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Báo cáo y học: "Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Detection of infectious disease outbreaks in twenty-two fragile states, 2000-2010: a systematic review. | Bruckner and Checchi Conflict and Health 2011 5 13 http www.conflictandhealth.eom content 5 1 13 CONFLICT AND HEALTH REVIEW Open Access Detection of infectious disease outbreaks in twenty-two fragile states 2000-2010 a systematic review Catherine Bruckner and Francesco Checchi Abstract Fragile states are home to a sixth of the world s population and their populations are particularly vulnerable to infectious disease outbreaks. Timely surveillance and control are essential to minimise the impact of these outbreaks but little evidence is published about the effectiveness of existing surveillance systems. We did a systematic review of the circumstances mode of detection of outbreaks occurring in 22 fragile states in the decade 2000-2010 i.e. all states consistently meeting fragility criteria during the timeframe of the review as well as time lags from onset to detection of these outbreaks and from detection to further events in their timeline. The aim of this review was to enhance the evidence base for implementing infectious disease surveillance in these complex resource-constrained settings and to assess the relative importance of different routes whereby outbreak detection occurs. We identified 61 reports concerning 38 outbreaks. Twenty of these were detected by existing surveillance systems but 10 detections occurred following formal notifications by participating health facilities rather than data analysis. A further 15 outbreaks were detected by informal notifications including rumours. There were long delays from onset to detection median 29 days and from detection to further events investigation confirmation declaration control . Existing surveillance systems yielded the shortest detection delays when linked to reduced barriers to health care and frequent analysis and reporting of incidence data. Epidemic surveillance and control appear to be insufficiently timely in fragile states and need to be strengthened. Greater reliance on formal and informal .