How health systems in sub-Saharan Africa can benefit from tuberculosis and other infectious disease programmes.

Weak and dysfunctional health systems in low-income countries, particularly in sub-Saharan Africa, are recognised as major obstacles to attaining the health-related Millennium Development Goals by 2015. Some progress is being made towards achieving the targets of Millennium Development Goal 6 for tuberculosis (TB), HIV/AIDS and malaria, with the achievements largely resulting from clearly defined strategies and intervention delivery systems combined with large amounts of external funding. This article is divided into four main sections. The first highlights the crucial elements that are needed in low-income countries in sub-Saharan Africa to deliver good quality health care through general health systems. The second discusses the main characteristics of infectious disease and TB control programmes. The third illustrates how TB control and other infectious disease programmes can help to strengthen these components, particularly in human resources; infrastructure; procurement and distribution; monitoring, evaluation and supervision; leadership and stewardship. The fourth and final section looks at progress made to date at the international level in terms of policy and guidelines, with some specific suggestions about this might be moved forward at the national level. For TB and other infectious disease programmes to drive broad improvements in health care systems and patient care, the lessons that have been learnt must be consciously applied to the broader health system, and sufficient financial input and the engagement of all players are essential

A Model Infectious Disease Curriculum for Fourth Grade Students: Integrating Prevention and Education Concepts in the Classroom

Despite the significant need for prevention education and updated disease curricula in elementary schools, there is a deficit of model units, lesson plans, and activities at the fourth grade level. An infectious disease and prevention teaching unit has been developed, following guidelines specified by the Centers for Disease Control and Prevention and a format consistent with proven pedagogical methods. This curriculum was tested in five classrooms with a total of 94 students.Prior to implementation, an assessment of all fourth grade teachers in the district examined their perceived knowledge of infectious diseases and their perceived self-efficacy in teaching such content. Evaluation of student progress included student pre and post-tests to assess changes in knowledge. Upon completion of the unit, teachers evaluated the unit to determine its relevance, effectiveness, and ease of implementation, and completed a post-test on their own knowledge and efficacy.Results indicate that the unit was effective in increasing student comprehension and interest in infectious disease prevention, and teacher efficacy in delivery of the material. This model curriculum can serve as a foundation to increase school health education in critical public health areas such as infectious diseases and preparedness, and provide an early introduction to public health careers

Global mapping of infectious disease

The primary aim of this review was to evaluate the state of knowledge of the geographical distribution of all infectious diseases of clinical significance to humans. A systematic review was conducted to enumerate cartographic progress, with respect to the data available for mapping and the methods currently applied. The results helped define the minimum information requirements for mapping infectious disease occurrence, and a quantitative framework for assessing the mapping opportunities for all infectious diseases. This revealed that of 355 infectious diseases identified, 174 (49%) have a strong rationale for mapping and of these only 7 (4%) had been comprehensively mapped. A variety of ambitions, such as the quantification of the global burden of infectious disease, international biosurveillance, assessing the likelihood of infectious disease outbreaks and exploring the propensity for infectious disease evolution and emergence, are limited by these omissions. An overview of the factors hindering progress in disease cartography is provided. It is argued that rapid improvement in the landscape of infectious diseases mapping can be made by embracing non-conventional data sources, automation of geo-positioning and mapping procedures enabled by machine learning and information technology, respectively, in addition to harnessing labour of the volunteer ‘cognitive surplus’ through crowdsourcing

Diagnostic Value Parameters Of Acute Phase Reactances Of Infectious-inflammatory Process In Diagnostics Of Early Neonatal Sepsis

An advanced progress of clinical neonatology in recent years has enabled to achieve considerable success in newborn management with due respect to both medical treatment and general care, especially in the group of neonates with low body weight at birth. At the same time, neonatal sepsis in the early period still predetermine sickness and mortality of newborns.Material and methods. Clinical-paraclinical indices with detection of diagnostic value of C-reactive protein and interleukins-6 and 8 were evaluated in 100 neonates with available susceptibility factors to early neonatal infection from mother\u27s side and clinical signs of organ dysfunction in neonates with precautions of generalized infectious-inflammatory process at the end of their first day of life.Results. The data obtained substantiate that low concentrations of IL-6 and IL-8 prevail, and therefore the mentioned mediators hardly can be used to verify early neonatal infection. In the majority of children C-reactive protein elevated the concentration of 10.0 mg/L which is traditionally considered to be a discriminant as to the verification of an infectious process in newborns.Conclusions. None of the clinical signs associated with infectious-inflammatory process in newborns in the first two days of their life enabled to verify reliably availability of systemic bacterial infection

'The captain of all these men of death' : aspects of the medical history of tuberculosis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Public Health at Massey University, Manawatu, New Zealand

Current evidence suggests that some time in pre-history the ancestor of the modern tubercle bacillus evolved from a soil organism into a human pathogen. Since that time it has caused death and misery to millions of human beings by causing the infectious disease we now call tuberculosis. This dissertation examines some of the aspects of the history of tuberculosis and specifically how it has affected humans from early times not only medically but socially. It looks at mankind’s struggle to overcome the disease, those who introduced scientific methods in attempts to halt and defeat the organism and its associated infectious disease. There are descriptions of the effects of the disease on prominent people and how the disease often cut short their productive lives. Stress is placed also on the organism’s ability to adapt and survive in a latent form and to develop virulence factors as and when necessary for its own survival. The advent of the co-infection with HIV/AIDS has caused a major setback in control methods and our attempts to halt the progress of the disease and these are factors in the resultant worldwide epidemic of tuberculosis. Particular importance is placed on the public health measures used in the past and the importance of continued and improved control measures at the community level now and in the future. The implementation of the knowledge gained about the disease and the organism to date, the avoidance of the errors made in the past, is emphasised if we are to make progress in the future. To totally defeat the organism remains the major goal of public health agencies, medical researchers and social scientists so we can say that, at last, tuberculosis is no longer the ‘Captain of all these Men of Death’

Early Diagnosis of Nonaneurysmal Infectious Thoracic Aortitis Using Transesophageal Echocardiogram in a Patient with Purulent Meningitis

Infectious thoracic aortitis is a rare entity in the antibiotic era and usually appears in patients with prior aortic disease and/or associated infective endocarditis. Infected nonaneurysmal aorta will likely progress to mycotic aneurysm if left untreated. In most of the reports, infectious thoracic aortitis presents with a mycotic aneurysm. We report the case of a patient with a nonaneurysmal infectious thoracic aortitis, probably secondary to purulent meningitis, early diagnosed by transesophageal echocardiogram

Tuberculosis diagnostics and biomarkers: needs, challenges, recent advances, and opportunities

Tuberculosis is unique among the major infectious diseases in that it lacks accurate rapid point-of-care diagnostic tests. Failure to control the spread of tuberculosis is largely due to our inability to detect and treat all infectious cases of pulmonary tuberculosis in a timely fashion, allowing continued Mycobacterium tuberculosis transmission within communities. Currently recommended gold-standard diagnostic tests for tuberculosis are laboratory based, and multiple investigations may be necessary over a period of weeks or months before a diagnosis is made. Several new diagnostic tests have recently become available for detecting active tuberculosis disease, screening for latent M. tuberculosis infection, and identifying drug-resistant strains of M. tuberculosis. However, progress toward a robust point-of-care test has been limited, and novel biomarker discovery remains challenging. In the absence of effective prevention strategies, high rates of early case detection and subsequent cure are required for global tuberculosis control. Early case detection is dependent on test accuracy, accessibility, cost, and complexity, but also depends on the political will and funder investment to deliver optimal, sustainable care to those worst affected by the tuberculosis and human immunodeficiency virus epidemics. This review highlights unanswered questions, challenges, recent advances, unresolved operational and technical issues, needs, and opportunities related to tuberculosis diagnostics

Progress report on a CDC framework for preventing infectious diseases : sustaining the essentials and innovating for the future : October 2011-May 2013.

A CDC Framework for Preventing Infectious Diseases: Sustaining the Essentials and Innovating for the Future (CDC's ID Framework) was issued in October 2011 as a roadmap for improving our ability to prevent known infectious diseases and to recognize and control rare, highly dangerous, and newly emerging threats. Although its primary purpose is to guide CDC's infectious disease activities, the document was also designed to guide collective public health action at a time of resource constraints and difficult decisions, while advancing opportunities to improve the nation's health. This Progress Report is intended to provide a brief update on the status of CDC's work since October 2011 to advance the three elements of the ID Framework: Strengthen public health fundamentals, including infectious disease surveillance, laboratory detection, and epidemiologic investigation; Identify and implement high-impact public health interventions to reduce infectious diseases; Develop and advance policies to prevent, detect, and control infectious diseases. Over the past year, CDC programs in the National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP); National Center for Immunization and Respiratory Diseases (NCIRD); and Center for Global Health (CGH) have made significant progress in preventing and controlling infectious diseases. This Progress Report provides a few, selected examples of these accomplishments, organized by Framework element. The examples illustrate how CDC is creating new partnerships and using new ideas and scientific findings to advance public health goals. They also reflect the broad range of infectious disease issues addressed by CDC and its public and private partners, including the issues of special concern highlighted in the ID Framework: antimicrobial resistance, chronic viral hepatitis, food safety, healthcare-associated infections (HAIs), HIV/AIDS, respiratory infections, safe water, vaccine-preventable diseases, and zoonotic and vectorborne diseases. The Progress Report also provides examples of ongoing work in areas that involve new directions, alliances, and innovations, a particular need highlighted in the ID Framework.16 numbered pages2013Prevention and Control686