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Category: Surveillance

IDASH Fellowship Meets in Kazakhstan for In-Person, and Virtual, Workshop

Post categories: Global Health Security Health Systems Strengthening Human Resources for Health Peter Rabinowitz Surveillance Ukraine Uncategorized
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IDASH fellows engage in group work during an October workshop in Almaty, Kazakhstan. Photo credit: Jamey Gentry/CDC.

Last month, the International Training and Education Center for Health (I-TECH), in collaboration with the U.S. Centers for Disease Control (CDC) and with support from the World Health Organization (WHO), facilitated the second of three in-person workshops for the Informatics and Data Science for Health (IDASH) fellowship.

Held in Almaty, Kazakhstan, the workshop marked the mid-point of the 12-month fellowship—and a chance for participants to come together to advance their ability to apply public health informatics and data science concepts and approaches.

“This workshop included a lot of hands-on practical exercises, and it was fun to observe how engaged the participants were with these activities and with the learning in general,” said Stacey Lissit, MPH, MS, Senior Technical Advisor for the IDASH program.

Content included all things data (quality, cleaning, analysis, visualization, governance, security, privacy, and confidentiality); interoperability; project management; business process analysis; and systems architecture. Sessions were a mix of didactic lecture, small group activities to practice application of skills and concepts, peer feedback, and guided hands-on learning in R and PowerBI. Over the course of the two weeks, participants collaborated  to develop a data dashboard, a database schema, and a data quality workplan.

The first cohort of the IDASH fellowship, with I-TECH instructors. Photo credit: Jamey Gentry/CDC.

The current fellowship, launched in April 2023, comprises a cohort of four participants each from Georgia, Kazakhstan, Kyrgyzstan, Ukraine, and Uzbekistan—a total of 20 fellows. Each four-person team includes a mix of mid-senior level epidemiologists, informaticians, data scientists, IT, and public health policy personnel.

Fellow Zhanibek Yerubayev, Director of Public Health Emergency Operations at the Kazakhstan Ministry of Health’s National Center of Public Health, says the team mix is an integral part of IDASH’s impact. “[IDASH] connects people from the public health side with people from the IT side,” he says. “These people have a lot of projects to do [together], but they are not always well connected, and they do not always understand each other well.”

“It was exciting to see the relationships and community that are being built through the IDASH Fellowship – both within the country teams where fellows can collaborate closely with colleagues outside of their typical ‘work silos,’ and across countries within the region,” said Lissit. “That peer learning element is such an important part of the fellowship.”

And all efforts were made to ensure multi-directional collaboration. The Ukrainian team did not receive permission to travel to the workshop, so I-TECH made arrangements for them to participate via Zoom. A location was identified in southwest Ukraine where the team could  attend the workshop together remotely, experience fewer daily safety issues related to the war, and avoid the distractions of being in their own workplace. A simultaneous translator for the Ukrainian language was provided on the Zoom call.

While remote participation is not ideal, the Ukraine team was able to attend and hear most of the workshop sessions and engage in the group work in meaningful ways. “A lot of effort went into setting up the technology that enabled this participation,” said Lissit. “At one point the Ukraine team was participating in a peer feedback activity with two country teams in Almaty—there were live cameramen, screen sharing, Zoom translators…and it worked mostly seamlessly!”

Fellow Durbek Aliyev, Deputy CEO at IT-Med LLC, which works under the Uzbekistan Ministry of Health, was especially appreciative of the chance to learn from a wide range experts across the region. “The digitalization of health care cannot be done by only one country itself,” said Aliyev. “The advantage of IDASH over other programs is that it brings [together] specialists from neighbor countries. We are talking to each other….We are learning from each other directly.”

And these relationships will be a lasting benefit of the program, he continued. “IDASH is a place where we can establish very good networking with other countries,” said Aliyev. “Any time I can contact them and learn from their expertise.”

IDASH is a project within the Integrated Next-Generation Surveillance in Global Health: Translation to Action (INSIGHT) program. In addition to acquiring new skills and knowledge in public health informatics and data science, IDASH country teams are developing and will implement a collaborative team project that demonstrates key competencies and is aligned with their country’s needs and priorities.

 

 

 

HIV Drug Resistance Surveillance in Malawi

Post categories: Gabrielle O'Malley HIV Care and Treatment Malawi Surveillance
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The World Health Organization recommends countries routinely implement nationally representative HIV drug resistance (HIVDR) surveys among people infected with HIV to measure the level of drug resistance. The results of HIVDR surveys are a critical component of HIV programs and can guide changes to pediatric and adult antiretroviral therapy (ART) treatment regimens, including first- and second-line regimen decisions. I-TECH has been implementing HIVDR surveys in Malawi since 2016.

HIV DR Surveys Conducted Since 2016:

  • Infant HIVDR Survey: An HIVDR survey was conducted among infants aged 18 months and younger to determine the level of pediatric resistance to nonnucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI), and protease inhibitors (PI) ART drugs through exposure during pregnancy and breastfeeding. A total of 232 eligible remnant dried blood spot (DBS) samples from nine early infant diagnosis (EID)-approved laboratories were used for the diagnosis of HIV in infants between June 2016 and December 2017.
  • Antenatal Care (ANC)/Pregnant Women HIVDR Survey: An HIVDR survey was conducted to measure resistance to NNRTI, NRTI and PI drugs among ANC clients who were found to have a recent HIV infection. A total of 45 DBS samples from women with recent HIV infection were collected as part of the 2016 HIV sentinel surveillance survey and were successfully amplified and sequenced.

The next step in HIV surveillance activity is monitoring HIVDR among pregnant women initiating dolutegravir (DTG)-based regimens, as well as the potential emergence of DTG resistance in infants via mother-to-child transmission. A study of DTG resistance is currently underway in Malawi and will determine the level of DTG resistance in adults who are unable to achieve viral load suppression and DTG resistance in children < 15 years old who are unable to achieve viral load suppression.

I-TECH Presents at 2023 IAS Conference on HIV Science

Post categories: Gabrielle O'Malley HIV Care and Treatment India Key Populations Malawi PrEP Quality Improvement Stefan Wiktor Surveillance Tuberculosis Zimbabwe
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The 2023 IAS Conference on HIV Science logo. Read the full background and inspiration behind the 2023 IAS Logo. Image credit: IAS

The International AIDS Society (IAS) hosted the 12th IAS Conference on HIV Science on 23 – 26 July 2023 in Brisbane, Australia, and virtually. This biennial conference brings together top HIV researchers, experts, and scientists for presentations and discussions on the latest advances in HIV research and practice.

This year, representatives from the International Training and Education Center for Health (I-TECH), I-TECH’s partner network organizations, and the Centers for Disease Control and Prevention (CDC) shared findings from I-TECH-supported programs in India, Malawi, and Zimbabwe. Read the ePoster abstracts below.

India:

Malawi:

Zimbabwe:

John Lynch

John Lynch, MD, MPH  is an infectious diseases physician focused on improving the operations and capacities of healthcare teams to improve patient care and safety. He is an Associate Medical Director at Harborview Medical Center (HMC), a mission-driven, Level-1 burn and trauma teaching hospital that is part of the University of Washington (UW) School of Medicine. At HMC, he leads the hospital’s Infection Prevention & Control (IPC), Employee Health, and Sepsis Programs, and was the lead clinician for UW Medicine’s COVID-19 emergency response. Dr. Lynch is also a Professor of Medicine in the Division of Allergy & Infectious Diseases in the University of UW Department of Medicine.

Dr. Lynch co-leads the Center for Stewardship in Medicine (CSiM), a group of physicians and pharmacists working to bridge knowledge gaps (in both directions) between academic medical centers and rural health care facilities. Their work is mainly in antimicrobial stewardship and infection prevention but also extends to building quality improvement programs in those facilities. CSiM is composed of three main activities, including UW Tele-Antimicrobial Stewardship, a telementoring program, the Intensive Quality Improvement Cohorts, and resource/tool development to support the goals of the program.  

In addition, Dr Lynch also works with Dr. Peter Rabinowitz (PI) to provide subject matter expertise on a long-running project to build IPC capacity in hospitals in Kenya as part of the I-TECH Global Health Security Agenda project.  

Program Highlights

Global Health Security Agenda in Kenya

I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding ...
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Triple Border Disease Surveillance in South America

Post categories: Peter Rabinowitz Surveillance
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Population movement, limited public health infrastructure, different country reporting systems, and poor environmental conditions increase incidence of certain infectious diseases across borders. Communities living in border areas are at increased vulnerability for and worse outcomes from infectious diseases such as COVID-19 and other priority pathogens.

I-TECH, as part of the Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project, is implementing a cross border surveillance strengthening program  to improve the detection, monitoring, investigation, and response to public health threats in two triple border regions in South America.

Strengthening Public Health Disease Surveillance

Post categories: Global Health Security Julianne Meisner One Health Peru Peter Rabinowitz Surveillance Ukraine
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The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the US Centers for Disease Control and Prevention to assess and strengthen global public health surveillance systems using a One Health approach. The INSIGHT project leverages the capacity building strengths of I-TECH and the One Health disease surveillance expertise of the Center for One Health Research, with a model of engaging local institutions and experts in countries where it will be working in a shared partnership model.

In its first year, the INSIGHT project focused on an in depth assessment of the public health surveillance systems in Peru, in partnership with experts from University of Peru Cayetano Heredia . The completed assessment has now catalyzed the formation of a technical working group with representation across multiple government agencies that will work with other stakeholders including the World Bank at implementing measures to strengthen regional and country capacity to detect, respond to, control, and prevent emerging disease threats to health security.

The INSIGHT surveillance work in Latin America is also now expanding to involve Paraguay, Brazil, Argentina, and Colombia.

IDASH TRAINING PROGRAM

In 2023, the INSIGHT program launched the Informatics and Data Science for Health (IDASH) training program in Eastern Europe and Central Asia. The goals of IDASH are to enhance capacity to create and use public health information systems that enable the capture, management, analysis, dissemination, and use of reliable, timely information to improve population-level health outcomes, as well as strengthen regional capacity to effectively respond to future global health challenges.

UKRAINE RECOVERY

Building on lessons learned from the Peru assessment work, the INSIGHT team is now working with the Ukraine Public Health Center on expanding sentinel and event based surveillance systems in Ukraine and strengthening the capacity of the public health system for emergency management of chemical biological, radiological, and nuclear threats. The INSIGHT team has organized a workshop in Poland bringing together key principals from the Ukraine ministry of health and local health departments to accelerate the pace of activities in support of public health in the country. INSIGHT is coordinating technical working groups on Early Warning and Response, Public Health Emergency Management, and Surveillance strengthening.

IDASH Program Launches for Eastern Europe and Central Asia Region

Post categories: Global Health Security Health Information Systems One Health Surveillance Ukraine
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Participants gather for group discussion during the first IDASH in-person workshop in Tbilisi, Georgia. Photo credit: CDC/EECA

On April 3, the International Training and Education Center for Health (I-TECH) launched the Informatics and Data Science for Health (IDASH) fellowship training program with an in-person workshop in Tbilisi, Georgia. The program launched in partnership with the United States Centers for Disease Control and Prevention’s Eastern Europe and Central Asia (CDC/EECA) Regional Office, the World Health Organization (WHO) Europe, and country governments.

The first IDASH cohort includes 20 fellows from Georgia, Kazakhstan, Kyrgyzstan, Ukraine, and Uzbekistan. Participants include mid- to senior-level technical, analytical, and public health staff working at the national level in public health informatics or data science.

“After several whirlwind months of collaboration and engagement with stakeholders from the five countries, it’s amazing to welcome the first cohort of IDASH to Tbilisi for the first of three in-person workshops,” said Stacey Lissit, MPH, MS, Senior Technical Advisor for the IDASH program.

Fellows will participate in a 12-month in-service training program, in which each country team of four fellows will identify and develop a collaborative project. Fellows will receive sustained mentorship, and regional communities of practice will be established to ensure regional collaboration, share lessons learned and best practices, and establish linkages for future programming needs that span multiple countries.

“IDASH provides the opportunity to link learning to experience, and enables the application of new public health skills, knowledge, and techniques acquired from the training in a real-life context,” said Peter Rabinowitz, MD, MPH, Principal Investigator for the IDASH project. “It also extends benefits beyond the trainees to partner agencies and organizations, helping strengthen public health capacity in the region.”

Proposed fellowship projects include automating data analysis and visualization for diseases, expanding digital immunization registries beyond COVID-19, and developing spatial analysis modules for multi-disease surveillance and response.

“Today, the afternoon of the 4th day, the room is buzzing as the five country teams are hard at work: two engrossed in consultation with our facilitation team of public health informatics and data science experts about their country team projects; the others working on a data science methods exercise, practicing interpretation of descriptive and inferential statistics plots to assess trends in Hepatitis C,” said Ms. Lissit. “The energy and engagement have been high, and we’re looking forward to the next six days and the rest of the year-long fellowship.”

IDASH goals are to enhance capacity to create and use public health information systems that enable the capture, management, analysis, dissemination, and use of reliable, timely information to improve population-level health outcomes, as well as strengthen regional capacity to effectively respond to future global health challenges and pandemics.

“The COVID-19 pandemic made clear the importance of public health data systems that provide real time, accurate data on disease threats to allow for timely intervention and combatting of mis- and disinformation,” said Dr. Rabinowitz. “Programs like IDASH will help ensure there is a workforce prepared to detect, prevent, and respond to future global health threats.”

Story updated: April 11, 2023

I-TECH Presents at ICBD 2023 Conference

Post categories: Malawi Surveillance
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Representatives from I-TECH Malawi attend ICBD 2023 in Santiago, Chile from 1-4 March 2023 to present findings from the Malawi Birth Defects Surveillance Program. L-R: Luke Chiwala, Simkonda Yamikani Malanga, George Bello. Photo Credit: I-TECH Malawi

Representatives from I-TECH Malawi attended and presented findings from the Malawi Birth Defects Surveillance Program at the 2023 International Conference on Birth Defects and Disabilities in the Developing World (ICBD 2023). ICBD 2023, hosted by the March of Dimes, took place in Santiago, Chile, from 1-4 March 2023.

The conference brought together maternal and child health practitioners and researchers from around the world who presented their latest research, tools, and approaches in surveillance, diagnosis, and care for babies born with birth defects. This year’s theme was “Accelerating Action for Birth Defects and Disabilities: Surveillance, Prevention, Diagnosis, Management and Family-Centered Care.”

The following presentations were given during the conference:

  • “Prevalence of Adverse Birth Outcomes and External Birth Defects Among Women Living with HIV in Malawi”
    Authors: Bello G, Smith-Sreen J, Williamson D, Taulo F, Kabaghe A, Kerry Thomson K, Kagoli M, Chipeta S, Namakhoma I, Nyirenda R, Babaye Y, Auld A, Kim E, Matatiyo B, Zenengeya E, Muula AS, Nyasulu I, Gomes MF, Chiwala L, Kamzati M, Mkungudza J, Valencia D, Moore C, O’Malley G, Wadonda-Kabondo AN
  • “Correct Diagnosis of Birth Defects by Health Facility Staff in Four Facilities in Malawi”
    Authors: Malanga SY, Luke Chiwala L, Kamzati M, Valencia D, Mkungudza J, Bello G, Williamson D, Moore C, Thomson K, Ireen Namakhoma I, Gondwe E, Banda F, Sangaya N, Chirwa M, Kagoli M, Chipeta S, Nyirenda R, Zenengeya E, Babaye Y, O’Malley G, Wadonda-Kabondo N, Kabaghe AN
  • “Use of Electronic Data Collection and Web-Based Portal to Ensure the Completeness, Timeliness, and Accuracy of Final External Birth Defects Diagnosis in Malawi”
    Authors: Chiwala L, Kamzati M, Valencia D, Mkungudza J, Bello G, Williamson D, Moore C, Thomson K, Namakhoma I, Gondwe E, Banda F, Sangaya N, Chirwa M, Kagoli M, Chipeta S, Nyirenda R, Zenengeya E, Babaye Y, O’Malley G, Wadonda-Kabondo N, Kabaghe AN

To learn more about ICBD 2023 conference, please visit the ICBD 2023 website and review the ICBD 2023 Agenda.

*Bolded names indicates presenting author.

I-TECH Data Presented at CROI 2023

Post categories: Gabrielle O'Malley HIV and STI Prevention Malawi Surveillance
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Data from the International Training and Education Center for Health (I-TECH) program in Malawi were presented during the 2023 Conference on Retroviruses and Opportunistic Infections (CROI). The annual conference took place in Seattle, WA, from 19-22 February 2023, and brought together researchers, academics, and experts to discuss and present on their scientific achievements and new research.

During the “Insights into Prevention and Treatment of HIV in Women and Children” oral abstract session that was held on 20 February 2023, representatives from I-TECH Malawi presented on recent HIV infection surveillance data in breastfeeding women in Malawi:

The Centers for Disease Control and Prevention also presented a poster during the poster session that used data from the I-TECH Malawi HIV Recency Surveillance project:

To learn more about CROI, download conference resources, or to peruse the 2023 CROI program, please visit the CROI 2023 website.

Note: Bold name indicates presenting author.

 

Julianne Meisner

Julianne Meisner, PHD, MS, BVM&S, is an epidemiologist, veterinarian, and Assistant Professor in the Department of Global Health at the University of Washington (UW), researching issues related to One Health and pandemics. Her work focuses on human health at the human-animal-environment interface, with an emphasis on novel pathogen emergence, the human health effects of livestock keeping, and anticolonial approaches to global One Health research. She has many years of experience conducting linked human-animal research among livestock-keeping communities in sub-Saharan Africa, and strong teaching and research interests in epidemiologic methods and biostatistics, in particular spatial epidemiology and methods for drawing causal inference from observational studies. She holds her veterinary degree from the University of Edinburgh, and her MS and PhD in Epidemiology from UW.

Her current projects focus on novel virus emergence at high-risk human-animal interfaces in South America, Africa, and Asia, and the role of land use change in disease emergence; methods for modeling human-animal contact networks for more accurate modeling of disease transmission between animals and humans; the role of land tenure and land rights in human and animal health; and One Health surveillance system strengthening.

Program Highlights

Strengthening Public Health Disease Surveillance

The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the ...
Read More