Analysing human population movement data for malaria control and elimination

Background: Human population movement poses a major obstacle to malaria control and elimination. With recent technological advances, a wide variety of data sources and analytical methods have been used to quantify human population movement (HPM) relevant to control and elimination of malaria. Methods: The relevant literature and selected studies that had policy implications that could help to design or target malaria control and elimination interventions were reviewed. These studies were categorized according to spatiotemporal scales of human mobility and the main method of analysis. Results: Evidence gaps exist for tracking routine cross-border HPM and HPM at a regional scale. Few studies accounted for seasonality. Out of twenty included studies, two studies which tracked daily neighbourhood HPM used descriptive analyses as the main method, while the remaining studies used statistical analyses or mathematical modelling. Conclusion: Although studies quantified varying types of human population movement covering different spatial and temporal scales, methodological gaps remain that warrant further studies related to malaria control and elimination

Household Preparedness and Preferred Communication Channels in Public Health Emergencies: A Cross-Sectional Survey of Residents in an Asian Developed Urban City

Disaster awareness and household preparedness are crucial for reducing the negative effects of a disaster. This study aims to examine the citizens’ preparedness level in the event of a general disaster or outbreak of infectious disease and to identify suitable channels for community disease surveillance and risk communication. We used a stratified random design to conduct a digit-dialed telephone survey in Hong Kong during February 2014. Level of disaster preparedness was examined according to the possession of disaster kit items. Associations between socio-demographic factors and good household preparedness were assessed using multiple logistic regression models. Preferences for infectious disease surveillance were collected and analyzed. There were 1020 respondents. Over half of the respondents (59.2%) had good household preparedness. After adjustment, female respondents, having higher education and higher household income were significantly associated with good household preparedness. Television and telephone were the preferred channels to obtain and report infectious disease information, respectively. In conclusion, general and specific infectious-disease household preparedness levels in Hong Kong were generally good. Tailored preparedness programs targeted to specific communities are necessary for those lacking preparedness. Risk communication and public health surveillance should be conducted through television and telephone, respectively

Is Singapore on track to eliminate tuberculosis by 2030? A policy case study

Tuberculosis remains the top 10 causes of death worldwide in 2015, with the largest number of new tuberculosis cases occurring in Asia. Singapore, a high-income Asian country, still has an intermediate tuberculosis burden. This study is to determine Singapore’s tuberculosis policy with regard to achieving tuberculosis elimination goals. This is a case study of tuberculosis elimination policy in Singapore. Data were collected by policy review and literature review. Policy documents and reports were gathered from the websites of the Ministry of Health and the World Health Organization for policy review. The literature review was carried out through PubMed and Google Scholar to identify articles on epidemiology, treatment, and prevention of tuberculosis in Singapore. Data analysis of policy reports revealed that despite the overall downwards trend in the tuberculosis incidence rates between 2000 and 2015, the tuberculosis incidence rates reversed in 2008. Singapore tuberculosis policies are mostly consistent with the World Health Organization Stop TB Strategy, although over half of the performance indicators were not achieved by 2015. After screening 1014 articles, 18 studies were included in the literature review. The rapidly ageing population, great population mobility, and continuous community transmission were found to be major obstacles to achieving Millennium Development Goals in Singapore. Singapore is lagging in achieving the targets. Scaling up the existing tuberculosis programme to accelerate the tuberculosis decline is required to meet Sustainable Development Goals 2030. Unlike other high-income countries with an intermediate tuberculosis burden in Asia, Singapore has increasing tuberculosis incidence rates. While other countries face the burden of an ageing population, Singapore faces an additional burden of an influx of migrants from high-incidence countries. Singapore will need to control tuberculosis in both these demographic groups to reverse the increasing incidence trend

Advances in paediatric gastroenterology

Recent developments in paediatric gastrointestinal surgery have focused on minimally invasive surgery, the accumulation of high-quality clinical evidence, and scientific research. The benefits of minimally invasive surgery for common disorders like appendicitis and hypertrophic pyloric stenosis are all supported by good clinical evidence. Although minimally invasive surgery has been extended to neonatal surgery, it is difficult to establish its role for neonatal disorders such as oesophageal atresia and biliary atresia through clinical trials because of the rarity of these disorders. Advances in treatments for biliary atresia and necrotising enterocolitis have been achieved through specialisation, multidisciplinary management, and multicentre collaboration in research; similarly robust clinical evidence for other rare gastrointestinal disorders is needed. As more neonates with gastrointestinal diseases survive into adulthood, their long-term sequelae will also need evidence-based multidisciplinary care. Identifying cures for long-term problems of a complex developmental anomaly such as Hirschsprung's disease will rely on unravelling its pathogenesis through genetics and the development of stem-cell therapy

Targeting Adults for Supplementary Immunization Activities of Measles Control in Central China: A Mathematical Modelling Study

Abstract Routine immunizations and supplementary immunization activities (SIAs) have significantly improved measles control over the past two decades in China. Progress towards eliminating measles currently faces multiple challenges as the infection age increases, and adult-targeted SIA strategies are being considered. This study developed an age-stratified susceptible-exposed-infectious-recovered model using a recently published contact matrix to depict measles transmissions between individuals in seven age groups. Hubei, a high measles-incidence province in central China, was the selected setting. The baseline scenario was calibrated by fitting with the 2012–2015 age-stratified incidence data. SIAs targeting multiple age groups were simulated. Adult-targeted (>29 years) two-year SIA cycles produced the greatest annual incidence rate decrease, reducing incidences by half over a long timespan with 90% coverage levels. Incidences could remain below 10/100,000 until 2030 if SIAs were provided to individuals ≥6 years old with at least 50% coverage. These findings will help officials prioritize supplementary vaccination strategies. Public health officials in China should consider adult-to-adult transmissions and provide adult-targeted SIAs. Although officials have reported approximately 90% SIA coverage in the past, SIAs for the adult population should be provided on shorter intervals, particularly for the aging population with decreased immunity

Longitudinal study of infectious intestinal disease in the UK (IID2 study): incidence in the community and presenting to general practice

Objectives To estimate, overall and by organism, the incidence of infectious intestinal disease (IID) in the community, presenting to general practice (GP) and reported to national surveillance. Design Prospective, community cohort study and prospective study of GP presentation conducted between April 2008 and August 2009. Setting Eighty-eight GPs across the UK recruited from the Medical Research Council General Practice Research Framework and the Primary Care Research Networks. Participants 6836 participants registered with the 88 participating practices in the community study; 991 patients with UK-acquired IID presenting to one of 37 practices taking part in the GP presentation study. Main outcome measures IID rates in the community, presenting to GP and reported to national surveillance, overall and by organism; annual IID cases and GP consultations by organism. Results The overall rate of IID in the community was 274 cases per 1000 person-years (95% CI 254 to 296); the rate of GP consultations was 17.7 per 1000 person-years (95% CI 14.4 to 21.8). There were 147 community cases and 10 GP consultations for every case reported to national surveillance. Norovirus was the most common organism, with incidence rates of 47 community cases per 1000 person-years and 2.1 GP consultations per 1000 person-years. Campylobacter was the most common bacterial pathogen, with a rate of 9.3 cases per 1000 person-years in the community, and 1.3 GP consultations per 1000 person-years. We estimate that there are up to 17 million sporadic, community cases of IID and 1 million GP consultations annually in the UK. Of these, norovirus accounts for 3 million cases and 130?000 GP consultations, and Campylobacter is responsible for 500?000 cases and 80?000 GP consultations. Conclusions IID poses a substantial community and healthcare burden in the UK. Control efforts must focus particularly on reducing the burden due to Campylobacter and enteric viruses