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The Institute for Global Health and Development

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    Social Sciences in Emerging Infectious Disease: The Ebola Disease Response
    (Springer International Publishing, 2023-01-01) James, Peter Bai; Lane, Rashon; Bah, Abdulai Jawo
    Emerging infectious disease outbreaks are increasingly prevalent, and the need to develop or strengthen existing health systems to effectively respond to a global health threat has become more apparent. Moreover, it has become clear the critical role social science research plays in exploring human behavior, cultural, social, and political economic forces that are equally important to inform emerging infectious disease response and recovery. This chapter discusses the role of social science research in infectious disease outbreaks, looking at benefits and current barriers. It further considers Ebola as a e study to illustrate how social science research approaches are used to explain the cultural, social, and political economic forces that explain community response and inform public health response to recent Ebola outbreaks in Western and Eastern Africa. Specifically, it discusses issues surrounding the origin of the Ebola virus, community beliefs and understanding of Ebola virus disease, surveillance, burial practices, the influence of politics and conflict on Ebola response efforts, vaccine hesitancy and Ebola survivorship relating to community stigma, as well as discrimination and health-seeking behavior. © Springer Nature Switzerland AG 2023.
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    Prevalence of Mycobacterium tuberculosis in sputum and reported symptoms among clinic attendees compared to a community survey in rural South Africa
    (Oxford University Press, 2022-01-12) Govender, Indira; Karat, Aaron S.; Olivier, Stephen; Baisley, Kathy; Beckwith, Peter; Dayi, Njabulo; Dreyer, Jaco; Gareta, Dickman; Gunda, Resign; Kielmann, Karina; Koole, Olivier; Mhlongo, Ngcebo; Modise, Tshwaraganang; Moodley, Sashen; Mpofana, Xolile; Ndung’u, Thumbi; Pillay, Deenan; Siedner, Mark J.; Smit, Theresa; Surujdeen, Ashmika; Wong, Emily B.; Grant, Alison D.
    Background Tuberculosis (TB) case finding efforts typically target symptomatic people attending health facilities. We compared the prevalence of Mycobacterium tuberculosis (Mtb) sputum culture-positivity among adult clinic attendees in rural South Africa with a concurrent, community-based estimate from the surrounding demographic surveillance area (DSA). Methods Clinic: Randomly-selected adults (≥18 years) attending two primary healthcare clinics were interviewed and requested to give sputum for mycobacterial culture. HIV and antiretroviral therapy (ART) status were based on self-report and record review. Community: All adult (≥15 years) DSA residents were invited to a mobile clinic for health screening, including serological HIV testing; those with ≥1 TB symptom (cough, weight loss, night sweats, fever) or abnormal chest radiograph were asked for sputum. Results Clinic: 2,055 patients were enrolled (76.9% female, median age 36 years); 1,479 (72.0%) were classified HIV-positive (98.9% on ART) and 131 (6.4%) reported ≥1 TB symptom. Of 20/2,055 (1.0% [95% CI 0.6–1.5]) with Mtb culture-positive sputum, 14 (70%) reported no symptoms. Community: 10,320 residents were enrolled (68.3% female, median age 38 years); 3,105 (30.3%) tested HIV-positive (87.4% on ART) and 1,091 (10.6%) reported ≥1 TB symptom. Of 58/10,320 (0.6% [95% CI 0.4–0.7]) with Mtb culture-positive sputum, 45 (77.6%) reported no symptoms. In both surveys, sputum culture positivity was associated with male sex and reporting >1 TB symptom. Conclusions In both clinic and community settings, most participants with Mtb culture-positive sputum were asymptomatic. TB screening based only on symptoms will miss many people with active disease in both settings.
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    Delivery of integrated infectious disease control services under the new antenatal care guidelines: A service availability and readiness assessment of health facilities in Tanzania
    (2019-03-11) Odjidja, Emmanuel Nene; Gatasi, Ghislaine; Duric, Predrag
    BACKGROUND:Tanzania remains among the countries with the highest burden of infectious diseases (notably HIV, Malaria and Tuberculosis) during pregnancy. In response, the country adopted World Health Organization's (WHO) latest antenatal care (ANC) guidelines which recommend comprehensive services including diagnostic screening and treatment for pregnant women during antenatal. However, as Tanzania makes efforts to scale up these services under the existing health system resources, it is crucial to understand its capacity to deliver these services in an integrated fashion. Using the WHO's service availability and readiness assessment(SARA) framework, this study assesses the capacity of the Tanzanian Health System to provide integrated Malaria, Tuberculosis and HIV services.