Disease surveillance and epidemiology, immunizations

Hepatitis B virus (HBV) is causally linked to acute and chronic form of hepatitis, which due to continuous immune mediated inflammation and scarring may lead to cirrhosis and/or hepatocellular carcinoma. HBV spread via exchange of infected bodily fluids underlie unique public health considerations due to similarities with other community related issues such as sexually transmitted diseases (eg HIV) blood borne pathogens (Hepatitis-C) and perinatal transmissions (TORCH complex).

The completion of poliomyelitis eradication is a global health
emergency which must be pursued with vigour. Kano state has
remained one of the epicenters for polio virus outbreaks in
northern Nigeria. There is paucity of information as it relates to
polio antibody prevalence amongst children in the state. Periodic
serologic assessment is needed to determine the quality and
effectiveness of routine vaccination campaigns carried in the state
to rapidly build immunity against poliovirus. Children were
randomly selected throughout the state for the assessment
between Sept. 2013 and Jan. 2014. Blood samples were
collected from eighty children and tested for the presence of
antibodies to the three poliovirus serotypes. Indirect ELISA was
used to rapidly screen for the antibodies. Epi Info 3.5.4 version
was used for the data analysis. Out of the samples collected, 61
(76.3%) had antibodies to all the serotypes. While 73 (91.3%), 66
(82.5%) and 72 (90%) had antibodies to virus serotypes 1, 2 and
3 respectively. Age of the children, number of doses the children
had taken and educational level of the children’s fathers were
statistically significant risk factors on the prevalence of poliovirus
antibodies. Access to immunization services must be improved in
urban and rural areas so as to effectively reach a large number of
children in those places. Effective and high quality campaigns are
needed so that every eligible child is reached. Greater focus on
good mobilization is also needed to reach children in households
in rural areas as well as in households with children whose
fathers’ educational level was low.

Diarrhoea is a leading cause of death in children under 5 years of age, due mostly to failures to increase access to safe water and improve sanitation and hygiene practices (WASH). Rotavirus vaccines are a useful addition to existing diarrhoeal disease control measures. Recommendations are to introduce the vaccine in low-income settings. A study was conducted in Nepal to examine whether immunisation programmes offer a useful entry point for hygiene promotion as part of a comprehensive approach for diarrhoea control. Service-provider and recipient perspectives on integration were explored in focus group discussions with Female Community Health Volunteers and caregivers of infants in Kaski district, Western Region. Key health, WASH and disease surveillance informants (government, I/NGOs and donors) were interviewed at national, regional and district level.

In recent years, urban air quality in developing countries such as Nigeria has continued to degenerate and this has constituted a major environmental risk to human health. It has been shown that an increase in ambient particulate matter (PM 10) load of 10 µg/m 3 reduces life expectancy by 0.64 years. Air Quality Index (AQI) as demonstrated in this study shows how relatively clean or polluted the boundary layer environment of any location can be. The study was designed to measure the level of suspended particulate matter (PM 2.5 and PM 10) for dry and wet seasons, compute the prevalent air quality index of selected locations in Abuja with possible health implications. Suspended particulate matter (PM 2.5 and PM 10) was assessed using handheld aerosol particulate sampler. The US Oak Ridge National AQI was adopted for the eleven (11) locations sampled and monitored. The study results showed that the air quality of the selected areas in Abuja were generally good and healthy. Dry season, assessments, showed 15-95 µg/m 3 and 12-80 µg/m 3 for PM 2.5 and PM 10 , respectively. While in wet season, 09-75 µg/m 3 and 07-65 µg/m 3 were recorded for PM 2.5 and PM 10. However at Jebi Central Motor Park, there was light air contamination with AQI of 42 for dry season and 31 for wet season. Other locations had clean air with AQI ≤ 11. It is revealed that clean air exists generally during the wet season. Comparing study outcome to other cities in Nigeria, residents of Abuja are likely not to be affected with health hazards of particulate matter pollution. Nonetheless, the high range of PM 2.5 and PM 10

Final project poster presented for Georgia State University undergraduate course, PH 4030 Social and Behavioral Dimensions of Public Health.

In this project I performed a literature review of existing research on the impact of immunization mandates on the ACIP vaccination schedule.

Use of Google Drive Technology For Daily Monitoring Of 2012 Nationwide Measles Campaign In Kenya 
Titus Kipchirchir Kolongei1, Yusuf Ajack Ibrahim2
1Division of Disease Surveillance & Response  , Dagoreti, Nairobi County
2 Division of Disease Surveillance & Response  , Dagoreti, Nairobi County

Abstract
Kenya conducted a nationwide measles campaign  in November 2012 which entailed massive data collection. To effectively monitor the campaign daily there was need for data sharing and information dissemination  during  the period of the campaign from the 258 districts.
The Monitoring and Evaluation sub-committee team which was part of the technical committee coordinating the exercise was mandated to review the best possible option to  achieve this noble  initiative. The two authors being sub-committee members deliberated on the subject and weighed options of using Epi surveyor data platform, email file sharing, google drive and drob box as the effective and efficient data sharing and information dissemination means. Recognizing challenges among district teams to quickly internalize with such systems, large data management, need for quick data sharing across all levels the teams options was to settle  for a robust, cheap, efficient and  cost effective system  in view of  inadequate financial resources for data management.
The authors settled for the Google drive to upload and share data using the criteria of efficiency and effectiveness, robustness, free cost  and the ability of data managers to quickly internalize with the system.
Description:
Google drive is a web based tool that enable sharing and synchronization of files among users with 5 gigabytes storage. To ensure that the data for the nationwide Measles campaign was available the authors developed daily monitoring electronic excel sheet file which was shared with all District Data Managers. The excels sheet was customized with rights of access and edit based on level. The file was uploaded to Google drive and shared with regional information officers tasked to update the data on daily basis. The officers were emailed daily from their respective districts and updated the Google document for five day campaign period. Access rights were given to the respective heads of divisions for them to monitor the progress of the campaign.
Lessons learned:
Google document facilitates data sharing and information dissemination in a cheap, quick, and efficient manner. It's a cost effective to track performance in a large scale exercise from a remote point.
Next Steps:
In future data managers explore using such technology for real time monitoring in view of advantages . The security aspects of the system need to be fully understood, we acknowledge that this was one of our limitation in this inaugural venture.