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Polio Eradication, Microplanning and GIS

Categories: child health, immunization, polio

A Bugagi child travels by camel near Lake Chad in Borno State, Nigeria. Photo courtesy of Thomas Moran/WHO.

A Bugagi child travels by camel near Lake Chad in Borno State, Nigeria. Photo courtesy of Thomas Moran/WHO.

Victoria Gammino, PhD, MPH, Epidemiologist, CDC Global Immunization Division

Victoria Gammino, PhD, MPH, Epidemiologist, CDC Global Immunization Division

Geospatial data have been used in public health since John Snow mapped cholera cases around the Broad Street water pump during the London cholera epidemic of 1854.  And, while global positioning system technologies (GPS) are so ubiquitous in the United States that virtually all new smartphones, tablets and cars have this technology embedded, in many areas of the world, health care workers in the field are often without the most basic two-dimensional paper maps.

So what do maps and map literacy have to do with polio?  Polio is a crippling and potentially fatal infectious disease. There is no cure, but there are safe and effective vaccines. Therefore, the strategy to eradicate polio is based on preventing infection by immunizing every child to stop transmission of the virus that causes polio, and ultimately make the world polio free.   The four pillars of polio eradication all rely on “microplans”— detailed logistical blueprints that guide the planning and implementation of vaccination campaigns, routine immunization outreach, and surveillance for polio cases by providing critical data on the size and location of the target population in a given geographic area.  These target population numbers determine the amount of vaccine required, the number of health care workers and supervisors to deliver the vaccine, and the cost of transportation to get the vaccine and health care workers where they need to go.

Voices from the Central African Republic: FELTP residents remain committed to strengthening disease surveillance and outbreak response in CAR

Categories: child health, immunization, infectious disease, refugee health

CAR refugees forced from their homes by rebels

CAR refugees forced from their homes by rebels

Dr. Els Mathieu, Resident Advisor, CAR- FELTP

Dr. Els Mathieu, Resident Advisor, CAR- FELTP

The Central African Republic (CAR) is a landlocked country in Central Africa, bordered by Chad in the north, Sudan in the northeast, South Sudan in the east, the Democratic Republic of the Congo and the Republic of the Congo in the south and Cameroon in the west.  CAR is one of the world’s least developed nations and has experienced several periods of political instability, as well as deadly attacks and violence by rebels that have forced nearly 1 million people from their homes in search of refuge.  With so many civilians fleeing to refugee camps in the capital, Bangui, and the provinces, there is an increased need to strengthen disease surveillance and response.

Public Health Informatics in Action in Malawi: Making life easier for healthcare workers and patients while improving quality through an innovative national Electronic Medical Record System

Categories: HIV/AIDS, child health, global health security, women's/maternal health

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Instituting an Electronic Medical Record System reduces the need to manage and store growing volumes of patient charts, a major challenge in resource-limited settings.

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Denise Giles, M.P.H., Health Scientist, CDC-Malawi

Keeping track of even one patient undergoing treatment for HIV/AIDS can be complicated enough.

Doing it for over 472,865 patients when you’re a low income country coping with high demand and a sputtering economy magnifies the complexity.

Which is why Malawi’s story – and its solution – is attracting attention and praise. It’s a story of how Electronic Medical Record System (EMRS) technology is being used and the foresight needed to bring it to reality.

You don’t have to look far to see the positive results.

CDC Protects Families: My favorite stories

Categories: child health, malaria, tuberculosis (TB), women's/maternal health

Terri Still-LeMelle

Terri Still-LeMelle

As we celebrate families on Mother’s Day, May 11, and the International Day of Families, May 15, I am especially proud to work in CDC’s Center for Global Health.  As one of the Center’s  health communication specialists, I have the privilege to write or edit many stories about how CDC’s programs impact the lives of families around the world.  In honor of this season, I’d like to highlight a few of my favorite accounts about brave mothers, determined families, and CDC’s global health programs.

 
 
 
 

Vaccination: Your best shot

Categories: child health, immunization, infectious disease, measles

World Immunization Week Banner

In 2002, I was in Maracaibo, Venezuela assisting with the investigation of the last measles outbreak in South America when the news arrived: Ministers of health from the region agreed that a synchronized week of vaccination in the hemisphere would help prevent future outbreaks and increase access to immunization for many who would miss this opportunity. The idea of Vaccination Week in the Americas ignited 12 years ago and is now a global initiative: World Immunization Week! Since 2003, more than 465 million people in the Americas have been vaccinated under the framework that emerged from the original idea of Vaccination Week in the Americas (VWA), which takes place the last week in April every year.

Carla Lee, MA, Public Health Advisor, CDC Global Immunization Division

Carla Lee, MA, Public Health Advisor, CDC Global Immunization Division

VWA is truly a collaborative effort led by countries and territories of the Pan-American Health Organization (PAHO) to improve equity and access to vaccination for families. VWA activities strengthen the national immunization programs in the Americas by reaching out to families with little access to routine immunization programs. The focus is to find people living in urban peripheries, rural and border areas and in indigenous or other hard-to-reach communities and offer them vaccines.

The work has saved lives.

The Region of the Americas encompasses the entire Western Hemisphere (from Canada in the very north all the way down to the southern tip of South America, and all the countries in between), was certified polio-free in 1994. It interrupted the spread of indigenous measles in 2002 and rubella in 2009. However, globally these viruses are still circulating.  A huge global sporting event – the World Cup— takes place in Brazil this summer, attracting millions of travelers from around the world. That adds a new element of risk, increasing the risk of importation of vaccine-preventable diseases into the Americas. In light of the World Cup, VWA will highlight the importance of vaccination to protect the health of the people of the Americas, using slogans like “Vaccination: Your best shot,” and “Go on offense: Get vaccinated!”

April 7 is World Health Day

Categories: child health, infectious disease, malaria, mosquito-borne disease, neglected tropical diseases (NTDs), parasitic diseases

    

April 7 marks World Health Day. This year World Health Day focuses on vector-borne diseases. More than half the world is at risk from vector-borne diseases. What exactly is a vector? A vector is a small organism, like a tick or mosquito, that transmits disease. Malaria, dengue, Chagas Disease and lymphatic filariasis are just four examples of vector-borne infectious diseases.   

Come learn about some of these vector-borne diseases and the work that CDC does to prevent, treat, and control these diseases around the world.    

How Nigeria Is Helping Stop Polio for Good

Categories: child health, immunization, polio

 

This blog was originally posted in the Huffington Post on January 2, 2014.

 

CDC Director Dr. Tom Frieden

CDC Director Dr. Tom Frieden

There are three places in the world where wild poliovirus has never stopped killing and disabling children: Afghanistan, Pakistan, and Nigeria.

As with other health threats, polio doesn’t stay neatly within a country’s borders. In the case of Nigeria, polio has spread from there to 25 polio-free countries in the past 10 years.

The Nigerian government recognizes this as a public health threat that can be tackled. Last year they put a national emergency action plan in place to eradicate polio and activated an emergency operations center for the work.

The Nigerian plan includes improving immunization activities, outreach to underserved populations, special approaches in security-compromised areas, outbreak response, and improved routine immunization and disease tracking.

In December I had the chance to visit Nigeria and observe firsthand the progress they’re making.

What I saw was impressive. Here are a few highlights from the trip:

Working together to help strengthen Kenya’s capacity for birth defects prevention: A great collaborative start

Categories: child health, noncommunicable diseases (NCDs)

 

Working together to help strengthen Kenya’s capacity for birth defects prevention

 

Alejandro Azofeifa and Diana Valencia work to expand birth defects surveillance worldwide through Birth Defects COUNT, a CDC global initiative.

A Call for Assistance

Diana Valencia

Diana Valencia

Alejandro Azofeifa

Alejandro Azofeifa

In early 2012, Dr. Leland Albright, a pediatric neurosurgeon at Kijabe Hospital in Kijabe, Kenya, alerted CDC to what appeared to be a rising number of patients with some serious birth defects of the brain and spine called neural tube defects. He asked CDC to help pinpoint whether the prevalence was actually increasing or if there was simply an increased number of referrals to the hospital from throughout Kenya. Dr. Albright also questioned whether genetic, nutritional or social factors could be causing the increase.

Reflections on the Fight Against HIV in Malawi

Categories: HIV/AIDS, child health, women's/maternal health

 

CDC Malawi Laboratory Advisor Dr. Abdoulaye Sarr reviews a CDC supported HIV program during a site monitoring visit

CDC Malawi Laboratory Advisor Dr. Abdoulaye Sarr reviews a CDC supported HIV program during a site monitoring visit.

This year, my staff and I have had the opportunity to spend considerable time in health facilities that our HIV-funded partners support throughout this beautiful country. Some of these facilities are on back-country roads; others are on forest-covered hills, while others sit on the shores of Lake Malawi. For CDC-Malawi, making these trips every quarter has been critical to strengthening our partnership with the Malawi Ministry of Health, ensuring quality in our programming, keeping our technical discussions grounded and practical, and helping ensure each of us is aware of the challenging realities faced by health workers and patients on a daily basis.

Sundeep Gupta, MD, MPH, Director, CDC-Malawi

Sundeep Gupta, MD, MPH, Director, CDC-Malawi

It has also highlighted how, against enormous odds, Malawi has been a leader in achieving remarkable successes in the fight against HIV, despite being one of the poorest countries in the world, ranking 181 of 187 countries in GDP per capita. In Malawi, almost one in every four adult urban women are infected, child and maternal deaths remain elevated due to the epidemic, and almost every family in the country has a profound story to tell about how they have been personally affected by this disease.

I find it thrilling that in the next two months, Malawi is set to reach the milestone of 500,000 persons (one of every 30 Malawians) alive and on antiretroviral treatment, something that was simply inconceivable when the program started a decade ago.

Toward a World without Measles

Categories: child health, infectious disease, measles

STOP Measles

Stephen L. Cochi, M.D., M.P.H., Senior Advisor to the Director of the CDC Global Immunization Division (GID)

Stephen L. Cochi, M.D., M.P.H., Senior Advisor to the Director of the CDC Global Immunization Division (GID)

There was a time not so long ago that the thought of measles struck genuine fear in people’s hearts.

It’s easy to understand why. Measles is so contagious that any child exposed to it who’s not already immune is likely to get the disease. Worse still is that measles is hard to avoid, even for the most diligent and cautious parent since it spreads through the air by breathing, coughing or sneezing.

And yet, today in many settings the general reaction to measles is a worry-free, nonchalant shrug.

That’s the power – and legacy – of a vaccine introduced 50 years ago today that protected people and especially children from measles and in the process lifted the weight of worry from parents around the world.

Vaccines are rarely splashy or noticed by most people. But the discovery of the measles vaccine being celebrated today is a shining, monumental achievement in the history of public health.

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