241 research outputs found

    Sentinel malaria surveillance - more than a research tool

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    No Abstrac

    Editorial

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    Sentinal malaria surveillance - More than a research too

    Lay discourses about Brexit and prejudice: ‘ideological creativity’ and its limits in Brexit debates

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    Much research on Brexit has studied whether the vote to leave the EU is a marker of growing prejudice. In this paper, we study instead how the relationship between support for Brexit and prejudice is constructed, negotiated and contested in lay discourse. Our analysis of focus groups (N=12) conducted prior to and following the EU referendum shows that support for Brexit was predominantly constructed as based on nationalism and anti-immigration prejudice, especially in Remain-supporting accounts. This prompted identity management strategies and counter-arguments by Leave supporters, such as providing alternative constructions of prejudice and racism; relating Brexit with ‘progressive’ values; and presenting it as rational and economically sound. In our discussion, we draw attention to the ‘ideological creativity’ that underpins these accounts and also reflect on the possibilities and constraints of developing alternative political narratives under conditions of political polarisation

    Closing the gap in Australian Aboriginal infant immunisation rates - the development and review of a pre-call strategy

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    Background: Improving timely immunisation is key to closing the inequitable gap in immunisation rates between Aboriginal children and non-Indigenous children. Aboriginal Immunisation Officers were employed in Hunter New England Local Health District (HNELHD), New South Wales (NSW), Australia, to telephone the families of all Aboriginal infants prior to the due date for their first scheduled vaccination. Methods: Aboriginal Immunisation Officers contacted the families of Aboriginal children born in the Hunter New England Local Health District (HNELHD) by telephone before their due immunisation date (pre-call) to provide the rationale for timely immunisation, and to facilitate contact with culturally safe local immunisation services if this was required. The impact of this strategy on immunisation coverage rates is reviewed. Results: For the period March 2010 to September 2014 there was a significant increase in immunisation coverage rate for Aboriginal children at 12 months of age in HNELHD (p < 0.0001). The coverage in the rest of NSW Aboriginal children also increased but not significantly (p = 0.218). Over the full study period there was a significant decrease in the immunisation coverage gap between Aboriginal children and non-Indigenous children in HNELHD (p < 0.0001) and the rest of NSW (p = 0.004). The immunisation coverage gap between Aboriginal and non-Indigenous infants decreased at a significantly faster rate in HNELHD than the rest of NSW (p = 0.0001). By the end of the study period in 2014, immunisation coverage in HNELHD Aboriginal infants had surpassed that of non-Indigenous infants by 0.8 %. Conclusions: The employment of Aboriginal immunisation officers may be associated with closing of the gap between Aboriginal and non-Indigenous infants' immunisation coverage in HNELHD and NSW. The pre-call telephone strategy provided accelerated benefit in closing this gap in HNELHD

    Measuring HIV stigma for PLHAs and nurses over time in five African countries

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    The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association

    A One Health investigation of Salmonella enterica serovar Wangata in north-eastern New South Wales, Australia, 2016-2017

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    Salmonella enterica serovar Wangata (S. Wangata) is an important cause of endemic salmonellosis in Australia, with human infections occurring from undefined sources. This investigation sought to examine possible environmental and zoonotic sources for human infections with S. Wangata in north-eastern New South Wales (NSW), Australia. The investigation adopted a One Health approach and was comprised of three complimentary components: a case–control study examining human risk factors; environmental and animal sampling; and genomic analysis of human, animal and environmental isolates. Forty-eight human S. Wangata cases were interviewed during a 6-month period from November 2016 to April 2017, together with 55 Salmonella Typhimurium (S. Typhimurium) controls and 130 neighbourhood controls. Indirect contact with bats/flying foxes (S. Typhimurium controls (adjusted odds ratio (aOR) 2.63, 95% confidence interval (CI) 1.06–6.48)) (neighbourhood controls (aOR 8.33, 95% CI 2.58–26.83)), wild frogs (aOR 3.65, 95% CI 1.32–10.07) and wild birds (aOR 6.93, 95% CI 2.29–21.00) were statistically associated with illness in multivariable analyses. S. Wangata was detected in dog faeces, wildlife scats and a compost specimen collected from the outdoor environments of cases’ residences. In addition, S. Wangata was detected in the faeces of wild birds and sea turtles in the investigation area. Genomic analysis revealed that S. Wangata isolates were relatively clonal. Our findings suggest that S. Wangata is present in the environment and may have a reservoir in wildlife populations in north-eastern NSW. Further investigation is required to better understand the occurrence of Salmonella in wildlife groups and to identify possible transmission pathways for human infections.Whole genome sequencing for this project was supported by the NSW Public Health Pathogen Genomics Consortium, CIDM-PH, NSW Health

    A structured framework for improving outbreak investigation audits

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    Outbreak investigation is a core function of public health agencies. Suboptimal outbreak investigation endangers both public health and agency reputations. While audits of clinical medical and nursing practice are conducted as part of continuous quality improvement, public health agencies rarely make systematic use of structured audits to ensure best practice for outbreak responses, and there is limited guidance or policy to guide outbreak audit. A framework for prioritising which outbreak investigations to audit, an approach for conducting a successful audit, and a template for audit trigger questions was developed and trialled in four foodborne outbreaks and a respiratory disease outbreak in Australia. The following issues were identified across several structured audits: the need for clear definitions of roles and responsibilities both within and between agencies, improved communication between agencies and with external stakeholders involved in outbreaks, and the need for development of performance standards in outbreak investigations - particularly in relation to timeliness of response. Participants considered the audit process and methodology to be clear, useful, and non-threatening. Most audits can be conducted within two to three hours, however, some participants felt this limited the scope of the audit. The framework was acceptable to participants, provided an opportunity for clarifying perceptions and enhancing partnership approaches, and provided useful recommendations for approaching future outbreaks. Future challenges include incorporating feedback from broader stakeholder groups, for example those of affected cases, institutions and businesses; assessing the quality of a specific audit; developing training for both participants and facilitators; and building a central capacity to support jurisdictions embarking on an audit. The incorporation of measurable performance criteria or sharing of benchmark performance criteria will assist in the standardisation of outbreak investigation audit and further quality improvement

    The argument for integrating vector control with multiple drug administration campaigns to ensure elimination of lymphatic filariasis

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    BACKGROUND: There is a danger that mass drug administration campaigns may fail to maintain adequate treatment coverage to achieve lymphatic filariasis elimination. Hence, additional measures to suppress transmission might be needed to ensure the success of the Global Program for the Elimination of Lymphatic Filariasis. DISCUSSION: Vector control successfully eliminated lymphatic filariasis when implemented alone or with mass drug administration. Challenges to lymphatic filariasis elimination include uncertainty of the exact level and duration of microfilarial suppression required for elimination, the mobility of infected individuals, consistent non-participation of some infected individuals with mass drug administration, the possible development of anti-filarial drug resistance and treatment strategies in areas co-endemic with loasis. Integration of vector control with mass drug administration can address some of these challenges. The potential benefits of vector control would include: (1) the ability to suppress filariasis transmission without the need to identify all individual 'foci of infection'; (2) minimizing the risk of reestablishment of transmission from imported microfilaria positive individuals; and (3) decreasing the risk of dengue or malaria transmission where, respectively, Aedes or Anopheles are lymphatic filariasis vectors. SUMMARY: With adequate sustained treatment coverage, mass drug administration should meet the criteria for elimination of lymphatic filariasis. However, it may be difficult to sustain sufficiently high mass drug administration coverage to achieve lymphatic filariasis elimination in some areas, particularly, where Aedes species are the vectors. Since vector control was effective in controlling and even eliminating lymphatic filariasis transmission, integration of vector control with mass drug administration will ensure the sustainability of transmission suppression and thereby better ensure the success of national filariasis elimination programs. Although trials of some vector control interventions are needed, proven vector control strategies are ready for immediate integration with mass drug administration for many important vectors. Vector control is the only presently available additional lymphatic filariasis control measure with the potential for immediate implementation
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