Data Sources for Improving Estimates of the Global Burden of Injuries: Call for Contributors

Kavi Bhalla and colleagues invite individuals and organizations to provide local injury data sources to help inform estimates of the global burden of injuries

Conducting a Large Public Health Data Collection Project in Uganda: Methods, Tools, and Lessons Learned

We report on the implementation experience of carrying out data collection and other activities for a public health evaluation study on whether U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) investment improved utilization of health services and health system strengthening in Uganda. The retrospective study period focused on the PEPFAR scale-up, from mid-2005 through mid-2011, a period of expansion of PEPFAR programing and health services. We visited 315 health care facilities in Uganda in 2011 and 2012 to collect routine health management information system data forms, as well as to conduct interviews with health system leaders. An earlier phase of this research project collected data from all 112 health district headquarters, reported elsewhere. This article describes the lessons learned from collecting data from health care facilities, project management, useful technologies, and mistakes. We used several new technologies to facilitate data collection, including portable document scanners, smartphones, and web-based data collection, along with older but reliable technologies such as car batteries for power, folding tables to create space, and letters of introduction from appropriate authorities to create entrée. Research in limited-resource settings requires an approach that values the skills and talents of local people, institutions and government agencies, and a tolerance for the unexpected. The development of personal relationships was key to the success of the project. We observed that capacity building activities were repaid many fold, especially in data management and technology

Lessons learned and study results from HIVCore, an HIV implementation science initiative

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138261/1/jia21261.pd

Call for more research on injury from the developing world: Results of a bibliometric analyss

Background & objectives: Injury prevention is a daunting health challenge as public health systems particularly in the developing world are least prepared to respond to this issue. In 2005, an estimated 5.4 million people worldwide died from injuries over 90 per cent in low- and middle-income countries. The main objective of this bibliometric analysis was to document injury literature published on low- and middle-income countries, and also to quantify literature on road traffic injuries by countries before and after the World Health Day on Road Safety celebrated in April 2004. Methods: A systematic search was done using MeSH terms on PubMed. Papers on road traffic injuries were assessed by country/cluster and by publication date for two periods (March 2001 - March 2004) and (April 2004 - April 2007). The rate of articles published per million population was calculated. Finally, a comparison was made between disease burden in disability adjusted life years (DALYs) and quantum of papers published. The search was performed on April 29, 2007. Results: PubMed had 8.26 million articles listed; of which, 72 per cent were in English and only 2 per cent were on unintentional injuries. For papers in all languages including English on road traffic injuries, 41 per cent were from US, 36 per cent from Europe (other than Eastern Europe). Two most populous countries, China and India contributed only 0.9 and 0.7 per cent papers on road traffic injuries, respectively. On neoplasm there were 280 articles published per million population whereas for road traffic injuries, rate was 4 articles per million population. Northern Africa, India and China had less than one article on road traffic injuries per 1,000 road traffic related deaths. The percentage change in English papers on road traffic injuries for the period 2004-2007 in comparison to period 2001-2004 was +191 per cent for China, +118 per cent for India, and +106 per cent for Middle East. Unintentional injuries overall represented 18 per cent of the burden in terms of DALYs and represented only 2 per cent of all published articles. Interpretation & conclusion: The results noticeably reflected the small proportion of papers on injuries, the dominance of US, and the apparent increase in percentage of road traffic injuries papers from low- and middle-income countries after World Health Day on Road Safety in 2004. Policies on injury prevention and safety in developing countries will be effective if based on local evidence and research, and designed to suit the social, political, and economic circumstances found in developing countries

National burden of road traffic injuries in Argentina

Fil: Ubeda, Clotilde. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Epidemiología; Argentina.Fil: Espitia-Hardeman, Victoria. Centers for Disease Control and Prevention, Atlanta; Estados Unidos.Fil: Bhalla, Kavi. United States Agency for International Development (USAID). Washington, D.C.; Estados Unidos.Fil: Borse, Nagesh N. United States Agency for International Development (USAID). Washington, D.C.; Estados Unidos.Fil: Abraham, Jerry Puthenpurakal. United States Agency for International Development (USAID). Washington, D.C.; Estados Unidos.Fil: Dellinger, Ann. Centers for Disease Control and Prevention, Atlanta; Estados Unidos.Fil: Ferrante, Daniel. Ministerio de Salud; Argentina.Fil: Peltzer, Raquel. Universidad Nacional de Mar del Plata; Argentina.More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argentina. We used the methodology proposed by the Global Burden of Disease Injury Expert group. External causes of deaths with unknown codes were proportionately redistributed over the known categories. In 2007 in Argentina, we estimated 5915 RTI deaths, compared with 3983 RTI deaths reported previously by the Ministry of Health, accounting for 1931 additional cases. The highest number of deaths occurred in young men (15-29 years old), although the highest RTI death rates were in the age group of 55 years and older. Four-wheeled vehicle occupants were the most common road user type killed (59.1%); vulnerable road users represented one third (29.5%) of deaths and 64% of non-fatal RTI. The national and regional estimates of RTI in Argentina should help policy makers and public-health researchers to understand the importance of RTI prevention and design specific interventions to further reduce these preventable deaths and injuries

Annual cost of antiretroviral therapy among three service delivery models in Uganda

Introduction: In response to the increasing burden of HIV, the Ugandan government has employed different service delivery models since 2004 that aim to reduce costs and remove barriers to accessing HIV care. These models include community-based approaches to delivering antiretroviral therapy (ART) and delegating tasks to lower-level health workers. This study aimed to provide data on annual ART cost per client among three different service delivery models in Uganda. Methods: Costing data for the entire year 2012 were retrospectively collected as part of a larger task-shifting study conducted in three organizations in Uganda: Kitovu Mobile (KM), the AIDS Support Organisation (TASO) and Uganda Cares (UC). A standard cost data capture tool was developed and used to retrospectively collect cost information regarding antiretroviral (ARV) drugs and non-ARV drugs, ART-related lab tests, personnel and administrative costs. A random sample of four TASO centres (out of 11), four UC clinics (out of 29) and all KM outreach units were selected for the study. Results: Cost varied across sites within each organization as well as across the three organizations. In addition, the number of annual ART visits was more frequent in rural areas and through KM (the community distribution model), which played a major part in the overall annual ART cost. The annual cost per client (in USD) was $404 for KM,$332 for TASO and $257 for UC. These estimates were lower than previous analyses in Uganda or the region compared to data from 2001 to 2009, but comparable with recent estimates using data from 2010 to 2013. ARVs accounted for the majority of the total cost, followed by personnel and operational costs. Conclusions: The study provides updated data on annual cost per ART visit for three service delivery models in Uganda. These data will be vital for in-country budgetary efforts to ensure that universal access to ART, as called for in the 2015 World Health Organization (WHO) guidelines, is achievable. The lower annual ART cost found in this study indicates that we may be able to treat all people with HIV as laid out in the 2015 WHO guidelines. The variation of costs across sites and the three models indicates the potential for efficiency gains

Known Data Sources that Could Contribute to the GBD Injuries Estimates If Data Access Were Available

<p>This continuing environmental scan can be tracked on the expert group Web site [<a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000001#pmed-1000001-b003" target="_blank">3</a>].</p