Regional Initiatives in Support of Surveillance in East Africa: The East Africa Integrated Disease Surveillance Network (EAIDSNet) Experience.

The East African Integrated Disease Surveillance Network (EAIDSNet) was formed in response to a growing frequency of cross-border malaria outbreaks in the 1990s and a growing recognition that fragmented disease interventions, coupled with weak laboratory capacity, were making it difficult to respond in a timely manner to the outbreaks of malaria and other infectious diseases. The East Africa Community (EAC) partner states, with financial support from the Rockefeller Foundation, established EAIDSNet in 2000 to develop and strengthen the communication channels necessary for integrated cross-border disease surveillance and control efforts. The objective of this paper is to review the regional EAIDSNet initiative and highlight achievements and challenges in its implementation. Major accomplishments of EAIDSNet include influencing the establishment of a Department of Health within the EAC Secretariat to support a regional health agenda; successfully completing a regional field simulation exercise in pandemic influenza preparedness; and piloting a web-based portal for linking animal and human health disease surveillance. The strategic direction of EAIDSNet was shaped, in part, by lessons learned following a visit to the more established Mekong Basin Disease Surveillance (MBDS) regional network. Looking to the future, EAIDSNet is collaborating with the East, Central and Southern Africa Health Community (ECSA-HC), EAC partner states, and the World Health Organization to implement the World Bank-funded East Africa Public Health Laboratory Networking Project (EAPHLNP). The network has also begun lobbying East African countries for funding to support EAIDSNet activities

Urbanisation and health in China.

China has seen the largest human migration in history, and the country's rapid urbanisation has important consequences for public health. A provincial analysis of its urbanisation trends shows shifting and accelerating rural-to-urban migration across the country and accompanying rapid increases in city size and population. The growing disease burden in urban areas attributable to nutrition and lifestyle choices is a major public health challenge, as are troubling disparities in health-care access, vaccination coverage, and accidents and injuries in China's rural-to-urban migrant population. Urban environmental quality, including air and water pollution, contributes to disease both in urban and in rural areas, and traffic-related accidents pose a major public health threat as the country becomes increasingly motorised. To address the health challenges and maximise the benefits that accompany this rapid urbanisation, innovative health policies focused on the needs of migrants and research that could close knowledge gaps on urban population exposures are needed

A preliminary spatial analysis of diagnosed stroke disease in Osun state, Nigeria

Introduction: There have been a number of clinical studies on diagnosed Stroke disease. However, there have been few studies on the geographical disparities for stroke. This study investigates the spatial pattern of stroke disease reflecting socio-demographic characteristics in the State. Methods: Stroke patients’ admissions for 22 years (from 1990 to 2012) were examined. Their socio-demographic characteristics were extracted from their health records and analyzed. The location of the stroke patients were categorized by Local Governments Areas (LGAs). Spatial maps were generated and produced in a Geographical Information System (GIS) environment. It involves the analysis of the distribution of stroke cases in relation to their underlying population to determine the areas of high and low density of diagnosed cases across the state. Results: The result highlighted the spatial distribution of diagnosed stroke cases and also highlighted the areas of concern regarding their spatial distribution within the state. Social inequalities in stroke were persistent as incidence rates in urban areas (North) were around 3 times higher than in the rural areas (South). However, this could be due to better healthcare access in the urban areas than in the rural areas as there were disparities in the distribution of healthcare facilities involved in administering care to stroke patients in Osun State. Conclusion: The outcome of this study appears to indicate that spatial inequalities in the access to Stroke healthcare is a concern that needs to be addressed in order to manage the disease adequately

Theresienstadt: A Geographical Picture of Transports, Demography, and Communicable Disease in a Jewish Camp-Ghetto, 1941–45

The Nazi ghetto system was one of the principal vehicles for the persecution of Jewish and other peoples in German-occupied Europe in World War II. Transport and confinement – twin pillars of the ghetto system – were intrinsically geographical matters that operated on scales from the international to the local and which shaped the demographic and epidemiological character of ghettos across Eastern Europe. This article uses geographical techniques of map-based visualisation and spatial analysis to portray the demographic and epidemic history of the Nazi ‘model’ camp-ghetto at Theresienstadt (Terezín) in the former German Protectorate of Bohemia and Moravia, 1941–45. Our study reconstructs the space-time pattern and demographic structure of transports of Jewish prisoners to the ghetto and their association with substantial outbreaks of communicable diseases in the ghetto. The study highlights the importance of a geographical approach to an understanding of the demographic and public health impacts of both the Holocaust and other genocidal events

Mass Drug Administration and beyond: how can we strengthen health systems to deliver complex interventions to eliminate neglected tropical diseases?

Achieving the 2020 goals for Neglected Tropical Diseases (NTDs) requires scale-up of Mass Drug Administration (MDA) which will require long-term commitment of national and global financing partners, strengthening national capacity and, at the community level, systems to monitor and evaluate activities and impact. For some settings and diseases, MDA is not appropriate and alternative interventions are required. Operational research is necessary to identify how existing MDA networks can deliver this more complex range of interventions equitably. The final stages of the different global programmes to eliminate NTDs require eliminating foci of transmission which are likely to persist in complex and remote rural settings. Operational research is required to identify how current tools and practices might be adapted to locate and eliminate these hard-to-reach foci. Chronic disabilities caused by NTDs will persist after transmission of pathogens ceases. Development and delivery of sustainable services to reduce the NTD-related disability is an urgent public health priority. LSTM and its partners are world leaders in developing and delivering interventions to control vector-borne NTDs and malaria, particularly in hard-to-reach settings in Africa. Our experience, partnerships and research capacity allows us to serve as a hub for developing, supporting, monitoring and evaluating global programmes to eliminate NTDs

Gap Analysis of Environmental Health Research in Malawi : Report to the National Commission of Science and Technology

The aim of this consultancy was to assess the current gaps in research for the environmental health sector in Malawi, and to recommend research priorities and an effective action plan to address these gap

Essential health information available for India in the public domain on the internet

<p>Abstract</p> <p>Background</p> <p>Health information and statistics are important for planning, monitoring and improvement of the health of populations. However, the availability of health information in developing countries is often inadequate. This paper reviews the essential health information available readily in the public domain on the internet for India in order to broadly assess its adequacy and inform further development.</p> <p>Methods</p> <p>The essential sources of health-related information for India were reviewed. An extensive search of relevant websites and the PubMed literature database was conducted to identify the sources. For each essential source the periodicity of the data collection, the information it generates, the geographical level at which information is reported, and its availability in the public domain on the internet were assessed.</p> <p>Results</p> <p>The available information related to non-communicable diseases and injuries was poor. This is a significant gap as India is undergoing an epidemiological transition with these diseases/conditions accounting for a major proportion of disease burden. Information on infrastructure and human resources was primarily available for the public health sector, with almost none for the private sector which provides a large proportion of the health services in India. Majority of the information was available at the state level with almost negligible at the district level, which is a limitation for the practical implementation of health programmes at the district level under the proposed decentralisation of health services in India.</p> <p>Conclusion</p> <p>This broad review of the essential health information readily available in the public domain on the internet for India highlights that the significant gaps related to non-communicable diseases and injuries, private health sector and district level information need to be addressed to further develop an effective health information system in India.</p