A cost-effectiveness analysis of provider and community interventions to improve the treatment of uncomplicated malaria in Nigeria: study protocol for a randomized controlled trial.

BACKGROUND: There is mounting evidence of poor adherence by health service personnel to clinical guidelines for malaria following a symptomatic diagnosis. In response to this, the World Health Organization (WHO) recommends that in all settings clinical suspicion of malaria should be confirmed by parasitological diagnosis using microscopy or Rapid Diagnostic Test (RDT). The Government of Nigeria plans to introduce RDTs in public health facilities over the coming year. In this context, we will evaluate the effectiveness and cost-effectiveness of two interventions designed to support the roll-out of RDTs and improve the rational use of ACTs. It is feared that without supporting interventions, non-adherence will remain a serious impediment to implementing malaria treatment guidelines. METHODS/DESIGN: A three-arm stratified cluster randomized trial is used to compare the effectiveness and cost-effectiveness of: (1) provider malaria training intervention versus expected standard practice in malaria diagnosis and treatment; (2) provider malaria training intervention plus school-based intervention versus expected standard practice; and (3) the combined provider plus school-based intervention versus provider intervention alone. RDTs will be introduced in all arms of the trial. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers) as they exit primary health centers, pharmacies, and patent medicine dealers. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider and community knowledge. Costs will be estimated from both a societal and provider perspective using standard economic evaluation methodologies. TRIAL REGISTRATION: Clinicaltrials.gov NCT01350752

HAN

August 22, 2014, 17:45 ET (5:45 PM ET)HANINFO-0367Summary: The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.CDC has activated its Emergency Operations Center to respond to Ebola. Below, please find resources and guidance that we hope will be useful to you and your organization. Please share with your colleagues and networks.In this HAN INFOService message:\uf0b7 Ebola Cases and Deaths (West Africa)\uf0b7 Online Resources\uf0b7 Summary Key Messages2014Ebola Outbreak in West Africa (March 2014-present)VirusEbolaviru

HAN

August 21, 2014, 15:30 ET (3:30 PM ET)HANINFO-0366Summary: The Centers for Disease Control and Prevention (CDC) is working with other U.S. government agencies, the World Health Organization, and other domestic and international partners in an international response to the current Ebola outbreak in West Africa. This document summarizes key messages about the outbreak and the response. It will be updated as new information becomes available and distributed regularly. Please share the document with others as appropriate.CDC has activated its Emergency Operations Center to respond to Ebola. Below, please find resources and guidance that we hope will be useful to you and your organization. Please share with your colleagues and networks.In this HAN INFOService message:\uf0b7 Ebola Cases and Deaths (West Africa)\uf0b7 Online Resources\uf0b7 Summary Key Messages2014Ebola Outbreak in West Africa (March 2014-present)VirusEbolaviru

U.S. Influenza Surveillance System : purpose and methods

The Influenza Division at CDC collects, compiles and analyzes information on influenza activity year-round in the United States. FluView, a weekly influenza surveillance report, and FluView Interactive, an online application which allows for more in-depth exploration of influenza surveillance data, are updated each week. The data presented each week are preliminary and may change as more data is received.The U.S. influenza surveillance system is a collaborative effort between CDC and its many partners in state, local, and territorial health departments, public health and clinical laboratories, vital statistics offices, healthcare providers, clinics, and emergency departments. Information in five categories is collected from eight data sources in order to:\u2022 Find out when and where influenza activity is occurring;\u2022 Determine what influenza viruses are circulating;\u2022 Detect changes in influenza viruses; and\u2022 Measure the impact influenza is having on outpatient illness, hospitalizations and deaths.U.S. World Health Organization (WHO) Collaborating Laboratories System and the National Respiratory and Enteric Virus Surveillance System (NREVSS) -- Virus Characterization -- Surveillance for Novel Influenza A Viruses -- U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) -- ILI Activity Indicator Map -- Summary of the Geographic Spread of Influenza -- Hospitalization Surveillance -- National Center for Health Statistics (NCHS) mortality surveillance data -- Influenza-Associated Pediatric Mortality Surveillance System.2020908

Legal Myths of Ebola Preparedness and Response

In March 2014, Ebola viral disease (“EVD”) emerged from several West African countries as a substantial threat to global health. Through a series of core legal powers pursuant to its declaration of a public health emergency of international concern (“PHEIC”) on August 8, 2014, the World Health Organization (“WHO”) averted a global health disaster by requiring member countries to engage in mul- tiple public health interventions. These efficacious WHO-mandated measures included implementation of border closures to limit the spread of EVD within and outside of countries like Guinea, Liberia, Senegal, and Sierra Leone. Industrialized nations, including the United States, responded swiftly as well through their own emergency declarations. Resulting emergency legal powers enabled strong coordination among federal, state, and local actors to systematically identify and limit cases. Among these powers, the federal Centers for Disease Control and Prevention (“CDC”) required state and local governments to follow its national guidance on quarantine and isolation procedures for persons exposed to or infected with EVD. This led to the justified quarantine of health care workers (“HCWs”) returning from treating Ebola patients in West African “hot zones.” In collaboration with CDC, U.S. Customs and Border Control agents screened thousands of incoming passengers at multiple domestic airports to find and contain numerous, potential cases of EVD. The Food and Drug Administra- tion (“FDA”) worked in real-time to authorize the use of an extensive array of experimental tests or drugs proven effective in identifying cases and treating EVD patients. These (and other) legally-supported efforts worked in unison to control the impacts, and protect the public’s health

Legal Myths of Ebola Preparedness and Response

In March 2014, Ebola viral disease (“EVD”) emerged from several West African countries as a substantial threat to global health. Through a series of core legal powers pursuant to its declaration of a public health emergency of international concern (“PHEIC”) on August 8, 2014, the World Health Organization (“WHO”) averted a global health disaster by requiring member countries to engage in mul- tiple public health interventions. These efficacious WHO-mandated measures included implementation of border closures to limit the spread of EVD within and outside of countries like Guinea, Liberia, Senegal, and Sierra Leone. Industrialized nations, including the United States, responded swiftly as well through their own emergency declarations. Resulting emergency legal powers enabled strong coordination among federal, state, and local actors to systematically identify and limit cases. Among these powers, the federal Centers for Disease Control and Prevention (“CDC”) required state and local governments to follow its national guidance on quarantine and isolation procedures for persons exposed to or infected with EVD. This led to the justified quarantine of health care workers (“HCWs”) returning from treating Ebola patients in West African “hot zones.” In collaboration with CDC, U.S. Customs and Border Control agents screened thousands of incoming passengers at multiple domestic airports to find and contain numerous, potential cases of EVD. The Food and Drug Administra- tion (“FDA”) worked in real-time to authorize the use of an extensive array of experimental tests or drugs proven effective in identifying cases and treating EVD patients. These (and other) legally-supported efforts worked in unison to control the impacts, and protect the public’s health

Health equity and public health department accreditation

Health equity is commonly defined as \u201cthe attainment of the highest level of health for all people...Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historic and contemporary injustices, and the elimination of health and healthcare disparities.\u201d Health equity is achieved when everyone in our society has the same opportunity to be as healthy as possible, regardless of race, ethnicity, gender, sexual orientation, economic status, or geographic location. According to the World Health Organization, good health is a fundamental human right, and everyone should have the opportunity to attain it. By addressing inequities, public health leaders can create opportunities for all people and communities to feel empowered to achieve the highest level of health.This report examines the link between state health departments\u2019 activities to advance health equity through the public health department standards set by the Public Health Accreditation Board (PHAB) to embrace a system-wide approach toward a culture of health equity. The health department plays an essential role, leading the comprehensive strategies needed to address health inequities.Throughout the report, you will find public health programs and organizational strategies to integrate health equity into state, local, territorial, and tribal public health through the lens of PHAB accreditation. Health department staff provided each example, offering reflections on practices and approaches specific to that jurisdiction.This report was supported by funds made available from the CDC\u2019s Center for State, Tribal, Local, and Territorial Support. The content, findings, and conclusions shared are those of the authors and do not necessarily reflect the official position of or endorsement by the CDC.201

Evolution of an Epidemic: 25 Years of HIV/AIDS Media Campaigns in the U.S.

Traces the development of national public education campaigns, from those aimed at raising general awareness, to treatment and prevention. Looks at the role played by entertainment media, including more recent initiatives focusing on the global pandemic