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I-TECH

Category: Surveillance

Implementing a National Laboratory Information System in Mauritius

Post categories: DIGI Jan Flowers Laboratory Systems Mauritius Nancy Puttkammer Surveillance
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Since 2020, the Digital Initiative Group at I-TECH (DIGI)  has worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to deploy a national laboratory information management system (LIMS) using the OpenELIS platform. The LIMS connects the national reference laboratory to regional laboratories and flu clinics around the country to quickly process COVID-19 tests, as well as send results notifications to patients via text message or email.

The OpenELIS system, while implemented to support COVID-19 surveillance, was also designed to be able to support most routine lab workflows, including HIV viral load testing and other other infectious diseases (e.g., HIV, Ebola, Zika, Chikungunya), which ensures MOHW can quickly trace, respond to, and manage cases.

DIGI continues to support MOHW with LIMS training, LIMS maintenance, and national laboratory strengthening.

Birth Defects Surveillance in Malawi

Post categories: Gabrielle O'Malley Malawi Surveillance
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Malawi is one of first countries in Southeast Africa to respond to the World Health Organization’s call for robust birth surveillance systems. Routine surveillance is essential for public health monitoring of pregnancy outcomes and birth defects, especially in high-HIV burden settings where women living with HIV initiate the use of antiretroviral therapy before or during pregnancy.

Since 2016, the International Training and Education Center for Health, in collaboration with the Centers for Disease Control and Prevention, has supported the implementation of an active hospital-based birth surveillance system at four high-volume facilities in Malawi. To date, a total of 165,608 of births have been assessed. A subset of women are also enrolled in an ongoing nested case control study to assess associations between external birth defects and maternal exposures such as prior health conditions, medications, and environmental and lifestyle factors.

Anticipated use of these data include:

  • Establish a baseline prevalence of external birth defects in Malawi
  • Evaluate the impact of introducing new drugs for the management of HIV (e.g., dolutegravir) on the prevalence of external birth defects
  • Advocate for investment in programs and interventions to reduce the occurrence of birth defects and adverse pregnancy outcomes.

National COVID-19 Emergency Response in Malawi

Post categories: COVID-19 Gabrielle O'Malley Malawi Surveillance
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In collaboration with the Malawi Ministry of Health (MOH) and Centers for the Disease Control and Prevention (CDC), I-TECH has supported the national COVID-19 response in Malawi since March 2020. Technical assistance has focused on laboratory capacity, supporting quality COVID-19 surveillance and data management, and implementing a COVID-19 population-based survey with oversight from the Public Health Institute of Malawi (PHIM), under MOH.

In June 2020, I-TECH seconded a Technical Advisor (TA) to PHIM to support COVID-19 activities. The I-TECH TA acts as secretariat for the national Public Health Emergency Operations Center (PHEOC), supporting the coordination of the multi-sectoral COVID-19 response, developing and revising strategies and procedures, facilitating communication, and ensuring access to and sharing of COVID-19 data and information between partners.

I-TECH has also assisted with data management and reporting at the district level, as well as with contact tracing and adherence to infection prevention and control measures.

I-TECH has been able to leverage use of its platform for HIV laboratory activities to provide critical lab support for COVID-19 activities and provide key support to the National Health Reference Laboratory, focusing on building or increasing laboratory capacity including with genomic sequencing, maintaining quality assurance, and improving communication and coordination among laboratory stakeholders.

The I-TECH Team also coordinated a population-based survey to evaluate the extent of spread of COVID-19 in five high-burden districts in Malawi.

I-TECH Presents Posters at IAS 2021 Conference on HIV Science

Post categories: COVID-19 Differentiated Care HIV and STI Prevention HIV Care and Treatment Index Testing/Partner Notification India Malawi Monitoring & Evaluation Namibia Surveillance Tanzania Zimbabwe
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The International AIDS Society (IAS) virtually hosted the 11th Conference on HIV Science on 18-21 July 2021. The conference also included a “local partner hub” in Berlin, the original host city, for local experts to gather in person. This biennial conference brings together top HIV researchers, experts, and scientists for presentations and discussions on the latest advances in HIV research and practice.

Representatives from the International Training and Education Center for Health (I-TECH) virtually presented the following posters:

Representatives from I-TECH’s partner network organizations and the Centers for Disease Control and Prevention (CDC) also presented data from I-TECH-supported programs in Malawi, India, and Zimbabwe.

HIV Recency Surveillance in Malawi

Post categories: Gabrielle O'Malley HIV Counseling and Testing Malawi Monitoring & Evaluation Surveillance
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The International Training and Education Center for Health (I-TECH), in collaboration with the Malawian Ministry of Health (MOH) and the Centers for Disease Control and Prevention, began implementing recent HIV infection surveillance in April 2019. The project aims to establish a surveillance system among persons newly diagnosed with HIV infection by integrating point-of-care testing for recent infection into routine HIV testing services (HTS). A rapid test for recent infection is given to consenting clients 13-years-and-older who screen HIV positive within routine HTS across participating health facilities. Between April 2019-2020, I-TECH and MOH activated 485 testing points at 155 facilities in Malawi. All 155 facilities implemented recent HIV infection surveillance and reported data. The project has reached 11 of 28 districts to date.

These data allow the detection and characterization of recent HIV infection among newly diagnosed individuals and identify geographic areas associated with recent HIV-1 infection to inform geographic prioritization of HIV prevention and treatment strategies. The project has demonstrated high uptake and allowed characterization of recent infections according to socio-demographic and geographic factors. PEPFAR implementers in Malawi will collaborate with MOH to further investigate the reasons for high recent infection prevalence in identified clusters. Based on the findings of these responses, Malawi may focus on interventions such as youth-focused programs that aim to limit HIV acquisition and transmission among young people.

Global Health Security Agenda in Kenya

Post categories: eLearning/Distance Learning Global Health Security Health Information Systems Human Resources for Health John Lynch Kenya Laboratory Systems Peter Rabinowitz Surveillance
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I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding to disease threats to health security.

For the past 8 years, I-TECH Kenya has had a cooperative agreement with US Centers for Disease Control and Prevention (CDC) to work closely with the Kenya Ministry of Health (MOH) on multiple projects related to health security. The key objectives of these activities are preventing and reducing the likelihood of disease outbreaks, improving the efficiency and accuracy of the detection of communicable diseases, strengthening surveillance capacity and national and county levels for a rapid and effective response, enhancing Infection Prevention and Control (IPC) practices to prevent the emergence and spread of pathogens and antimicrobial resistant bacteria.

Prevention

Use IPC practices to combat antimicrobial resistance (AMR) and other microbial threats:

  • Building capacity for IPC in health care facilities is a critical part of disease outbreak and AMR preparedness and prevention. In Kenya, I-TECH has partners with the CDC National Center for Emerging and Zoonotic Infectious Disease and Kenya MOH to support two model hospitals in developing capacity for quality improvement measures for strengthening evidence-based IPC practices, infrastructure, and tools including hand hygiene, waste management, injection safety, surgical site infections, and antimicrobial stewardship. As part of this IPC work, I-TECH created and piloted e-learning modules for IPC. The modules aim to build clinical skills and technical knowledge in infection prevention and control and antimicrobial stewardship among health care workers in low-resource settings, and have now been adopted by WHO.
  • With the onset of the COVID-19 pandemic, I-TECH Kenya was able to play a leadership role in the country in assessing and improving facility readiness at the national and local level to handle COVID-19 cases and maintain the health care workforce.
  • Current IPC activity is focused on surveillance for surgical site infections, an important cause of hospital acquired infections (HAIs).

Disease Prevention through Immunization Program Strengthening:

  • I-TECH collaborated with the Kenya MOH, CDC Global Health Protection Division, and the CDC Global Immunization Division, to build and roll out an online mobile platform for capturing immunization data at the point of care.

Detection

Laboratory Information Systems Strengthening:

  • In Kenya, I-TECH collaborated with the MOH and National Public Health Laboratory Services to enhance and strengthen laboratory information systems at the facility and national levels to improve timeliness and efficiency of testing and reporting results, specifically for AMR testing.

Response

Disease Surveillance and Response:

  • I-TECH supports the Kenya MOH Surveillance Unit in the rollout of trainings for health care workers to routinely and consistently use the real-time surveillance reporting system in Kenya.

Gabrielle O’Malley

Gabrielle O’Malley, MA, PHD, is I-TECH’S Director of Implementation Science. Dr. O’Malley has worked as an applied research and evaluation professional for over 25 years. Her experience includes a wide variety of international and domestic programs including child survival, private agricultural enterprise, medical education, community technology, reproductive health, HIV prevention (PrEP), and care and treatment as well as applied research for private industry. Her research interests include innovative practices for program evaluation and improvement, formative research, qualitative methods, and the relationship of gender and health.

Dr. O’Malley received her PhD from UW, an MA from Johns Hopkins University and a BA from Smith College.

Program Highlights

Field Epidemiology Training Program in Malawi
The Frontline Field Epidemiology Training Program (Frontline FETP) enhances the capacity of HIV and AIDS surveillance and strengthens health systems. The program contributes to a sustainable response to HIV by training health professionals in basic field epidemiology that can support responsiveness to HIV surveillance needs.  ...
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Health and Wellness National Survey of Youth in Namibia
Since 2017, I-TECH worked closely with the Ministry of Gender Equality and Child Welfare, Ministry of Health and Social Services, UNICEF, Centers for Disease Control and Prevention, and the Namibia Statistics Agency to implement a nationally representative survey on youth experiences as well as HIV incidence and prevalence. Survey results ...
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HIV Drug Resistance Surveillance in Malawi
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) ...
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HIV Recency Surveillance in Malawi
The International Training and Education Center for Health (I-TECH), in collaboration with the Malawian Ministry of Health (MOH) and the Centers for Disease Control and Prevention, began implementing recent HIV infection surveillance in April 2019. The project aims to establish a surveillance system among persons newly diagnosed with HIV infection ...
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Peter Rabinowitz

Peter Rabinowitz, MD, MPH, directs the Center for One Health Research and has multiple faculty appointments including Professor, Global Health, at UW. The “One Health” center explores linkages between human, animal, and environmental health. Dr. Rabinowitz has expertise in zoonotic infectious disease; diseases of animal workers; microbiome sharing between humans and animals; emerging infectious disease; antimicrobial resistance animal sentinels of environmental health hazards; and noise and hearing loss.

Dr. Rabinowitz also directs the Canary Database, an online resource for evidence about animals as sentinels of environmental health threats from both toxic and infectious hazards. He was a visiting scientist at the Global Influenza Program of the WHO, and also in the Animal Health Division of the U.N. Food and Agriculture Organization (FAO). He completed a Family Medicine residency through the University of California San Francisco, and completed fellowships in General Preventive Medicine and Occupational and Environmental Medicine at the Yale School of Medicine.

Program Highlights

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Field Epidemiology Training Program in Malawi

Post categories: Gabrielle O'Malley Human Resources for Health Malawi Surveillance
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The Frontline Field Epidemiology Training Program (Frontline FETP) enhances the capacity of HIV and AIDS surveillance and strengthens health systems. The program contributes to a sustainable response to HIV by training health professionals in basic field epidemiology that can support responsiveness to HIV surveillance needs.  Continue reading “Field Epidemiology Training Program in Malawi”