Addressing the Challenges of Open Fracture Management in Malawi: Insights from preliminary research from the TITAN study

Epidemiology, Biodiversity, and Technological Trajectories in the Brazilian Amazon: From Malaria to COVID-19

The Amazon biome is under severe threat due to increasing deforestation rates and loss of biodiversity and ecosystem services while sustaining a high burden of neglected tropical diseases. Approximately two thirds of this biome are located within Brazilian territory. There, socio-economic and environmental landscape transformations are linked to the regional agrarian economy dynamics, which has developed into six techno-productive trajectories (TTs).

Non-communicable diseases: a challenge for global cooperation

In current times, it’s easy to forget that over 70% of deaths worldwide are due to non-communicable diseases. How can we tackle their rise? The theory of epidemiological transition (or the changing patterns of population age distributions, mortality, fertility, life expectancy, and causes of death) offers a valuable framework for understanding how different types of diseases can occur simultaneously in a population. 

Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leone’s Ebola epidemic

Typical epidemiology of respiratory virus infections in a Brazilian slum

For this study researchers collected nasopharyngeal specimens from 282 children aged ≤5 years with acute respiratory tract infection (ARI) during 2005 to 2006 in one of the largest Brazilian slums.

Zika Virus Outbreak on Curaçao and Bonaire, a Report Based on Laboratory Diagnostics Data

ZIKV cases confirmed by qRT-PCR indicate that the virus was circulating on Curaçao between at least December 2015 and March 2017, and on Bonaire between at least October 2016 and February 2017, with peak cases occurring in November 2016.

Advances in Visualization Tools for Phylogenomic and Phylodynamic Studies of Viral Diseases

The authors of this study focus on solutions that address joint temporal and spatial visualization but also consider what the future may bring in terms of visualization and how this may become of value for the coming era of real-time digital pathogen surveillance, where actionable results and adequate intervention strategies need to be obtained within days.

Advances in using Internet searches to track dengue

Dengue is a mosquito-borne disease that threatens over half of the world’s population. Despite being endemic to more than 100 countries, government-led efforts and tools for timely identification and tracking of new infections are still lacking in many affected areas. Multiple methodologies that leverage the use of Internet-based data sources have been proposed as a way to complement dengue surveillance efforts. Among these, dengue-related Google search trends have been shown to correlate with dengue activity. We extend a methodological framework, initially proposed and validated for flu surveillance, to produce near real-time estimates of dengue cases in five countries/states: Mexico, Brazil, Thailand, Singapore and Taiwan. Our result shows that our modeling framework can be used to improve the tracking of dengue activity in multiple locations around the world.

Epidemiological evaluation of vaccines: efficacy, safety and policy (Short Course)

The Epidemiological evauation of vaccines course: efficacy, safety and policy

Tranexamic Acid Use in Severely Injured Civilian Patients and the Effects on Outcomes

 Objective: To characterize the relationship between tranexamic acid (TXA) use and patient outcomes in a severely injured civilian cohort, and to determine any differential effect between patients who presented with and without shock. Background: TXA has demonstrated survival benefits in trauma patients in an international randomized control trial and the military setting. The uptake of TXA into civilian major hemorrhage protocols (MHPs) has been variable. The evidence gap in mature civilian trauma systems is limiting the widespread use of TXA and its potential benefits on survival. Methods: Prospective cohort study of severely injured adult patients (Injury severity score > 15) admitted to a civilian trauma system during the adoption phase of TXA into the hospital's MHP. Outcomes measured were mortality, multiple organ failure (MOF), venous thromboembolism, infection, stroke, ventilator-free days (VFD), and length ofstay. Results: Patients receiving TXA (n = 160, 42%) were more severely injured, shocked, and coagulopathic on arrival. TXA was not independently associated with any change in outcome for either the overall or nonshocked cohorts. In multivariate analysis, TXA was independently associated with a reduction in MOF [odds ratio (OR) = 0.27, confidence interval (CI): 0.10–0.73, P = 0.01] and was protective for adjusted all-cause mortality (OR = 0.16 CI: 0.03–0.86, P = 0.03) in shocked patients. Conclusions: TXA as part of a major hemorrhage protocol within a mature civilian trauma system provides outcome benefits specifically for severely injured shocked patients. 

Prioritisation of surgery in the national health strategic plans of Africa: A systematic review

Disease amenable to surgical intervention accounts for 11-15 % of world disability and there is increasing interest in surgery as a global public health issue. National HealthStrategic Plans (NHSPs) reflect countries' long-term health priorities, plans and targets. These plans were analysed to assess the prioritisation of surgery as a public health issue inAfrica.NHSPs of 43 independent Sub-Saharan African countries available in the public domain in March 2014 in French or English were searched electronically for key terms: surg*, ortho*, trauma, cancer, appendic*, laparotomy, HIV, tuberculosis, malaria. They were then searched manually for disease prevalence, targets, and human resources.19 % of NHSPs had no mentionof surgery or surgical conditions. 63 % had five or less mentions of surgery. HIV and malaria had 3772 mentions across all the policies, compared to surgery with only 376 mentions. Trauma had 239 mentions, while the common surgical conditions of appendicitis, laparotomy and hernia had no mentions at all. Over 95 % of NHSPs specifically mentioned the prevalence of HIV, tuberculosis, malaria, infant mortality and maternal mortality. Whereas, the most commonly mentioned surgical condition for which a prevalence was given was trauma, in only 47 % of policies. All NHSPs had plans and measurable targets for the reduction of HIV and tuberculosis. Of the total 4064 health targets, only 2 % were related to surgical conditions or surgical care. 33 % of policies had no surgical targets.NHSPs are the best available measure of health service and planning priorities. It is clear from our findings that surgery is poorly represented and that surgical conditions and surgical treatment are not widely recognised as a public health priority. Greater prioritisation of surgery in national health strategic policies is required to build resilient surgical systems. Read the full article here.

Injury assessment in three low-resource settings: a reference for worldwide estimates

Background Trauma has become a worldwide pandemic. Without dedicated public health interventions, fatal injuries will rise 40% and become the 4th leading cause of death by 2030, with the burden highest in low-income and middle-income countries (LMICs). The aim of this study was to estimate the prevalence of traumatic injuries and injury-related deaths in low-resource countries worldwide, using population-based data from the Surgeons OverSeas Assessment of Surgical Need (SOSAS), a validated survey tool.

Injury prevalence and causality in developing nations: Results from a countrywide population-based survey in Nepal

Traumatic injury affects nearly 5.8 million people annually and causes 10% of the world's deaths. In this study we aimed to estimate injury prevalence, to describe risk-factors and mechanisms of injury, and to estimate the number of injury-related deaths in Nepal, a low-income South Asian country.

Traumatic injury in Sierra Leone: results from a nationwide survey

Traumatic injuries are an important cause of disability and mortality worldwide and more than 90% of injury-related deaths occur in low-income and middle-income countries. Despite its overall significance, little information exists about the burden of injuries in developing countries. We aim to estimate the prevalence of traumatic injuries, describe injury mechanisms, and assess the degree of associated disability in Sierra Leone.

The KIM: The Key Informant Method (KIM)

The Key Informant Method (KIM) is is an approach to identifying children with disabilities in the community through trained community volunteers, known as Key Informants (KIs). KIM is an evolving method that has been used by ICED in a number of projects, supported by CBM.

Indignity, exclusion, pain and hunger: the impact of musculoskeletal impairments in the lives of children in Malawi

Purpose: To develop a conceptual model representing the impact of musculoskeletal impairments (MSIs) in the lives of children in Malawi. Method: A total of 169 children with MSIs (CMSIs), family and other community members participated in 57 interviews, focus groups and observations. An inductive approach to data analysis was used to conceptualise the impact of MSIs in children’s day-to-day lives. Results: The main themes that emerged were Indignity, Exclusion, Pain and Hunger. Indignity represents various affronts to children’s sense of inherent equal worth as human beings, for example when bullied by peers. Exclusion refers to CMSIs being excluded from three core daily activities: school, play and household chores. Some CMSIs experienced Pain, for example as an outcome of striving to participate. Children with severe mobility impairments were at increased risk of Hunger, having less access to food outside the home and placing a burden of care on the family that could restrict household productivity. Household Poverty was therefore included in the model, as this household impact was inseparable from the impact on CMSIs. Conclusion: It is recommended that rehabilitation interventions are planned and evaluated with consideration to their impact on Exclusion, Indignity, Pain, Hunger and Household Poverty using multi-faceted partnerships.

A National Survey of Musculoskeletal Impairment in Rwanda: Prevalence, Causes and Service Implications

Accurate information on the prevalence and causes of musculoskeletal impairment (MSI) is lacking in low income countries. We present a new survey methodology that is based on sound epidemiological principles and is linked to the World Health Organisation's International Classification of Functioning.

The global burden of other musculoskeletal disorders: estimates from the Global Burden of Disease 2010 study

Objective: To estimate disability from the remainder of musculoskeletal (MSK) disorders (categorised as other MSK) not covered by the estimates made specifically for osteoarthritis (OA), rheumatoid arthritis (RA), gout, low back pain and neck pain, as part of the Global Burden of Disease (GBD) 2010 study.

The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study

Objective: To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions.

The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study

Objectives: To estimate the global burden of rheumatoid arthritis (RA), as part of the Global Burden of Disease 2010 study of 291 conditions and how the burden of RA compares with other conditions.

The global burden of musculoskeletal conditions for 2010: an overview of methods

The objective of this paper is to provide an overview of methods used for estimating the burden from musculoskeletal (MSK) conditions in the Global Burden of Diseases 2010 study. It should be read in conjunction with the disease-specific MSK papers published in Annals of Rheumatic Diseases.

Epidemiology: Measurement matters—making musculoskeletal disease count

Reliable estimates of disease burden support rational allocation of financial and human resources. Measurement is a powerful force for change as 'what gets measured gets done'. The global burden of musculoskeletal disease studies ensures visibility of these highly prevalent, disabling diseases. Now we must act to reduce disease burden.

Development of real-time tracking tools to monitor dengue

Real-time dengue surveillance is critical for identifying areas where transmission is ongoing or likely to occur so that interventions can be optimized. Sophisticated new tools can help - and so can you.

Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?