TB and Other Communicable Diseases
- Evidence-Based Process for Prioritizing Positive Behaviors for Promotion: Zika Prevention in Latin America and the Caribbean and Applicability to Future Health Emergency Responses
To maximize the impact of Zika prevention programming efforts, a prioritization process for social and behavior change programming was developed based on a combination of research evidence and programmatic experience. Prioritized behaviors were: application of mosquito repellent, use of condoms, removing unintentional standing water, covering and scrubbing walls of water storage containers, seeking prenatal care, and seeking counseling on family planning if not planning to get pregnant.
- The Challenges of Transition From Donor-Funded Programs: Results From a Theory-Driven Multi-Country Comparative Case Study of Programs in Eastern Europe and Central Asia Supported by the Global Fund
Transitioning from donor funding toward domestic financing for HIV and TB programs in Eastern Europe and Central Asia presents major challenges. It will require a substantial multipronged approach through well-planned collective and coordinated responses from global, bilateral, and national partners.
- Rapid Integration of Zika Virus Prevention Within Sexual and Reproductive Health Services and Beyond: Programmatic Lessons From Latin America and the Caribbean
During the 2015–16 Zika virus outbreak, IPPF member association providers reached clients and affected populations faster by integrating critical information and services within existing sexual and reproductive health platforms. Challenges included: (1) communicating rapidly evolving evidence to providers; (2) overcoming restrictive social norms on gender and sexuality and a related lack of public messaging on preventing sexual transmission; and (3) addressing disability stigma and breaching service gaps to support children and caregivers affected by congenital Zika syndrome.
- VECTOS: An Integrated System for Monitoring Risk Factors Associated With Urban Arbovirus Transmission
To strengthen local surveillance of mosquito-borne viral diseases such as dengue and Zika, a multidisciplinary team developed an integrated web-based information system called VECTOS that captures geo-referenced entomological, epidemiological, and social data. The system has revealed previously unidentified features, such as specific neighborhoods, at persistently high risk.
- Scale and Ambition in the Engagement of Private Providers for Tuberculosis Care and Prevention
The tuberculosis (TB) community knows the importance of engaging private providers to reach critical TB targets, and knows how to engage successfully. The next challenge is to transition such efforts to government stewardship and financing in order to reach scale.
- Successfully Engaging Private Providers to Improve Diagnosis, Notification, and Treatment of TB and Drug-Resistant TB: The EQUIP Public-Private Model in Chennai, India
Based on a participatory program design that addressed the self-described needs of private providers, a local NGO offered the providers access to rapid diagnostics and support for notification and patient treatment including free anti-TB drugs. The model resulted in high provider participation, contributing more than 10% of the overall TB case notifications, and an 89% treatment success rate for drug-sensitive TB.
- Decentralized, Community-Based Treatment for Drug-Resistant Tuberculosis: Bangladesh Program Experience
Shifting from hospital- to community-based management of drug-resistant TB, increased treatment enrollment, reduced treatment initiation delays, improved follow-up and adherence, and lowered treatment failure, and was associated with higher cure rates and lower mortality.
- High Background Congenital Microcephaly in Rural Guatemala: Implications for Neonatal Congenital Zika Virus Infection Screening
A variety of microcephaly case definitions detect high background prevalence in rural Guatemala, which complicates congenital Zika screening efforts. In addition, gestational age is needed for most screening tools but is usually unknown in low-resource settings. Fenton growth curves, originally designed for use in preterm infants, offer a standardized approach to adjust for unknown gestational age and may improve screening efforts.
- Overcoming Operational Challenges to Ebola Case Investigation in Sierra Leone
Deficiencies in transportation and communication, low frontline staff morale, and mistrust among communities, among other operational challenges, greatly limited Ebola case investigation in Sierra Leone. Recommendations for future outbreaks: (1) timely compensation for frontline staff, (2) context-appropriate transportation and communication resources, (3) systematic data collection, storage, and retrieval systems, (4) sound linkages between frontline staff and communities, (5) daily meetings between frontline staff and epidemiologists, (6) clear and appropriate operational chain of command, and (7) political and funding support to operational agencies.
- Infant Feeding Policy and Programming During the 2014–2015 Ebola Virus Disease Outbreak in Sierra Leone
Policies on breastfeeding and possible mother-to-child transmission of Ebola Virus Disease (EVD) during the outbreak evolved depending on public health priorities and the evidence available at that particular time. To improve responses to future outbreaks, research on vertical transmission of EVD should be prioritized; infant and young child feeding experts should be integrated into the outbreak response; and a digital repository of national policies and associated messages should be created.