To the best of our knowledge, this is the first study of this kind and, hopefully, our analysis can be useful to inform and encourage further research on these issues. We should note, however, several study limitations.
First, key informant interviews are particularly vulnerable to social desirability biases, especially when informants represent institutions and government departments. In our study, whenever possible, we tried to encourage personal and critical engagement with the given topics. At times, however, this was difficult to achieve, particularly in group interviews at government departments, where meetings were more formal and provided less opportunities for questioning and probing.
Second, given the exploratory nature of this study, we could generate insights on the socio-technical complexity of health data and information sharing, but in-depth exploration of emerging issues would require additional work and specific methodologies. For example, network analysis could be used to chart structural patterns in the flow of data and information within and across countries, including centrality of nodes, reciprocity in information exchange, clustering, and, importantly, brokerage dynamics.
In addition, participant observation at regional meetings, informed by interactionist perspectives [ 63 ], would provide a deeper understanding of ways in which imbalances in access to resources may affect, in practice, knowledge exchange between country partners.
Lastly, this study was conducted in a particular geopolitical and public health context of regional cooperation. As noted earlier, the focus on Southeast Asia provides strategic opportunities to explore different aspects of the phenomenon investigated here.
However, future research work could be conducted in other areas to enable comparative case study analysis and provide stronger evidential bases for theory development and generalisation.
Our study documents ways in which imbalances between national health systems and capacities may affect the practice of cross-border data and information sharing, suggesting that best practices require significant involvement of an independent third-party brokering organisation or office, which can redress gaps between country partners at different levels in the data sharing process, create meaningful communication channels and make the most of shared information and data sets.
By way of conclusion, we can extend this argument a step further and speculate that data and information sharing works better if supported by strong multilateral arrangements, since these typically involve a third—party organisation with responsibilities for budget administration, data management, and overall coordination. By contrast, a bilateral cooperation agreement is likely to have a weaker brokering orientation and is generally thought to be a less effective mechanisms to address collective good problems, as documented in studies of aid relationships [ 64 ]; this is even more apparent in contexts where transnational issues have a wide regional dimension and require harmonisation, coordination, and integration between more than two parties.
Further attention to these issues is much needed in the present historical context. In the past few years, political developments in Europe and the United States have coincided with a crisis of multilateralism and regional cooperation - two foundations of the global order from the postwar to the present [ 65 ].
Thus, research that can inform a better understanding of ways in which these changes may affect cooperation amongst countries and the achievement of the common good, in public health as in other policy areas, is timely. Strengthening border surveillance between Ebola affected countries. Ebola Bulletin. The Ebola outbreak, old lessons for new epidemics. Article Google Scholar.
The spread of artemisinin-resistant plasmodium falciparum in the greater Mekong subregion: a molecular epidemiology observational study. Lancet Infect Dis. Spread of artemisinin resistance in plasmodium falciparum malaria.
N Engl J Med. Cross-border cholera outbreaks in sub-Saharan Africa, the mystery behind the silent illness: what needs to be done? PLoS One. Anticipating the international spread of Zika virus from Brazil. Implications of global and regional patterns of highly pathogenic avian influenza virus H5N1 clades for risk management. Vet J. Cross-border collaboration for neglected tropical disease efforts-lessons learned from onchocerciasis control and elimination in the Mano River union West Africa.
Glob Health. Estimating the burden of Japanese encephalitis virus and other encephalitides in countries of the Mekong region. Pisani E, AbouZahr C. Sharing health data: good intentions are not enough. Bull World Health Organ. Cross-border collaboration on emerging infectious diseases. Report of the bi-regional meeting Bangkok, February Google Scholar. Chatham House. A Guide to sharing the data and benefits of public health surveillance.
Centre on global health security. London: Chatham House; Liverani M, Coker R. J Health Polit Policy Law. Emerg Health Threats J. Eliminate now: seven critical actions required to accelerate elimination of plasmodium falciparum malaria in the greater Mekong subregion. Malar J. Communicable diseases and governance: a tale of two regions. Glob Public Health. Enhanced surveillance for detection and management of infectious diseases: regional collaboration in the middle east. Regional collaboration in the Middle East to deal with H5N1 avian flu.
Epidemiological surveillance of land borders in North and South America: a case study. Evaluation of UNDP contribution to south-south cooperation.
Curley M, Thomas N. Aust J Int Aff. Thomas N. The regionalization of avian influenza in East Asia: responding to the next pandemic? Asian Surv. The coming pandemic: transnational health challenges in East and Southeast Asia. In: Tan, ATH, editor.
East and South-East Asia: international relations and security perspectives. New York: Routledge; Hameiri S. Pac Rev. Ross E. Perspectives on data sharing in disease surveillance. A systematic review of barriers to data sharing in public health.
BMC Public Health. Research stakeholders' views on benefits and challenges for public health research data sharing in Kenya: the importance of trust and social relations. Developing ethical practices for public health research data sharing in South Africa: the views and experiences from a diverse sample of research stakeholders.
Sweat, skepticism, and uncharted territory: a qualitative study of opinions on data sharing among public health researchers and research participants in Mumbai, India. Yin R. Case study research: design and methods. Thousand Oaks: Sage; Emerging infectious diseases in Southeast Asia: regional challenges to control.
The challenge of artemisinin resistance can only be met by eliminating plasmodium falciparum malaria across the greater Mekong subregion. Sharma M, Chatterjee A. Harm Reduct J. Prevention and control of avian influenza in Asia and the Pacific.
Project report. Manila: Asian Development Bank; Emergency response to artemisinin resistance in the greater Mekong subregion: regional framework for action — Geneva: World Health Organization; Regional mechanisms of communicable disease control in Asia and Europe.
Singapore: Asia-Europe Foundation; Mekong malaria. Update of malaria, multi-drug resistance and economic development in the Mekong region of Southeast Asia.
PubMed Google Scholar. Western Pac Surveill Response J. Strauss A, Corbin J. Basics of qualitative research. London: Sage; The Kingdom of Cambodia.
Health system review. Ramesh M. Health care reform in Vietnam: chasing shadows. J Contemp Asia. Rhee H. Promoting South-South cooperation through knowledge exchange.
Catalyzing Development. Washington: Brookings Institution Press; Leonelli S. Data-centric biology. A philosophical study. Chicago: The University of Chicago Press; Book Google Scholar. The role of culture in health communication. Annu Rev Public Health. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods.
Sharing health data: developing country perspectives. Calain P. From the field side of the binoculars: a different view on global public health surveillance.
Health Policy Plan. Sustainability of sub-regional disease surveillance networks. Global Health Gov. Framework of operational guidelines on United Nations support to South-South and triangular cooperation. High-level Committee on South-South Cooperation. Active humoral Immunity, which usually lasts for years, is attained either naturally by infection with or without clinical manifestations, or artificially by inoculation of the agent itself in killed, modified or variant form, or of fractions or products of the agent.
Inapparent infection —The presence of infection in a host without recognizable clinical signs or symptoms. Inapparent infections are identifiable only by laboratory means such as a blood test or by the development of positive reactivity to specific skin tests. Synonyms: asymptomatic , subclinical , occult infection.
Incidence rate —The number of new cases of a specified disease diagnosed or reported during a defined period of time, divided by the number of persons in a stated population in which the cases occurred. This is usually expressed as cases per 1, or , per annum. This rate may be expressed as age- or gender-specific or as specific for any other population characteristic or subdivision.
See Morbidity rate and Prevalence rate. Attack rate , or case rate , is a proportion measuring cumulative incidence often used for particular groups, observed for limited periods and under special circumstances, as in an epidemic; it is usually expressed as percent cases per in the group. The secondary attack rate is the number of cases among familial or institutional contacts occurring within the accepted incubation period following exposure to a primary case, in relation to the total of exposed contacts; the denominator may be restricted to susceptible contacts when determinable.
Infection rate is a proportion that expresses the incidence of all identified infections, manifest and inapparent. Incubation period —The time interval between initial contact with an infectious agent and the first appearance of symptoms associated with the infection. In a vector, it is the time between entrance of an organism into the vector and the time when that vector can transmit the infection extrinsic incubation period. The period in people between the time of exposure to a parasite and the time when the parasite can be detected in blood or stool is called the prepatent period.
Infected Individual —A person or animal that harbors an infectious agent and who has either manifest disease see Patient or sick person or inapparent infection see Carrier.
An infectious person or animal is one from whom the infectious agent can be naturally acquired. Infection —The entry and development of many parasites or multiplication of an infectious agent in the body of persons or animals. Infection is not synonymous with infectious disease; the result may be inapparent see Inapparent infection or manifest see Infectious disease. The presence of living infectious agents on exterior surfaces of the body, or on articles of apparel or soiled articles, is not infection, but represents contamination of such surfaces and articles.
See Infestation and Contamination. Infectious agent —An organism virus, rickettsia, bacteria, fuingus, protozoan or helminth that is capable of producing infection or infectious disease.
Infectivity expresses the ability of the disease agent to enter, survive and multiply in the host; infectiousness indicates the relative ease with which a disease is transmitted to other hosts. Infectious disease —A clinically manifest disease of humans or animals resulting from an infection. See Infection. Infestation —For persons or animals, the lodgment, development and reproduction of arthropods on the surface of the body or in the clothing.
Infested articles or premises are those that harbor or give shelter to animal forms, especially arthropods and rodents. The term larvicide is generally used to designate insecticides applied specifically for destruction of immature stages of arthropods; adulticide or imagocide , to designate those applied to destroy mature or adult forms.
The term insecticide is often used broadly to encompass substances for the destruction of all arthropods, but acaricide is more properly used for agents against ticks and mites. More specific terms such as lousicide and miticide are sometimes used. Isolation —As applied to patients, isolation represents separation, for the period of communicability, of infected persons or animals from others in such places and under such conditions as to prevent or limit the direct or indirect transmission of the infectious agent from those infected to those who are susceptible to infection or who may spread the agent to others.
In contrast, quarantine q. CDC has recommended that Universal Precautions be used consistently for all patients in hospital settings as well as outpatient settings regardless of their bloodborne infection status. This practice is based on the possibility that blood and certain body fluids any body secretion that is obviously bloody, semen, vaginal secretions, tissue, CSF, and synovial, pleural, peritoneal, pericardial and amniotic fluids of all patients are potentially infectious for HIV, HBV and other bloodborne pathogens.
Universal precautions are intended to prevent parenteral, mucous membrane and nonintact skin exposures of healthcare workers to bloodbome pathogens. Protective barriers include gloves, gowns, masks and protective eyewear or face shields.
A private room is indicated if patient hygiene is poor. Waste management is controlled by local and state authority. There are two basic requirements that are common for care of all potentially infectious cases:. Recommendations made for isolation of cases in section 9B2 of each disease may allude to the methods that had been recommended by CDC CDC Guideline for Isolation Precautions in Hospitals as category-specific isolation precautions, in addition to universal precautions, based on the mode of transmission of the specific disease.
These categories are as follows:. The specifications, in addition to those above, include a private room and the use of masks, gowns and gloves for all persons entering the room. Special ventilation requirements with the room at negative pressure to surrounding areas are desirable. In addition to the basic requirements, a private room is indicated, but patients infected with the same pathogen may share a room.
Masks are indicated for those who come close to the patient, gowns are indicated if soiling is likely and gloves are indicated for touching infectious material. In addition to the basic requirements, masks are indicated for those who come in close contact with the patient; gowns and gloves are not indicated. Specifications include use of a private room with special ventilation and closed door.
In addition to the basic requirements, respirator-type masks are used by those entering the room. Gowns are used to prevent gross contamination of clothing. Gloves are not indicated. In addition to the basic requirements, specifications include use of a private room if patient hygiene is poor. Masks are not indicated; gowns should be used if soiling is likely and gloves are to be used for touching contaminated materials.
A private room and masking are not indicated; in addition to the basic requirements, gowns should be used if soiling is likely and gloves should be used for touching contaminated materials.
After studying this information, outline the chain of infection by identifying the reservoir s , portal s of exit, mode s of transmission, portal s of entry, and factors in host susceptibility.
Check your answer. Dengue is an acute infectious disease that comes in two forms: dengue and dengue hemorrhagic fever. The principal symptoms of dengue are high fever, severe headache, backache, joint pains, nausea and vomiting, eye pain, and rash. Generally, younger children have a milder illness than older children and adults. Dengue hemorrhagic fever is a more severe form of dengue.
It is characterized by a fever that lasts from 2 to 7 days, with general signs and symptoms that could occur with many other illnesses e. This stage is followed by hemorrhagic manifestations, tendency to bruise easily or other types of skin hemorrhages, bleeding nose or gums, and possibly internal bleeding. This may lead to failure of the circulatory system and shock, followed by death, if circulatory failure is not corrected.
Diagnosis of dengue infection requires laboratory confirmation, either by isolating the virus from serum within 5 days after onset of symptoms, or by detecting convalescent-phase specific antibodies obtained at least 6 days after onset of symptoms.
There is no specific medication for treatment of a dengue infection. Persons who think they have dengue should use analgesics pain relievers with acetaminophen and avoid those containing aspirin. They should also rest, drink plenty of fluids, and consult a physician. Persons with dengue hemorrhagic fever can be effectively treated by fluid replacement therapy if an early clinical diagnosis is made, but hospitalization is often required.
Dengue is endemic in many tropical countries in Asia and Latin America, most countries in Africa, and much of the Caribbean, including Puerto Rico.
Cases have occurred sporadically in Texas. Epidemics occur periodically. Globally, an estimated 50 to million cases of dengue and several hundred thousand cases of dengue hemorrhagic fever occur each year, depending on epidemic activity. Between and suspected cases are introduced into the United States each year by travelers.
Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito becomes infected with dengue virus when it bites a person who has dengue or DHF and after about a week can transmit the virus while biting a healthy person.
Monkeys may serve as a reservoir in some parts of Asia and Africa. Dengue cannot be spread directly from person to person. Susceptibility to dengue is universal. Residents of or visitors to tropical urban areas and other areas where dengue is endemic are at highest risk of becoming infected. While a person who survives a bout of dengue caused by one serotype develops lifelong immunity to that serotype, there is no cross-protection against the three other serotypes.
There is no vaccine for preventing dengue. The best preventive measure for residents living in areas infested with Aedes aegypti is to eliminate the places where the mosquito lays her eggs, primarily artificial containers that hold water.
Items that collect rainwater or are used to store water for example, plastic containers, gallon drums, buckets, or used automobile tires should be covered or properly discarded. Pet and animal watering containers and vases with fresh flowers should be emptied and scoured at least once a week. This will eliminate the mosquito eggs and larvae and reduce the number of mosquitoes present in these areas.
For travelers to areas with dengue, as well as people living in areas with dengue, the risk of being bitten by mosquitoes indoors is reduced by utilization of air conditioning or windows and doors that are screened.
The risk of dengue infection for international travelers appears to be small, unless an epidemic is in progress. The emphasis for dengue prevention is on sustainable, community-based, integrated mosquito control, with limited reliance on insecticides chemical larvicides and adulticides.
Residents are responsible for keeping their yards and patios free of sites where mosquitoes can be produced. Dengue Fever. Description: The chain of infection has 3 main parts. A reservoir such as a human and an agent such as an amoeba. The mode of transmission can include direct contact, droplets, a vector such as a mosquito, a vehicle such as food, or the airborne route.
The susceptible host has multiple portals of entry such as the mouth or a syringe. Return to text. Description: The agent Dracunculus medinensis , develops in the intermediate host fresh water copepod. Man acquires the infection by ingesting infected copepods in drinking water. An infected individual enters the water. When a blister caused by adult female worm comes into contact with water, it rapidly becomes an ulcer through which the adult female worm releases first-stage larvae. The larvae are ingested by copepods.
Within 10 to 14 days larvae ingested by the copepods develop into infective third stage larvae. The susceptible individual consumes water containing infected copepods.
Infected individuals are symptom free for 10 to 14 months then ingested third-stage larvae mature into adult worms. The adult female worm provokes the formation of a painful blister in the skin of the infected individual. Then the cycle starts over. Skip directly to site content Skip directly to page options Skip directly to A-Z link.
Section Navigation. Facebook Twitter LinkedIn Syndicate. Lesson 1: Introduction to Epidemiology. Minus Related Pages.
0コメント