185 research outputs found
Back rubs or foot flicks for neonatal stimulation at birth in a low-resource setting: A randomized controlled trial
No full textApproximately 15% of infants require stimulation in low-resource settings, but data on effectiveness of different stimulation approaches are limited. We aimed to compare two recommended approaches of stimulation (back rubs vs. foot flicks) in reducing the need for face-mask ventilation in newly born infants who were not crying immediately after birth in a low-resource setting
Pan Afr Med J
No full textBackgroundThe capacity of public health professionals to rapidly detect and respond to disease pandemics is critical to understand and control global disease spread. On June 11, 2009, the World Health Organization (WHO) declared H1N1 virus infection as pandemic. In May 2009, we assessed the participation of Field Epidemiology and Laboratory Training Programs (FELTPs) based in sub-Saharan Africa on pandemic influenza preparedness and response.MethodsWe administered an electronic survey to directors and resident advisors of African Field Epidemiology Network (AFENET) member and associate FELTPs. The survey included questions on the following attributes: program involvement in suspected H1N1 investigations, experience in influenza outbreak investigations, national influenza surveillance and response plans, and H1N1 outbreak preparedness.ResultsNine countries (100%) responded to the survey; all had existing national influenza response plans. Six programs reported their trainees had participated in past pandemic preparedness and response exercise, five (83%) of them were influenza specific.ConclusionFELTPs played an important role in H1N1 surveillance and response in sub-Saharan Africa. Continued technical assistance and support to these programs is vital to foster their capacity to monitor and control public health threats.201122187593PMC32829361095
The Tanzania Field Epidemiology and Laboratory Training Program: Building and Transforming the Public Health Workforce.
No full textThe Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must address include development of a full range of in-country teaching capacity for the program, as well as a career path for graduates
The Ebola outbreak in West Africa: a story of related public health challenges and a pointer to solutions to mitigate the inevitable next outbreak
No full textNo Abstract. Key words: Ebola, Public Health, Systems, Workforc
The Ebola outbreak in West Africa: a story of related public health challenges and a pointer to solutions to mitigate the inevitable next outbreak. Pan Afr Med
No full textA machine learning approach to predict E. coli antibacterial resistance using whole-genome sequencing data
No full textBackground: Antimicrobial resistance (AMR) is a significant global health threat, particularly impacting low- and middle-income countries(LMICS) such as Uganda, where reliable and rapid methods for detecting AMR in E. coli and other pathogens are scarce. This lack can lead to inappropriate treatment and the spread of drug-resistant infections. This thesis undertakes a comprehensive study, where various machine learning models to predict AMR in E. coli for ciprofloxacin(CIP), ampicillin(AMP), and cefotaxime(CTX) were trained on whole genome sequencing (WGS) data from England where such data is more readily available. A separate Ugandan dataset was used for validation purposes, further demonstrating the generalizability and effectiveness of the models in LMICS.
Methods: 1496 (CIP), 1428 (CTX), and 1396 (AMP) sequences from England were divided into training and testing. 42 from Uganda were used for validation. Eight different machine learning models were trained and tested: Logistic Regression(LR), Random Forest(RF), Gradient Boosting(GB), XGBoost(XGB), LightGBM(LGBM), CatBoost(CB), Feed-Forward Neural Network(FFNN), and Support Vector Machine(SVM). The models were evaluated based on precision, recall, and Area Under the Receiver Operating Characteristic Curve (AUC-ROC). Upsampling techniques were implemented to address class imbalance in the data.
Results: Model predictive performance varied significantly across different antibiotics, underlining the critical role of model selection and dataset characteristics. Notably, the FFNN model demonstrated superior performance during testing for CIP (accuracy 84%; F1 0.55; AUC 91%), LR for CTX (accuracy 91%; F1 0.37; AUC 83%) and GB for AMP (accuracy 57%; F1 0.62, AUC 53%), while the LGBM and RF models outperformed others in same scenarios (p < 0.001). Upsampling did not significantly improve the models' performance, underscoring the complexity and high-dimensionality of SNP data. Despite high accuracy scores with the Ugandan validation dataset(FFNN with CIP accuracy 95%, LR with AMP accuracy 98% and GB with CTX accuracy 65%), the models struggled with the recall metric due to severe class imbalance. Key mutations associated with antimicrobial resistance were identified for these antibiotics.
Conclusion: As the threat of AMR continues to rise, the successful application of these models - particularly on the Ugandan dataset, signals a promising avenue for improving AMR detection and treatment strategies in LMICS were genomic data is scarce. This work thus not only expands our current understanding of the genetic underpinnings of AMR but also provides a robust methodological framework that can guide future research and applications in the fight against antimicrobial resistance.The author was funded by the East African Network for Bioinformatics Training (EANBIT) under Fogarty International Center at the U.S. National Institutes of Health (NIH) under award number U2RTW010677 as a Masters scholar.
The author would also like to acknowledge the Open Science Grid (OSG) consortium which provided computational resources to carry out this study. The OSG is supported by the National Science Foundation award number 2030508 and 1836650
Pan Afr Med J
No full textLaboratories are integral to the delivery of quality health care and for public health functions; however laboratory systems and services are often neglected in resource-poor settings such as the East African region. In order to sustainably strengthen national laboratory systems in resource-poor countries, there is a need to train laboratory personnel to work in clinical as well as public health laboratories. In 2004,Kenya, Uganda, Tanzania, and South Sudan began training public health laboratory workers jointly with field epidemiologists in the Kenya Field Epidemiology and Laboratory Training Program (FELTP), and later through the Tanzania FELTP, as a strategy to strengthen public health laboratories. These programs train laboratory epidemiologists through a two-year public health leadership development course, and also offer various types of short course training for frontline staff. The FELTP laboratory graduates in Kenya, Tanzania, Uganda, and South Sudan are working in their respective countries to strengthen public health laboratory systems while the short course participants provide a pool of frontline implementers with the capacity to support the lower tiers of health systems, as well as serve as surge capacity for the regions and the national level. Through training competent public health laboratory workers, the East African ministries of health, in collaboration with other regional partners and stakeholders are now engaged in developing and implementing a holistic approach that will guarantee an overall strengthening of the health system by using well-trained public health laboratory leaders to drive the process. Strengthening public health laboratory medicine in East Africa is critical to improve health-care systems. The experience with the FELTP model in East Africa is a step in the right direction towards ensuring a stronger role for the laboratory in public health.201122359702PMC3266675665
Influenza preparedness and response: Involvement of African Field Epidemiology and Laboratory Training Programs, 2009
No full textAbstract Background: The capacity of public health professionals to rapidly detect and respond to disease pandemics is critical to understand and contro
Influenza preparedness and response: Involvement of African Field Epidemiology and Laboratory Training Programs, 2009
No full textst pandemic preparedness and response exercise, five (83%) of them were influenza specific. CONCLUSION: FELTPs played an important role in H1N1 surveillance and response in sub-Saharan Africa. Continued technical assistance and support to these programs is vital to foster their capacity to monitor and control public health threats
Aprentissafe par la pratque: le roect de lutte contre le SIDA de I'Ouganda dome les pleins pouvoirs aux responsables locaux
No full textSurveillance systems in Uganda detect
that HIV prevalence declined from 21.1 percent in 1991 to
6.4 percent in 2001. The most common explanations for this
decrease are that the population mobilized itself with the
consequence that more people were faithful to their
partners, or abstained from sexual contact, and used condoms
during sexual intercourse (Low-Beer et al 2003). Although
one might debate which of these behavior changes contributed
most to the apparent reduction in HIV prevalence, no one
would claim that Uganda can now become complacent about its
HIV/AIDS programs. Quite the contrary. National HIV/AIDS
Committees continue to have the responsibility for both
covering their populations with the highest quality
prevention, care, support, and treatment programs possible,
and to improve them constantly
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