Community health cares O-Process for evaluation : A Participatory approach for increasing sustainability

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<i>Salmonella enterica</i> Infections in the United States and Assessment of Coefficients of Variation: A Novel Approach to Identify Epidemiologic Characteristics of Individual Serotypes, 1996–2011

<div><p>Background</p><p>Despite control efforts, salmonellosis continues to cause an estimated 1.2 million infections in the United States (US) annually. We describe the incidence of salmonellosis in the US and introduce a novel approach to examine the epidemiologic similarities and differences of individual serotypes.</p><p>Methods</p><p>Cases of salmonellosis in humans reported to the laboratory-based National <i>Salmonella</i> Surveillance System during 1996–2011 from US states were included. Coefficients of variation were used to describe distribution of incidence rates of common <i>Salmonella</i> serotypes by geographic region, age group and sex of patient, and month of sample isolation.</p><p>Results</p><p>During 1996–2011, more than 600,000 S<i>almonella</i> isolates from humans were reported, with an average annual incidence of 13.1 cases/100,000 persons. The annual reported rate of <i>Salmonella</i> infections did not decrease during the study period. The top five most commonly reported serotypes, Typhimurium, Enteritidis, Newport, Heidelberg, and Javiana, accounted for 62% of fully serotyped isolates. Coefficients of variation showed the most geographically concentrated serotypes were often clustered in Gulf Coast states and were also more frequently found to be increasing in incidence. Serotypes clustered in particular months, age groups, and sex were also identified and described.</p><p>Conclusions</p><p>Although overall incidence rates of <i>Salmonella</i> did not change over time, trends and epidemiological factors differed remarkably by serotype. A better understanding of <i>Salmonella</i>, facilitated by this comprehensive description of overall trends and unique characteristics of individual serotypes, will assist in responding to this disease and in planning and implementing prevention activities.</p></div

Incidence of five most common <i>Salmonella</i> serotypes reported to CDC, United States, 1996–2011.

<p>Incidence of five most common <i>Salmonella</i> serotypes reported to CDC, United States, 1996–2011.</p

Incidence of <i>Salmonella</i> Isolates from Humans, United States, 1996–2011.

<p>Incidence of <i>Salmonella</i> Isolates from Humans, United States, 1996–2011.</p

Improving the effectiveness of Field Epidemiology Training Programs: characteristics that facilitated effective response to the COVID-19 pandemic in Uganda

Abstract Background The global need for well-trained field epidemiologists has been underscored in the last decade in multiple pandemics, the most recent being COVID-19. Field Epidemiology Training Programs (FETPs) are in-service training programs that improve country capacities to respond to public health emergencies across different levels of the health system. Best practices for FETP implementation have been described previously. The Uganda Public Health Fellowship Program (PHFP), or Advanced-FETP in Uganda, is a two-year fellowship in field epidemiology funded by the U.S. Centers for Disease Control and situated in the Uganda National Institute of Public Health (UNIPH). We describe how specific attributes of the Uganda PHFP that are aligned with best practices enabled substantial contributions to the COVID-19 response in Uganda. Methods We describe the PHFP in Uganda and review examples of how specific program characteristics facilitate integration with Ministry of Health needs and foster a strong response, using COVID-19 pandemic response activities as examples. We describe PHFP activities and outputs before and during the COVID-19 response and offer expert opinions about the impact of the program set-up on these outputs. Results Unlike nearly all other Advanced FETPs in Africa, PHFP is delinked from an academic degree-granting program and enrolls only post-Master’s-degree fellows. This enables full-time, uninterrupted commitment of academically-trained fellows to public health response. Uganda’s PHFP has strong partner support in country, sufficient technical support from program staff, Ministry of Health (MoH), CDC, and partners, and full-time dedicated directorship from a well-respected MoH staff member. The PHFP is physically co-located inside the UNIPH with the emergency operations center (EOC), which provides a direct path for health alerts to be investigated by fellows. It has recognized value within the MoH, which integrates graduates into key MoH and partner positions. During February 2020-September 2021, PHFP fellows and graduates completed 67 major COVID-related projects. PHFP activities during the COVID-19 response were specifically requested by the MoH or by partners, or generated de novo by the program, and were supervised by all partners. Conclusion Specific attributes of the PHFP enable effective service to the Ministry of Health in Uganda. Among the most important is the enrollment of post-graduate fellows, which leads to a high level of utilization of the program fellows by the Ministry of Health to fulfill real-time needs. Strong leadership and sufficient technical support permitted meaningful program outputs during COVID-19 pandemic response. Ensuring the inclusion of similar characteristics when implementing FETPs elsewhere may allow them to achieve a high level of impact