The document discusses using community care centers (CCCs) to treat Ebola patients in Sierra Leone as Ebola treatment centers (ETCs) have reached capacity. An transmission model was used to evaluate the benefits and risks of introducing CCCs. The model suggests CCCs could help reduce cases if they offset increased risk of exposure for non-infected persons waiting for test results and sufficiently reduced transmission from infected patients. Expert opinion estimated a median 63% reduction in transmission from CCCs would be beneficial, and introducing 500 CCC beds could help slow the epidemic if certain exposure and transmission risks are managed.
The SIR Model and the 2014 Ebola Virus Disease Outbreak in Guinea, Liberia an...CSCJournals
This document presents a mathematical model using the SIR (Susceptible, Infected, Recovered) model to understand the spread of the 2014 Ebola virus disease outbreak in Guinea, Liberia, and Sierra Leone. The model divides the population into compartments based on disease status. Differential equations are formulated and numerically solved using data from the outbreak. The results show that initially the number of infected individuals increases, reaches a peak, and then decreases as individuals recover or die, indicating the outbreak could be controlled. Public health interventions that reduce transmission rates can help an outbreak die out by lowering the reproduction number below 1.
PDF Problem III - Langley-Tucker - D1 - CobrasMadison Lewis
This document summarizes a mathematical model of a hypothetical zombie outbreak in Atlanta, Georgia. It describes the assumptions and parameters used in a susceptible-infected-removed model to simulate the outbreak over time under different response scenarios. These include a baseline scenario with no intervention, as well as scenarios modeling quarantine and evacuation, arming civilians, and preventative warnings. The model predicts that without intervention, the outbreak would cause a rapid population crash within 5 days as the infected population exponentially increased. Intervention strategies aimed to more effectively contain, fight off, or evacuate from infected individuals to minimize loss of life.
Understanding zoonotic impacts: the added value from One Health approachesNaomi Marks
This document discusses the benefits of mass vaccination programs for animal diseases that can infect humans (zoonoses).
It first presents data showing that mass vaccinating 25 million livestock animals in Mongolia against brucellosis would provide over $30 million in total societal benefits, including public health benefits, private health benefits, reduced household income loss, and agricultural benefits.
It then uses a mathematical model to show that mass dog vaccination is less costly than human post-exposure prophylaxis for controlling rabies transmission between dogs and humans.
Finally, it references a study that found an approach combining dog and human vaccination for rabies control in N'Djaména to be more cost-effective than human
The linkages between biodiversity and the transmission of emerging infectious...Alison Specht
The document discusses the linkages between biodiversity and emerging infectious diseases. It summarizes the aims of the BIODIS/CESAB working group, which are to understand how biodiversity impacts disease spillovers and transmission in wildlife, test these relationships using different host-disease models and field studies, and understand which host traits influence disease infection and transmission. The group is made up of researchers studying various disease systems like Lyme disease, West Nile virus, and Buruli ulcer. They use mathematical modeling and have published several papers investigating whether the "dilution effect" concept, where higher diversity lowers disease risk, applies broadly. Their work examines how local diversity in host reservoirs and vectors influences disease transmission patterns.
Riff: A Social Network and Collaborative Platform for Public Health Disease S...Taha Kass-Hout, MD, MS
A hybrid (event-based and indicator-based) platform designed to streamline the collaboration between domain experts and machine learning algorithms for detection, prediction and response to health-related events (such as disease outbreaks or pandemics). The platform helps synthesize health-related event indicators from a wide variety of information sources (structured and unstructured) into a consolidated picture for analysis, maintenance of “community-wide coherence”, and collaboration processes. The platform offers features to detect anomalies, visualize clusters of potential events, predict the rate and spread of a disease outbreak and provide decision makers with tools, methodologies and processes to investigate the event.
The document summarizes the SIR model, which is an epidemiological model used to predict the spread of infectious diseases. The SIR model divides a population into three categories: susceptible (S), infected (I), and recovered/removed (R). It uses differential equations to model how individuals move between these categories over time based on infection and recovery rates. The SIR model makes simplifying assumptions and has limitations but can provide a basic understanding of disease transmission dynamics.
One Health for the Real World: partnerships and pragmatismNaomi Marks
Presentation by Professor Sarah Cleaveland of the University of Glasgow at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
This study analyzed the correlation between tuberculosis (TB) and human immunodeficiency virus (HIV) infections at the census tract level in Harris County, Texas from 2009-2010. The authors found that census tracts with higher percentages of poverty, Black residents, and foreign-born residents had above average rates of both HIV and TB. Logistic regression also showed these factors were associated with higher odds of co-infection of HIV/TB. The authors conclude targeted testing and education programs should focus on areas with these high-risk demographic characteristics.
The SIR Model and the 2014 Ebola Virus Disease Outbreak in Guinea, Liberia an...CSCJournals
This document presents a mathematical model using the SIR (Susceptible, Infected, Recovered) model to understand the spread of the 2014 Ebola virus disease outbreak in Guinea, Liberia, and Sierra Leone. The model divides the population into compartments based on disease status. Differential equations are formulated and numerically solved using data from the outbreak. The results show that initially the number of infected individuals increases, reaches a peak, and then decreases as individuals recover or die, indicating the outbreak could be controlled. Public health interventions that reduce transmission rates can help an outbreak die out by lowering the reproduction number below 1.
PDF Problem III - Langley-Tucker - D1 - CobrasMadison Lewis
This document summarizes a mathematical model of a hypothetical zombie outbreak in Atlanta, Georgia. It describes the assumptions and parameters used in a susceptible-infected-removed model to simulate the outbreak over time under different response scenarios. These include a baseline scenario with no intervention, as well as scenarios modeling quarantine and evacuation, arming civilians, and preventative warnings. The model predicts that without intervention, the outbreak would cause a rapid population crash within 5 days as the infected population exponentially increased. Intervention strategies aimed to more effectively contain, fight off, or evacuate from infected individuals to minimize loss of life.
Understanding zoonotic impacts: the added value from One Health approachesNaomi Marks
This document discusses the benefits of mass vaccination programs for animal diseases that can infect humans (zoonoses).
It first presents data showing that mass vaccinating 25 million livestock animals in Mongolia against brucellosis would provide over $30 million in total societal benefits, including public health benefits, private health benefits, reduced household income loss, and agricultural benefits.
It then uses a mathematical model to show that mass dog vaccination is less costly than human post-exposure prophylaxis for controlling rabies transmission between dogs and humans.
Finally, it references a study that found an approach combining dog and human vaccination for rabies control in N'Djaména to be more cost-effective than human
The linkages between biodiversity and the transmission of emerging infectious...Alison Specht
The document discusses the linkages between biodiversity and emerging infectious diseases. It summarizes the aims of the BIODIS/CESAB working group, which are to understand how biodiversity impacts disease spillovers and transmission in wildlife, test these relationships using different host-disease models and field studies, and understand which host traits influence disease infection and transmission. The group is made up of researchers studying various disease systems like Lyme disease, West Nile virus, and Buruli ulcer. They use mathematical modeling and have published several papers investigating whether the "dilution effect" concept, where higher diversity lowers disease risk, applies broadly. Their work examines how local diversity in host reservoirs and vectors influences disease transmission patterns.
Riff: A Social Network and Collaborative Platform for Public Health Disease S...Taha Kass-Hout, MD, MS
A hybrid (event-based and indicator-based) platform designed to streamline the collaboration between domain experts and machine learning algorithms for detection, prediction and response to health-related events (such as disease outbreaks or pandemics). The platform helps synthesize health-related event indicators from a wide variety of information sources (structured and unstructured) into a consolidated picture for analysis, maintenance of “community-wide coherence”, and collaboration processes. The platform offers features to detect anomalies, visualize clusters of potential events, predict the rate and spread of a disease outbreak and provide decision makers with tools, methodologies and processes to investigate the event.
The document summarizes the SIR model, which is an epidemiological model used to predict the spread of infectious diseases. The SIR model divides a population into three categories: susceptible (S), infected (I), and recovered/removed (R). It uses differential equations to model how individuals move between these categories over time based on infection and recovery rates. The SIR model makes simplifying assumptions and has limitations but can provide a basic understanding of disease transmission dynamics.
One Health for the Real World: partnerships and pragmatismNaomi Marks
Presentation by Professor Sarah Cleaveland of the University of Glasgow at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
This study analyzed the correlation between tuberculosis (TB) and human immunodeficiency virus (HIV) infections at the census tract level in Harris County, Texas from 2009-2010. The authors found that census tracts with higher percentages of poverty, Black residents, and foreign-born residents had above average rates of both HIV and TB. Logistic regression also showed these factors were associated with higher odds of co-infection of HIV/TB. The authors conclude targeted testing and education programs should focus on areas with these high-risk demographic characteristics.
SIR Model & Medical Organizations : EpidemiologySubhajit Sahu
Compartmental models simplify the mathematical modelling of infectious diseases. The population is assigned to compartments with labels - for example, S, I, or R, (Susceptible, Infectious, or Recovered). People may progress between compartments. The order of the labels usually shows the flow patterns between the compartments; for example SEIS means susceptible, exposed, infectious, then susceptible again.
The origin of such models is the early 20th century, with an important work being that of Kermack and McKendrick in 1927.[1]
The models are most often run with ordinary differential equations (which are deterministic), but can also be used with a stochastic (random) framework, which is more realistic but much more complicated to analyze.
Keynote presentation by Dr Delia Grace of the International Livestock Research Institute, Nairobi, at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
The Real World: One Health - zoonoses, ecosystems and wellbeingNaomi Marks
Opening keynote presentation by Professor Jeremy Farrar, Director, Wellcome Trust, at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
Epidemiology is the study of disease frequency, distribution, and determinants in populations. It measures morbidity and mortality rates to describe disease occurrence and identifies risk factors. The key aspects are disease frequency, distribution over time/place/person, and determinants. Epidemiologists examine transmission dynamics from reservoirs to hosts and principles of disease control include diagnosis, treatment, and prevention like immunization and health education.
Concept of sufficient cause and component causesamitakashyap1
This document discusses key epidemiological concepts related to measuring disease occurrence, including sufficient causes, component causes, risk, prevalence, and incidence rate. It provides examples to illustrate how these measures are calculated and how they relate to one another. For example, it notes that prevalence is equal to incidence multiplied by disease duration when rates are stable over time. The document also discusses problems that can arise in measuring these variables and how changes in incidence and prevalence over time can provide insights into disease dynamics.
1) The document analyzes the legacy of colonial medical campaigns in Central Africa between 1921-1956. The campaigns forcibly treated and examined villagers for diseases like sleeping sickness, sometimes with severe side effects.
2) The authors digitized archival records on campaign locations and find greater exposure reduces modern trust in medicine, as measured by blood test consent rates. Exposure also correlates with worse health outcomes and less success of modern health projects.
3) An instrumental variable strategy using soil suitability and distance to colonial capitals suggests the campaigns causally reduced trust in medicine. However, the mistrust seems specific to medicine, not other institutions.
U.S. Preps For Ebola Outbreak Cases May Exceed 100,000 By December “The Numbe...Hope Small
The article does not mention that a completely unrelated strain of ebola has broken out in the Congo. What are the chances of that?
Though news on the Ebola virus has been muted since two American health care workers were admitted to U.S.-based facilities last month, the deadly contagion continues to spread. According to the World Health Organization more than 40% of all Ebola cases thus far have occurred in just the last three months, suggesting that the virus is continuing to build steam.
Physicist Alessandro Vespignani of Northeastern University in Boston is one of several researchers trying to figure out how far Ebola may spread and how many people around the world could be affected. Based on his findings, there will be 10,000 cases by September of this year and it only gets worse from there.
1) The document analyzes demographic and cultural factors that may have influenced the spread of the Ebola virus in West Africa during the 2014-2016 outbreak.
2) The authors collected data on variables like religion, ethnicity, and healthcare access to cluster similar areas and visualize relationships between these factors and outbreak case counts.
3) Their visualizations and clustering analysis suggested that religion correlated more strongly with outbreak patterns and healthcare usage than ethnicity did, so religion would be a more important predictor variable for their statistical model of outbreak spread over time.
This study aimed to provide an updated estimate of the global burden of latent tuberculosis (TB) infection. The researchers constructed trends in annual risk of TB infection for countries from 1934 to 2014, using data from LTBI surveys and estimates of smear-positive TB prevalence. They estimated that in 2014, approximately 1.7 billion people, or 23% of the global population, had a latent TB infection. The regions with the highest prevalence were South-East Asia, Western Pacific, and Africa, accounting for around 80% of cases. An estimated 55.5 million people had a recent infection and were at high risk of developing active TB disease, of which around 11% were isoniazid-resistant. Left unaddressed,
1. An outbreak investigation was conducted to determine the source and mode of transmission of an illness that exceeded expected numbers. Interviews, specimen collection, and data analysis were performed.
2. Analysis revealed the pathogen and identified a water source as the likely mode of transmission. Over 100 cases were reported in the affected area within two weeks.
3. Recommendations included controlling the contaminated water source, strengthening surveillance, and preventing future outbreaks through improved sanitation.
Social dimensions of zoonoses in interdisciplinary researchNaomi Marks
This document summarizes Dr. Hayley MacGregor's research on the social dimensions of zoonoses (diseases that can be transmitted between animals and humans) in emerging livestock systems. It discusses two key areas: 1) how cultural and social practices influence zoonotic risk, and 2) the relationship between humans and animals. For area 1, it describes how factors like intensification of production, supply chains, processing practices, markets and consumer demand can drive zoonotic risk. For area 2, it discusses how human-animal relations blur traditional categories, and how the health of humans and animals is interdependent.
This document discusses disease classification and prevention and control strategies. It describes communicable diseases as being caused by biological agents and transmitted between individuals, while noncommunicable diseases have complex, multifactorial causes. The chain of infection model outlines the steps by which a communicable disease is transmitted. Prevention strategies target various levels - primary prevention prevents disease, secondary prevention detects and treats early, and tertiary prevention focuses on rehabilitation. Both individuals and communities play important roles in prevention efforts.
The epidemiology of tuberculosis in Kenya, a high TB/HIV burden country (2000...Premier Publishers
Interest in the epidemiology of TB was triggered by the re-emergence of tuberculosis in the early 1990’s with the advent of HIV and falling economic status of many people which subjected them to poverty. The dual lethal combination of HIV and poverty triggered an unprecedented TB epidemic. In this study, we focused on the period 2000-2013 and all the notified data in Kenya was included. Data on estimates of TB incidence, prevalence and mortality was extracted from the WHO global Tuberculosis database. Data was analysed to produce trends for each of the years and descriptive statistics were calculated. The results showed that there was an average decline of 5% over the last 8 years with the highest decline being reported in the year 2012/13. TB continues to disproportionately affect the male gender with 58% being male and 42% being female. Kenya has made significant efforts to address the burden of HIV among TB patients with cotrimoxazole preventive therapy (CPT) uptake reaching 98% AND ART at 74% by the end of 2013. Kenya’s TB epidemic has evolved over time and it has been characterised by a period where there was increase in the TB cases reaching a peak in the year 2007 after which there was a decline which began to accelerate in the year 2011. The gains in the decline of TB could be attributed in part to the outcomes of integrating TB and HIV services and these gains should be sustained. What is equally notable is the clear epidemiologic shift in age indicating reduced transmission in the younger age groups.
A presentation on tuberculosis control efforts in Cuba vs. Haiti. Presented for my class Intensive Study of Public Health Services in Cuba, June 25, 2015.
Dynamics and Control of Infectious Diseases (2007) - Alexander Glaser Wouter de Heij
See also:
- https://food4innovations.blog/2020/03/26/montecarlo-simulaties-tonen-aan-wat-de-onzekerheid-is-en-dat-we-minimaal-1600-maar-misschien-wel-2000-2500-ic-plaatsen-nodig-hebben/
Imperial college-covid19-npi-modelling-16-03-2020Wouter de Heij
- The document presents the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US.
- Two fundamental strategies are evaluated: mitigation, which focuses on slowing spread to protect healthcare systems, and suppression, which aims to reverse epidemic growth and maintain low case numbers indefinitely until a vaccine is available.
- Modelling suggests that while mitigation may halve deaths and reduce the healthcare demand peak, hundreds of thousands could still die and healthcare systems would be overwhelmed. Suppression is the preferred option if possible, requiring a combination of social distancing, case isolation and household quarantine.
The document discusses integrated vector management (IVM) as an approach to vector-borne disease control. IVM involves understanding local vector ecology and patterns of disease transmission in order to select appropriate control methods from available options. It aims to improve cost-effectiveness and sustainability compared to traditional reliance on insecticides alone. Key elements of IVM include disease and vector surveillance, identifying and mapping local risk factors, participatory selection of control methods, monitoring and evaluation. The document outlines the steps in implementing IVM, including assessing disease burden and local resources available before developing context-specific strategies.
The UF Emerging Pathogens Institute was created with $60 million in state funding to research human, animal, and plant pathogens. It has over 200 faculty members from various colleges focusing on pathogens. A study in Kolkata found that around 1/3 of diarrhea cases involved multiple pathogens. The GEMS study analyzed samples from over 3,600 children in Africa and Asia to identify pathogens using genetic techniques and found on average 3,900 sequences per sample. The distribution of pathogens differed by country. While pathogens clearly matter for public health impact, transmission pathways and prevention strategies also depend on the specific pathogen.
Ebola Outbreak in Liberia : August 2014Amit Bhagat
This report is about the Outbreak of Ebola Virus Disease (EVD) (also known as Ebola Hemmorhagic fever) in Liberia, which occurred mainly in most parts of the West Africa starting from Guinea and reaching to heart of Sierra Leone, Liberia, Nigeria and most other places. EVD is an epidemic disease and also highly infectious. This disease is very severe, rare and deadly, with a fatality rate of approx 90%. There is no such cure or vaccine is present, only some experimental drugs have been using (till date). Thus, many organizations viz WHO, CDC, Red Cross etc are working for prevention and relief of patients to fight against this epidemic disease.
SIR Model & Medical Organizations : EpidemiologySubhajit Sahu
Compartmental models simplify the mathematical modelling of infectious diseases. The population is assigned to compartments with labels - for example, S, I, or R, (Susceptible, Infectious, or Recovered). People may progress between compartments. The order of the labels usually shows the flow patterns between the compartments; for example SEIS means susceptible, exposed, infectious, then susceptible again.
The origin of such models is the early 20th century, with an important work being that of Kermack and McKendrick in 1927.[1]
The models are most often run with ordinary differential equations (which are deterministic), but can also be used with a stochastic (random) framework, which is more realistic but much more complicated to analyze.
Keynote presentation by Dr Delia Grace of the International Livestock Research Institute, Nairobi, at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
The Real World: One Health - zoonoses, ecosystems and wellbeingNaomi Marks
Opening keynote presentation by Professor Jeremy Farrar, Director, Wellcome Trust, at the One Health for the Real World: zoonoses, ecosystems and wellbeing symposium, London 17-18 March 2016
Epidemiology is the study of disease frequency, distribution, and determinants in populations. It measures morbidity and mortality rates to describe disease occurrence and identifies risk factors. The key aspects are disease frequency, distribution over time/place/person, and determinants. Epidemiologists examine transmission dynamics from reservoirs to hosts and principles of disease control include diagnosis, treatment, and prevention like immunization and health education.
Concept of sufficient cause and component causesamitakashyap1
This document discusses key epidemiological concepts related to measuring disease occurrence, including sufficient causes, component causes, risk, prevalence, and incidence rate. It provides examples to illustrate how these measures are calculated and how they relate to one another. For example, it notes that prevalence is equal to incidence multiplied by disease duration when rates are stable over time. The document also discusses problems that can arise in measuring these variables and how changes in incidence and prevalence over time can provide insights into disease dynamics.
1) The document analyzes the legacy of colonial medical campaigns in Central Africa between 1921-1956. The campaigns forcibly treated and examined villagers for diseases like sleeping sickness, sometimes with severe side effects.
2) The authors digitized archival records on campaign locations and find greater exposure reduces modern trust in medicine, as measured by blood test consent rates. Exposure also correlates with worse health outcomes and less success of modern health projects.
3) An instrumental variable strategy using soil suitability and distance to colonial capitals suggests the campaigns causally reduced trust in medicine. However, the mistrust seems specific to medicine, not other institutions.
U.S. Preps For Ebola Outbreak Cases May Exceed 100,000 By December “The Numbe...Hope Small
The article does not mention that a completely unrelated strain of ebola has broken out in the Congo. What are the chances of that?
Though news on the Ebola virus has been muted since two American health care workers were admitted to U.S.-based facilities last month, the deadly contagion continues to spread. According to the World Health Organization more than 40% of all Ebola cases thus far have occurred in just the last three months, suggesting that the virus is continuing to build steam.
Physicist Alessandro Vespignani of Northeastern University in Boston is one of several researchers trying to figure out how far Ebola may spread and how many people around the world could be affected. Based on his findings, there will be 10,000 cases by September of this year and it only gets worse from there.
1) The document analyzes demographic and cultural factors that may have influenced the spread of the Ebola virus in West Africa during the 2014-2016 outbreak.
2) The authors collected data on variables like religion, ethnicity, and healthcare access to cluster similar areas and visualize relationships between these factors and outbreak case counts.
3) Their visualizations and clustering analysis suggested that religion correlated more strongly with outbreak patterns and healthcare usage than ethnicity did, so religion would be a more important predictor variable for their statistical model of outbreak spread over time.
This study aimed to provide an updated estimate of the global burden of latent tuberculosis (TB) infection. The researchers constructed trends in annual risk of TB infection for countries from 1934 to 2014, using data from LTBI surveys and estimates of smear-positive TB prevalence. They estimated that in 2014, approximately 1.7 billion people, or 23% of the global population, had a latent TB infection. The regions with the highest prevalence were South-East Asia, Western Pacific, and Africa, accounting for around 80% of cases. An estimated 55.5 million people had a recent infection and were at high risk of developing active TB disease, of which around 11% were isoniazid-resistant. Left unaddressed,
1. An outbreak investigation was conducted to determine the source and mode of transmission of an illness that exceeded expected numbers. Interviews, specimen collection, and data analysis were performed.
2. Analysis revealed the pathogen and identified a water source as the likely mode of transmission. Over 100 cases were reported in the affected area within two weeks.
3. Recommendations included controlling the contaminated water source, strengthening surveillance, and preventing future outbreaks through improved sanitation.
Social dimensions of zoonoses in interdisciplinary researchNaomi Marks
This document summarizes Dr. Hayley MacGregor's research on the social dimensions of zoonoses (diseases that can be transmitted between animals and humans) in emerging livestock systems. It discusses two key areas: 1) how cultural and social practices influence zoonotic risk, and 2) the relationship between humans and animals. For area 1, it describes how factors like intensification of production, supply chains, processing practices, markets and consumer demand can drive zoonotic risk. For area 2, it discusses how human-animal relations blur traditional categories, and how the health of humans and animals is interdependent.
This document discusses disease classification and prevention and control strategies. It describes communicable diseases as being caused by biological agents and transmitted between individuals, while noncommunicable diseases have complex, multifactorial causes. The chain of infection model outlines the steps by which a communicable disease is transmitted. Prevention strategies target various levels - primary prevention prevents disease, secondary prevention detects and treats early, and tertiary prevention focuses on rehabilitation. Both individuals and communities play important roles in prevention efforts.
The epidemiology of tuberculosis in Kenya, a high TB/HIV burden country (2000...Premier Publishers
Interest in the epidemiology of TB was triggered by the re-emergence of tuberculosis in the early 1990’s with the advent of HIV and falling economic status of many people which subjected them to poverty. The dual lethal combination of HIV and poverty triggered an unprecedented TB epidemic. In this study, we focused on the period 2000-2013 and all the notified data in Kenya was included. Data on estimates of TB incidence, prevalence and mortality was extracted from the WHO global Tuberculosis database. Data was analysed to produce trends for each of the years and descriptive statistics were calculated. The results showed that there was an average decline of 5% over the last 8 years with the highest decline being reported in the year 2012/13. TB continues to disproportionately affect the male gender with 58% being male and 42% being female. Kenya has made significant efforts to address the burden of HIV among TB patients with cotrimoxazole preventive therapy (CPT) uptake reaching 98% AND ART at 74% by the end of 2013. Kenya’s TB epidemic has evolved over time and it has been characterised by a period where there was increase in the TB cases reaching a peak in the year 2007 after which there was a decline which began to accelerate in the year 2011. The gains in the decline of TB could be attributed in part to the outcomes of integrating TB and HIV services and these gains should be sustained. What is equally notable is the clear epidemiologic shift in age indicating reduced transmission in the younger age groups.
A presentation on tuberculosis control efforts in Cuba vs. Haiti. Presented for my class Intensive Study of Public Health Services in Cuba, June 25, 2015.
Dynamics and Control of Infectious Diseases (2007) - Alexander Glaser Wouter de Heij
See also:
- https://food4innovations.blog/2020/03/26/montecarlo-simulaties-tonen-aan-wat-de-onzekerheid-is-en-dat-we-minimaal-1600-maar-misschien-wel-2000-2500-ic-plaatsen-nodig-hebben/
Imperial college-covid19-npi-modelling-16-03-2020Wouter de Heij
- The document presents the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US.
- Two fundamental strategies are evaluated: mitigation, which focuses on slowing spread to protect healthcare systems, and suppression, which aims to reverse epidemic growth and maintain low case numbers indefinitely until a vaccine is available.
- Modelling suggests that while mitigation may halve deaths and reduce the healthcare demand peak, hundreds of thousands could still die and healthcare systems would be overwhelmed. Suppression is the preferred option if possible, requiring a combination of social distancing, case isolation and household quarantine.
The document discusses integrated vector management (IVM) as an approach to vector-borne disease control. IVM involves understanding local vector ecology and patterns of disease transmission in order to select appropriate control methods from available options. It aims to improve cost-effectiveness and sustainability compared to traditional reliance on insecticides alone. Key elements of IVM include disease and vector surveillance, identifying and mapping local risk factors, participatory selection of control methods, monitoring and evaluation. The document outlines the steps in implementing IVM, including assessing disease burden and local resources available before developing context-specific strategies.
The UF Emerging Pathogens Institute was created with $60 million in state funding to research human, animal, and plant pathogens. It has over 200 faculty members from various colleges focusing on pathogens. A study in Kolkata found that around 1/3 of diarrhea cases involved multiple pathogens. The GEMS study analyzed samples from over 3,600 children in Africa and Asia to identify pathogens using genetic techniques and found on average 3,900 sequences per sample. The distribution of pathogens differed by country. While pathogens clearly matter for public health impact, transmission pathways and prevention strategies also depend on the specific pathogen.
Ebola Outbreak in Liberia : August 2014Amit Bhagat
This report is about the Outbreak of Ebola Virus Disease (EVD) (also known as Ebola Hemmorhagic fever) in Liberia, which occurred mainly in most parts of the West Africa starting from Guinea and reaching to heart of Sierra Leone, Liberia, Nigeria and most other places. EVD is an epidemic disease and also highly infectious. This disease is very severe, rare and deadly, with a fatality rate of approx 90%. There is no such cure or vaccine is present, only some experimental drugs have been using (till date). Thus, many organizations viz WHO, CDC, Red Cross etc are working for prevention and relief of patients to fight against this epidemic disease.
Dr. Bryan Lewis and Dr. Madhav Marathe (both at Virginia Tech) will present a data driven multi-scale approach for modeling the Ebola epidemic in West Africa. We will discuss how the models and tools were used to study a number of important analytical questions, such as:
(i) computing weekly forecasts, (ii) optimally placing emergency treatment units and more generally health care facilities, and (iii) carrying out a comprehensive counter-factual analysis related to allocation of scarce pharmaceutical and non-pharmaceutical resources. The role of big-data and behavioral adaptation in developing the computational models will be highlighted.
The document summarizes ethical issues that arise in treating patients with Ebola virus disease. It discusses principles of medical ethics like utilitarianism and deontology. It describes the author's experience working in an Ebola treatment unit in Sierra Leone. Key issues discussed include health worker safety, patient selection and triage if resources become overwhelmed, experimental treatments, and stigmatization of survivors.
The Ebola outbreak in West Africa has killed over 1,000 people and experimental treatments are being considered. While Ebola virus disease has a high fatality rate, the current outbreak's magnitude may be underestimated. Countries have taken extreme precautions like cordoning off infected areas, but health officials say such measures must proceed humanely. No approved vaccine or treatment exists, so controlling transmission through safe burials and protective equipment is critical.
What is Global Health?: Defining Global HealthUWGlobalHealth
As proposed by the Declarations of the Alma Ata and challenged by the Millennium
Development Goals, action by players and stakeholders of diverse specialties and
backgrounds is required to achieve health for all. This assembled expert panel
drawn from different backgrounds will enrich the discussion with their own experiences.
This document provides an overview of Ebola virus disease (EVD) including its epidemiology, transmission, clinical presentation, treatment and management. It discusses the 2014-2015 West Africa Ebola outbreak as the largest in history. Key points include Ebola being transmitted through direct contact with body fluids, fruit bats being the likely natural reservoir, and monitoring of travelers returning from affected countries being conducted by local health departments.
The document provides an overview of Ebola virus disease (EVD), including its origins, transmission, signs and symptoms, diagnosis, treatment and recovery. Some key points:
- EVD first appeared in 1976 in simultaneous outbreaks in Sudan and Democratic Republic of Congo. The current 2014 outbreak in West Africa is the largest on record.
- The virus is transmitted through direct contact with body fluids of infected humans or animals. Early symptoms are nonspecific but progress to hemorrhagic fever, vomiting, diarrhea and organ failure.
- Diagnosis involves detecting the virus or antibodies in blood, with RT-PCR being the most sensitive test. There is no approved vaccine or treatment, so care is largely supportive
This document summarizes a seminar presentation on Ebola virus disease (EVD). It provides an overview of EVD outbreaks, case definitions, epidemiology, clinical presentation, diagnosis, treatment, and control/prevention. Key points include: EVD is caused by infection with Ebola virus and transmitted through contact with infected body fluids; symptoms range from fever and fatigue to vomiting and hemorrhaging; diagnosis involves virus detection through antigen/antibody tests or PCR; treatment is supportive care as no vaccine currently exists; control relies on isolation, contact tracing, and barrier precautions.
This document provides information on Ebola virus disease (EVD), including its history, transmission, pathogenesis, clinical features, diagnosis, and prevention. It notes that EVD is caused by one of five viruses in the family Filoviridae, is highly fatal in humans and nonhuman primates, and is transmitted through direct contact with bodily fluids. Symptoms include fever, headache, vomiting and severe hemorrhaging. While there are no approved vaccines, prevention focuses on avoiding contact with infected hosts and bodily fluids through safe burial practices and hygiene.
An introduction to the 2014 West Africa Ebola outbreak for educational use, with additional sources for health professionals in need of up-to-date information.
Updated on 7th December, 2014, with additional infographics and WHO data.
Infographics may be requested for professional use on a creative commons/source attribution basis (micrognome.priobe.net). An interactive version will be available for educational use via the Nearpod share site.
Ebola virus disease is a severe, often fatal illness caused by the Ebola virus. The virus was first discovered in 1976 near the Ebola River in the Democratic Republic of Congo. The 2014 outbreak in West Africa was the largest in history, infecting thousands and killing over 11,000. The virus is transmitted through direct contact with body fluids of infected humans or animals. Common symptoms include fever, headache, muscle pain and weakness. While there is no approved vaccine, treatment involves supportive care to improve symptoms.
This document provides an overview of global health by defining key terms, outlining major players and organizations, and summarizing the history and evolution of the field from 1945 to the present day. It describes how global health has shifted from a focus on infectious disease control to addressing social determinants of health and health issues that transcend national borders. Major milestones discussed include the founding of the UN and WHO, the Alma-Ata Declaration, structural adjustment policies, the Millennium Declaration and MDGs, debt relief campaigns, and the establishment of the Global Fund. The summary highlights the ongoing tension between disease-specific and comprehensive primary healthcare approaches.
This document provides an introduction to global health. It defines global health as health problems that transcend national boundaries and are best addressed through international cooperation. Reasons for interest in global health include moral duty, public diplomacy, and investment in self-protection. Key challenges are limited past resources, uncoordinated present efforts wasting resources, lack of stable leadership, and high turnover causing strategic uncertainty. The future direction of global health depends on expanding the talent pool in developing countries, effective disease prevention and treatment systems, and strengthening health infrastructure.
This document provides an overview of tropical medicine and global health issues. It discusses diseases that disproportionately impact those living in tropical regions, including neglected tropical diseases. It also covers non-communicable diseases, trauma, urbanization, vector-borne diseases, influenza, avian influenza, measles, malaria, Ebola virus disease, and long-term consequences of the 2014-2015 West Africa Ebola outbreak. Health worker migration is also briefly discussed. The document contains detailed information on the transmission, epidemiology, and impact of various tropical and global health challenges.
The document discusses the 2014-2016 Ebola virus outbreak in West Africa, which was declared a Public Health Emergency of International Concern by the WHO. It provides details on the Ebola virus, including its transmission, symptoms, diagnosis, treatment and prevention. The outbreak began in Guinea in December 2013 and involved the Zaire species of the Ebola virus. As of August 2014, there were over 2,000 suspected and confirmed cases reported across Guinea, Liberia and Sierra Leone.
WHAT IS ANDROID? Android is a mobile operating system (OS) based on the Linux kernel and currently developed by Google. With a user interface based on direct manipulation, Android is designed primarily for touchscreen mobile devices such as smartphones and tablet computers, with specialized user interfaces for televisions (Android TV), cars (Android Auto), and wrist watches (Android Wear).
Android is a software stack for mobile devices that includes an operating system, middleware and key applications. Android is a software platform and operating system for mobile devices based on the Linux operating system and developed by Google and the Open Handset Alliance. It allows developers to write managed code in a Java-like language that utilizes Google-developed Java libraries, but does not support programs developed in native code.
This document discusses employee involvement and participation in organizations. It defines employee involvement as creating an environment where employees can impact decisions that affect their jobs. Employee participation means employees are part of teams and can suggest ideas and make decisions about their work. Involving employees can motivate workers and improve productivity, creativity, and commitment. The document outlines several methods for implementing employee participation, such as giving employees responsibility, training, communication, and rewards. It also discusses the objectives and benefits of participative management styles in organizations.
This document discusses worker participation in management (WPM) in India. It defines WPM and explains its objectives and importance, including mutual understanding, higher productivity, and industrial harmony. Several forms of WPM are described, such as consultative participation, administrative participation, and decision/decisive participation. Examples of WPM levels in India include collective bargaining, works committees, shop councils, joint councils, and board representation. Challenges to effective WPM implementation in India are also outlined, as well as examples of WPM practices at Tata Steel and BHEL.
Impact of pulmonary tuberculosis in hiv patients, retrospective study from ja...Dr Nzasi Deppinair Mundabi
A research done by Dr Mundabi to find out how the impact of TB to HIV patients especially concerning the CD4 for patients on ART and regularly followed up.
This review summarizes evidence on the burden of tuberculosis in populations affected by crises such as armed conflict, displacement, and natural disasters. 51 reports were identified that provided data on tuberculosis notification rates, prevalence, incidence, case fatality ratios, and drug resistance levels among crisis-affected populations. Most studies found elevated notification rates and prevalence compared to reference populations, with incidence and prevalence ratios over 2 in 11 of 15 reports that could make comparisons. Case fatality ratios were generally below 10% and drug resistance levels were usually comparable to background levels, with some exceptions. Analysis of surveillance data from refugee camps also suggested a pattern of excess tuberculosis risk. National tuberculosis notification data analysis found that more intense conflicts were associated with decreases in reported tuberculosis cases
Modeling the Effect of Variation of Recruitment Rate on the Transmission Dyna...IOSR Journals
In this Paper, the effect of the variation of recruitment rate on the transmission dynamics of
tuberculosis was studied by modifying an existing model. While the recruitment rate into the susceptible class of
the existing model is constant, in our modified model we used a varying recruitment rate. The models were
analyzed analytically and numerically and these results were compared. The Disease Free Equilibrium (DFE)
state of the existing model was found to be
,0,0,0
, the DFE of the modified model was found to be
( ,0,0,0) * S where * S is arbitrary. While all the eigenvalue of the existing model are negative, one of the
eigenvalues of the modified model is zero. The basic reproduction number o R of both models are established to
be the same. The numerical experiments show a gradual decline in the infected and exposed populations as the
recruitment rates increase in both models but the decline is more in the modified model than in the existing
model. This implies that eradication will be achieved faster using the model with a varying recruitment rate.
Incidence of Tuberculosis in HIV Sero-positive Patients at HIV Clinic at Kamp...PUBLISHERJOURNAL
Incidence of Tuberculosis in HIV Sero-positive Patients at HIV Clinic at Kampala International University Teaching Hospital, Bushenyi District
Okello, Andrew
School of Allied Health Sciences Kampala International University-Western Campus
________________________________________
ABSTRACT
This study on the prevalence of TB among HIV sero-positive was carried at the HIV CLINIC of Kampala International University Teaching Hospital (KIUTH), Ishaka Bushenyi district. A retrospective cross-sectional study design was used to conduct this research. The study targeted all patients attending KIUTH HIV/TB clinic. A standard structured and semi-structured questionnaires were designed and pre-tested for validity and reliability at Kampala International University Teaching Hospital HIV/Tuberculosis clinic before being used for data collection. Data collection started by recruitment of qualified research assistants, appropriate training and orientation of the interviewers before the survey for example when reading the questions. Quantitative methods of data analysis was used in which data was presented in form of bar charts, graphs and tables. The prevalence of TB among HIV sero-positive patients attending HIV clinic at KIUTH stands at 8.06 per 100 participants. The study found that generally, people are aware about the modes of transmission of TB but there is still need for more awareness. Many patients are still not certain whether TB is curable in HIV patients. As seen from the above study, most of the people are not yet aware whether HIV goes hand in hand with tuberculosis. The prevalence of TB in HIV sero-positive attending HIV clinic at KIUTH is high. Generally, TB is affecting patients of all ages and most patients are still not aware if TB in HIV is curable. Most patients have a perception that all TB patients have HIV. Health workers in HIV clinic of KIU-TH should teach patients the modes of transmission and prevention of TB. KIUTH also need to provide easy access to TB screening services to patients. There is need for financial support by the government to the unemployed patients and low-income earners in order to curb TB infections.
Keywords: Tuberculosis, HIV, Sero-positive, Bushenyi District
________________________________________
This document provides information from a training bulletin about Ebola virus disease (EVD) for EMS providers, including that EVD can only be transmitted through direct contact with bodily fluids from a symptomatic, infected person. It outlines signs and symptoms of EVD, precautions EMS providers should take when evaluating patients, and disinfection procedures after transporting a patient. It notes collaboration between EMS agencies and health organizations to provide timely information during the Ebola outbreak.
This paper proposes a vaccine-dependent mathematical model to study the transmission dynamics of tuberculosis (TB) epidemics at the population level. The model divides the population into susceptible, latently infected unvaccinated, latently infected vaccinated, actively infected, recovered, and vaccinated classes. The paper proves the existence and uniqueness of a solution to the system of equations that defines the model. It also shows that the infection will die out if the basic reproduction number is less than one. The model could be used to estimate new TB infections and help design prevention and intervention strategies.
Abstract
Prevalence and incidence are measures that are used for monitoring the occurrence of a disease. Prevalence can be computed from readily available cross-sectional data but incidence is traditionally computed from longitudinal data from longitudinal studies. Longitudinal studies are characterised by financial and logistical problems where as cross-sectional studies are easy to conduct. This paper introduces a new method for estimating HIV incidence from grouped cross-sectional sero-prevalence data from settings where antiretroviral therapy is provided to those who are eligible according to recommended criteria for the administration of such drugs.
The 2014 Ebola outbreak was the most severe to date, spreading rapidly across multiple West African countries and into the United States. New Jersey designated three hospitals to treat Ebola patients and implemented training, protocols, and $1 million of protective equipment to prevent transmission. Current legislation aims to support healthcare workers exposed to Ebola, use former military facilities as quarantine areas, and improve access to healthcare to help control infectious disease spread.
Systematic home screening for active pulmonary tuberculosis in the san commun...Dalton Malambo
Systematic home screening for active pulmonary tuberculosis was conducted in the San community of Platfontein, South Africa, which is an historically disadvantaged ethnic minority group. The aim was to detect undiagnosed active pulmonary tuberculosis cases in their homes using WHO screening tools. While passive case finding relies on symptomatic individuals seeking care, targeted active screening is important for disease control and has been shown to stop epidemics by finding infectious cases early through screening high-risk groups according to WHO guidelines.
Systematic home screening for active pulmonary tuberculosis in the San commun...Dalton Malambo
Systematic home screening for active pulmonary tuberculosis was conducted in the San community of Platfontein, South Africa, which is an historically disadvantaged ethnic minority group. The aim was to detect undiagnosed active pulmonary tuberculosis cases in their homes using WHO screening tools. While passive case finding relies on symptomatic individuals seeking care, targeted active screening is important for disease control and has been shown to stop epidemics by finding infectious cases early through screening high-risk groups according to WHO guidelines.
Systematic home screening for active pulmonary tuberculosis in the san commun...Dalton Malambo
The detection of active pulmonary tuberculosis in participants within a high risk tuberculosis community, who face the challenges of extreme poverty, increased tuberculosis incidence and prevalence, increased HIV incidence and prevalence, language and cultural barriers, high incidences and prevalence of sexual abuse, substance abuse, severe acute malnutrtion and illiteracy.
Systematic home screening for active pulmonary tuberculosis in the san commun...Dalton Malambo
The detection of active pulmonary tuberculosis in participants within their homes, who reside in a high risk tuberculosis community confronted with minority ethnic groups, language and social barriers, high prevalence and incidence of HIV infections, high prevalence of abuse against women, high prevalence of teenage pregnancies, high prevalence of substance abuse and a high prevalence of poverty and illiteracy.
This document discusses tuberculosis (TB) in India. It notes that India has the highest TB burden in the world, accounting for nearly 1/5 of global cases. Every year approximately 1.8 million people develop TB in India, of which around 800,000 are new smear-positive cases. India also has the fastest expanding DOTS program for treating TB, which has treated over 7.3 million patients since 1997.
An Epidemiological Model of Malaria Transmission in Ghana.pdfEmily Smith
- The document presents an epidemiological model of malaria transmission in Ghana using a system of ordinary differential equations with human and mosquito populations.
- The model divides the human population into susceptible, exposed, infectious, and recovered categories and the mosquito population into susceptible, exposed, and infectious categories.
- Sensitivity analysis found that the mosquito biting rate and mosquito death rate were the most sensitive parameters affecting the basic reproduction number. Simulations showed that combining four control measures - insecticide spraying, bed net usage, and treatment of infected humans and pregnant women - had the highest impact on reducing disease transmission.
The document discusses the ongoing Ebola outbreak in West Africa and the factors contributing to its severity. It argues that the high mortality rates are due not just to lack of staff and resources, but more fundamentally to lack of adequate health systems to effectively deploy them. In particular, it notes the lack of basic protective equipment, guidelines, and supportive care that could reduce unnecessary deaths. It calls for responses to both provide immediate aid and invest in building sustainable systems focused on quality, safety, effectiveness, and treating patients with dignity to restore lost trust and prevent future crises.
Outbreak! Learning about Zika Transmission and TestingDanielle Snowflack
In this lesson, students will explore transmission and diagnosis of infectious diseases using the recent Zika outbreak as a model. First, students will use a simple model to simulate the spread of an infectious disease through a population. Next, they will use the Enzyme Linked Immunosorbent Assay (ELISA) to test patient samples for Zika. The results will be summarized in a laboratory report.
Real Time Pcr Detection Of Hiv Viral LoadAlison Reed
The document discusses real-time PCR detection of HIV viral load. It introduces HIV and how it progresses through different stages, eventually causing AIDS. It describes how HIV binds to and destroys CD4+ T cells, weakening the immune system. Millions of people worldwide have HIV/AIDS, particularly in Sub-Saharan Africa. Real-time PCR is used to detect and measure HIV viral load, which rapidly increases during acute infection before declining as CD4+ T cells are lost.
The document provides background information on the 2014-2016 Ebola outbreak in West Africa, the largest and most complex Ebola outbreak in history. It discusses how Ebola spread from Guinea to the neighboring countries of Liberia and Sierra Leone due to porous borders and mobility. Issues that promoted the spread included cultural practices like eating bushmeat, lack of understanding of Western medicine, and damage to health infrastructure from civil wars in the affected countries. Problems arose regarding personal protective equipment recommendations, availability of supplies, and proper use of PPE. However, specialized treatment units like the one at Emory Hospital helped successfully treat patients through years of preparation and stringent safety protocols.
Fighting Against Ebola: Public Health and NepalMMC, IOM, Nepal
Ebola virus disease is a severe and often fatal illness in humans that was first identified in 1976. The current 2014-2016 outbreak in West Africa was the largest in history. While supportive care can improve survival rates, there are currently no licensed vaccines or treatments for Ebola. Approximately 3,000-5,000 Nepalese citizens work in the affected regions of West Africa, placing Nepal at risk of an outbreak. However, Nepal is ill-prepared to handle Ebola cases, as its airports lack proper screening and designated treatment hospitals lack necessary resources and isolation facilities. Some experts argue that market incentives have led to a lack of Ebola research by pharmaceutical companies, as the disease primarily affects poor regions of Africa
Genotypes and Associated Risk Levels of Human Papilloma Virus among Female Pa...IIJSRJournal
Background: Human papillomavirus is the main factor in the etiology of cervical cancer, with over 99.7% of cases being associated with high-risk human papillomavirus infection. Although the majority of HPV infections are asymptomatic and self-limiting, persistent HPV infection can result in genital warts, oropharyngeal cancer, and cervical cancer in women, in addition to various anogenital malignancies and other genital warts in both men and women.
Method: This was a cross-sectional descriptive study which employed a convenience sampling technique where both qualitative and quantitative methods were used for data collection. A total of 374 participants were enrolled in the study and a semi structured questionnaire was administered to collect socio-demographic, reproductive and sexual history data. Laboratory analysis involved detection of HPV DNA hybrids with a chemiluminescent substrate, Digene Hybrid Capture 2 technology. Descriptive and inferential (logistic regression) analyses at level of significant (α=0.05) were used to summarize the data, and results illustrated using charts and tables.
Results: The study findings reported a significant risk level of human papillomavirus among female of age group 40-49 years (AOR; 0.15, 95% CI: 0.03-0.79; p = 0.026). Furthermore, in bivariate logistic regression the circulating HPV genotypes among the respondents was significantly characterized among women of the same age group (95% CI; 0.09-0.7; p = 0.008) as well as in the multivariate regression (AOR = 0.13; 95% CI: 0.02-0.72; p = 0.019).
Conclusion: The study thus concluded that there is 23/94 (25.67%) risk of developing cervical cancer due to high risk level HPV (with the presence of low risk level HPV 71/94 (74.33%) known for causing various forms of warts. Therefore, there is need for combined efforts from the Ministry of health and stakeholders to avail and train health care workers on the usage of HPV DNA kits to ensure timely detection of low and high-risk levels HPV. This will ensure timely identification of women at increased risk for the development of cervical cancer, thereby reducing mortality rate.
Similar to Evolution of the benfits and risks of introducing Ebola Community CAre Centers in Sierra Leone (20)
Riprendendo le basi di quanto già realizzato con gli NVG durante l'anno 2017 in Piemonte, EMSpedia ed Emergency Live hanno concluso una interessante intervista con il dottor Roberto Vacca del 118 di Torino
APERTE LE ISCRIZIONI!
Elisoccorso Sanitario Tra Prospettive E Realtà
Dal 24 Al 26 Maggio a Palermo, per il ventennale di SEUS
https://www.emergency-live.com/it/news/elisoccorso-sanitario-tra-prospettive-e-realta-dal-24-al-26-maggio-a-palermo/
Poster IRC 2016 - Follow up dopo arresto cardiaco pre-ospedalieroEmergency Live
Valutare la sopravvivenza a lungo termine nei pazienti con STEMI sottoposti a PCI con o senza OHCA. Un follow up post arresto cardiaco extra-ospedaliero
#SCUOLESICURE un progetto sostenibile per insegnare con efficacia RCP nelle s...Emergency Live
#Scuolesicure è il paper presentato da: E. Baldi, E. Contri, S. Cornara, F. Epis, D. Fina, C. Dossena, F. Fichtner, M. Tonani, A. Somaschini
Avendo chiaro che i bambini imparano la RCP in modo più rapido ed efficace degli adulti, e partendo dagli assunti che dal 2015 è obbligatorio l'insegnamento del primo soccorso nelle scuole, e manca ancora uno schema di insegnamento dimostrato come efficace e sostenibile, il progetto si è posto come obiettivo di valutare se #SCUOLESICURE - progetto su base provinciale realizzato da Pavia nel Cuore e Robbio nel Cuore - è un valido sistema da adottare in tutta Italia per l'insegnamento delle manovre salva-vita all'interno del percorso curricolare scolastico.
Progetto presentato a IRC2016 - Milano
Corso TSSA - Manovre pediatriche: l'immobilizzazione nel trauma dal neonato a...Emergency Live
In Italia e in Europa l’incidente stradale rappresenta la prima causa di morte nella popolazione al di sotto dei 40 anni, seguito dall'incidente domestico,dal fuoco e della caduta in genere.
Al termine politraumatizzato si associa, per definizione, un soggetto,vittima di un incidente,che presenta lesioni a carico di due o più distretti corporei.Un bambino è,per le sue caratteristiche anatomiche, da considerare sempre un politraumatizzato in questi casi. Quindi bisogna trattare il bimbo con moltissima cautela. Non bisogna trattare il bambino come un adulto di taglia ridotta.Conoscere e ricordare le differenze anatomico-fisiologico che rendono diverso l’approccio diagnostico-terapeutico è fondamentale. Il bambino infatti ha ridotta massa muscolare, ridotta quantità di grasso corporeo con conseguente vicinanza degli organi interni alla superficie esterna, ridotta calcificazione ossea e una aumentata elasticità del tessuto connettivo.
22 Corso TSSA Croce Rossa - Traumi dell’apparato muscolo scheletricoEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
23 Corso TSSA - comportamento con ferite, emorragie, lesioni da caldo e da f...Emergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
24 corso TSSA - Comportamento in caso di traumi particolariEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
24b - Corso TSSA Croce Rossa. Gli indici di gravità in sintesiEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
25 Corso TSSA - Il soccorritore volontario nelle maxi emergenzeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
25 - TSSA Croce Rossa Protocollo START esercitazione pratica corso Maxi Emerg...Emergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
26 Corso TSSA Croce Rossa - L'uso di tecniche e presidiEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
28 Corso TSSA Croce Rossa - Approccio psico-socialeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze. La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
29 Corso TSSA - Lo stress nel soccorritore e il lavoro di equipeEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
31 Corso TSSA - Manovre di immobilizzazione del neonato traumatizzatoEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
30 Corso TSSA Croce Rossa: abusi di sostanze e intossicazioniEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. I moduli formativi sono 6. Bastano i primi 4 moduli per diventare soccorritore, gli altri due moduli sono di approfondimento e completamento di percorsi regionali. L’accesso a questo corso prevede l’obbligatorietà di essere Socio Attivo CRI e quindi di aver frequentato il Corso Base. Gli incontri vertono principalmente sulle problematiche del soccorso extra-ospedaliero e si dividono in lezioni teoriche e parti pratiche con particolare riferimento alla Traumatologia, alla Rianimazione cardio-polmonare con l’ottenimento del brevetto BLS-D (defibrillazione) ed all’uso dei Presidi disponibili sulle ambulanze.
La cooperazione che ha portato alla creazione di queste dispense di TSSA è molto importante. Infatti non esiste materiale univoco e ufficiale per tutto il territorio Nazionale. Il materiale delle lezioni che stiamo ripubblicando è nato grazie alla collaborazione dei formatori e degli istruttori di Croce Rossa, specializzati in PSTI (Pronto Soccorso e Trasporto Infermi). Questi istruttori hanno realizzato le schede che potete liberamente consultare. Il team è costituito da 15 istruttori qualificati, il cui lavoro è stato controllato da 5 revisori (formatori, medici specialistici e tecnici esperti) che hanno corretto alcuni contenuti scientifici, rendendo poi omogeneo l'aspetto visivo del corso. In questo modo sono nate delle wikiSLIDES che ad oggi hanno più di 5.000 download dal link ufficiale.
Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio.
Corso TSSA riconoscimento e trattamento trauma cranico e spinaleEmergency Live
Il trauma costituisce oggi in Italia, come tutti i paesi industrializzati, la causa più frequente di morte nella popolazione di età inferiore ai 44 anni, con un'incidenza di circa 120 casi ogni 100.000 abitanti. Il politraumatizzato è un paziente che presenta una o più lesioni traumatiche ad organi o apparati differenti con compromissione attuale o potenziale delle funzioni vitali.
L'evento traumatico costituisce un enorme costo sociale in quanto interessa le fasce di età maggiormente produttive. Inoltre in molti traumatizzati permangono condizioni invalidanti che aggravano ulteriormente la sequenza di negatività sia su un piano umano che economico. È stato dimostrato che una buona organizzazione del trattamento pre-ospedaliero comporta una notevole riduzione della mortalità e dell'invalidità. Diversi studi confermano che la percentuale di "morti evitabili" per trauma è significativamente più elevata quando non esistono strutture e personale adeguatamente formato. È quindi necessaria una precisa crescita della professionalità del personale addetto al soccorso pre-ospedaliero munito di attrezzature adeguate.
[url="http://www.emergency-live.com/it/?p=13218"] MAGGIORI INFORMAZIONI SUL TRAUMA SPINALE E CERVICALE QUI [/url]
Corso TSSA - parte 9: le emergenze urgenze pediatricheEmergency Live
Il corso TSSA (corso nazionale per l’attività di trasporto sanitario e soccorso in ambulanza) è il corso sanitario avanzato della Croce Rossa Italiana che si prefigge di formare il SOCCORRITORE, cioè il Volontario che svolgerà la sua attività sulle ambulanza e perciò il percorso addestrativo è tipicamente sanitario. I corsi sono tenuti da Istruttori di Croce Rossa qualificati con un apposito percorso specifico. Il ringraziamento di Emergency Live va al gruppo TSSA e al coordinatore Egidio Tuccio, per la scelta di mettere il materiale online e disponibile a tutto il pubblico. Questo articolo presenta le schede sulle emergenze pediatriche
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Evolution of the benfits and risks of introducing Ebola Community CAre Centers in Sierra Leone
1. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015 393
In some parts of western Africa, Ebola treatment centers
(ETCs) have reached capacity. Unless capacity is rapidly
scaled up, the chance to avoid a generalized Ebola epi-
demic will soon diminish. The World Health Organization
and partners are considering additional Ebola patient care
options, including community care centers (CCCs), small,
lightly staffed units that could be used to isolate patients out-
side the home and get them into care sooner than otherwise
possible. Using a transmission model, we evaluated the
benefits and risks of introducing CCCs into Sierra Leone’s
Western Area, where most ETCs are at capacity. We found
that use of CCCs could lead to a decline in cases, even if
virus transmission occurs between CCC patients and the
community. However, to prevent CCC amplification of the
epidemic, the risk of Ebola virus–negative persons being ex-
posed to virus within CCCs would have to be offset by a re-
duction in community transmission resulting from CCC use.
The current epidemic of Ebola virus disease in western
Africa has resulted in thousands of cases during 2014
(1). To date, Ebola treatment centers (ETCs) have been used
to isolate patients and provide clinical care. These facilities
typically have large capacity (some have >100 beds) and
function under high levels of infection control. However,
in Sierra Leone, ETCs have reached capacity, and patients
are being turned away (1). The reproduction number (de-
fined as the average number of secondary cases generated
by a typical infectious person) has been >1 in Sierra Leone,
leading to growth in the number of cases reported each
week (2–4). As a result, there is an urgent need to rapidly
scale up treatment and isolation facilities. Delays in imple-
mentation will result in falling further behind the epidemic
curve and in an even greater need for patient care facilities.
ETCs are complex facilities that require a substantial
number of staff and time to set up; thus, the World Health
Organization and other partners are looking at additional
care options to supplement existing ETCs. One approach
is the use of Ebola community care centers (CCCs), which
would represent a possible change in operational approach
(5–7). As envisioned in the World Health Organization
approach, CCCs would be small units with 3–5 beds and
would be staffed by a small group of health care workers.
The main objective would be to isolate patients outside the
home and, hence, reduce the movement and contacts of in-
fectious persons within the community. CCCs are designed
to engage the community and to increase the acceptance
of isolation. Care for patients in CCCs would be provided
primarily by a caregiver who would be given personal pro-
tective equipment (PPE) and basic patient care training.
Patients would be free to leave the unit while awaiting test
results. The specific utilization of CCCs would vary, de-
pending on local context, and units would form part of a
package of interventions, including monitoring of commu-
nity contacts and burials within the community.
CCCs would be easier to set up than ETCs because
they would be lightly staffed and could be made from local
materials or even tents. Thus, CCCs have the potential to
more rapidly begin treating patients. At present in Sierra
Leone, the average time from symptom onset to hospital-
ization for Ebola virus disease patients is 4.6 days, which
means patients remain in the community until the late stage
of the disease (4). However, the use of CCCs has potential
risks: the number of cases could be amplified if Ebola vi-
rus–negative patients in CCC assessment areas are exposed
to infectious persons before admission, and virus could be
transmitted between patients and caregivers or others in
Evaluation of the Benefits
and Risks of Introducing
Ebola Community Care Centers,
Sierra Leone
Adam J. Kucharski, Anton Camacho, Francesco Checchi, Ron Waldman,
Rebecca F. Grais, Jean-Clement Cabrol, Sylvie Briand, Marc Baguelin,
Stefan Flasche, Sebastian Funk, W. John Edmunds
Author affiliations: London School of Hygiene and Tropical
Medicine, London, UK (A.J. Kucharski, A. Camacho, M. Baguelin,
S. Flasche, S. Funk, W.J. Edmunds); Save the Children, London
(F. Checchi); Milken Institute School of Public Health, George
Washington University, Washington, DC, USA (R. Waldman);
Epicentre, Paris, France (R.F. Grais); Médecins sans Frontières,
Geneva, Switzerland (J.-C. Cabrol); World Health Organization,
Geneva (S. Briand)
DOI: http://dx.doi.org/10.3201/eid2103.141892
RESEARCH
2. RESEARCH
394 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015
the community if virus containment within the CCC is not
perfect. Given the urgent need for new operational solu-
tions for Ebola patient care, it is critical to assess the condi-
tions under which CCCs might exacerbate or mitigate the
epidemic and to compare the scale-up of CCCs with the
expansion of ETCs or home care.
We used an Ebola virus transmission model to evalu-
ate the relative benefits and risks of introducing CCCs in a
situation similar to that in Western Area, an administrative
division of Sierra Leone. Western Area has exhibited con-
sistent exponential growth in reported cases, and ETCs in
the area are at capacity (1). Expert elicitation was used to
estimate plausible values for key model parameters; these
values were compared with simulation results to establish
whether CCCs could be beneficial. We also estimated how
many CCC beds, either alone or in combination with addi-
tional ETC beds, would be required to potentially turn over
the epidemic (i.e., reduce the reproduction number below
the critical threshold of 1).
Methods
Because precise medical and operational details of CCCs
are still under discussion, we focused on the implications
of CCC introduction under a set of general assumptions.
We modeled Ebola transmission by using a modified sus-
ceptible-exposed-infectious-resolved framework (8–10). In
the model, persons were initially susceptible to the virus;
upon infection, patients moved into a latent state for an av-
erage of 9.4 days (4) and then became symptomatic and
infectious for an average of 9.5 days (4) before the disease
was resolved (through either recovery or death and buri-
al) and the patient no longer contributed to transmission.
The model accounted for changes in ETC capacity to date
(details available at https://drive.google.com/file/d/0B_
BzCqSK1DZaYnRoeWtHOTU2TVk/).
First, we used the model to generate epidemiologic
forecasts for Western Area and to establish a baseline sce-
nario for the level of infection if no additional interven-
tions were introduced. We fitted the model to the number
of weekly reported Ebola virus disease cases in Western
Area during August 16–November 31, 2014 (1). We es-
timated that in Western Area the basic reproduction num-
ber (defined as the average number of secondary cases
generated by a typical infectious person in the absence of
control measures) was 1.94 (95% credible interval [CrI]
1.86–1.98) and that there would be 1,060 exposed persons
(95% CrI 800–1,420) and 650 symptomatic persons (95%
CrI 460–910) in the community on December 1, 2014.
To model the introduction of CCCs, we assumed that
Ebola virus–susceptible persons could also become infected
with other febrile diseases that have Ebola virus disease–like
symptoms, which we assumed had symptoms that lasted an
averageof7days.Thus,2typesofsymptomaticpersonswere
included in our simulation model: Ebola virus–positive and
Ebolavirus–negativepatients(Figure1;https://drive.google.
com/file/d/0B_BzCqSK1DZaYnRoeWtHOTU2TVk/).
In the model, Ebola virus–positive and –negative patients
took an average of 4.6 days (4) after the onset of symptoms
before attending an ETC. The probability that a patient
was admitted to an ETC depended on the number of cur-
rently available beds. Well-managed ETCs operate strict
patient isolation, careful use of PPE, and safe burial pro-
cedures (11,12), so we assumed that no virus transmission
occurred between Ebola virus–infected patients and com-
munity members once patients were admitted to an ETC. If
suspected case-patients were admitted to ETCs and subse-
quently found to be negative for Ebola virus, they returned
to the community; we assumed there was no risk of Ebola
virus–negative patients becoming infected while waiting for
test results.
We also included CCCs in the model. We assumed that
for patients visiting local CCCs, the time between symptom
onset and CCC visit was shorter than that for patients visit-
ing the larger and more distant ETCs; in the main analysis,
we assumed that the average time from symptom onset to
CCC attendance was 3 days. If CCCs were full, then pa-
tients attended ETCs instead. If ETCs were full, patients re-
mained in the community. We assumed there was a possi-
bility for some transmission of virus from CCC patients to
community members (either directly, through caregivers,
Figure 1. Structure of transmission model used to evaluate the
benefits and risks of introducing CCCs into Western Area, Sierra
Leone. Persons start off being susceptible to infection (S). Upon
infection with Ebola virus, they enter an incubation period (E),
and at symptom onset, they become infectious in the community
(I+
). After this point, infected persons seek health care in CCCs
or ETCs; if centers are full, the infectious persons remain in the
community until the infection is resolved (R) (i.e., the patients
have recovered from the disease or are dead and buried).
Patients admitted to ETCs and CCCs also move into the resolved
compartment (R). We also assume that Ebola virus–susceptible
persons could also become infected with other febrile diseases
that have Ebola virus disease–like symptoms (I–
). These Ebola
virus–negative patients also seek health care; if centers are
full, the patients return to the susceptible compartment (S) as
symptoms wane. We assume the latent period is 9.4 days, the
average time from symptom onset to CCC attendance is 3 days,
and the average interval from symptom onset to ETC attendance
is 4.6 days. CCCs, Ebola community care centers; ETCs, Ebola
treatment centers.
3. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015 395
or during burial); we did not assume any transmission of
virus from ETC patients. There was also a chance that
Ebola virus–negative patients would be exposed to Ebola
virus while waiting for test results. We assumed that 50%
of symptomatic patients who attended CCCs/ETCs were
Ebola virus–positive; on the basis of the number of Ebola
virus disease cases and noncases reported in Sierra Leone,
this percentage is plausible (1,13,14).
Two other parameters, besides the shorter time be-
tween onset of symptoms and attendance at a center, make
CCCs potentially different from ETCs in the model: 1) the
probability that Ebola virus–negative patients would be ex-
posed to Ebola virus while waiting for test results in CCCs
and 2) the reduction in virus transmission from infectious
patients to the community as a result of the patient being
isolated in a CCC. If the CCC model had a 100% reduction
in transmission and 0% chance that Ebola virus–negative
patients would be exposed virus, it was equivalent to the
ETC set-up in the model, except that there would be a re-
duced time from symptom onset to CCC attendance.
Results
We first considered the potential level of infection in the com-
munity during December 2014 based on our estimates for
Western Area. With 259 ETC beds available (1,14–16), our
model suggests that ETCs would be at capacity in mid-De-
cember and the number of cases would rise over the follow-
ing weeks (Figure 2, panel A). We also considered the pos-
sibility that a proposed additional 500 ETC beds (15) would
be introduced on December 15, 2014 (Figure 2, panel B). Our
forecast suggested that the addition of these beds would cause
the growth in number of cases to slow in the following weeks,
but the change would not turn over the epidemic.
To assess what reduction in transmission and in risk
of Ebola virus–negative patient exposure to virus would be
required for 500 CCC beds to be beneficial, we varied 2
key parameters and, after 30 days, compared model out-
puts with those for the baseline scenario (Figure 3, panel
A). If there is a high probability that Ebola virus–negative
patients will be exposed but only a small reduction in trans-
mission, CCCs could act as incubators and generate more
cases than the baseline scenario with 259 ETC beds only.
The CCC approach has not been fully tested in the field,
so we conducted an elicitation of 6 expert opinions to ob-
tain estimates for the median and interquartile range (IQR)
for reduction in transmission as a result of patients being
in CCCs and for the probability of exposing Ebola virus–
negative patients to infectious patients (details at https://
drive.google.com/file/d/0B_BzCqSK1DZaYnRoeW-
tHOTU2TVk/). The distribution for the group opinion for
reduction in transmission while in a CCC had a median of
63% (IQR 41%–81%). The distribution for the probabil-
ity of exposure had a median of 0.09 (IQR 0.01–0.36).
When compared with model results, these estimates were
within the region of parameter space in which CCCs would
be beneficial (see Figure 3 at https://drive.google.com/file/
d/0B_BzCqSK1DZaYnRoeWtHOTU2TVk/).
Figure 2. Model fits and forecasts used to evaluate the benefits
and risks of introducing Ebola community care centers into
Western Area, Sierra Leone. A) Reported cases over time.
Black points show reported incidence data. B) No. patients in
ETC beds. Blue lines to the left of the dashed vertical divides
show the median estimate; blues line to the right of the dashed
vertical divides show forecast with no change in number of
ETC beds; green lines show forecast if 500 ETC beds are
introduced on December 15, 2014. Shaded areas represent
95% credible interval, which reflects uncertainty about reporting
and model parameters; darker shading indicates overlap
between 2 forecasts. Estimates were scaled depending on the
number of daily situation reports issued by the Sierra Leone
Ministry of Health and Sanitation each week (see https://drive.
google.com/file/d/0B_BzCqSK1DZaYnRoeWtHOTU2TVk/).
ETC, Ebola treatment center.
Ebola Community Care Centers, Sierra Leone
4. RESEARCH
396 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015
To confirm that 63% was a plausible value for reduction
in transmission, we used the following theoretical argument.
In the model, the basic reproduction number, R0
, was near 2,
the time from onset to outcome was 9.5 days on average, and
patients took an average of 3 days after onset of symptoms
to attend CCCs. If infected persons did not enter an available
CCC and instead remained in the community for the next
6.5 days, they would generate an average of 1.4 secondary
cases (because 2 × 6.5/9.5 = 1.4). Even if Ebola patients had
a 50% probability of infecting their sole caregiver, it meant
they would, on average, generate 0.5 secondary cases while
in a CCC. The relative reduction in cases as a result of being
in a CCC would therefore be (1.4 –0.5)/1.4 = 64%. If each
case-patient generated an average of 0.25 cases while in a
CCC, the expected reduction would be ≈80%.
To elucidate the potential benefits and risks of CCC
introduction, we considered 2 specific examples. If CCCs
reduced virus transmission from Ebola virus–infected pa-
tients to the community by 75% once the patient was ad-
mitted and if Ebola virus–negative patients have a 25%
probability of exposure while waiting for test results, then
the introduction of 500 CCC beds would slow virus trans-
mission (Figure 3, panel B). However, if CCCs only re-
duced transmission by 25% and Ebola virus–negative pa-
tients have a 50% probability of exposure to Ebola virus,
the introduction of 500 CCC beds could lead to a rise in the
number of cases within the community (Figure 3, panel B).
We also assessed how many CCC beds would be re-
quired to stop the exponential increase in cases and turn
over the epidemic (i.e., reduce the reproduction number
of the infection, R, to <1). A larger number of beds would
be required if the reduction in transmission was smaller
(Figure 4, panel A). The requirement was also larger if Eb-
ola virus–negative patients were more likely to be exposed
to virus, patients took longer to attend CCCs, or there were
more Ebola virus–negative patients (see figures 4 and 5 at
https://drive.google.com/file/d/0B_BzCqSK1DZaYnRoe
WtHOTU2TVk/). The large number of infected persons on
December 1, 2014, meant that the number of cases still rose
in the model (Figure 2), suggesting additional interventions
would be required to control the epidemic. Therefore we as-
sessed a combination of the 2 health care approaches, with
additional ETC beds, CCC beds, or both introduced on De-
cember 15, 2014 (Figure 4, panel B). Because CCCs reduce
the time from symptom onset to attendance at a health care
center, our results suggest it would be possible to turn over
the epidemic in Western Area with a sufficient number of
CCC beds, either as a standalone strategy or in combination
with additional ETCs.
Discussion
We used a transmission model to evaluate the potential ef-
fects of the introduction of Ebola CCCs in Western Area,
Figure 3. Factors influencing reduction or amplification of Ebola
virus infection in the community if 500 CCC beds were introduced
in Western Area, Sierra Leone, on December 15, 2014. A) Change
in infection compared with baseline scenario (259 Ebola treatment
center beds) between December 1, 2014, and February 1, 2015,
for a range of values for reduction in transmission and probability
of exposure to virus. Median parameter estimates for Western
Area were used (Table). B) Change in infection over time. Black
line, baseline scenario. Blue line, 500 CCC beds with transmission
reduced by 75% (blue line in A), and Ebola virus–negative patients
have 25% probability of exposure to virus. Red line, 500 CCC
beds with transmission reduced by 25% (red line in A), and Ebola
virus–negative patients have 50% probability of exposure to virus.
Shaded areas show 95% bootstrapped credible intervals generated
from 1,000 simulations with parameters sampled from posterior
estimates. We assumed that time from symptom onset to CCC
attendance was 3 days and that 50% of symptomatic patients were
Ebola virus–positive. CCC, Ebola community care center.
5. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015 397
Sierra Leone. Our results show that CCCs could reduce the
number of Ebola virus disease cases in the community if
1) the probability for Ebola virus–negative patients being
exposed to the virus is low and 2) there is reduction in virus
transmission as a result of infected patients being in CCCs.
The introduction of CCCs could potentially turn over the
epidemic (i.e., reduce the reproduction number, R, below
the critical threshold of 1) if the time from symptom onset
to CCC attendance is <3 days. Assuming that CCCs open
in mid-December, ensuring epidemic turnover would re-
quire a large number of CCC beds (potentially at least 500
for Western Area). In addition to reducing the time from
symptom onset to attendance at a treatment facility, a large
number of CCCs would have the added benefit of reduc-
ing the time from symptom onset to admission because
infected patients would not have to wait for ETC beds to
become available.
Our analysis does have limitations. One of those limi-
tations is that we used an illustrative scenario for Western
Area based on current epidemiologic reports. Given un-
certainty about the influence of factors such as changes in
behavior (18), we focused our analysis on short-term fore-
casts and estimation of the number of beds required to turn
over the epidemic. However, the epidemiologic landscape
is changing rapidly, and the situation might have been dif-
ferent by late December/January, which would influence
our specific estimates for bed requirements. In addition,
transmission dynamics may vary by district, which would
influence the precise number of beds required in different
areas. Our results should therefore be viewed as qualita-
tive rather than quantitative. In addition, the reduction in
transmission as a result of patients being in CCCs will, in
reality, depend on several factors, including patient move-
ments, PPE effectiveness, infection control in the facility,
and burial procedures (12), and these factors will likely
differ between settings. Because it was not possible to es-
tablish the contribution of each factor to disease transmis-
sion without detailed data on the source of infection (8), we
used a single parameter to capture the reduction in trans-
mission as a result of a patient being in a CCC. Given the
uncertainty about the precise magnitude of this reduction,
we assessed the effect of CCCs under the full range of po-
tential reductions in transmission, from no change to full
containment, and conducted an elicitation of expert opin-
ions to identify plausible parameter ranges.
Furthermore, we assumed that infectiousness does not
vary over the course of Ebola virus infection. However, if
patients are most infectiousness during the final stages of in-
fection (19,20), then CCCs and ETCs would provide an even
greater reduction in transmission because they would isolate
patients when they are most infectious. In addition, it has
been shown that it is not possible to reliably estimate mul-
tiple routes of transmission for Ebola virus from a single in-
cidence curve (8); thus, we chose to model community trans-
mission by using a single parameter, rather than attempting
to estimate the contribution from living infected persons and
from funerals. In the model, we also assumed that all patients
seek health care. If in reality some do not, this will have the
effect of increasing the average time from symptom onset to
admission in a care center. A crucial point is that if patients
on average spent more than half of their infectious periods in
the community, then expansion of bed capacity alone would
not be enough to turn over the epidemic in regions where the
reproduction number is near 2.
Table. Parameters used in a transmission model for evaluating the benefits and risks of introducing CCCs into Western Area,
Sierra Leone*
Parameter Value Source
Mean time from symptom onset to outcome
Ebola virus–positive patients 9.5 d (4)
Ebola virus–negative patients 7.0 d Assumed
Mean time from symptom onset to admission
To ETC 4.6 d (4)
To CCC 3.0 d Assumed
Mean time from exposure to symptom onset (latent period) 9.4 d (4)
Proportion of patients with Ebola-like symptoms in Western Area who are Ebola-positive 50.0% (1)
Population of Western Area 1.4 million (17)
Probability that an Ebola virus–negative patient seeking care in CCC will be exposed to Ebola
virus
Varies† NA
Reduction in transmission from infected patients to the community as a result of being in CCC Varies† NA
Basic reproduction no. (95% CrI)‡ 1.94 (1.86–1.98) Estimated
No. infectious persons on August 16, 2014 (95% CrI)§ 51 (39.0–57.0) Estimated
Proportion of cases in Western Area reported in Sierra Leone Ministry of Health situation reports
(95% CrI)
0.42 (0.33–0.46) Estimated
Variability in accuracy of reports, define as standard deviation of proportion of cases reported
(95% CrI)
0.014 (0.010–0.024) Estimated
*CCC, Ebola community care center; CrI, credible interval; ETC, Ebola treatment center; NA, not applicable.
†In the analysis, the full range of possible values for these parameters is tested.
‡Basic reproduction number refers to the average number of secondary cases generated by a typical infectious patient at the start of an epidemic
§This parameter represents the initial no. of infectious patients at the start of the model simulation. Additional information is available at
https://drive.google.com/file/d/0B_BzCqSK1DZaYnRoeWtHOTU2TVk/.
Ebola Community Care Centers, Sierra Leone
6. RESEARCH
398 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015
In summary, CCCs may offer a rapid, high-coverage
complement to ETCs and, thus, hold considerable potential
for bringing about a sizeable shift in the epidemic pattern
in Sierra Leone. The UK government is therefore support-
ing such a combined intervention in the Sierra Leone (7).
However, the CCC approach is little tested in the field and
could be harmful if infection control in CCCs is worse than
that in the community or if Ebola virus–negative patients
have a high risk of exposure to virus. Settings with limited
triage, such as primary health care facilities, may also ex-
pose Ebola virus–negative patients to the virus and could
therefore also have the potential to amplify the Ebola epi-
demic. Given the potential benefits and risks of introducing
CCCs, real-time evaluation of their effectiveness must be
carried out as they are implemented. In particular, to con-
firm the usefulness of CCCs as an epidemic control strate-
gy, estimates must be determined for the reduction in virus
transmission as a result of infected patients being isolated
in CCCs and for the probability of Ebola virus–negative
patients being exposed to virus in CCCs.
Funding was provided by the Medical Research Council (fellow-
ships: MR/J01432X/1 to A.C., MR/K021524/1 to A.J.K., and
MR/K021680/1 to S.F.) and the Research for Health in Humani-
tarian Crises (R2HC) Programme, managed by the Research for
Humanitarian Assistance (grant no. 13165).
Dr. Kucharski is a research fellow in infectious disease epi-
demiology at London School of Hygiene and Tropical Medi-
cine. His research focuses on the dynamics of emerging infec-
tions and how population structure and social behavior shape
disease transmission.
References
1. Ministry of Health and Sanitation. Ebola virus disease—situation
report [cited 2014 Dec 10]. http://Health.gov.sl
2. Gomes MFC, Pastore y Piontti A, Rossi L, Chao D, Longini I,
Halloran ME, et al. Assessing the international spreading risk
associated with the 2014 West African Ebola outbreak. PLoS
Currents Outbreaks. 2014 Sep 2 [cited 2014 Dec 1]. http://currents.
plos.org/outbreaks/article/assessing-the-international-spreading-
risk-associated-with-the-2014-west-african-ebola-outbreak/
3. Nishiura H, Chowell G. Early transmission dynamics of Ebola
virus disease (EVD), West Africa, March to August 2014. Euro
Surveill. 2014;19:pii: 20894.
4. WHO Ebola Response Team. Ebola virus disease in West Africa—
the first 9 months of the epidemic and forward projections. N Engl
J Med. 2014;371:1481–95. http://dx.doi.org/10.1056/
NEJMoa1411100
5. Save The Children. Save the Children opens first Ebola community
care centre in Liberia [cited 2014 Dec 1]. http://www.savethe
children.net/article/save-children-opens-first-ebola-community-
care-centre-liberia
6. Logan G, Vora NM, Nyensuah TG, Gasasira A, Mott J, Walke H.
Establishment of a community care center for isolation and
management of Ebola patients—Bomi County Liberia, October
2014. MMWR Morb Mortal Wkly Rep. 2014;63:1010–2.
7. Whitty CJ, Farrar J, Ferguson N, Edmunds WJ, Piot P, Leach M,
et al. Tough choices to reduce Ebola transmission. Nature.
2014;515:192–4. http://dx.doi.org/10.1038/515192a
8. Camacho A, Kucharski AJ, Funk S, Breman J, Piot P, Edmunds WJ.
Potential for large outbreaks of Ebola virus disease. Epidemics.
2014;9:70–8. http://dx.doi.org/10.1016/j.epidem.2014.09.003
9. Legrand J, Grais RF, Boelle PY, Valleron AJ, Flahault A.
Understanding the dynamics of Ebola epidemics. Epidemiol Infect.
2007;135:610–21. http://dx.doi.org/10.1017/S0950268806007217
10. Lewnard JA, Mbah MLN, Alfaro-Murillo JA, Altice FL, Bawo L,
Nyenswah TG, et al. Dynamics and control of Ebola virus
transmission in Montserrado, Liberia: a mathematical modelling
Figure 4. Estimated number of CCC beds required to control
Ebola virus epidemic in Western Area, Sierra Leone. A) Number
of CCC beds required to turn over the outbreak (i.e., reduce the
reproduction number, R, to <1). When transmission is reduced
by only 50%, no amount of CCC beds can stop the growth in
cases. We assume there is a 10% probability that Ebola virus–
negative patients are exposed to virus. Lines show bootstrapped
95% credible intervals generated from 1,000 simulations with
parameters sampled from posterior estimates; points show
median estimates. B) Number of CCC beds required to turn over
the epidemic when an additional 500 Ebola treatment center
beds are also introduced on December 15, 2014. CCC, Ebola
community care center.
7. Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 3, March 2015 399
analysis. Lancet Infect Dis. 2014;14:1189–95. http://dx.doi.
org/10.1016/S1473-3099(14)70995-8
11. Fischer WA II, Hynes NA, Perl TM. Protecting health care work-
ers from Ebola: personal protective equipment is critical but is
not enough. Ann Intern Med. 2014;161:753–4. http://dx.doi.
org/10.7326/M14-1953
12. World Health Organization. Global Alert and Response (GAR).
Infection prevention and control guidance for care of patients in
health-care settings, with focus on Ebola [cited 2014 Nov 20].
http://who.int/csr/resources/publications/ebola/filovirus_
infection_control/en/
13. Medécins sans Frontières. Ebola: MSF case numbers [cited
2014 Dec 1]. http://www.doctorswithoutborders.org/our-work/
medical-issues/ebola
14. World Health Organization. Ebola virus disease [cited 2014 Dec 1].
http://who.int/csr/disease/ebola/en/
15. HDXBeta
(Humanitarian Data Exchange Beta). West Africa: Ebola
outbreak [cited 2014 Dec 8]. https://data.hdx.rwlabs.org/ebola
16. UK Government. Department for International Development.
UK action plan to defeat Ebola in Sierra Leone. 2014
Sep 23 [cited 2014 Dec 1]. https://www.gov.uk/government/
publications/uk-action-plan-to-defeat-ebola-in-sierra-leone-
background
17. ACAPS. Sierra Leone: country profile [cited 2014 Dec 1]
http://reliefweb.int/sites/reliefweb.int/files/resources/acaps-country-
profile-sierra-leone.pdf
18. Funk S, Knight GM, Jansen VAA. Ebola: the power of behaviour
change. Nature. 2014;515:492. http://dx.doi.org/10.1038/515492b
19. Dowell SF, Mukunu R, Ksiazek TG, Khan AS, Rollin PE, Peters CJ.
Transmission of Ebola hemorrhagic fever: a study of risk factors in
family members, Kikwit, Democratic Republic of the Congo, 1995.
J Infect Dis. 1999;179:S87–91. http://dx.doi.org/10.1086/514284
20. Yamin D, Gertler S, Ndeffo-Mbah ML, Skrip LA, Fallah M,
Nyenswah TG, et al. Effect of Ebola progression on transmission
and control in Liberia. Ann Intern Med. 2014 [Epub 2014 Oct 28].
http://dx.doi.org/10.7326/M14-2255
Address for correspondence: Adam J. Kucharski, Department of
Infectious Disease Epidemiology, London School of Hygiene
and Tropical Medicine, London WC1E 7HT, UK; email:
adam.kucharski@lshtm.ac.uk
Find emerging infectious disease
information on
http://www.facebook.com
Ebola Community Care Centers, Sierra Leone