Dataset Information

Strategic Planning for Tuberculosis Control in the Republic of Fiji.

ABSTRACT: The tuberculosis (TB) health burden in Fiji has been declining in recent years, although challenges remain in improving control of the diabetes co-epidemic and achieving adequate case detection across the widely dispersed archipelago. We applied a mathematical model of TB transmission to the TB epidemic in Fiji that captured the historical reality over several decades, including age stratification, diabetes, varying disease manifestations, and incorrect diagnoses. Next, we simulated six intervention scenarios that are under consideration by the Fiji National Tuberculosis Program. Our findings show that the interventions were able to achieve only modest improvements in disease burden, with awareness raising being the most effective intervention to reduce TB incidence, and treatment support yielding the highest impact on mortality. These improvements would fall far short of the ambitious targets that have been set by the country, and could easily be derailed by moderate increases in the diabetes burden. Furthermore, the effectiveness of the interventions was limited by the extensive pool of latent TB infection, because the programs were directed at only active cases, and thus were unlikely to achieve the desired reductions in burden. Therefore, it is essential to address the co-epidemic of diabetes and treat people with latent TB infection.

SUBMITTER: Ragonnet R

PROVIDER: S-EPMC6631049 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Strategic Planning for Tuberculosis Control in the Republic of Fiji.

Ragonnet Romain R Underwood Frank F Doan Tan T Rafai Eric E Trauer James J McBryde Emma E

Tropical medicine and infectious disease 20190424 2

The tuberculosis (TB) health burden in Fiji has been declining in recent years, although challenges remain in improving control of the diabetes co-epidemic and achieving adequate case detection across the widely dispersed archipelago. We applied a mathematical model of TB transmission to the TB epidemic in Fiji that captured the historical reality over several decades, including age stratification, diabetes, varying disease manifestations, and incorrect diagnoses. Next, we simulated six interven ...[more]

PMID: 31022901

Similar Datasets

Project description:BackgroundIdentifying human and malaria parasite movements is important for control planning across all transmission intensities. Imported infections can reintroduce infections into areas previously free of infection, maintain 'hotspots' of transmission and import drug resistant strains, challenging national control programmes at a variety of temporal and spatial scales. Recent analyses based on mobile phone usage data have provided valuable insights into population and likely parasite movements within countries, but these data are restricted to sub-national analyses, leaving important cross-border movements neglected.MethodsNational census data were used to analyse and model cross-border migration and movement, using East Africa as an example. 'Hotspots' of origin-specific immigrants from neighbouring countries were identified for Kenya, Tanzania and Uganda. Populations of origin-specific migrants were compared to distance from origin country borders and population size at destination, and regression models were developed to quantify and compare differences in migration patterns. Migration data were then combined with existing spatially-referenced malaria data to compare the relative propensity for cross-border malaria movement in the region.ResultsThe spatial patterns and processes for immigration were different between each origin and destination country pair. Hotspots of immigration, for example, were concentrated close to origin country borders for most immigrants to Tanzania, but for Kenya, a similar pattern was only seen for Tanzanian and Ugandan immigrants. Regression model fits also differed between specific migrant groups, with some migration patterns more dependent on population size at destination and distance travelled than others. With these differences between immigration patterns and processes, and heterogeneous transmission risk in East Africa and the surrounding region, propensities to import malaria infections also likely show substantial variations.ConclusionThis was a first attempt to quantify and model cross-border movements relevant to malaria transmission and control. With national census available worldwide, this approach can be translated to construct a cross-border human and malaria movement evidence base for other malaria endemic countries. The outcomes of this study will feed into wider efforts to quantify and model human and malaria movements in endemic regions to facilitate improved intervention planning, resource allocation and collaborative policy decisions.

Project description:Background: Many lower and middle income countries (LMICs) have high levels of linguistic diversity, meaning that health information and care is not available in the languages spoken by the majority of the population. This research investigates the extent to which language needs are taken into account in planning for HIV/AIDS-related health communication in development contexts. Methods: We analysed all HIV/AIDS-related policy documents and reports available via the websites of the Department for International Development UK, The Global Fund, and the Ministries of Health and National AIDS commissions of Burkina Faso, Ghana and Senegal. We used quantitative and qualitative analysis to assess the level of prominence given to language issues, ascertain the level at which mentions occur (donor/funder/national government or commission), and identify the concrete plans for interlingual communication cited in the documents. Results: Of the 314 documents analysed, 35 mention language or translation, but the majority of the mentions are made in passing or in the context of providing background socio-cultural information, the implications of which are not explored. At donor level (DFID), no mentions of language issues were found. Only eight of the documents (2.5%) outline concrete actions for addressing multilingualism in HIV/AIDS-related health communication. These are limited to staff training for sign language, and the production of multilingual resources for large-scale sensitization campaigns. Conclusions: The visibility of language needs in formal planning and reporting in the context of HIV/AIDS-related health care is extremely low. Whilst this low visibility should not be equated to a complete absence of translation or interpreting activity on the ground, it is likely to result in insufficient resources being dedicated to addressing language barriers. Further research is needed to fully understand the ramifications of the low prominence given to questions of language, not least in relation to its impact on gender equality.

Dataset Information

Strategic Planning for Tuberculosis Control in the Republic of Fiji.

Publications

Strategic Planning for Tuberculosis Control in the Republic of Fiji.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets