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Towards integrated surveillance-response systems for the prevention of future pandemics

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Infectious Diseases of Poverty 2020年第5期9卷 87-92页

作者： jakob zinsstag Jürg Utzinger Nicole Probst-Hensch Lv Shan Xiao-Nong Zhou Swiss Tropical and Public Health Institute BaselSwitzerland University of Basel BaselSwitzerland National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention&Chinese Center for Tropical Diseases Research WHO Collaborating Center for Tropical DiseasesShanghaiPeople's Republic of China School of Global Health Chinese Center for Tropical Diseases Research-Shanghai Jiao Tong University School of MedicineShanghaiPeople's Republic of China

Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs.The transmission of such pathogens to humans may lead to self-sustaining chains of transmission.These pathogens represent the highest risk for future pandemics.For their prevention,the transmission over the species barrier—although rare—should,by all means,be avoided.In the current COVID-19 pandemic,surprisingly though,most of the current research concentrates on the control by drugs and vaccines,while comparatively little scientific inquiry focuses on future prevention.Already in 2012,the World Bank recommended to engage in a systemic One Health approach for zoonoses control,considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons.First examples,like integrated West Nile virus surveillance in mosquitos,wild birds,horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors.Provided a zoonotic origin can be ascertained for the COVID-19 pandemic,integrated wildlife,domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks.In conclusion,the earlier a zoonotic pathogen can be detected in the environment,in wildlife or in domestic animals;and the better human,animal and environmental surveillance communicate with each other to prevent an outbreak,the lower are the cumulative costs.

关键词： Integrated surveillance-response One health Pandemics Transdisciplinarity Zoonoses

The impact of pastoralist mobility on tuberculosis control in Ethiopia:a systematic review and meta-synthesis

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Infectious Diseases of Poverty 2019年第5期8卷 91-91页

作者： Faisal Nooh Lisa Crump Abdiwahab Hashi Rea Tschopp Esther Schelling Klaus Reither Jan Hattendorf Seid M.Ali Brigit Obrist Jurg Utzinger jakob zinsstag Swiss Tropical and Public Health Institute P.O.BoxCH-4002BaselSwitzerland University of Basel P.O.BoxCH-4003BaselSwitzerland 不详

Background:Directly observed treatment,short-course(DOTS)is the current mainstay to control tuberculosis(TB)worldwide.Context-specific adaptations of DOTS have impending implications in the fight against TB.In Ethiopia,there is a national TB control programme with the goal to eliminate TB,but uneven distribution across lifestyle gradients remains a challenge.Notably,the mobile pastoralist communities in the country are disproportionately left uncovered.The aim of this study was to summarize the evidence base from published literature to guide TB control strategy for mobile pastoralist communities in Ethiopia.Main text:We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines and systematically reviewed articles in seven electronic databases:Excerptra Medical Database,African Journal Online,PubMed,Google Scholar,Centre for Agriculture and Bioscience International Direct,Cochrane Library and Web of Science.The databases were searched from inception to December 31,2018,with no language restriction.We screened 692 items of which 19 met our inclusion criteria.Using a meta-ethnographic method,we identified six themes:(i)pastoralism in Ethiopia;(ii)pastoralists’livelihood profile;(iii)pastoralists’service utilisation;(iv)pastoralists’knowledge and awareness on TB control services;(v)challenges of TB control in pastoral settings;and(vi)equity disparities affecting pastoralists.Our interpretation triangulates the results across all included studies and shows that TB control activities observed in pastoralist regions of Ethiopia are far fewer than elsewhere in the country.Conclusions:This systematic review and meta-synthesis shows that TB control in Ethiopia does not align well with the pastoralist lifestyle.Inaccessibility and lack of acceptability of TB care are the key bottlenecks to pastoralist TB service provision.Targeting these two parameters holds promise to enhance effectiveness of an intervention.

关键词： Directly observed treatment short-course(DOTS) Effectiveness Equity Ethiopia,Meta-ethnographic method Pastoralist Systematic review Tuberculosis

Ecological and behavioural risk factors of scrub typhus in central Vietnam:a case-control study

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Infectious Diseases of Poverty 2021年第4期10卷 97-97页

作者： Hanh Thi Duc Tran Jan Hattendorf Hung Manh Do Thanh Tien Hoang Hang Thi Hai Hoang Hoa Ngoc Lam Mai Kim Huynh Lan Thi Hoang Vu jakob zinsstag Daniel Henry Paris Esther Schelling Department of Epidemiology and Public Health Swiss Tropical and Public Health InstituteBaselSwitzerland 不详

Background The risk factors for scrub typhus in Vietnam remain unknown.Scrub typhus caused by Orientia tsutsugamushi often presents as an undifferentiated febrile illness and remains under appreciated due to the limited availability of diagnostic tests.This tropical rickettsial illness is increasingly recognized as an important cause of non-malaria acute undifferentiated fever in Asia.This study aimed to investigate behavioural and ecological related risk factors of scrub typhus to prevent this potentially life-threatening disease in Vietnam.Methods We conducted a clinical hospital-based active surveillance study,and a retrospective residence-enrolment date-age-matched case–control study in Khanh Hoa province,Vietnam,from August 2018 to March 2020.Clinical examinations,polymerase chain reaction and enzyme-linked immunosorbent assay IgM tests were applied to define cases and controls.All enrolled participants filled out a questionnaire including demographic socio-economic status,personal behaviors/protective equipment,habitat connections,land use,and possible exposure to the vector.Multivariable conditional logistic regression was used to define the scrub typhus associated risk factors.Results We identified 44 confirmed cases and matched them with 152 controls.Among cases and controls,the largest age group was the 41–50 years old and males accounted for 61.4%and 42.8%,respectively.There were similarities in demographic characteristics between the two groups,with the exception of occupation.Several factors were significantly associated with acquisition of scrub typhus,including sitting/laying directly on household floor[adjusted OR(aOR)=4.9,95%CI:1.6–15.1,P=0.006],household with poor sanitation/conditions(aOR=7.9,95%CI:1.9–32.9,P=0.005),workplace environment with risk(aOR=3.0,95%CI:1.2–7.6,P=0.020),always observing mice around home(aOR=3.7,95%CI:1.4–9.9,P=0.008),and use of personal protective equipment in the field(aOR=0.4,95%CI:0.1–1.1,P=0.076).Conclusions Ecological and household hygiene-related factors were more

关键词： Ecological Environmental Behaviour Risk factor Scrub typhus Orientia tsutsugamushi Vietnam

Social Services for Mobile Pastoralists： Cross-sector Strategy Based on ＂One Health＂

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Journal of Sociology Study 2012年第9期2卷 705-714页

作者： Mahamat Bechir zinsstag jakob Mahamat Abdoulaye Schelling Esther Kessely Hamit Fokou Gilbert Moto Daugla Bonfoh Bassirou Tanner Marcel University of N'Djamena Chad Centre de Support en Sante lnternationale Chad Swiss Tropical and Public Health Institute/University ofBasel Swiss Centre Suisse de Recherche Scientifique Cite d'Ivoire

Mobile pastoralist communities in Sahel countries have serious problems of access to social services. Classic strategies for social services were always based on a single sector, focused on settled populations, and hardly reached mobile communities. This paper aims to show a cross‐sector approach as a part of solutions to provide social services for mobile pastoralist communities and describes the ongoing scaling‐up process. The method used is based on a transdisciplinary approach which involves target communities and authorities in all processes through workshops and site visits. Interventions adopted the concept of "one health" benefiting of an added value of closer cooperation between human and animal health. This approach was tested with joint interventions between human and animal health, which provided access to health services for unreached communities and saved resource when compared with single sector intervention. Such approaches could be extended to other social services within cross‐sector interventions such as the delivery of basic education in nomadic areas. Such a strategy was validated by the communities and authorities and was further transformed into a national programme after a series of six national stakeholders’ seminars. The cross‐sector intervention will provide a minimum package of services (MPS) without compromising the structural services.

关键词：社会服务动物健康移动牧民萨赫勒地区利益相关者资源保存保健服务