Field epidemiology training programs contribute to COVID-19 preparedness and response globally

Abstract Background Field epidemiology training programs (FETPs) have trained field epidemiologists who strengthen global capacities for surveillance and response to public health threats. We describe how FETP residents and graduates have contributed to COVID-19 preparedness and response globally. Methods We conducted a cross-sectional survey of FETPs between March 13 and April 15, 2020 to understand how FETP residents or graduates were contributing to COVID-19 response activities. The survey tool was structured around the eight Pillars of the World Health Organization’s (WHO) Strategic Preparedness and Response Plan for COVID-19. We used descriptive statistics to summarize quantitative results and content analysis for qualitative data. Results Among 88 invited programs, 65 (74%) responded and indicated that FETP residents and graduates have engaged in the COVID-19 response across all six WHO regions. Response efforts focused on country-level coordination (98%), surveillance, rapid response teams, case investigations (97%), activities at points of entry (92%), and risk communication and community engagement (82%). Descriptions of FETP contributions to COVID-19 preparedness and response are categorized into seven main themes: conducting epidemiological activities, managing logistics and coordination, leading risk communication efforts, providing guidance, supporting surveillance activities, training and developing the workforce, and holding leadership positions. Conclusions Our findings demonstrate the value of FETPs in responding to public health threats like COVID-19. This program provides critical assistance to countries' COVID-19 response efforts but also enhances epidemiologic workforce capacity, public health emergency infrastructure and helps ensure global health security as prescribed in the WHO’s International Health Regulations.

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Prevalence of overweight and obesity and anthropometric reference centiles for Albanian children and adolescents living in four Balkan nation-states

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0253 ◽

2018 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Jakob Tarp ◽

Juel Jarani ◽

Florian Muca ◽

Andi Spahi ◽

Anders Grøntved

Keyword(s):

Public Health ◽

Children And Adolescents ◽

Task Force ◽

Overweight And Obesity ◽

World Health ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Nation States ◽

Country Differences ◽

Age And Sex

Abstract Background The extent of the obesity epidemic among youth is an important public health statistic which provides an indication of the future burden of non-communicable diseases. Many developing countries, including Albania, do not have systematic and repeated monitoring systems in operation. Methods The Balkan Survey of Inactivity in Children study is a population-based cross-sectional survey including Albanian children living in the four Balkan nation-states of Albania, Kosovo, FYR Macedonia and Montenegro. In total, 19,850 children from 49 schools were approached. The LMS method was used to provide body mass index (BMI), height, weight and waist circumference reference centiles for boys and girls. The World Health Organisation (WHO) and International Obesity Task Force (IOTF) age- and sex-specific BMI cut-points were applied to evaluate adiposity levels. Results A sample of 18,460 participants aged 6–16 years old was available for creation of the BMI for age and sex reference centiles. The prevalence of overweight (including obesity) in the full sample was 21% (95% CI: 20%–21%) according to IOTF cut-off points and 28% (95% CI: 28%–29%) at WHO cut-off points. Overweight/obesity levels where higher in boys than in girls irrespective of the cut-off points applied (p<0.001). Noticeable between-country differences were observed with a prevalence of overweight/obesity of 40% (95% CI: 38%–42%) in Montenegro but only 20% (95% CI: 19%–21%) in Kosovo (WHO cut-off points). Conclusions Overweight/obesity is highly prevalent in Albanian children and adolescents. The apparent sex and country differences may inform public health actions.

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The role of risk communication in public health interventions. An analysis of risk communication for a community quarantine in Germany to curb the SARS-CoV-2 pandemic

PLoS ONE ◽

10.1371/journal.pone.0256113 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256113

Author(s):

Juliane Scholz ◽

Wibke Wetzker ◽

Annika Licht ◽

Rainer Heintzmann ◽

André Scherag ◽

...

Keyword(s):

Public Health ◽

Risk Communication ◽

Public Health Intervention ◽

Health Interventions ◽

Successful Implementation ◽

Public Health Interventions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Information Level ◽

Public Health Authorities

Background Separating ill or possibly infectious people from their healthy community is one of the core principles of non-pharmaceutical interventions. However, there is scarce evidence on how to successfully implement quarantine orders. We investigated a community quarantine for an entire village in Germany (Neustadt am Rennsteig, March 2020) with the aim of better understanding the successful implementation of quarantine measures. Methods This cross-sectional survey was conducted in Neustadt am Rennsteig six weeks after the end of a 14-day mandatory community quarantine. The sample size consisted of 562 adults (64% of the community), and the response rate was 295 adults, or 52% (33% of the community). Findings National television was reported as the most important channel of information. Contact with local authorities was very limited, and partners or spouses played a more important role in sharing information. Generally, the self-reported information level was judged to be good (211/289 [73.0%]). The majority of participants (212/289 [73.4%]) approved of the quarantine, and the reported compliance was 217/289 (75.1%). A self-reported higher level of concern as well as a higher level of information correlated positively with both a greater acceptance of quarantine and self-reported compliant behaviour. Interpretation The community quarantine presented a rare opportunity to investigate a public health intervention for an entire community. In order to improve the implementation of public health interventions, public health risk communication activities should be intensified to increase both the information level (potentially leading to better compliance with community quarantine) and the communication level (to facilitate rapport and trust between public health authorities and their communities).

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Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health (SRH) Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

10.21203/rs.3.rs-17230/v3 ◽

2020 ◽

Author(s):

Pacifique Ndayishimiye ◽

Rosine Uwase ◽

Isabelle Kubwimana ◽

Jean de la Croix Niyonzima ◽

Roseline Dine Dzekem ◽

...

Keyword(s):

Health Care Providers ◽

Health Facilities ◽

Urban Setting ◽

World Health ◽

Care Providers ◽

Health Seeking ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Tool

Abstract Background: Adolescents are still getting pregnant and contracting Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Rwanda as elsewhere. Quality and comprehensive SRH services and information for adolescents is valuable for adolescents’ wellbeing. This study aimed at understanding SRH services providers’ viewpoints on accessibility, availability, and quality of SRH services provided to adolescents in selected cities of Rwanda. Method: The study was a descriptive cross-sectional survey conducted between May 2018 and May 2019 in six selected cities of Rwanda using a mixed-methods approach. A checklist was used to collect data from 159 conveniently selected SRH services providers. The survey tool was validated. SPSS version 20 was used to describe quantitative data and ATLAS TI version 5.2 was used to code and analyze the qualitative data thematically.Results: Qualitatively, health care providers reported that the availability of adolescent SRHS are satisfactory with access to accurate SRH information, contraceptive methods, prevention and management of STIs and HIV services, and counselling. However, the accessibility of some services remains limited. According to respondents, some products such as female condoms are less in demand and often expire before they can be distributed. One nurse clarified that they render services at a low price if an adolescent has insurance medical coverture. Religious leaders and family members may hinder adolescents from health-seeking behavior by promoting abstinence and discouraging use of protective means. Quantitatively, we found that 94.3% of health facilities provide information to adolescents on SRH services that were available and 51.6% affirmed delivering services at a low cost. Only 57.2% of respondents mentioned that adolescents are involved in designing the feedback mechanisms at their facilities.Conclusion: SRH services in Rwanda are available for the general population and are not specifically designed for adolescents. These SRH services seem to be fairly accessible to adolescents with insufficient quality as adolescents themselves do not get to be fully involved in service provision among other aspects of quality SRH as stated by the World Health Organization (WHO). Therefore, there is a need to improve the present quality of these services to meet adolescents’ needs in an urban setting.

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Availability, Accessibility, and Quality of Adolescent Sexual and Reproductive Health (SRH) Services in Urban Health Facilities of Rwanda: A survey among social and healthcare providers

10.21203/rs.3.rs-17230/v4 ◽

2020 ◽

Author(s):

Pacifique Ndayishimiye ◽

Rosine Uwase ◽

Isabelle Kubwimana ◽

Jean de la Croix Niyonzima ◽

Roseline Dine Dzekem ◽

...

Keyword(s):

Health Care Providers ◽

Health Facilities ◽

Urban Setting ◽

World Health ◽

Care Providers ◽

Health Seeking ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Tool

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Factors Related to Health Risk Communication Outcomes among Migrant Workers in Thailand during COVID-19: A Case Study of Three Provinces

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182111474 ◽

2021 ◽

Vol 18 (21) ◽

pp. 11474

Author(s):

Ratchadaporn Papwijitsil ◽

Hathairat Kosiyaporn ◽

Pigunkaew Sinam ◽

Mathudara Phaiyarom ◽

Sataporn Julchoo ◽

...

Keyword(s):

Public Health ◽

Health Risk ◽

Risk Communication ◽

Health Information ◽

Migrant Workers ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health Measures ◽

Preventive Practices

Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease, and risk communication is one of several public health emergency responses. During the pandemic, many migrant workers in Thailand experienced barriers that hamper access to health information. This study aims to explore factors related to the outcomes of health risk communication, including awareness of public health measures and preventive practices. We conducted a cross-sectional survey on migrants between January and April 2021 using cluster sampling in Phuket, Ranong, and Samut Sakhon. In the descriptive analysis, we presented the median, proportion, and ratio, while in the inferential analysis, we employed a logistic regression with robust standard errors. Although a total of 303 participants were initially included in this study, the final number was narrowed down to 288 samples due to insufficient information required for the analysis. Frequent reception of health information and primary school education showed a statistically significant association with preventive practices. Middle-aged migrant workers demonstrated a significantly lower level of preventive practices than younger migrant workers. A longer stay in Thailand was significantly related to a lower degree of awareness toward public health measures. Thus, it is necessary to promote the accessibility of health information among migrant workers in Thailand, especially those who have lived in Thailand for more than eight years, are older, and have no formal education.

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Global community perception of ‘surgical care’ as a public health issue: a cross sectional survey

BMC Public Health ◽

10.1186/s12889-021-10936-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nurhayati Lubis ◽

Meena Nathan Cherian ◽

Chinmayee Venkatraman ◽

Fiemu E. Nwariaku

Keyword(s):

Public Health ◽

Surgical Care ◽

World Health ◽

Health Issue ◽

Public Health Issue ◽

Community Perception ◽

Cross Sectional Survey ◽

Cross Sectional ◽

World Health Assembly Resolution ◽

A Priority

Abstract Background In the last decade surgical care has been propelled into the public health domain with the establishment of a World Health Organisation (WHO) designated programme and key publications. The passing of the historic World Health Assembly Resolution (WHA) acknowledged surgical care as a vital component towards achieving Universal Health Coverage (UHC). We conducted the first worldwide survey to explore the perception of surgical care as a public health issue. Method The anonymous, cross sectional survey targeted worldwide participants across a range of professional backgrounds, including non-medical using virtual snowball sampling method (in English) using Google Forms (Google Inc., Mountain View, CA, USA) from 20th February 2019 to 25th June 2019. The survey questions were designed to gauge awareness on Sustainable Development Goals (SDGs), UHC, WHO programmes and key publications on surgical care as well as perception of surgical care as a priority topic in public health. Results The survey was completed by 1954 respondents from 118 countries. Respondents were least aware of surgical care as a teaching topic in public health courses (27%; n = 526) and as a WHO programme (20%; n = 384). 82% of respondents were aware of UHC (n = 1599) and of this 72% (n = 1152) agreed that surgical care fits within UHC. While 77% (n = 1495) of respondents were aware of SDGs, only 19% (n = 370) agreed that surgery was a priority to meet SDGs. 48% (n = 941) rated surgical care as a cost-effective component of Primary Health Care. 88% (n = 1712) respondents had not read the WHA Resolution on ‘Strengthening emergency and essential surgical care and anaesthesia as a component of UHC’. Conclusion There is still a widespread gap in awareness on the importance of surgical care as a public health issue amongst our respondents. Surgical care was not seen as a priority to reach the SDGs, less visible as a WHO programme and not perceived as an important topic for public health courses.

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Risk Communication and Crisis Communication in Infectious Disease Outbreaks in Germany: What Is Being Done, and What Needs to be Done

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2014.36 ◽

2014 ◽

Vol 8 (3) ◽

pp. 206-211 ◽

Cited By ~ 4

Author(s):

Petra Dickmann ◽

Nadine Biedenkopf ◽

Sam Keeping ◽

Markus Eickmann ◽

Stephan Becker

Keyword(s):

Public Health ◽

Infectious Disease ◽

Risk Communication ◽

Crisis Communication ◽

Contextual Information ◽

International Health ◽

Disease Outbreaks ◽

World Health ◽

Health Authorities ◽

Public Health Authorities

AbstractObjectiveRisk communication plays a central role in the management of infectious disease. The World Health Organization's 2005 International Health Regulations have highlighted the need for countries to strengthen their capacities in this area to ensure effective responses to public health emergencies. We surveyed laboratories, hospitals, and public health institutions in Germany to detail the current situation regarding risk communication and crisis management and to identify which areas require further development.MethodsA mixed methods approach was adopted. An initial questionnaire was distributed to relevant persons in laboratories and hospitals, and semistructured interviews were conducted with selected participants. Representatives from state public health authorities, federal agencies, and media also were interviewed to add additional contextual information to the questionnaire responses.ResultsBased on the responses received, the universal sense among key stakeholders was that risk communication and crisis communication measures must be improved. Collaborative working was a consistent theme, with participants suggesting that a partnering strategy could help to improve performance. This approach could be achieved through better coordination between groups, for example, through a knowledge-sharing policy.ConclusionsMore research is needed on how such collaboration might be implemented, along with a general conceptual framework for risk communication to underpin the overall strategy. (Disaster Med Public Health Preparedness. 2014;0:1-6)

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Household Preparedness and Preferred Communication Channels in Public Health Emergencies: A Cross-Sectional Survey of Residents in an Asian Developed Urban City

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15081598 ◽

2018 ◽

Vol 15 (8) ◽

pp. 1598 ◽

Cited By ~ 10

Author(s):

Greta Tam ◽

Zhe Huang ◽

Emily Chan

Keyword(s):

Public Health ◽

Infectious Disease ◽

Hong Kong ◽

Risk Communication ◽

Disaster Preparedness ◽

Disease Surveillance ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Urban City ◽

Household Preparedness

Disaster awareness and household preparedness are crucial for reducing the negative effects of a disaster. This study aims to examine the citizens’ preparedness level in the event of a general disaster or outbreak of infectious disease and to identify suitable channels for community disease surveillance and risk communication. We used a stratified random design to conduct a digit-dialed telephone survey in Hong Kong during February 2014. Level of disaster preparedness was examined according to the possession of disaster kit items. Associations between socio-demographic factors and good household preparedness were assessed using multiple logistic regression models. Preferences for infectious disease surveillance were collected and analyzed. There were 1020 respondents. Over half of the respondents (59.2%) had good household preparedness. After adjustment, female respondents, having higher education and higher household income were significantly associated with good household preparedness. Television and telephone were the preferred channels to obtain and report infectious disease information, respectively. In conclusion, general and specific infectious-disease household preparedness levels in Hong Kong were generally good. Tailored preparedness programs targeted to specific communities are necessary for those lacking preparedness. Risk communication and public health surveillance should be conducted through television and telephone, respectively.

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Missed Opportunities in Tuberculosis Investigation and Associated Factors at Public Health Facilities in Uganda

10.21203/rs.3.rs-124193/v1 ◽

2020 ◽

Author(s):

Keith Kakame ◽

Noel Namuhani ◽

Andrew Kazibwe ◽

Felix Bongomin ◽

Joseph Baluku ◽

...

Keyword(s):

Public Health ◽

Health Workers ◽

Health Facilities ◽

World Health ◽

Cross Sectional Survey ◽

Prevalence Survey ◽

Cross Sectional ◽

Missed Opportunities ◽

Public Health Facilities ◽

Factors Associated

Abstract BackgroundThe incidence of tuberculosis (TB) is high in Uganda; yet, TB case detection is low. A recent national TB prevalence survey revealed that only 16% of presumptive TB patients seeking care at health facilities were offered sputum microscopy or chest-X ray (CXR). The objective of this study was to determine the magnitude of, and patient factors associated with missed opportunities in TB investigation at public health facilities of Wakiso District in Uganda.MethodsA facility-based cross-sectional survey was conducted at 10 high volume public health facilities offering comprehensive TB services in Wakiso, Uganda, among adults (≥18 years) with at least one symptom suggestive of TB predefined according to World Health Organisation criteria. Using exit interviews, data on demographics, TB symptoms, and clinical data relevant to TB were collected. A missed opportunity in TB investigation was defined as a patient with symptoms suggestive of TB who did not have sputum and/or CXR evaluation to rule out TB. Poisson regression analysis was performed to determine factors associated with missed opportunities in TB investigation using STATA 14.ResultsTwo hundred forty seven presumptive TB patients were recruited into this study exiting at antiretroviral therapy (ART) clinics (n=132) or general outpatient clinics (n=115) at public health facilities. Majority of participants were females (161/247, 65.2%) and the mean +SD age was 35.1 + 11.5 years. Sputum and/or CXR were not requested from 138 (55.9%) patients with symptoms suggestive of TB disease. Patients who did not inform health workers about TB related symptoms were more likely to miss a TB investigation (adjusted prevalence ratio: 1.68, 95%CI; 1.36-2.08, P<0.001). Conclusion; A large proportion of patients with symptoms suggestive of TB did not have sputum and/ or CXR requested for investigation. Patients who did not inform health workers about their TB related symptoms were more likely to miss having sputum and/ or CXR requested. We recommend studies to explore barriers and facilitators of disclosure of TB symptoms to enable formulation of effective interventions to empower people to improve likelihood of disclosing TB related symptoms.

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The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19

JMIR Public Health and Surveillance ◽

10.2196/18503 ◽

2020 ◽

Vol 6 (1) ◽

pp. e18503 ◽

Cited By ~ 3

Author(s):

Mohannad Al Nsour ◽

Haitham Bashier ◽

Abulwahed Al Serouri ◽

Elfatih Malik ◽

Yousef Khader ◽

...

Keyword(s):

Public Health ◽

Global Health ◽

Eastern Mediterranean ◽

World Health ◽

Health Development ◽

Health Network ◽

The Public ◽

Field Epidemiology ◽

Variable Capacity ◽

Health Threats

The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR’s Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.

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