Guidance, tools and support for countries transitioning to digital case-based TB surveillance

July 26, 2022 Department News Geneva Reading time: 2 minutes (478 words) More than 300 country representatives and partners attended the webinar on "Strengthening Pipeline Surveillance: Supporting Countries to Transition to Case-Based Digital Surveillance". Strengthening TB surveillance systems is one of the strategic work areas of the World Health Organization (WHO). Robust surveillance systems that produce reliable, high-quality data are essential to understanding the extent of the TB burden and the impact of our programmatic interventions. WHO is leading efforts to support countries to transition to a robust, case-based, real-time digital TB surveillance system. The webinar will be organized by WHO on 8 July 2022 in two sessions to allow participation from all time zones. Presentations by WHO and partner agencies, the Global Fund and the University of Oslo (UiO) showed the guidance, tools and support available to countries to implement digital TB case-based surveillance. Lessons learned from recent country implementation efforts were also shared, including a presentation of the National TB Program in Tanzania. More specifically, the webinar covers: An overview of current and future WHO guidelines and tools to support the transition to case-based digital TB surveillance. It emphasizes the importance of an integrated digital environment for the collection, analysis and use of data in the prevention and care of people with TB disease. Introduction and live demonstration of the WHO DHIS2 TB tracker for monitoring patients and surveillance program activities. It shows the features included in the DHIS2 digital packages for tuberculosis surveillance and explores the different scenarios that exist in countries for the implementation of these packages. Dissemination of best practices emerging from a multi-country evaluation of DHIS2 TB tracker implementation found to support successful implementation. These include: the importance of political commitment, involvement of health information system stakeholders, ownership of TB programs and coordination of the implementation process, and the existence of supporting policies for health data management. Experiences from Tanzania informed participants that implementing digital surveillance is a long process that requires commitment, careful process control, and constant adaptation of the system to meet the new needs of the TB program. WHO, the Global Fund and the University of Oslo highlighted their role in providing programmatic, technical and financial support to countries to implement the DHIS2 digital packages for TB. The Global Fund presents the options available under its target for eligible countries and invites these countries to plan, prioritize and budget for digital surveillance in the next round of submissions starting in early 2023. The University of Oslo presents several regional networks available for technical support countries. WHO provides an overview of its role in leading as well as providing and coordinating support to countries.

is it monkeypox?

Monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar to, but less severe than, smallpox. While smallpox was eradicated in 1980, monkeypox continues to occur in Central and West African countries.

Two distinct clades are recognized: the West African clade and the Congo Basin clade, also known as the Central African clade. Monkeypox is a zoonosis: a disease that is transmitted from animals to humans. Cases are often found near tropical rainforests where animals carrying the virus live. Evidence of monkeypox virus infection has been found in animals including squirrels, Gambian rats, hamsters, various species of monkeys, and others.

Human-to-human transmission is limited, the longest documented chain of transmission is 6 generations, meaning that the last infected person in that chain is 6 links from the original patient. . It can be transmitted by contact with body fluids, skin lesions, or internal mucosal surfaces such as the mouth or throat, respiratory droplets, and contaminated objects. Detection of viral DNA by polymerase chain reaction (PCR) is the preferred laboratory test for monkeypox.

The best diagnostic samples are directly from the rash – skin, fluid or crust, or if possible a biopsy. Antigen and antibody detection methods may not be useful because they do not identify orthopoxviruses.

How to check?

Monkeypox presents with fever, an extensive characteristic rash and usually swollen lymph nodes. It is important to distinguish monkeypox from other illnesses such as chickenpox, measles, bacterial skin infections, scabies, syphilis and medication-associated allergies. The incubation period of monkeypox can range from 5 to 21 days.

The febrile stage of illness usually lasts 1 to 3 days with symptoms including fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle ache), and an intense asthenia (lack of energy). The febrile stage is followed by the skin eruption stage, lasting for 2 to 4 weeks.

Lesions progress from macules (flat-based lesions) to papules (raised firm painful lesions) to vesicles (clear fluid-filled) to pustules (pus-filled), followed by scabs or crusts. The proportion of patients who died ranged between 0 and 11% of documented cases and was higher in children.

Yess!!! we can stop it

Treatment

Treatment of patients with monkey pox is recommended based on symptoms. Various compounds are being developed and tested that may be effective against the monkey virus.

Prevention and control of infectious diseases depends on raising public awareness and educating health workers to prevent disease and stop the spread. Many mosquito-borne diseases are transmitted through animal-to-human transmission.

Contact with sick or dead animals should be avoided and all foods containing meat or animal parts should be thoroughly cooked before consumption. Close contact with infected people or contaminated materials should be avoided.

Gloves and other personal protective clothing and equipment should be worn while taking care of the sick, whether in a health facility or in the home.

Populations have become more susceptible to monkeypox as a result of the termination of routine smallpox vaccination, which offered some cross-protection in the past.

Vaccination against smallpox with first generation vaccinia virus-based smallpox vaccine was shown to be 85% effective in preventing monkeypox in the past.

Family and community members, health workers and laboratory personnel who were vaccinated against smallpox in childhood may have some remaining protection against monkeypox.

Study estimates more than one million Indians died from snakebite envenoming over past two decades

A study estimates that more than one million Indians have died from snakebites in the past two decades. July 10, 2020  Department News Reading Time: 2 minutes (591 words) India is one of the countries most affected by snakebites, accounting for almost half of the world's total annual deaths. The authors of the article, titled "Trends in snakebite mortality in India from 2000 to 2019 in a nationally representative mortality study," analyzed 2,833 snakebite deaths out of 611,483 who underwent oral autopsies from a previous study1 and conducted a systematic review of the literature from 20000 , covering 097 stars. The authors estimated that India had 1.2 million snakebite deaths from 2000 to 2019 (an average of 58,000 per year), with nearly half of the victims aged 30-69 and more than a quarter children under 15. People living in densely populated, low-altitude agricultural areas in the states of Bihar, Jharkhand, Madhya Pradesh, Odisha, Uttar Pradesh, Andhra Pradesh (which includes Telangana, a newly defined state), Rajasthan and Gujarat suffer 70% of deaths during the period. 2001-2014, especially during the rainy season, when encounters between snakes and humans are more frequent both indoors and outdoors.

The World Health Organization (WHO) has set the target of reducing by half the number of deaths due to snakebite envenoming by 2030 and India’s efforts to prevent and control this disease will largely influence this global target.

“Since deaths are restricted mainly to lower altitude, intensely agricultural areas, during a single season of each year, this should make the annual epidemics easier to manage. India’s tremendous snakebite burden is staring us in the face and we need to act now” said Romulus Whitaker of the Centre for Herpetology/Madras Crocodile Bank. “Targeting these areas with education about simple methods, such as ‘snake-safe’ harvest practices, wearing rubber boots and gloves and using rechargeable torches (or mobile phone flashlights) could reduce the risk of snakebites.”

The need for more national epidemiological studies on countries with endemic snakebite

Further nationally representative studies with increased mapping resolution and more detailed data sources, including mortality and morbidity data from hospitals as well as data collected at the community level, are needed for more targeted and effective public health interventions in other snake-endemic countries. The authors also noted that the Indian government's official declaration of snakebite deaths in public hospitals between 2003 and 2015 was only 15,500, one-tenth of the 154,000 snakebite deaths detected in the same period from MDS public and private hospitals.

Guidelines for International Arrivals by gov of India

February 10, 2022

Government of India Ministry of Health and Family Care Instructions for international arrivals (supersedes all directives issued on this subject on and after 20 January 2022)

Introduction

The global and Indian development trajectory of the COVID-19 pandemic continues with regional changes. and it is necessary to monitor the constant change in the nature of the virus and the development of variants of SARS-CoV-2 v The focus must therefore remain on the concern (VOC). Existing Guidelines for International Arrivals in India continuously formulated with a risk-based approach. While watching nature and spread infection in the country and around the world, also aware of the fact that the economy activities must be carried out without obstacles.

Travel planning 

All travelers must

a Enter complete and true information in the Air online declaration form Suvidha Portal (https://www.newdelhiairport.in/airsuvidha/apho-registration) for the planned trip, including trip details for the last 14 days.

b. Upload a negative report of COVID-19 RT-PCR * (The test should have been performed up to 72 hours before travel) or Certificate of completion of the complete scheme of basic vaccination against COVID-19 vaccination**.

c. Each passenger must also present a declaration of authenticity report and subject to prosecution if found otherwise.

ii. They must also place an order on the portal or at the Ministry of Civil Aviation, by the Government of India by the airlines concerned before they can execute travel that they will follow the decision of the relevant government authority a home/constitutional quarantine/self-health check is required upon arrival, If needed.

A.2. Before boarding 

Do's and Don'ts for Airline/Agency Ticketed Passengers worry

iv. Airlines will allow boarding only to passengers who fill in all information Self Declaration Form on Air Suvidha portal and upload negative RT-PCR test a report or confirmation of vaccination against Covid-19 who has completed the basic vaccination plan**. 

Once you board ,the plane, only asymptomatic passengers will be allowed to board thermal shielding.

i. All passengers are advised to download Aarogya Setu app on their mobile devices.

A.3. During Travel

vii. In-flight announcements about COVID-19 including precautions to follow will take place at airports and on flights and during travel.

viii. During the flight, the crew must ensure that appropriate COVID etiquette is followed at all times.

ix. If any passenger reports symptoms of COVID-19 during the flight, they must be isolated as directed protocol.

X. Airlines must make appropriate in-flight announcements about the test requirements and persons to undergo such test to avoid inconvenience arrival airports.

A.4. on arrival

xi. Exiting must be done to ensure physical distancing.

xi. Medical personnel will conduct a thermal examination of all passengers he is at the airport. The online self-declaration form will be issued at the airport medical staff.

xiii. Passengers who show symptoms during screening must be immediately isolated and transferred to a medical facility according to the medical protocol. If they test positive, their contacts should identify and manage according to prescribed protocol# .

xiv. The following protocol must also be followed on arrival 

A sub-section (2% of the total number of passengers on the flight) will be subjected to random post-arrival testing at the airport upon arrival.

b. Such passengers on each flight must identify the relevant airlines (preferably from different countries). They submit the samples and release them AIRPORT.

C. If these travelers test positive, their samples must be sent for genomic testing INSACOG test network of laboratories.

d. Should be handled/separated according to standard protocol.

xv. All passengers will self-check their health for the next 14 days after arrival. xvi. If passengers are under monitoring of their own health, have signs and symptoms reminiscent of COVID 19, they should isolate themselves immediately and report to their nearest medical facility or call Národní. helpline number (1075) / state helpline number. International passengers arriving at land ports/ports xvii. International passengers arriving via land ports/ports must also go same protocol as above except no online registration facility is available for such passengers today.

xviii. These passengers must submit a self-declaration form to the relevant authorities at the address Government of India ports/land ports of arrival.

* Children under 5 are exempt from pre- and post-arrival testing. But if found to have symptoms of COVID-19 on arrival or during the self-monitoring period must undergo testing and treatment as outlined in the protocol.

There are countries that have an agreement with India on mutual recognition of vaccinations nationally recognized or WHO recognized vaccine certificates. Likewise, there are countries that currently there is no such agreement with India, but they exempt Indian citizens who are fully vaccinated with nationally recognized or WHO-recognised vaccines. Based on the exchange of passengers relaxation will be allowed only from countries that provide free entry to quarantine for Indians under confirmation of completion of the full schedule of basic vaccination against COVID-19.

List from these countries are available on the website of the Ministry of Health and Welfare (mohfw.gov.in) and the link is available on the Ministry of External Affairs website and the Air Suvidha portal. This is also a dynamic list and will be updated from time to time. Travelers from such countries they are only considered for granting access on the basis of a vaccination card and must be uploaded in full vaccination certificate on the Air Suvidha portal. # The contacts of the suspected case are passengers sitting in the same row, 3 rows in front and 3 back row with the acclaimed Cabin Crew.

WHO has issued a global update on the COVID-19 vaccination strategy to reach the vulnerable?

The global rollout of a vaccine against COVID-19 is the largest and fastest on record, but many of those most at risk remain unprotected – only 28% of the elderly and 37% of health care workers in low-income countries receive primary care. course of vaccines and most do not receive booster doses.

On the way to achieving the goal of 70% coverage, healthcare workers, over 60 years of age and other risk groups must be addressed as a priority.

The WHO strategy update increases vaccination targets to 100% of healthcare workers and 100% of the population at highest risk for primary and booster doses, with the aim of reducing mortality, keeping societies open and ensuring economies function while transmission continues. .

While vaccines have saved countless lives, they have not slowed the spread of COVID-19. Innovation is needed to develop new vaccines that significantly reduce transmission, are easier to administer, and provide broader and longer protection.

WHO today published an update on the global vaccine strategy for COVID-19 in response to the spread of Omicron subvariants, advances in vaccine evidence and lessons from the global vaccination programme.

An estimated 19.8 million lives were saved in the first year of the introduction of the COVID-19 vaccine. Thanks to an unprecedented and rapid global rollout, more than 12 billion doses have been administered worldwide, in almost every country in the world, resulting in countries reaching an average of 60% of their population.

However, in the primary series, only 28% of the elderly population and 37% of health workers in low-income countries were vaccinated. 27 WHO Member States have not yet launched a booster or extra dose programme, including 11 low-income countries.

The strategy aims to use primary and booster doses to reduce mortality and serious illness, to protect health systems, society and the economy. In order to achieve the 70% vaccination coverage target, countries must prioritize achieving baseline targets for immunizing 100% of the health population and 100% of the most vulnerable groups, including the elderly population (over 60 years) and those with weakened immunity or underlying diseases.

state. "Even where 70% vaccination coverage is achieved, if many health workers, the elderly and other high-risk groups remain unvaccinated, deaths will continue, health systems will remain under pressure and the recovery of the whole world will be at risk," he said. WHO Director-General Dr Tedros Adhanom Ghebreyesus. "Vaccinating all those most at risk is the best way to save lives, protect health systems and keep societies and economies open."

To ensure that vaccines reach the highest priority groups, the strategy emphasizes the need to measure progress in vaccinating these groups and develop targeted methods to reach them. Methods include leveraging local data and engaging communities to sustain demand for vaccines, building adult immunization systems, and reaching more displaced people through humanitarian response. The strategy also aims to accelerate the development and ensure equal access to improved vaccines to reduce transmission as a top priority, while achieving strong, broad-based protective immunity.

Today's vaccines are designed to prevent serious illness and death, and they succeed, saving millions of lives. However, they did not reduce the transmission. As the virus continues to spread, new and dangerous variants emerge, including those that make vaccines less effective. It is important to continue investing in research and development to create more effective and easier vaccines, such as nasal sprays.

Other important steps to take include: equitable distribution of production facilities across regions and support for strong vaccine delivery programs. WHO will continue to work with COVAX partners and the COVID-19 Vaccine Delivery Partnership (CoVDP) to support countries to introduce and also integrate COVID-19 vaccination with other health interventions