Current status and future prospects of epidemiology and public health training and research in the WHO African region

Background To date little has been published about epidemiology and public health capacity (training, research, funding, human resources) in WHO/AFRO to help guide future planning by various stakeholders. Methods A bibliometric analysis was performed to identify published epidemiological research. Information about epidemiology and public health training, current research and challenges was collected from key informants using a standardized questionnaire. Results From 1991 to 2010, epidemiology and public health research output in the WHO/AFRO region increased from 172 to 1086 peer-reviewed articles per annum [annual percentage change (APC) = 10.1%, P for trend 90%) reported that this increase is only rarely linked to regional post-graduate training programmes in epidemiology. South Africa leads in publications (1978/8835, 22.4%), followed by Kenya (851/8835, 9.6%), Nigeria (758/8835, 8.6%), Tanzania (549/8835, 6.2%) and Uganda (428/8835, 4.8%) (P < 0.001, each vs South Africa). Independent predictors of relevant research productivity were ‘in-country numbers of epidemiology or public health programmes' [incidence rate ratio (IRR) = 3.41; 95% confidence interval (CI) 1.90-6.11; P = 0.03] and ‘number of HIV/AIDS patients' (IRR = 1.30; 95% CI 1.02-1.66; P < 0.001). Conclusions Since 1991, there has been increasing epidemiological research productivity in WHO/AFRO that is associated with the number of epidemiology programmes and burden of HIV/AIDS cases. More capacity building and training initiatives in epidemiology are required to promote research and address the public health challenges facing the continen

Current status and future prospects of epidemiology and public health training and research in the WHO African region

Since 1991, there has been increasing epidemiological research productivity in WHO/AFRO that is associated with the number of epidemiology programmes and burden of HIV/AIDS cases. More capacity building and training initiatives in epidemiology are required to promote research and address the public health challenges facing the continent

An evaluation of the incidence and absenteeism rates of health care workers reporting flu-related illnesses at an academic hospital in the Western Cape: a retrospective cohort study

Thesis (MOccTher)--Stellenbosch University, 2017.ENGLISH SUMMARY : Introduction: Seasonal Influenza -related illnesses impose a heavy burden on society. Vaccination programmes are the most effective strategy for preventing the illnesses and have been recommended for certain high- risk groups. Healthcare workers involved in the care of these vulnerable patients may be infected clinically or sub-clinically with Influenza. They are therefore urged to accept influenza vaccination as part of the broader control of Influenza policy. This study evaluates the willingness of uptake and the impact that influenza vaccination campaigns might have among healthcare workers in a tertiary health setting. Objective: To determine the proportion of voluntary vaccine uptake among healthcare workers as well as describing any potential differences between this vaccinated population and their randomly selected unvaccinated controls. Methods: A retrospective cohort study investigating the incidence of flu and its related illnesses, including its impact on absenteeism rates in the seasonal flu years of 2013 and 2014. The study setting was Tygerberg Academic Hospital, Parow, Western Cape. All vaccinated employees during the study period were compared to matched unvaccinated controls in a 1:2 ratio. Employees who got ill during the study period were sourced from the facility’s Human Resource database. Illness incidence and absenteeism rates were extracted from this outcome database and analysed to determine trends between study arms as well as between occupational categories. Results: A total of 4.6% and 2.8% of employees accepted vaccination for the seasonal flu years of the 2013 and 2014 respectively. The study population was 1020 with 340 healthcare workers in the exposed arm. Overall, there were more employees that fell ill compared to those that remained healthy during the study period (700 vs 320). For all instances of Influenza and related illnesses (clinically specified) illnesses, there was no statistically significant difference between the vaccinated and unvaccinated study groups [RR 1.06, 95% CI (0.87- 1.28), p=0.28]. The frequency of illness in the vaccinated was less than that observed in the controls (79 vs 164, z-score=2.04 p-value= 0.041). About 60% of all sick leaves had no clinically specified diagnosis while the incidence of clinically specified illnesses was 32.65% among the vaccinated and 30.88% in the control group. This therefore placed the true incidence rate of influenza-related illnesses between 32,647 to 69,706 /100,000 population per year in the vaccinated and 30,882 to 68,088 /100,000 population per year in the unvaccinated. Conclusion: There was very low response to calls for influenza vaccination despite unexpected high reports of influenza-related illnesses in our study setting. Among healthcare workers, a higher proportion reported illness incidents and consequently had higher absenteeism rates compared to those that remained healthy during the study duration. These variables did not differ based on vaccination status perhaps due to the low acceptance rate. Healthcare workers are encouraged to partake in the seasonal flu vaccinations to minimise influenza transmission risks to vulnerable patients.AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar

Update on diagnostic and treatment of uncomplicated and complicated malaria in adults and selected vulnerable populations

Although malaria remains one of the most important infectious causes of morbidity and mortality world-wide with 40% of the global population at risk, significant progress has been made toward elimination, notably with the development and use of rapid diagnostic tests, insecticide-treated bed nets, indoor residual spraying, and artemisinin-based combination therapies (ACTs). P. falciparum infection remains the most common cause of severe infection and death, but non-P. P. falciparum infections, including the recently emerged 5(th) plasmodium species, P. knowlesi, are increasingly recognized as causes of severe disease, especially in southeast Asia. Chemotherapy for severe infections has been revolutionized following results of the SEQUAMAT and AQUAMAT trials showing that parenteral artesunate (versus quinine) reduced severe malaria mortality by 34.7% and 22.5% in Asian adults and African children, respectively, making it the drug of choice for severe malaria. However, rising rates of artemisinin resistance, currently confined to the Greater Mekong sub-region, are threatening the long-term efficacy of artemisinins. HIV infection remains an important risk factor for death and severe disease due to malaria. The full amplitude of mutual interactions between these conditions is only beginning to be elucidated while the complex, multi-directional and pharmacokinetic interactions between antimalarial agents and HIV drugs continue to emerge