Yellow card or red card: airport tribulations and new developments on yellow fever vaccination

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Tracking the polio virus down the Congo River: a case study on the use of Google Earth™ in public health planning and mapping

<p>Abstract</p> <p>Background</p> <p>The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth™ (GE) is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps.</p> <p>Results</p> <p>The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response.</p> <p>Conclusion</p> <p>GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals.</p

Extending usability of old terrestrial fibre optic cables in Third-World Economic Zones

Communication Fibre Optic Cables (FOC) experience mechanical perturbations while in service thereby deforming their cylindrical shape and increasing birefringence. This leads to Polarization Mode Dispersion (PMD). This work investigated PMD fluctuations in cables that have been buried underground for more than 10 years in a semi-arid climatic region in Kenya. PMD was measured using EXFO-FTB5700 analyzer at hourly intervals in the target cables for 2,480 hours. PMD coefficient of 0.215 √⁄ was recorded. Outage margin () of 2.13 for the 10 Gbps system running an On-Off Keying Non-Return-to-Zero (OOK-NRZ) scheme (with 10ps receiver tolerance) was obtained. Similar analysis for the 100 Gbps system running a Dual Polarization Quadrature Phase-Shift Keying (DPQPSK) scheme (with 30 ps receiver tolerance), revealed an outage margin of 6.38. The availability of 99.29 % (corresponding to a downtime of 53.44 hours per year) revealed that, the cable under test could not sustain PMD limitations in a Dense Wavelength Division Multiplexing (DWDM) system that is deployed with a 10 Gbps transponder in a non-regenerated fibre span exceeding 450 km. 100 Gbps DWDM systems proved more resilient when using DP-QPSK than 10Gbps when using OOK-NRZ. The outage of 53.44 hours per year in a high capacity traffic system can translate to a substantial amount of losses in terms of credit notes to customers for not meeting the standard service level agreement of 99.999 % service availability. To overcome this limitation, it is recommended that 10 Gbps transponders that use OOK-NRZ channel modulation technique be replaced with 100 Gbps that uses DP QPSK technique to mitigate dispersion related outages in the links. This would also effectively provide a lot of idle capacity that can accelerate digitization of institutions and villages

Web-based public health geographic information systems for resources-constrained environment using scalable vector graphics technology: a proof of concept applied to the expanded program on immunization data

BACKGROUND: Geographic Information Systems (GIS) are powerful communication tools for public health. However, using GIS requires considerable skill and, for this reason, is sometimes limited to experts. Web-based GIS has emerged as a solution to allow a wider audience to have access to geospatial information. Unfortunately the cost of implementing proprietary solutions may be a limiting factor in the adoption of a public health GIS in a resource-constrained environment. Scalable Vector Graphics (SVG) is used to define vector-based graphics for the internet using XML (eXtensible Markup Language); it is an open, platform-independent standard maintained by the World Wide Web Consortium (W3C) since 2003. In this paper, we summarize our methodology and demonstrate the potential of this free and open standard to contribute to the dissemination of Expanded Program on Immunization (EPI) information by providing interactive maps to a wider audience through the Internet. RESULTS: We used SVG to develop a database driven web-based GIS applied to EPI data from three countries of WHO AFRO (World Health Organization – African Region). The system generates interactive district-level country immunization coverage maps and graphs. The approach we describe can be expanded to cover other public health GIS demanding activities, including the design of disease atlases in a resources-constrained environment. CONCLUSION: Our system contributes to accumulating evidence demonstrating the potential of SVG technology to develop web-based public health GIS in resources-constrained settings

Pan African Medical Journal (Pamj) – African Field Epidemiology Network (AFENET): A partnership for the future of medical publishing in Africa

No Abstract

Pan African Medical Journal (Pamj) and African Field Epidemiology Network (AFENET): A partnership for the future of medical publishing in Africa

In October 2008, AFANET and the Pan African Medical Journal signed a memorandum of understanding establishing the terms for future involvement of AFENET in open access publishing through the Pamj

Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal

Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study’s findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peerreviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to contribute in enhancing the value of research in Africa, the Pan African Medical Journal will start a new regular column that will highlight priority systematic reviews relevant to the continent.Pan African Medical Journal 2016; 2

Designing and implementing an electronic health record system in primary care practice in sub-Saharan Africa: a case study from Cameroon

Objective To review the key issues related to the design and implementation of an electronic health record (EHR) system in urban primary health care (PHC) practice in Cameroon. Methodology The goal of the project was to assess EHR as a tool to improve providers' performance, quality and continuity of care, and the availability of data in PHC practice in Cameroon. A locally designed EHR system called MEDCAB was developed. The system was based on the International Classification for Primary Care (ICPC) and was designed taking into consideration the PHC practice environment in Cameroon. An original cohort of 14 users was involved in the experiment. Results Users generally showed good acceptance of the system. Monitoring the use of the system at the early stages of implementation was important to ensure immediate response to users' comments and requests. Some of the key issues identified during the development and implementation of the system were: user involvement, the choice of an appropriate terminology, pre-existing data collection culture and leadership issues. Some positive achievements brought about by the system included promotion of good medical practice and routine availability of consultation data. Conclusion Strengthening the medical record in general, and the EHR in particular, could contribute to its position as a valuable source of information for healthcare delivery, public health and policy making in Cameroon. Challenges to adoption are huge and successful implementation for any specific setting will require a comprehensive modelling of the local medical practice, the choice of an appropriate terminology and a co-ordinated approach involving all stakeholders

PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems

The utility and effectiveness of routine health information systems (RHIS) in improving health system performance in developing countries has been questioned. This paper argues that the health system needs internal mechanisms to develop performance targets, track progress, and create and manage knowledge for continuous improvement. Based on documented RHIS weaknesses, we have developed the Performance of Routine Information System Management (PRISM) framework, an innovative approach to design, strengthen and evaluate RHIS. The PRISM framework offers a paradigm shift by putting emphasis on RHIS performance and incorporating the organizational, technical and behavioural determinants of performance. By describing causal pathways of these determinants, the PRISM framework encourages and guides the development of interventions for strengthening or reforming RHIS. Furthermore, it conceptualizes and proposes a methodology for measuring the impact of RHIS on health system performance. Ultimately, the PRISM framework, in spite of its challenges and competing paradigms, proposes a new agenda for building and sustaining information systems, for the promotion of an information culture, and for encouraging accountability in health systems