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The WHO member countries undertook to eliminate poliomyelitis globally by the year 2000. Acute flaccid paralysis (AFP) surveillance finds paralytic cases of polio so that swift action can be taken and shows that wild poliovirus has been eliminated when polio cases no longer occur. Mpumalanga Province, a rural province in the north-east of South Africa, developed a rapid reporting system where infection control nurses at the public and private sector hospitals report weekly to the AFP surveillance Officer, including zero reporting, on 9 infectious disease syndromes that require rapid action on clinical presentation alone. This system was implemented in 1998 and included AFP. The non-polio AFP reporting rate increased from 0.37 in 1997 to 0.55 during 1998 with more than 80% of the units reporting weekly. The binomial exact confidence intervals however include 1. A hospital record review of all paediatric admissions revealed that only 2 AFP cases were missed by the system. The AFP reporting rate remains below the international standard of 1 per 100 000 children under 15 years of age despite an adequate reporting system. The role of chance variation, particularly in small geographical areas, has not been discussed in official polio-eradication guidelines but it is . imperative that population size be taken into account when judging the rate of AFP case detection. With the low international reference rate and play of chance variation it is possible that regions with relatively small populations, low non-polio AFP detection rates and no cases of polio detected for an extended period may have adequate surveillance systems supporting polio free certification. In these areas additional criteria for determining the adequacy of the surveillance system should also be considered.
This publication is one of a series of practical field guides produced by the Pan American Health Organization with best practice guidance for immunisation programmes in the region. This guide describes the strategies that have made the elimination of neonatal tetanus in the Americas possible, highlighting the progress made in surveillance to identify and monitor high-risk areas as well as immunisation activities geared towards women of childbearing age who live in those areas. Sections cover: epidemiology, clinical aspects, case definitions and investigations, surveillance, data analysis, control in high risk areas, programme monitoring, vaccine storage and supply.
Many bacteria, viruses, protozoa, and fungi play key roles in the development of gastrointestinal diseases, and this practical reference brings you up to speed with this increasingly important area. Covering a broad range of GI diseases and cancers, this resource provides an expert overview of the field, ideal for all gastroenterologists and infectious disease physicians. Covers infections associated with gastroesophageal reflux disease and Barrett’s esophagus, gallbladder disease, acute pancreatitis, small intestinal bacterial overgrowth, irritable bowel syndrome, inflammatory bowel disease, appendicitis, Whipple Disease, Crohn’s Disease, and more. Discusses esophageal cancer, gastric cancer, cholangiocarcinoma, hepatocellular carcinoma, and colorectal cancer. Includes chapters on gut microbiome, fecal transplants, and the molecular pathgenesis of gastrointestinal infections. Consolidates today’s available information on this timely topic into a single convenient resource.
The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.
Pastoralism has shaped livelihoods and landscapes on the African continent for millennia. Mobile livestock husbandry has generally been portrayed as an economic strategy that successfully met the challenges of low biomass productivity and environmental variability in arid and semi-arid environments. This volume focuses on the emergence, diversity, and inherent dynamics of pastoralism in Africa based on research during a twelve-year period on the southwest and northeast regions. Unraveling the complex prehistory, history, and contemporary political ecology of African pastoralism, results in insight into the ingenuity and flexibility of historical and contemporary herders.
Why did sustained economic growth arise in Europe rather than in China? The authors combine economic theory and historical evidence to argue that political processes drove the economic divergence between the two world regions, with continued consequences today that become clear in this innovative account.
"In May 2015, the Sixty-eighth World Health Assembly adopted the Global action plan on antimicrobial resistance, which reflects the global consensus that AMR poses a profound threat to human health. One of the five strategic objectives of the Global action plan is to strengthen the evidence base through enhanced global surveillance and research. The Global Antimicrobial Resistance Surveillance System (GLASS) has been developed to facilitate and encourage a standardized approach to AMR surveillance globally and in turn support the implementation of the Global action plan on antimicrobial resistance. This manual addresses the early phase of implementation of GLASS, focussing on surveillance of resistance in common human bacterial pathogens. The intended readership of this publication is public health professionals and health authorities responsible for national AMR surveillance. It outlines the GLASS standards and describes the road map for implementation of the system between 2015 and 2019. Further development of GLASS will be based on the lessons learnt during this period"--Publisher's description.
This publication contains a number of papers which consider the public health role of vaccines in improving the health of the world's populations, and looks at the challenges of using immunisation to combat emerging and re-emerging diseases. Issues discussed include the innovative use of vaccines against diseases such as meningococcal infection in Africa, Haemophilus influenza type b, varicella, and hepatitis, efforts to develop a new generation of vaccines against cholera and typhoid, shigella and Helicobacter pylori, as well as developments in the quest for vaccines against tuberculosis, HIV/AIDS, dengue, malaria, and hookworm. It also deals with the use of vaccines to fight bioterrorism attacks; regulatory and safety issues; financing issues, impact of health sector reform and the sustainability of immunisation programmes.
The growth of biostatistics has been phenomenal in recent years and has been marked by considerable technical innovation in both methodology and computational practicality. One area that has experienced significant growth is Bayesian methods. The growing use of Bayesian methodology has taken place partly due to an increasing number of practitioners valuing the Bayesian paradigm as matching that of scientific discovery. In addition, computational advances have allowed for more complex models to be fitted routinely to realistic data sets. Through examples, exercises and a combination of introductory and more advanced chapters, this book provides an invaluable understanding of the complex world of biomedical statistics illustrated via a diverse range of applications taken from epidemiology, exploratory clinical studies, health promotion studies, image analysis and clinical trials. Key Features: Provides an authoritative account of Bayesian methodology, from its most basic elements to its practical implementation, with an emphasis on healthcare techniques. Contains introductory explanations of Bayesian principles common to all areas of application. Presents clear and concise examples in biostatistics applications such as clinical trials, longitudinal studies, bioassay, survival, image analysis and bioinformatics. Illustrated throughout with examples using software including WinBUGS, OpenBUGS, SAS and various dedicated R programs. Highlights the differences between the Bayesian and classical approaches. Supported by an accompanying website hosting free software and case study guides. Bayesian Biostatistics introduces the reader smoothly into the Bayesian statistical methods with chapters that gradually increase in level of complexity. Master students in biostatistics, applied statisticians and all researchers with a good background in classical statistics who have interest in Bayesian methods will find this book useful.