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The National Action Plan for the Prevention and Control of Non-communicable Diseases and Health Promotion in Pakistan--Cardiovascular diseases.

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) incorporates prevention and control of cardiovascular diseases (CVD) as part of a comprehensive and integrated non-communicable Disease (NCD) prevention effort. In this programme, surveillance of cardiovascular risk factors is part of an integrated population-based NCD surveillance system. The population approach to CVD prevention is a priority area in this programme with a focus on broad policy measures and behavioural change communication. The former include revision of the current policy on diet and nutrition to expand its focus on under-nutrition; the development of a physical activity policy; strategies to limit the production of, and access to, ghee as a medium for cooking and agricultural and fiscal policies that increase the demand for, and make healthy food more accessible. The programme focuses attention on improving the quality of prevention programmes within primary and basic health sites and integrates concerted primary and secondary prevention programmes into health services as part of a comprehensive and sustainable, scientifically valid, and resource-sensitive programme for all categories of healthcare providers. It promotes screening for raised blood pressure at the population level and screening for dyslipidaemia and diabetes in high-risk groups only. It highlights the need to ensure the availability of aspirin, beta blockers, thiazides, ACE inhibitors, statins and penicillin at all levels of healthcare. The programme points out the need to conduct clinical end-point trials in the native Pakistani setting to define cost-effective therapeutic strategies for primary and secondary prevention of CVDs. Emphasis is laid on building capacity of health systems in support of CVD prevention and control and building a coalition or network of organizations to add momentum to CVD prevention and control efforts.

Cardiovascular Diseases↗

[Communicable diseases and isolation: a nursing student's perceptions].

The Communicable Diseases have been associated to stigma and segregation for a long time. This investigation was carried out in order to detect the undergraduation students' perception concerning communicable diseases and isolation, as well as their expectation in working at isolation units. A questionnaire was elaborated and then validated by 3 referees. We attested that some of these students have stereotyped and negative conotations concerning the bearer of such diseases and isolation. Just a few of them mentioned that they would choose this specific unit as the workplace. It is important for us, professors, to know their previous knowledgement about the concepts of communicable diseases and isolation, so that we can reinforce the positive features and work with the negative ones during the courses. It can contribute to prepare these students to give an effective nursing care without fears and stigmas.

Attitude of Health Personnel↗

International law and communicable diseases.

Historically, international law has played a key role in global communicable disease surveillance. Throughout the nineteenth century, international law played a dominant role in harmonizing the inconsistent national quarantine regulations of European nation-states; facilitating the exchange of epidemiological information on infectious diseases; establishing international health organizations; and standardization of surveillance. Today, communicable diseases have continued to re-shape the boundaries of global health governance through legally binding and "soft-law" regimes negotiated and adopted within the mandate of multilateral institutions - the World Health Organization, the World Trade Organization, the Food and Agriculture Organization, and the Office International des Epizooties. The globalization of public health has employed international law as an indispensable tool in global health governance aimed at diminishing human vulnerability to the mortality and morbidity burdens of communicable diseases.

Communicable Disease Control↗

PHLS overview of communicable diseases 1999.

Every other year since 1995 the Public Health Laboratory Service has undertaken a consultation exercise to identify communicable diseases of high public health priority. The purpose of identifying disease priorities is to guide rational and transparent service planning and resource allocation. Also, the process aims to ensure a customer sensitive service. This paper presents the results of the priority setting exercise undertaken in 1999. A postal questionnaire was sent to 1130 key professionals involved in communicable disease control in the United Kingdom. Respondents were asked to assess the relative priority of 61 communicable diseases and to identify priority areas of work associated with these diseases. Five criteria were used to assess relative priority. The five criteria were; present burden of ill-health, social and economic impact, potential threat to health, health gain opportunity and public concern and confidence. For each disease, respondents were asked to score the importance of each criterion. Forty six percent of participants (518/1130) returned completed questionnaires. There was no significant difference in response rate by professional group. Based on the scores assigned to each of the five criteria, the relative priority of 61 communicable diseases has been established. The top ten diseases in descending order of priority are, HIV/AIDS, meningococcal diseases, Chlamydia trachomatis, influenza, tuberculosis, E. coli O157, Methicillin resistant Staphylococcus aureus, salmonellosis, transmissible spongiform encephalopathies and Helicobacter pylori. The opinion of a large number of health care professionals has been used to establish a priority rank for a wide range of communicable diseases. This work provides planners and policy makers with a synthesis of current professional opinion that can be used as a foundation for making decisions on service developments.

Attitude of Health Personnel↗

Challenges for communicable disease surveillance and control in southern Iraq, April-June 2003.

The recent war in Iraq presents significant challenges for the surveillance and control of communicable diseases. In early April 2003, the World Health Organization (WHO) sent a team of public health experts to Kuwait and a base was established in the southern Iraqi governorate of Basrah on May 3. We present the lessons learned from the communicable disease surveillance and control program implemented in the Basrah governorate in Iraq (population of 1.9 million) in April and May 2003, and we report communicable disease surveillance data through June 2003. Following the war, communicable disease control programs were disrupted, access to safe water was reduced, and public health facilities were looted. Rapid health assessments were carried out in health centers and hospitals to identify priorities for action. A Health Sector Coordination Group was organized with local and international health partners, and an early warning surveillance system for communicable disease was set up. In the first week of May 2003, physicians in hospitals in Basrah suspected cholera cases and WHO formed a cholera control committee. As of June 29, 2003, Iraqi hospital laboratories have confirmed 94 cases of cholera from 7 of the 8 districts of the Basrah governorate. To prevent the transmission of major communicable diseases, restoring basic public health and water/sanitation services is currently a top priority in Iraq. Lack of security continues to be a barrier for effective public health surveillance and response in Iraq.

Communicable Disease Control↗

PHLS overview of communicable diseases 1997: results of a priority setting exercise.

In early 1997, the PHLS Overview of Communicable Diseases (OVCD) Committee carried out a consultation exercise to inform the development of PHLS priorities in communicable diseases for the years 1997 to 1999. The views of PHLS senior staff and scientific committees and consultants in communicable disease control in district health authorities were sought by postal questionnaire, and several organisations of health professionals were asked for their views on the initial findings. The main findings of the exercise are summarised in three areas of priority. Priority 1 diseases-those of major importance to public health-included food poisoning, meningitis, tuberculosis, sexually transmitted diseases, vaccine preventable diseases, hospital acquired infections, and antimicrobial resistance. Priority 2 diseases-those of moderate importance to public health-included respiratory syncytial virus and varicella zoster virus infections and emerging problems such as travel associated infections. Priority 3 diseases included those whose prevalence is declining as a result of public health action, such as listeriosis, and diseases of low prevalence and/or associated morbidity. The exercise identified four areas of possible future work for the PHLS: activities in prion diseases, helping to tackle inequalities in health, taking a more active approach to documenting the socioeconomic burden of diseases, and engaging more with those consulted. The PHLS has used the results of the priority setting exercise to guide major programme initiatives in tuberculosis, measles, mumps, and rubella, meningococcal and pneumococcal diseases, and in antibiotic resistance. In addition, they have helped to shape agenda in service delivery and research in hospital acquired infections, sexually transmitted diseases, and gastrointestinal diseases. This exercise of engaging corporately with key professionals in communicable disease has paved the way for a wider engagement with stakeholders in the setting of future priorities.

Communicable Disease Control↗

[Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease Control Act].

The new Communicable Diseases Control Act has come into force in Norway. It makes it compulsory for a physician to warn a third party if it is obvious that a HIV-positive patient, with a high degree of certainty, puts the third party at risk of being infected with HIV. Some philosophers characterize medical confidentiality as an intransigent and absolute obligation, others as a prima facie duty. This article supports the latter view, but the author still argues that strict conditions have to be fulfilled before a physician should consider breaking medical confidentiality: The doctor must try repeatedly to gain the consent or co-operation of the patient involved. Possible negative long-term consequences for the preventive HIV-work support strict medical confidentiality.

Acquired Immunodeficiency Syndrome↗

[Study on the timeliness of the notifiable communicable diseases surveillance system in Fujian province, China, 2004].

OBJECTIVE: To understand the timeliness of the notifiable communicable diseases surveillance system in Fujian province. METHODS: Database from the internet based communicable diseases reporting system was used. RESULTS: The 50th percentile of time between the disease diagnosed and report recorded in medical faculties was 1 day in 2004 which was 6 days less than that in 2001 - 2003. The timeliness rate of 0 day was 46.46%, a 2.7 times over that in 2001 - 2003. The timeliness of notifiable communicable diseases surveillance system in different administrative areas, reporting units and on different diseases was significantly different. Time between the disease diagnosed and report recorded was the shortest in those cases reported by hospitals and traditional Chinese medicine(TCM) hospitals at the county level and above, with 50th percentile as 0 day, but the timeliness rate of 0 day was 50.76% with 70.04% of the cases were reported from hospitals and TCM hospitals of county level and above. Length between the disease diagnosed and reported was the longest in those cases recorded by Centers for Disease Control and Prevention(CDCs) with the 50th percentile as 3 days. The source of cases recorded by CDCs came from hospitals at the township level, where there was no connection to internet but the reporting cards had to be sent to local CDCs. Time between the disease being diagnosed and reported was 2 days in those cases reported by hospitals at the township level. 21.21% of cases were recorded by hospitals of township level and CDCs. The 50th percentile of time shown between the reported records and confirmed by CDCs was 4 hours The 24 hour timeliness rate was 63.65%. CONCLUSION: The timeliness of the notifiable communicable diseases surveillance system had been improved significantly after the medical personnel recording the cases directly through internet. Timeliness could be further improved through access to internet at the hospitals of township level, training of staff and better hospital management systems.

China↗

Accuracy of ICD-9-CM codes in identifying reportable communicable diseases.

Billing records from the outpatient clinics of a university medical center were used to identify reportable communicable diseases. Patient charts were reviewed to check the accuracy of all cases of communicable diseases not reported to the local health department. Thirty-three percent of the cases identified as one of 20 communicable diseases, using the ICD-9-CM system, were found to be incorrectly coded. This study documents a lack of specificity (numerous false positives) when using encounter form data and ICD-9-CM codes to identify communicable diseases in an outpatient setting.

Abstracting and Indexing↗

[Computerized surveillance of communicable diseases as a part of public health surveillance].

Conducting surveillance of communicable diseases and/or public health surveillance in general, in developing countries such is B&H has some common specific things-health care system is an integral part of organized government services thus, fewer impediments to implementing any part of a surveillance system are recorded. Limited health care providers and laboratories reduce the number of data source and can facilitate quality assurance. An ideal surveillance system is discussed in this paper (what kind of surveillance system an epidemiologist would like to have in future), as well as barriers to the ideal surveillance system and technology of the future. Some elements of computerised public health surveillance system and surveillance of communicable diseases, particularly, are given (e.g. hardware, software, data entry, editing the data, analysis of data, ...) Computerising a surveillance system will results in increasing speed of processing providing graphic capability, enhancing analytic capabilities, improving quality of data of reports and improving quantity of data. The most important step in beginning to conduct computerising a surveillance system is identifying the public health objective such is, for example, surveillance of communicable diseases.

Bosnia and Herzegovina↗

Some observations on the communicable diseases as public health problems.

Notwithstanding the deficiencies in reporting, an attempt is made in the present study to provide some useful information on the importance of the communicable diseases in the world over the decade 1957-58 to 1967-68. In this period health authorities in the developing countries almost invariably reported communicable diseases as their main public health problems, whereas, in the developed countries, the only communicable diseases still considered as public health problems were tuberculosis, venereal diseases, and hepatitis. In the developing countries nearly half of the principal causes of death were communicable diseases, and in both the developing and developed countries respiratory infections ranked high on the list. Deaths from tuberculosis have come down markedly in the developed countries and to a lesser degree in the developing countries. Infectious diseases of childhood are no longer a problem in the developed countries but are still important in the developing countries. The communicable diseases of importance to the developing countries may be divided into two groups-those requiring long-term development for their solution (e.g., dysentery, typhoid fever, parasitic diseases, and respiratory infections) and those that would respond rapidly to control by such methods as immunization.

Adolescent↗

Health-care system frailties and public health control of communicable disease on the European Union's new eastern border.

In May, 2004, the border of the European Union (EU) will shift eastward such that the new frontier will be made up by Ukraine, Belarus, and a considerably longer Russian border. Here, we discuss three issues: first, the factors that have contributed to the growth of communicable disease in Russia, Ukraine, and Belarus; second, how public health systems have responded to these challenges; and third, the implications for the EU as a whole. Since the break-up of the Soviet Union, Russia, Ukraine, and Belarus have witnessed substantial political, social, and economic changes. These events have been reflected in changes in the epidemiology of communicable diseases, including tuberculosis and HIV (ie, HIV-1). Moreover, public health systems, rooted in Soviet traditions, are struggling to respond effectively to the challenges of resurgent infectious diseases, such as tuberculosis, and newly emergent challenges such as HIV. The changing patterns of communicable diseases east of the EU's new border has implications for how the EU aids the strengthening of public health systems east of the new frontier. Transborder spread of communicable diseases also challenges communicable disease control systems within the EU. Concerted action is needed by member states and the EU, building on models of cooperation between institutions that have been successful in areas beyond health, if public health systems are to meet the emerging challenges to communicable disease control.

Communicable Disease Control↗

Control of communicable diseases; apprehension and detention of persons with specific diseases; transfer of regulations. Food and Drug Administration and Centers for Disease Control and Prevention, HHS. Final rule.

The Secretary of Health and Human Service (the Secretary) is transferring a portion of the Food and Drug Administration (FDA) "Control of Communicable Diseases" regulations to the Centers for Disease Control and Prevention (CDC). In general, these regulations provide the Secretary with the authority to apprehend, detain, or conditionally release individuals to prevent the spread of specified communicable diseases. The regulations implement the provisions of the Public Health Service Act (PHS Act) to prevent the introduction, transmission, or spread of communicable diseases from one State or possession into any other State or possession. CDC will have authority for interstate quarantine over persons, while FDA will retain regulatory authority over animals and other products that may transmit or spread communicable diseases. The Secretary is taking this action to consolidate regulations designed to control the spread of communicable diseases, thereby increasing the agencies' efficiency and effectiveness.

Centers for Disease Control and Prevention, U.S.↗

International migration and control of communicable diseases.

The epidemiology and policy implications of communicable disease (CD) transmission associated with international migration have received little systematic study. This is a review of clinical and epidemiological reports in search of strategies to assess and manage the impact of international migration on the transmission of CDs. The economics and demography of migration from less developed to industrialized nations is considered. Migration-related transmission should differentiate between actual transmission as opposed to geographic relocation of disease. Limitations of current screening and disease prevention strategies are discussed. Social and ecological processes through which migration can contribute to increased CD transmission are described, including placement in refugee camps, unclear legal status of migrants in recipient nations, and temporary return migration. Strategies for non-discriminatory and non-punitive control of migration-related CDs, needed changes in clinical practice, and complexities presented by CDs of long latency (such as HIV infection) are reviewed.

Communicable Disease Control↗