April 25, 2023
Skepticism around next-generation tuberculosis sequencing diagnostics lingers worldwide.
Researchers interviewed stakeholders involved in next-generation sequencing-based tuberculosis (TB NGS) diagnostics in Madagascar and Canada to assess the barriers and facilitators of the technology and contrast its usage in low- and high-income countries. The interviews revealed an overall lack of familiarity and clarity surrounding TB NGS, as well as a sentiment of skepticism concerning its capacity and performance. Stakeholders from Madagascar and Canada agreed that TB NGS should be integrated into the existing TB management pipeline, which includes surveillance and clinical programs. Canadian interviewees were more likely to suggest acquiring recommendations to use TB NGS from various public health institutions, while interviewees in Madagascar almost uniformly reported the necessity of a formal recommendation from WHO. [BMJ Open]
Orientation and location of sanitation services determine perceived safety in informal settlements.
Researchers conducted a cross-sectional study across 1,714 households in four informal settlements to explore the environmental determinants of access to shared sanitation services in informal settlements in Abidjan, Côte d’Ivoire, and Nairobi, Kenya. Using a toilet outside the premises was associated with a perceived lack of safety in using the facility at any time in both Abidjan and Nairobi. Furthermore, perceived insecurity in toilet access was linked to a greater risk of diarrheal infections in children over five years old. Settlement morphology, including the orientation and form of the built environment, and the sanitation facility’s specific location were major predictors of perceived safety. [Infectious Diseases of Poverty]
Northern regions in Nigeria are significantly impacted by under-five malnutrition.
Researchers investigated the prevalence of malnutrition (measured by the Composite Index of Anthropometric Failure, or CIAF) and the spatial variations in the burden of malnutrition among children under five years in Nigeria. Overall, the prevalence of undernutrition in Nigeria was 41.3 percent. A geo-additive model was used to identify geographic hotspots of malnutrition, which revealed a high proportion of children experiencing undernutrition in northern districts compared to the south. Factors such as greater parental education and media access were associated with a lower aggregate index of undernutrition. [PLOS One]
Implementing a 7-1-7 outbreak response framework requires more stakeholder investment.
The 7-1-7 target has been proposed as a timely means of outbreak detection, notification, and early response, entailing detection within seven days of emergence, reporting within one day of detection, and completion of seven early response tasks within seven days of reporting. Researchers used this framework to analyze five countries’ responsiveness to public health events in a retrospective study. They found that the median performance was strong from a 7-1-7 perspective, but only a small proportion of events met the framework’s targets. Subnational resource limitations were typically responsible for diminishing a country’s ability to reach the 7-1-7 targets, necessitating more flexible and available funding for all levels of public health. [The Lancet Global Health]
Distrust in science and government in Liberia dates to the 2014 Ebola epidemic.
In focus groups with Liberians from three communities with varying health behaviors and attitudes during the 2014-2016 Ebola epidemic, participants revealed distrust in the national government and a lack of belief in the biomedical mechanisms of Ebola. While some health-related practices, such as routine handwashing and safely caring for sick individuals, have persisted in these communities, many participants believed that the Ebola epidemic was not real. The deep distrust in science and government across diverse communities in Liberia threatens future outbreak control and mitigation efforts and may undermine national and community public health efforts. [BMC Public Health]
COVID-19 caused significant health and education disruptions among mothers and children in South Asia.
The impact of the COVID-19 pandemic health service disruptions and school closures in South Asia in 2020 and 2021 were projected to have caused an excess of 317,000 child and 19,000 maternal deaths by a recent modeling study. Furthermore, over 9 million schoolchildren in South Asia dropped out of school due to pandemic-related lockdowns. The findings indicate that the COVID-19 pandemic disproportionately impacted women and children in South Asia, negatively impacting both health and educational outcomes. [PLOS Global Public Health]
COVID-19 infection was associated with a higher risk of diabetes in Canada.
A population-based cohort study was conducted in British Columbia, Canada, between January 2020 and December 2021 to assess whether COVID-19 infection was associated with a higher risk of incident (new-onset) diabetes. The incidence rate of diabetes was significantly higher among participants who tested positive for SARS-CoV-2 than among participants unexposed to COVID-19. Moreover, the risk of incident diabetes was higher among individuals with severe COVID-19 disease – including those admitted to the intensive care unit or hospital – than those uninfected. Researchers estimate that COVID-19 infection likely contributed to between three and five percent of incident diabetes cases in British Columbia during the studied time period. [JAMA Network Open]
Barriers to taking a gender-based approach to public health research.
Researchers identified challenges to integrating gender in the design of public health research projects in six low- and middle-income countries (LMICs). Through a synthesis dialogue, public health researchers noted that convincing funders and stakeholders of the added value of the gender dimension of health was a major barrier to including gender in public health studies. Compared to other social and demographic factors, gender is more often than not regarded as less important or irrelevant in public health research. [PLOS Global Public Health]
Wheat blast fungus outbreak sparks concerns about antifungal resistance.
Outbreaks of the “wheat blast” pathogen Magnaporthe oryzae in Africa and Asia threaten wheat production and increase the risk of spreading antifungal resistance among other food crops. First discovered in South America in the 1980s, genomic analyses suggest that strains of M. oryzae have reached parts of Africa and Asia through independent transmission events, likely facilitated by humans. Spontaneous mutations that confer resistance to common antifungal agents can also arise from the mating of two strains of M. oryzae, leading experts to call for immediate eradication of the fungus from Bangladesh and Zambia. [Nature]
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