Control program against hydatidosis and the decreased prevalence in Uruguay

Neglected tropical diseases (NTDs) cause significant morbidity and mortality worldwide and impose a large economic burden on endemic countries [1]. In 2006, the United States Agency for International Development (USAID) founded the NTD Control Program to target five NTDs in African, Asian, and Latin American countries, namely, lymphatic filariasis (LF), onchocerciasis, schistosomiasis, soil-transmitted helminthiases (STH), and trachoma; the three targeted STH infections are ascariasis, hookworm, and trichuriasis. The NTD Control Program supported national NTD control and elimination programs' efforts to integrate and scale up delivery of preventive chemotherapy (PC) [2]. PC is the administration of safe, single-dose drugs, either alone or in combination, as a public health intervention against targeted NTDs. Administration is characterized by population-based diagnosis,population-based treatment,and implementation at regular intervals. PC can be delivered as universal chemotherapy (i.e., mass drug administration [MDA]), where the entire population of an area is targeted; targeted chemotherapy, where only high-risk groups (e.g., school age children) are targeted; or selective chemotherapy, where only screened individuals found or suspected to be infected are targeted [3]. Between October 2006 and March 2012, the program provided 589 million NTD treatments through the collaborative efforts of ministries of health, implementing partners, funders, and pharmaceutical donation programs. The implementation of integrated NTD programs at the full national scale remains an important objective in many endemic countries [4]–[8]. Several theoretical frameworks for integration have been proposed; most protocols stress the importance of long-term commitments and concerted efforts of partnerships to realize NTD control and elimination objectives [9]–[14]. However, there is currently a paucity of economic evidence on the costs of integrated PC delivery for NTDs, primarily due to the significant variation in program structures and operations [14]. Given the scarce resources and substantial costs associated with NTD control and elimination, there is therefore a need to accurately determine the cost of program implementation. It is also important to delineate funding commitments to ensure that additional assistance is used to complement available resources, rather than duplicate or replace previous efforts. To allow governments to more easily enumerate costs and funding commitments for NTD control and elimination, the NTD Control Program developed the Tool for Integrated Planning and Costing (TIPAC). The TIPAC, a versatile planning and costing instrument, is designed to be used by members of a NTD program at the national level. For countries with decentralized political structures, the TIPAC can also be implemented at a subnational administrative level. NTD program and financial managers are the primary users of the tool; the involvement of other personnel, including representatives from partner organizations and ministries of education, improves the accuracy and completeness of the TIPAC data. The TIPAC implementation process includes four main phases: Background data collection: country coordinators compile, review, and verify demographic, epidemiologic, and cost classification data. In countries where individual disease control programs are not integrated, this phase may generate fruitful discussions among stakeholders and stimulate collaboration on program planning, outreach, implementation, and monitoring. Data entry: a focal person appointed by the national program enters the planned activity costs. The national strategic plans for NTD control and elimination, also referred to as master plans, serve as the guiding documents for data entry. As the tool is populated, integration opportunities and areas of overlap and duplication are identified. After the costs are entered, stakeholder meetings are convened to identify drug and funding commitments. Finalization and approval: the entered data is reviewed by all stakeholders and approved for use by ministry of health representatives from the national NTD control and elimination program. Results application: the results can be used to inform and guide annual work plans, drug applications, donor coordination efforts, and advocacy and fundraising strategies. The TIPAC is able to convert the information in the tool for use during another funding year, thereby facilitating data entry in subsequent years. The aim of this feasibility study is to assess whether the TIPAC effectively informs and facilitates country program decision-making and the integration of program activities. This study presents excerpts from data collected in two African countries (Sierra Leone, fiscal year [FY] Oct. 2010–Sept. 2011, and Tanzania, FY Oct. 2010–Sept. 2011), one Asian country (Nepal, FY Jul. 2010–Jul. 2011), and one Latin American country (Haiti, FY Oct. 2011–Sept. 2012). The lessons learned from implementing the TIPAC in these four countries can guide the planning and costing of annual NTD control and elimination activities in other NTD-endemic countries.

This report provides an overview of the 2017 official control activities on pesticide residues carried out in the European Union (EU) Member States, Iceland and Norway. It summarises the results of both the 2017 EU-coordinated control programme (EUCP) and the national control programmes (NP). While the NPs are mostly risk based (so called enforcement samples) focusing on pesticides or products originating from countries where a number of exceedances have been observed in the past, the EUCP aims to present a statistically representative snapshot of the situation of pesticide residues in food products that are mostly consumed in the EU following a random sampling procedure. The report includes the outcome of a dietary risk assessment based on the results of the overall 2017 control programmes. The comprehensive analysis of the results of all reporting countries provides risk managers with sound-based evidence for designing future monitoring programmes, in particular for taking decisions on which pesticides and food products should be targeted in risk-based national programmes.

Background Since leprosy was eliminated as a public health problem in 2000, trends in case detection have been declining. However, from 2015, case detection in the WHO Eastern Mediterranean (EM) region increased mainly due to reports from Somalia that re-instated the national programme. As Somalia reported 57% of new cases in the EM region in 2021, we reviewed the national control programme activities and the characteristics of reported cases to understand leprosy transmission in the country. Methods From 2012 to 2021, we extracted data from WHO’s Global Health Observatory and the national leprosy control programme’s patient register in Somalia. From 2015 onwards, leprosy cases were detected by the Federal Ministry of Health through mobile teams conducting “skin camps” in 47 districts across seven regions. We analyzed data to describe the overall case detection rate and rates per period, place and person, including severity measured by grade two disability (G2D) and multibacillary (MB) cases. Results The overall case detection rate increased 11-fold between 2012 and 2021, from 6 cases per million in 2012 to 106 cases per million in 2021 in females and from 16 cases per million in 2012 to 132 cases per million in 2021 in males. Case detection among children under 15-years of age also increased from 4 cases per million in 2012 to 13 cases per million in 2021. Initially, the proportion of MB cases and G2D at the time of diagnosis increased from 60% and 11% in 2012 to 87% and 42% in 2015 respectively, when the national programme resumed leprosy control activities. By 2021, the MB proportion decreased to 45% and G2D proportion also decreased to 2%. From 2015 to 2021, four regions in Somalia reported 77% of the new cases and 83% of cases with G2D: Lower Shabelle, Middle Juba, Lower Juba and Middle Shabelle. Conclusion “Skin-camps” for case detection were effective in finding hidden leprosy cases and reducing the delay in diagnosis over time. The constant case detection rate among the female population, equal to the male population, points to sufficient programme reach. However, low disability rates persisted among this population which could be due to continued underlying stigma. Reports of new cases among children suggest ongoing transmission requiring prevention strategies such as single dose rifampicin post-exposure prophylaxis.

Cutaneous leishmaniasis represents the most neglected tropical disease across the world. In Morocco, this disease is endemic and constitutes a major public health problem, with a national control program been implemented. The current study aimed to determine the pattern and epidemiological features of cutaneous leishmaniasis in affected patients in an area covered by the CL control and prevention program (Central Morocco). A total of 161 patients suspected for cutaneous leishmaniasis were diagnosed according to WHO laboratory methods, and 82 cases were confirmed positive for CL. The reports were analysed by patients' socio-geographic status, gender and age. The number and distribution of CL lesions by location, gender and age were investigated. Overall the confirmed cases, 89 % were infected by Leishmania tropica versus 21 % for Leishmania major. Females were significantly more affected than males (p < 0.01). Children (0-15years), especially those ≤ 7years of age, were the most affected. For the distribution of lesions, single lesion cases were largely preponderant (70.7 %) compared to multiple lesions. Face location was significantly more frequent (62.2 %) compared to limbs (26.8 %). Face lesions were found more prevalent in children than in adults while limb lesions were highly observed in adults. The pattern of the disease is affected by many factors (e.g. environment, gender, age, etc.) and has specifics to be considered in prevention and control programs in endemic areas.

A 5-year national mastitis control program was initiated in the Netherlands in 2005. Knowledge transfer and improvements of dairy farmers’ motivation towards udder health were used as means to decrease mastitis occurrence in Dutch dairy herds. The aim of this study was to determine the effect of the control program on (sub)clinical mastitis occurrence and on farmers’ mindset and behaviour in relation to clinical mastitis. Two identical surveys were conducted in the same herds at the beginning and end of the control program to quantify the change in mastitis occurrence and farmers’ mindset and behaviour. Prevalence of high composite somatic cell count (CSCC) and incidence rate of farmer-diagnosed clinical mastitis (IRCM) were compared between both surveys. The change in farmers’ mindset and behaviour towards udder health was associated with the change in IRCM in 104 dairy herds using factor analyses and linear regression models. There was no significant decrease in high CSCC prevalence between both surveys. However, IRCM decreased from 33.5 in 2004/2005 to 28.1 quarter cases per 100 cow-years at risk in 2009. The variation in the change in IRCM was mainly explained by the 2004/2005 IRCM (29%) and factors describing the change in farmers’ mindset (20%). These factors described a change in the perceived lack of control, a change in the perceived lack of influence on sources of mastitis, and a change in the worries about mastitis. This study indicated that udder health was improved in the Netherlands over the course of a mastitis control program. Changing dairy farmers’ mindset seemed effective in decreasing clinical mastitis occurrence in dairy herds.Keywordsudder health programmastitisprevalenceincidence ratemindset

The International Centers of Excellence for Malaria Research (ICEMR) were established by the National Institute of Allergy and Infectious Diseases more than a decade ago to provide multidisciplinary research support to malaria control programs worldwide, operating in endemic areas and contributing technology, expertise, and ultimately policy guidance for malaria control and elimination. The Southern and Central Africa ICEMR has conducted research across three main sites in Zambia and Zimbabwe that differ in ecology, entomology, transmission intensity, and control strategies. Scientific findings led to new policies and action by the national malaria control programs and their partners in the selection of methods, materials, timing, and locations of case management and vector control. Malaria risk maps and predictive models of case detection furnished by the ICEMR informed malaria elimination programming in southern Zambia, and time series analyses of entomological and parasitological data motivated several major changes to indoor residual spray campaigns in northern Zambia. Along the Zimbabwe-Mozambique border, temporal and geospatial data are currently informing investigations into a recent resurgence of malaria. Other ICEMR findings pertaining to parasite and mosquito genetics, human behavior, and clinical epidemiology have similarly yielded immediate and long-term policy implications at each of the sites, often with generalizable conclusions. The ICEMR programs thereby provide rigorous scientific investigations and analyses to national control and elimination programs, without which the impediments to malaria control and their potential solutions would remain understudied.

Bovine tuberculosis is an endemic disease in Egypt, a notable gap exists between limited cases identified by single intradermal tuberculin test performed through the national control program and higher detected cases at abattoirs. Therefore, this study aimed to investigate epidemiological situation and causes of the previously mentioned gap in Middle-Delta Region. A total of 25 emergency-slaughtered animals of unknown tuberculosis-status were investigated by cocktail-antigens ELISA and post-mortem examination. Five visible tuberculous-lesion cases were detected and confirmed by PCR, ELISA was sensitive and predictive of the existence of tuberculous-lesions; 4(80%) out of 5 visible-lesion cases were seropositive. True prevalence among the slaughtered animals was 27%. In addition, tuberculin-testing of 400 animals during the national control program was evaluated, many technical and procedural errors were detected, and all animals were negative.Out of them, 55 animals were tested by ELISA before the application of tuberculin test, 30 (54.5%) animals were seropositive. To confirm the effect of the reported errors on reliability of tuberculin test, reference serum of 20 tuberculosis-positive animals that were tested by standard-procedures tuberculin test and their status were confirmed by PCR after slaughtering, were tested by ELISA. A complete matching was evident, the 20 standard-tuberculin positive animals were all seropositive. In conclusion, bovine tuberculosis is endemic at high levels in the study area, reported errors of tuberculin test during national control program may be the cause for missing tuberculosis cases and not tuberculin test itself and finally, a further wide-scale funded study is required to discover the situation throughout Egypt.

BackgroundInfection control practitioners (ICPs) are a group of specialized nurses fundamental to effective healthcare infection prevention and control initiatives. Relative to other groups of nurses much less is known about their working conditions. Organizational factors may impact ICPs’ levels of job dissatisfaction and emotional job burnout and, subsequently, their quality of practice. We measure a range of organizational factors to document the working conditions of ICPs and show how these are linked to job satisfaction and emotional burnout in a sample of Australian ICPs.MethodsWe conducted a cross sectional study using an online survey. All employed ICPs in 50 of the largest public hospitals in Australia were invited to participate. One hundred and fifty three ICPs completed the survey.ResultsICPs are moderately to highly satisfied with their job but show high levels of emotional burnout, time pressure and cognitive demands. Low job satisfaction was associated with less job control, low perceived organizational support and poor communication. In contrast, emotional burnout was associated with high time pressure and cognitive demands coupled with poor communication.DiscussionThis study provides new evidence about the organizational context of ICPs in Australia, and about the factors that impact on job satisfaction and emotional burnout. These findings may be used to modify national infection prevention and control programs to suit local organizational contexts. Further research is needed to determine the precise nature of these relationships and the downstream impacts on hospital-wide infection control outcomes.ConclusionsOrganizational context and factors are important to consider when evaluating the impact and implementation of infection control programs.

Background: In India National programme for prevention and control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) programme was launched in 2011 to reduce the burden of Non-Communicable diseases (NCDs). Udupi district was one of the first few districts of Karnataka where NPCDCS programme was started in the year 2010.Methods: A qualitative cross-sectional study was conducted among the stakeholders involved in the NPCDCS programme of Udupi District, Karnataka from January 2017- June 2017. Purposive sampling method was used for the sample selection. A total of 36 in-depth interviews were carried out among the stakeholders of NPCDCS programme.Results: The programme has achieved initial success and its successful implementation has to be observed in the coming years. Health staff posts which are critical in implementation of NPCDCS are vacant in many of the healthcare centres. Awareness about this programme was relatively low in the community.Conclusions: It is necessary to conduct regular awareness and screening campaigns with proper follow-up services to make the community sensitized about the programme. Regular supply of medicines should be ensured for the effective implementation of the programme in the future so that it can achieve its goal in reducing the burden NCDs.

Attitudes towards biosecurity practices relevant to Johne's disease control on beef cattle farms

The human African trypanosomiasis (HAT) control programme of the Democratic Republic of Congo (DRC) uses mass screening with the card agglutination test for trypanosomes (CATT). We looked at the contribution of CATT and improved parasitological confirmation to the effectiveness of screening and treatment. The effectiveness of the screening and treatment process is measured by the percentage of HAT cases that is effectively cured after a single round of screening. The process is analysed in five steps: (i) the attendance at the screening, (ii) the sensitivity of the screening procedure, (iii) the sensitivity of the parasitological confirmation, (iv) the proportion of the confirmed cases that effectively receive treatment and (v) the cure rate of the treatment. We used a simplified model that multiplies proportions of infected persons that go through each step. We estimated these parameters using a combination of routine data collected by the national control programme over the period January 1997 to December 1998 and published data. For varying attendance rates we compared the effectiveness of screening strategies based on CATT or on CATT combined with improved parasitological confirmation by mini anion exchange column technique (mAECT) with the previously used strategy based on palpation of neck glands and microscopy alone. The model shows that overall effectiveness of the active case detection and treatment strategy is <50% under most scenarios. Attendance rates averaged 74% but showed considerable regional variability and are a major problem in some areas of DRC. The CATT and replacing traditional parasitology by mAECT increases the sensitivity of the screening but a substantial part of the gains are lost at other stages of the screening process. Improvements of the HAT screening process such as introduction of CATT or mAECT only make sense if other parameters and attendance rate in particular are optimized at the same time.

BackgroundSchistosoma antigen detection in urine is a valuable diagnostic approach for schistosomiasis control programmes because of the higher sensitivity compared to parasitological methods and preferred sampling of urine over stool. Highly accurate diagnostics are important in low Schistosoma transmission areas. Pregnant women and young children could particularly benefit from antigen testing as praziquantel (PZQ) can be given to only confirmed Schistosoma cases. This prevents the unborn baby from unnecessary exposure to PZQ. We present here the protocol of a diagnostic study that forms part of the freeBILy project. The aim is to evaluate the accuracy of circulating anodic antigen (CAA) detection for diagnosis of Schistosoma haematobium infections in pregnant women and to validate CAA as an endpoint measure for anti-Schistosoma drug efficacy. The study will also investigate Schistosoma infections in infants.MethodsA set of three interlinked prospective, observational studies is conducted in Gabon. The upconverting phosphor lateral flow (UCP-LF) CAA test is the index diagnostic test that will be evaluated. The core trial, sub-study A, comprehensively evaluates the accuracy of the UCP-LF CAA urine test against a set of other Schistosoma diagnostics in a cross-sectional trial design. Women positive for S. haematobium will proceed with sub-study B and will be randomised to receive PZQ treatment immediately or after delivery followed by weekly sample collection. This approach includes comparative monitoring of CAA levels following PZQ intake and will also contribute further data for safety of PZQ administration during pregnancy. Sub-study C is a longitudinal study to determine the incidence of S. haematobium infection as well as the age for first infection in life-time.DiscussionThe freeBILy trial in Gabon will generate a comprehensive set of data on the accuracy of the UCP-LF CAA test for the detection of S. haematobium infection in pregnant women and newborn babies and for the use of CAA as a marker to determine PZQ efficacy. Furthermore, incidence of Schistosoma infection in infants will be reported. Using the ultrasensitive diagnostics, this information will be highly relevant for Schistosoma prevalence monitoring by national control programs as well as for the development of medicaments and vaccines.Trial registrationThe registration number of this study is NCT03779347 (clinicaltrials.gov, date of registration: 19 December 2018).

The National Programme for Prevention and Control of Deafness (NPCD) was launched in 2006 by Government of India, but despite its phase wise implementation, the community oriented ear care has not been properly realized in view of existing IPHS Standards 2012 at PHC Level. So understanding of its real impact after implementation is desired. Therefore the Impact of Implementation status of community oriented ear care at the primary health system level on NPCD in India needs exploration.

A critical review of national diabetes prevention and control programs in 12 countries in Middle East

Animal health surveillance: Navigation amidst the flotsam of human frailty and fiscal inertia