ORCID Profile
0000-0002-6287-1296
Current Organisations
Australian National University
,
University of Tasmania
,
Médecins Sans Frontières - UK
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Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.PREVETMED.2011.03.003
Abstract: Live bird markets can become contaminated with and become a source of transmission for avian influenza viruses including the highly pathogenic H5N1 strain. Many countries affected by the H5N1-virus have limited resources for programs in environmental health, sanitation and disease control in live bird markets. This study proposes five critical control points (CCPs) to reduce the risk of H5N1-virus contamination in markets in low resource settings. The CCPs were developed based on three surveys conducted in Indonesia: a cross-sectional survey in 119 markets, a knowledge, attitudes and practice survey in 3 markets and a microbiological survey in 83 markets. These surveys assessed poultry workflow, market infrastructure, hygiene and regulatory practices and microbiological contamination with the H5N1-virus. The five CCPs identified were (1) reducing risk of receiving infected birds into the market, (2) reducing the risk of virus spread between different bird flocks in holding cages, (3) reducing surface contamination by isolating slaughter processes from other poultry-related processes, (4) minimizing the potential for contamination during evisceration of carcasses and (5) reducing the risk of surface contamination in the sale zone of the market. To be relevant for low resource settings, the CCPs do not necessitate large infrastructure changes. The CCPs are suited for markets that slaughter poultry and have capacity for daily disposal and removal of solid waste from the market. However, it is envisaged that the CCPs can be adapted for the development of risk-based programs in various settings.
Publisher: WHO Press
Date: 04-2012
Publisher: American Society for Clinical Investigation
Date: 09-11-2015
DOI: 10.1172/JCI83162
Publisher: Informa UK Limited
Date: 16-10-2007
DOI: 10.1080/10934520701567197
Abstract: Arsenic groundwater contamination in Bangladesh warrants immediate remediation. This randomised controlled intervention trial was conducted to determine the effectiveness of two possible interventions: dug wells and three-pitcher filters. A total of 640 in iduals participated with 218 randomised to the dug well group, 216 to the three-pitcher group and 206 to a control group. Data were collected at baseline and at 1, 6 and 12 months after the intervention. Self reported compliance with dug wells remained below 20% during the entire 12 months of the study. The compliance with the three-pitcher filters decreased after 6 months and became similar to the compliance of the dug well group after 12 months. A substantial decrease in urinary arsenic metabolites occurred only among those who were compliant with dug wells and three-pitcher filter systems after 1 month of intervention as opposed to control participants. However, a persistent reduction in urinary arsenic concentrations was observed only among the dug well users after 12 months of intervention. Our results show that a functional dug well could be offered as a long-term alternative to tube wells, but use of this option is likely to be low, unless appropriate behavioural change measures are taken. Our study also demonstrates that arsenic removal technologies such as three-pitcher filters are an effective option as a short-term measure. The three-pitcher filters that are not adequately maintained are not an effective option for a year. These arsenic removal technologies may be even harmful in the long term if the resultant water quality is not properly monitored.
Publisher: Cold Spring Harbor Laboratory
Date: 02-09-2020
DOI: 10.1101/2020.08.31.20185587
Abstract: Australia requires high quality evidence to optimise likely health and economy outcomes to effectively manage the current resurgence of COVID-19. We hypothesise that the most stringent social distancing (SD) measures (100% of level in Australia in April 2020) deliver better public health and economy outcomes. ‘Fit-for-purpose’ (in idual-based and compartment) models were used to simulate the effects of different SD and detection strategies on Australian COVID-19 infections and the economy from March to July 2020. Public reported COVID-19 data were used to estimate model parameters. Public health and economy outcomes for multiple social distancing levels were evaluated, assessing “hard” versus “soft” lockdowns, and for early versus later relaxation of social distancing. Outcomes included costs and the timing and magnitude of observed COVID-19 cases and cumulative deaths in Australia from March to June 2020. Higher levels of social distancing achieve zero community transmission with 100% probability and lower economy cost while low levels of social distancing result in uncontrolled outbreaks and higher economy costs. High social distancing total economy costs were $17.4B versus $41.2B for 0.7 social distancing. Early relaxation of suppression results in worse public health outcomes and higher economy costs. Better public health outcomes (reduced COVID-19 fatalities) are positively associated with lower economy costs and higher levels of social distancing achieving zero community transmission lowers both public health and economy costs compared to allowing community transmission to continue and early relaxation of social distancing increases both public health and economy costs. The known is that COVID-19 infections can be suppressed with social distancing (SD) measures of sufficient stringency and duration. The new is we find highest levels of SD (100% SD that prevailed in April 2020) generate much lower COVID-9 deaths reduced SD days increased economic activity and much higher probability of elimination over a subsequent 12-month period than lower levels of SD. The implications are that greater levels of SD are preferred to lower SD because they deliver both better public health and lower economy costs.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.PREVETMED.2012.05.017
Abstract: Live bird markets (LBMs) are at risk of contamination with the avian influenza H5N1 virus. There are a number of methods for prioritizing LBMs for intervention to curb the risk of contamination. Selecting a method depends on diagnostic objective and disease prevalence. In a low resource setting, options for prioritization are constricted by the cost of and resources available for tool development and administration, as well as the resources available for intervention. In this setting, tools can be developed using previously collected data on risk factors for contamination, and translated into prediction equations, including decision trees (DTs). DTs are a graphical type of classifier that combine simple questions about the data in an intuitive way. DTs can be used to develop tools tailored to different diagnostic objectives. To demonstrate the utility of this method, risk factor data arising from a previous cross-sectional study in 83 LBMs in Indonesia were used to construct DTs. A DT with high specificity was selected for the initial stage of an LBM intervention c aign in which authorities aim to focus intervention resources on a small set of LBMs that are at near-certain risk of contamination. Another DT with high sensitivity was selected for later stages in an intervention c aign in which authorities aim to detect and prioritize all LBMs with the risk factors for virus contamination. The best specific DT achieved specificity of 77% and the best sensitive DT achieved sensitivity of 90%. The specific DT had two variables: the size of the duck population in the LBM and the human population density in the LBM's district. The sensitive DT had three variables: LBM location, whether solid waste was removed from the LBM daily and whether the LBM was zoned to separate the bird holding, slaughtering and sale areas. High specificity or sensitivity will be preferred by authorities depending on the stage of the intervention c aign. The study demonstrates that simple tools utilizing DTs can be developed to prioritize LBMs for intervention to control H5N1-virus. DT tools are simple to apply, suitable for low-resource settings and can be tailored to the particular needs and stage of the disease control program.
Publisher: JMIR Publications Inc.
Date: 22-04-2019
DOI: 10.2196/11842
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.JVAL.2014.11.008
Abstract: Although tuberculosis is a major cause of morbidity and mortality worldwide, available funding falls far short of that required for effective control. Economic and spillover consequences of investments in the treatment of tuberculosis are unclear, particularly when steep gradients in the disease and response are linked by population movements, such as that between Papua New Guinea (PNG) and the Australian cross-border region. To undertake an economic evaluation of Australian support for the expansion of basic Directly Observed Treatment, Short Course in the PNG border area of the South Fly from the current level of 14% coverage. Both cost-utility analysis and cost-benefit analysis were applied to models that allow for population movement across regions with different characteristics of tuberculosis burden, transmission, and access to treatment. Cost-benefit data were drawn primarily from estimates published by the World Health Organization, and disease transmission data were drawn from a previously published model. Investing $16 million to increase basic Directly Observed Treatment, Short Course coverage in the South Fly generates a net present value of roughly $74 million for Australia (discounted 2005 dollars). The cost per disability-adjusted life-year averted and quality-adjusted life-year saved for PNG is $7 and $4.6, respectively. Where regions with major disparities in tuberculosis burden and health system resourcing are connected through population movements, investments in tuberculosis control are of mutual benefit, resulting in net health and economic gains on both sides of the border. These findings are likely to inform the case for appropriate investment in tuberculosis control globally.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.PUHE.2012.08.015
Abstract: Information on the effectiveness of interventions regarding control in closed institutional settings, including prisons, is limited. This study gathered evidence relating to influenza control in an Australian prison. This study built on a 2009 H1N1 outbreak investigation at the Alexander Maconochie Centre (AMC) in the Australian Capital Territory (ACT). Influenza surveillance data, ACT 2010 Inmate Health Survey data, New South Wales 2001 and 2009 Inmate Health Survey data, ACT Department of Corrective Services administrative data, and ACT Health clinical data were analysed. In 2011, the AMC was exposed to influenza virus, resulting in a single case. Public health activities included exclusion of symptomatic cases from the health facility, isolation of cases, and quarantine of contacts. Contact between prisoners and the ACT community was maintained the AMC detainee visitor rate was one visitor per prisoner every 10 days. The rehabilitative benefits of human contact for AMC detainees were not compromised during the surveillance period, despite the potential that a higher visitor rate may suggest. This highlights some features of the AMC which make its operational context different from many other correctional settings, but gives some indication of how good public health practice supports human rights.
Publisher: Elsevier BV
Date: 07-2016
Publisher: Cambridge University Press (CUP)
Date: 07-2010
DOI: 10.1017/S1446181111000587
Abstract: High tuberculosis (TB) prevalence in Papua New Guinea (PNG) is a serious public health concern. The epidemic in this region is exacerbated by the presence of drug-resistant TB strains as well as HIV infection. This presents a public health threat not only locally but also to Australia due to the high potential for cross-border transmission between PNG’s Western Province and the Australian Torres Strait Islands. We present two mathematical models of TB in the Western Province: a simple model of the underlying TB dynamics, and a detailed model which accounts for the additional effects of HIV and drug resistance. The detailed model is used to make quantitative predictions about the impact of expanding the TB case detection rate under the Directly Observed Treatment, Short-course treatment regimen. This paper provides a framework for future investigation into the economic costs and public health benefits of potential TB interventions in this region, with the eventual aim of providing recommendations to guide policy makers in both PNG and Australia.
Publisher: F1000Research
Date: 2017
Publisher: F1000Research
Date: 2017
Publisher: JMIR Publications Inc.
Date: 05-08-2018
Abstract: mobile-based consultation service, or telehealth, can be used for remote consultations with health care professionals for screening, self-care management, and referral. In rural Bangladesh, where there is high demand for scarce male and even scarcer female doctors, remote consultations may help women seeking maternal and child health care. Aponjon is a mHealth service in Bangladesh that provides weekly voice or text messages to pregnant women, new mothers, and family members on various aspects of maternal, neonatal, and infant health. Subscribers can also access a dedicated 24*7 call center to discuss maternal, neonatal, and infant health or emergencies with medically trained doctors. The service provides advice, primary diagnoses, prescriptions, and referrals to subscriber callers. e investigated the Aponjon service to understand access, acceptability, usability, benefits, and challenges of a mobile phone-based consultation service. e conducted call log data analysis for September to November 2015 to understand how many unique subscribers accessed the service, who accessed the service, the geographical distribution of callers, and the purpose of the calls. We also conducted a qualitative exploratory substudy of eight married women and eight married men who were subscribers to and accessed the service during this time to understand their experiences. We interviewed 11 doctors from the same service who provided phone consultations to subscribers. pproximately 3894 unique subscribers accessed the service for single or multiple consultations during the study period 68.36% (2662/3894) of subscribers were from rural households, and 53.00% (2064/3894) of calls were made by pregnant women or new mothers. Approximately 96.08% (5081/5288) calls were nonurgent, 2.69% (142/5288) semiurgent, and 1.23% (65/5288) urgent. Almost 64.7% (134/207) semiurgent or urgent calls came between 8 PM and 8 AM. Callers found the consultation service trustworthy, cost-effective, and convenient. The doctors dispelled misconceptions and promoted good health care practices, regular health check-ups, and responsible use of medicine. They helped families understand the severity of sicknesses and advised them to seek care at health facilities for semiurgent or urgent conditions. The service lacked a pro-poor policy to support talk times of subscribers from poor households and a proper referral system to help patients find the right care at the right facilities. lthough a regular messaging service is constrained by a one-way communication system, this service using the same platform, gave subscribers access to an abbreviated “consultation” with medical doctors. The consultations provided subscribers with valued medical advice and support, although they were limited in their population reach and their integration into the wider medical system. Further research is required to understand the impact of advice and referral, cost-effectiveness, and willingness to pay for mHealth consultation services, but this research suggests that these services should be supported or even expanded.
Publisher: Springer Science and Business Media LLC
Date: 24-06-2017
Publisher: JMIR Publications Inc.
Date: 20-07-2020
DOI: 10.2196/17665
Abstract: Text or voice messages have been used as a popular method for improving women’s knowledge on birth preparedness and newborn health care practices worldwide. The Aponjon service in Bangladesh provides twice-weekly messages to female subscribers about their pregnancy and newborn care on mobile phones that they own or share with family members. It is important to understand whether women’s singular access to a phone affects their service satisfaction and the adoption of health messages before deploying such interventions in resource-limited settings. This study aims to evaluate the effect of women’s singular and shared access to mobile phone messages on their service utilization and perceived behavioral change around birth preparedness and pregnancy care. In 2014, Aponjon conducted a retrospective cross-sectional survey of 459 female subscribers who received text or voice messages during their pregnancy by themselves (n=253) or with family members (n=206). We performed multivariable regression analyses to investigate the association between pregnant women’s differential access to messages and other socioeconomic factors and outcomes of service satisfaction, ability to recall service short code, ability to identify danger signs of pregnancy, preference for skilled delivery, arrangement of a blood donor for delivery and pregnancy complications, maternal nutrition, use of potable drinking water, and washing hands with soap for hygiene. In the multivariable analysis, women who had singular access to messages had higher odds of reporting high satisfaction (odds ratio [OR] 1.72, 95% CI 1.12-2.63 P=.01), recalling the service short code (OR 2.88, 95% CI 1.90-4.36 P .001), consuming nutritious food 5 times a day (OR 1.58, 95% CI 1.04-2.40 P=.03), and following the instructions of Aponjon on drinking potable water (OR 1.90, 95% CI 1.17-3.09 P=.01) than women who shared access with family members. Women’s differential access to messages did not affect their knowledge of danger signs and preparedness around delivery. Adolescent women and women aged 20-24 years had lower odds of planning safe deliveries than older women (aged≥25 years). Secondary education was statistically significantly associated with women’s ability to recall the short code and pregnancy danger signs, plan safe delivery, and select blood donors for emergencies. Higher family income was associated with women’s satisfaction, recognition of danger signs, and arrangement of blood donors and nutritious diet. Women who received more than 4 antenatal care visits had higher odds of liking the service, preferring skilled delivery, recalling danger signs, and consuming nutritious food. The capacity of women to independently access mobile phone messages can improve their adoption of mobile health services and some pregnancy health care practices. A holistic approach and equitable support are required to improve access to resources and knowledge of delivery preparedness among low-literate and younger women in low-income households.
Publisher: JMIR Publications Inc.
Date: 02-01-2020
Abstract: ext or voice messages have been used as a popular method for improving women’s knowledge on birth preparedness and newborn health care practices worldwide. The Aponjon service in Bangladesh provides twice-weekly messages to female subscribers about their pregnancy and newborn care on mobile phones that they own or share with family members. It is important to understand whether women’s singular access to a phone affects their service satisfaction and the adoption of health messages before deploying such interventions in resource-limited settings. his study aims to evaluate the effect of women’s singular and shared access to mobile phone messages on their service utilization and perceived behavioral change around birth preparedness and pregnancy care. n 2014, Aponjon conducted a retrospective cross-sectional survey of 459 female subscribers who received text or voice messages during their pregnancy by themselves (n=253) or with family members (n=206). We performed multivariable regression analyses to investigate the association between pregnant women’s differential access to messages and other socioeconomic factors and outcomes of service satisfaction, ability to recall service short code, ability to identify danger signs of pregnancy, preference for skilled delivery, arrangement of a blood donor for delivery and pregnancy complications, maternal nutrition, use of potable drinking water, and washing hands with soap for hygiene. n the multivariable analysis, women who had singular access to messages had higher odds of reporting high satisfaction (odds ratio [OR] 1.72, 95% CI 1.12-2.63 i P /i =.01), recalling the service short code (OR 2.88, 95% CI 1.90-4.36 i P /i & .001), consuming nutritious food 5 times a day (OR 1.58, 95% CI 1.04-2.40 i P /i =.03), and following the instructions of Aponjon on drinking potable water (OR 1.90, 95% CI 1.17-3.09 i P /i =.01) than women who shared access with family members. Women’s differential access to messages did not affect their knowledge of danger signs and preparedness around delivery. Adolescent women and women aged 20-24 years had lower odds of planning safe deliveries than older women (aged≥25 years). Secondary education was statistically significantly associated with women’s ability to recall the short code and pregnancy danger signs, plan safe delivery, and select blood donors for emergencies. Higher family income was associated with women’s satisfaction, recognition of danger signs, and arrangement of blood donors and nutritious diet. Women who received more than 4 antenatal care visits had higher odds of liking the service, preferring skilled delivery, recalling danger signs, and consuming nutritious food. he capacity of women to independently access mobile phone messages can improve their adoption of mobile health services and some pregnancy health care practices. A holistic approach and equitable support are required to improve access to resources and knowledge of delivery preparedness among low-literate and younger women in low-income households.
Publisher: Springer Science and Business Media LLC
Date: 13-02-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: Oxford University Press (OUP)
Date: 19-10-2011
DOI: 10.1093/CID/CIR740
Abstract: By 30 July 2009, Indonesia had reported 139 outbreaks of avian influenza (AI) H5N1 infection in humans. Risk factors for case clustering remain largely unknown. This study assesses risk factors for cluster outbreaks and for secondary case infection. The 113 sporadic and 26 cluster outbreaks were compared on household and in idual level variables. Variables assessed include those never reported previously, including household size and genealogical relationships between cases and their contacts. Cluster outbreaks had larger households and more blood-related contacts, especially first-degree relatives, compared with sporadic case outbreaks. Risk factors for cluster outbreaks were the number of first-degree blood-relatives to the index case (adjusted odds ratio [aOR], 1.50 95% confidence interval [CI]: 1.20-1.86) and index cases having direct exposure to sources of AI H5N1 virus (aOR, 3.20 95% CI: 1.15-8.90). Risk factors for secondary case infection were being aged between 5 and 17 years (aOR, 8.32 95% CI: 1.72-40.25), or 18 and 30 years (aOR, 6.04 95% CI: 1.21-30.08), having direct exposure to sources of AI H5N1 virus (aOR, 3.48 95% CI: 1.28-9.46), and being a first-degree relative to an index case (aOR, 11.0 95% CI: 1.43-84.66). Siblings to index cases were 5 times more likely to become secondary cases (OR, 4.72 95% CI: 1.67-13.35). The type of exposure and the genealogical relationship between index cases and their contacts impacts the risk of clustering. The study adds evidence that AI H5N1 infection is influenced by, and may even depend on, host genetic susceptibility.
Publisher: Cold Spring Harbor Laboratory
Date: 09-12-2021
DOI: 10.1101/2021.12.06.21266926
Abstract: Ongoing management of COVID-19 requires an evidence-based understanding of the performance of public health measures to date, and application of this evidence to evolving response objectives. This paper aims to define system requirements for COVID-19 management under future transmission and response scenarios, based on surveillance system performance to date. From 1 st November 2020 to 30 th June 2021 community transmission was eliminated in Australia, allowing investigation of system performance in detecting novel outbreaks, including against variants of concern (VoCs). We characterised surveillance systems in place from peer-reviewed and publicly available data, analysed the epidemiological characteristics of novel outbreaks over this period, and assessed surveillance system sensitivity and timeliness in outbreak detection. These findings were integrated with analysis of other critical COVID-19 public health measures to establish requirements for future COVID-19 management. Australia reported 25 epidemiologically distinct outbreaks and 5 distinct clusters of cases in the study period, all linked through genomic sequencing to breaches in quarantine facilities housing international travellers. Most (21/30, 70%) were detected through testing of those with acute respiratory illness in the community, and 9 through quarantine screening. For the 21 detected in the community, the testing rate (percent of the total State population tested in the week preceding detection) was 2.07% on average, was higher for those detected while prior outbreaks were ongoing. For 17/30 with data, the delay from the primary case to detection of the index case was, on average 4.9 days, with 10 of the 17 outbreaks detected within 5 days and 3 detected after 7days. One outbreak was preceded by an unexpected positive wastewater detection. Of the 24 outbreaks in 2021, 20 had publicly available sequencing data, all of which were VoCs. Surveillance for future VoCs using a similar strategy to that used for detecting SARS-CoV-2 to date would necessitate a 100-1,000-fold increase in capacity for genomic sequencing. Australia’s surveillance systems performed well in detecting novel introduction of SARS-CoV-2 in a period when community transmission was eliminated, introductions were infrequent and case numbers were low. Detection relied on community surveillance in symptomatic members of the general population and quarantine screening, supported by comprehensive genomic sequencing. Once vaccine coverage is maximised, the priority for future COVID-19 control will shift to detection of SARS-CoV-2 Vos associated with increased severity of disease in the vaccinated and vaccine ineligible. This will require ongoing investment in maintaining surveillance systems and testing of all international arrivals, alongside greatly increased genomic sequencing capacity. Other essential requirements for managing voices are maintaining outbreak response capacity and developing capacity to rapidly engineer, manufacture, and distribute variant vaccines at scale. The most important factor in management of COVID-19 now and into the future will continue to be how effectively governments support all sectors of the community to engage in control measures.
Publisher: AMPCo
Date: 02-2017
DOI: 10.5694/MJA16.00255
Abstract: To investigate time to follow-up (clinical investigation) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality (HGA) being detected by Pap smear. Population-based retrospective cohort analysis of linked data from the Queensland Pap Smear Register (PSR), the Queensland Hospital Admitted Patient Data Collection, and the Queensland Cancer Registry. 34 980 women aged 20-68 years (including 1592 Indigenous women) with their first HGA Pap smear result recorded on the PSR (index smear) during 2000-2009 were included and followed to the end of 2010. Time from the index smear to clinical investigation (histology test or cancer diagnosis date), censored at 12 months. The proportion of women who had a clinical investigation within 2 months of a HGA finding was lower for Indigenous (34.1% 95% CI, 31.8-36.4%) than for non-Indigenous women (46.5% 95% CI, 46.0-47.0% unadjusted incidence rate ratio [IRR], 0.65 95% CI, 0.60-0.71). This difference remained after adjusting for place of residence, area-level disadvantage, and age group (adjusted IRR, 0.74 95% CI, 0.68-0.81). However, Indigenous women who had not been followed up within 2 months were subsequently more likely to have a clinical investigation than non-Indigenous women (adjusted IRR for 2-4 month interval, 1.21 95% CI, 1.08-1.36) by 6 months, a similar proportion of Indigenous (62.2% 95% CI, 59.8-64.6%) and non-Indigenous women (62.8% 95% CI, 62.2-63.3%) had been followed up. Prompt follow-up after a HGA Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.
Publisher: Public Library of Science (PLoS)
Date: 04-04-2012
Publisher: Public Library of Science (PLoS)
Date: 06-02-2009
Publisher: Maad Rayan Publishing Company
Date: 17-03-2022
Abstract: Background: Health system performance indicators are widely used to assess primary healthcare (PHC) performance. Despite the numerous tools and some convergence on indicator criteria, there is not a clear understanding of the common features of indicator selection processes. We aimed to review the literature to identify papers that document indicator selection processes for health system performance indicators in PHC. Methods: We searched the online databases Scopus, Medline, and CINAHL, as well as the grey literature, without time restrictions, initially on July 31, 2019 followed by an update November 13, 2020. Empirical studies or reports were included if they described the selection of health system performance indicators or frameworks, that included PHC indicators. A combination of the process focussed research question and qualitative analysis meant a quality appraisal tool or assessment of bias could not meaningfully be applied to assess in idual studies. We undertook an inductive analysis based on potential indicator selection processes criteria, drawn from health system performance indicator appraisal tools reported in the literature. Results: We identified 16 503 records of which 28 were included in the review. Most studies used a descriptive case study design. We found no consistent variations between indicator selection processes of health systems of high income and low- or lower-middle income countries. Identified common features of selection processes for indicators in PHC include literature review or adaption of an existing framework as an initial step a consensus building process with stakeholders structuring indicators into categories and indicator criteria focusing on validity and feasibility. The evidence around field testing with utility and consideration of reporting burden was less clear. Conclusion: Our findings highlight several characteristics of health system indicator selection processes. These features provide the groundwork to better understand how to value indicator selection processes in PHC.
Publisher: F1000Research
Date: 2015
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 07-2011
Publisher: Public Library of Science (PLoS)
Date: 10-06-2016
Publisher: SAGE Publications
Date: 2009
Abstract: A cross-sectional study of patients living with HIV/ AIDS treated during 2003 to 2007 in decentralized, rural health centers in Zambia was performed to measure virological outcomes after 12 months of antiretroviral therapy and identify factors associated with virological failure. Data from 228 patients who started antiretroviral therapy months prior were analyzed. In all, 93% received stavudine + lamivudine + nevirapine regimens, and median antiretroviral therapy duration was 23.5 months (interquartile range 20-28). Of the 205 patients tested for viral load, 177 (86%) had viral load copies/mL. Probability of developing virological failure (viral load copies/mL) was 8.9% at 24 months and 19.6% at 32 months. Predictors for virological failure were % adherence, body mass index .5 kg/m 2 , and women years old. Of those with virological failure who underwent 3 to 6 months of intensive adherence counseling, 45% obtained virological success. In a remote, resource-limited setting in decentralized health centers, virological and immunological assessments of patients on antiretroviral therapy months showed that positive health outcomes are achievable.
Publisher: Public Library of Science (PLoS)
Date: 09-03-2016
Publisher: Elsevier BV
Date: 10-2017
Abstract: Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Systematic review of peer-reviewed literature (November 2009-2014) on Indigenous health program evaluation. We identified 118 papers describing evaluations of 109 interventions 72.0% were university/research institution-led. 82.2% of evaluations included a quantitative component 49.2% utilised quantitative data only and 33.1% used both quantitative and qualitative data. The most common design was a before/after comparison (30.5%, n=36/118). 7.6% of studies (n=9/118) used an experimental design: six in idual-level and three cluster-randomised controlled trials. 56.8% (67/118) reported on service delivery rocess outcomes (versus health or health risk factor outcomes) only. Given the number of Indigenous health programs that are implemented, few evaluations overall are published in the peer-reviewed literature and, of these, few use optimal methodologies such as mixed methods and experimental design. Implications for public health: Multiple strategies are required to increase high-quality, accessible evaluation in Indigenous health, including supporting stronger research-policy-practice partnerships and capacity building for evaluation by health services and government.
Publisher: Centers for Disease Control and Prevention (CDC)
Date: 12-2010
Publisher: Wiley
Date: 11-04-2016
DOI: 10.1002/CNCR.29954
Publisher: Public Library of Science (PLoS)
Date: 11-04-2016
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.VACCINE.2019.05.010
Abstract: Lassa fever is an acute viral illness caused by Lassa virus (LASV), a rodent-borne pathogen. LASV is endemic to much of Sub-Saharan West Africa, where seasonal outbreaks cause significant morbidity and mortality. Increased global awareness of LASV has led to development of improved diagnostic tests, treatments and vaccines. As vaccine candidates are trialled, it is essential to assess the potential outcomes of introducing a LASV vaccination program in endemic regions. This study investigates the potential outcomes of routine and pulse vaccination strategies using a deterministic mathematical model that captures seasonal LASV transmission between rodents and humans. For plausible parameter values, we find that immunization of 40% of infants at 70% vaccine effectiveness achieves a population-level reduction in infectious case numbers of 30%, while coverage of 60% at 90% vaccine effectiveness achieves a 56% reduction. Similar reductions can be achieved more rapidly via population-wide pulse vaccination at 11% coverage (30% reduction at 70% effectiveness) or 23% coverage (56% reduction at 90% effectiveness) repeated every 10 years. Similar pulse vaccine doses delivered at reduced frequency, but increased coverage achieves a greater reduction in infectious cases. Findings around infant vaccination are sensitive to our assumption that immunity is life-long, while pulse-vaccination has only slightly reduced effect if immunity lasts 10-30 years. An effective LASV vaccination program would incorporate pulse vaccination in addition to routine childhood immunization to limit disease. Estimates of feasible vaccine coverage and effectiveness are needed to fully quantify the likely benefits of a vaccination program in LASV endemic regions.
Publisher: Elsevier BV
Date: 05-2008
Publisher: Public Library of Science (PLoS)
Date: 25-11-2013
Publisher: Springer Science and Business Media LLC
Date: 04-07-2017
Publisher: Informa UK Limited
Date: 11-2013
Publisher: Springer Science and Business Media LLC
Date: 28-05-2019
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 2012
Publisher: Elsevier BV
Date: 12-2023
Publisher: AMPCo
Date: 06-2014
DOI: 10.5694/MJA14.00172
Abstract: Crusted scabies is a highly infectious, debilitating and disfiguring disease, and remote Aboriginal communities of northern Australia have the highest reported rates of the condition in the world. We draw on monitoring data of the East Arnhem Scabies Control Program to discuss outcomes and lessons learnt through managing the condition in remote communities. Using active case finding, we identified seven patients with crusted scabies in three communities and found most had not presented to health services despite active disease. We compared presentations and hospitalisations for a cumulative total of 99 months during a novel preventive program with 99 months immediately before the program for the seven cases and seven sentinel household contacts. Our preventive long-term case management approach was associated with a significant 44% reduction in episodes of recurrent crusted scabies (from 36 to 20 P = 0.025) in the seven cases, and a non-significant 80% reduction in days spent in hospital (from 173 to 35 P = 0.09). It was also associated with a significant 75% reduction in scabies-related presentations (from 28 to 7 P = 0.017) for the seven sentinel household contacts. We recommend active surveillance and wider adoption of this preventive case management approach, with ongoing evaluation to refine protocols and improve efficiency. Contacts of children presenting with recurrent scabies should be examined to exclude crusted scabies. In households where crusted scabies is present, a diagnosis of parental neglect due to recurrent scabies and weight loss in children should be made with extreme caution. Improved coordination of care by health services, and research and development of new therapies including immunotherapies for crusted scabies, must be a priority.
Publisher: Wiley
Date: 15-05-2012
DOI: 10.1111/J.1743-7563.2012.01532.X
Abstract: Patient navigator programs have evolved to facilitate access to care and improve outcomes for Indigenous cancer patients. We reviewed the scientific literature on patient navigator programs in Indigenous people with cancer. We conducted a review of the published literature up to 13 April 2011. PubMed, MEDLINE and CINAHL databases were searched for original articles on Indigenous patient navigation programs. The review produced eight relevant articles covering two specific programs, the Native Sisters Program and the Walking Forward Program. Program descriptions, patient navigator's roles, cultural aspects and the impact of the programs were described. Patient navigators' roles in the programs varied, as did their qualifications, but importantly, all were Indigenous. Both programs aimed to increase participation in screening, remove barriers to treatment and decrease mortality. The Native Sisters Program documented an increase in adherence to breast screening among navigated American Indian participants, although there were substantial differences in the baseline screening adherence between navigated and non-navigated participants. The Walking Forward Program yielded on average 3 fewer days of treatment delays for navigated American Indians than for non-navigated American Indians. However, adjustments for socioeconomic characteristics and disease characteristics were not described. Although preliminary outcomes are seemingly positive, further rigorous evaluation of quantitative impacts are needed.
Publisher: Wiley
Date: 25-11-2014
DOI: 10.1111/ADD.12395
Publisher: F1000Research
Date: 2015
Publisher: F1000Research
Date: 2015
Publisher: Environmental Health Perspectives
Date: 08-2004
DOI: 10.1289/EHP.6866
Abstract: Many interventions have been advocated to mitigate the impact of arsenic contamination of drinking water in Bangladesh. However, there are few data on the true magnitude of arsenic-related disease in Bangladesh nationally. There has also been little consideration given to possible adverse effects of such interventions, in particular, diarrheal disease. The purpose of this study was to estimate and compare the likely impacts of arsenic mitigation interventions on both arsenic-related disease and water-borne infectious disease. We found that arsenic-related disease currently results in 9,136 deaths per year and 174,174 disability-adjusted life years (DALYs undiscounted) lost per year in those exposed to arsenic concentrations > 50 microg/L. This constitutes 0.3% of the total disease burden in Bangladesh in terms of undiscounted DALYs. We found intervention to be of overall benefit in reducing disease burden in most scenarios examined, but the concomitant increase in water-related infectious disease significantly reduced the potential benefits gained from intervention. A minimum reduction in arsenic-related DALYs of 77% was necessary before intervention achieved any reduction in net disease burden. This is assuming that interventions were provided to those exposed to > 50 microg/L and would concomitantly result in a 20% increase in water-related infectious disease in those without access to adequate sanitation. Intervention appears to be justified for those populations exposed to high levels of arsenic, but it must be based on exposure levels and on the effectiveness of interventions not only in reducing arsenic but in minimizing risk of water-related infections. Key words: arsenic/adverse effects, Bangladesh, burden of disease, diarrhea, risk assessment, water pollutants, water supply.
Publisher: Public Library of Science (PLoS)
Date: 04-01-2012
Publisher: Public Library of Science (PLoS)
Date: 05-2017
Publisher: Springer Science and Business Media LLC
Date: 02-05-2018
Publisher: Elsevier BV
Date: 04-2023
Location: No location found
Location: Australia
Location: Bangladesh
Location: Philippines
Location: Australia
Location: United States of America
Location: Indonesia
Location: United Kingdom of Great Britain and Northern Ireland
Location: Netherlands
Location: Belgium
Start Date: 2012
End Date: 2015
Funder: Australian Primary Health Care Research Institute, Australian National University
View Funded ActivityStart Date: 2014
End Date: 2017
Funder: Department of Foreign Affairs and Trade, Australian Government
View Funded ActivityStart Date: 2009
End Date: 2011
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2010
End Date: 2010
Funder: Australian National University
View Funded Activity