doing so would
provide the systems needed to give every country full, digital
access to their HIV viral load testing results at a national,
regional, district or site level, the RCC reduced and de-
identified access to HIV data in their region, and the Africa
CDC the real-time summary information necessary to guide
effective policy. Putting the entire continent’s HIV drug
resistance testing into a multi-tiered AMR surveillance
network is extraordinarily inexpensive and yields
extraordinary AMR insights around one of the deadliest
diseases in history. The costs for connecting diagnostics for
pathogens of concern is, in our opinion, at or below the cost
of doing so for HIV. This is attainable in the short term.
Conclusion
As we prepare for future outbreaks and monitoring of AMR,
we should use the advanced technologies that are available to
us in order to evolve and strengthen key factors in ensuring a
well-functioning surveillance strategy: laboratory detection,
reporting and response systems. The opportunity exists to take
advantage of the ability to collect unprecedented amounts of
electronic data from diagnostic platforms through connectivity
solutions. By connecting the deployed devices at the beginning
of an outbreak or, better yet, prior to new outbreaks during
simulations of preparedness, a highly reliable and real-time
system for detection and response can be activated at ‘patient
zero’. Immediate reports via any electronic means of positive
cases can be sent directly to key decision-makers and response
coordinators, reducing the time to response, improving
data quality issues and stopping unnecessary deaths due to
prolonged disease transmission. Reliable, automated data,
sent directly from diagnostic systems, enables national,
regional, and continent-wide political and health decision-
makers to act confidently, as all stakeholders will be utilising
high-quality data generated in real-time.
Acknowledgements
Competing interests
Authors N.M.G., J.T. and C.M. are all either employees,
shareholders or both of SystemOne LLC, a company that
provides a disease intelligence software currently operating
in the industry.
Sources of support
None.
Authors’ contributions
N.M.G. and J.T. drafted the article; A.A., C.M. and P.C.O.
provided critical review, intellectual content and editing of
the article; all authors provided final approval of the version
to be published.
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