Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: Moffett D [original query] |
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Improvement in infection prevention and control compliance at the three tertiary hospitals of Sierra Leone following an operational research study
Kamara RZ , Kamara IF , Moses F , Kanu JS , Kallon C , Kabba M , Moffett DB , Fofanah BD , Margao S , Kamara MN , Moiwo MM , Kpagoi Sstk , Tweya HM , Kumar AMV , Terry RF . Trop Med Infect Dis 2023 8 (7) Implementing infection prevention and control (IPC) programmes in line with the World Health Organization's (WHO) eight core components has been challenging in Sierra Leone. In 2021, a baseline study found that IPC compliance in three tertiary hospitals was sub-optimal. We aimed to measure the change in IPC compliance and describe recommended actions at these hospitals in 2023. This was a 'before and after' observational study using two routine cross-sectional assessments of IPC compliance using the WHO IPC Assessment Framework tool. IPC compliance was graded as inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800). The overall compliance scores for each hospital showed an improvement from 'Basic' in 2021 to 'Intermediate' in 2023, with a percentage increase in scores of 16.9%, 18.7%, and 26.9% in these hospitals. There was improved compliance in all core components, with the majority in the 'Intermediate' level for each hospital IPC programme. Recommended actions including the training of healthcare workers and revision of IPC guidelines were undertaken, but a dedicated IPC budget and healthcare-associated infection surveillance remained as gaps in 2023. Operational research is valuable in monitoring and improving IPC programme implementation. To reach the 'Advanced' level, these hospitals should establish a dedicated IPC budget and develop long-term implementation plans. |
Mycobacterium tuberculosis RD-Rio Strain in Kazakhstan
Skiba Y , Mokrousov I , Nabirova D , Vyazovaya A , Maltseva E , Malakhova N , Ismagulova G , Pole I , Ranka R , Sapiyeva Z , Ismailov S , Moffett D . Emerg Infect Dis 2019 25 (3) 604-606 Mycobacterium tuberculosis RD-Rio strains are still rare in the former Soviet Union countries and Asia. We describe a strain in Kazakhstan that belongs to the RD-Rio secondary branch, which is endemic to northwest Russia and eastern Europe. Although RD-Rio strains are frequently multidrug resistant, this heterogeneous branch included only drug-susceptible isolates. |
Prevalence of Crimean-Congo hemorrhagic fever virus among livestock and ticks in Zhambyl Region, Kazakhstan, 2017
Bryant-Genevier J , Bumburidi Y , Kazazian L , Seffren V , Head JR , Berezovskiy D , Zhakipbayeva B , Salyer SJ , Knust B , Klena JD , Chiang CF , Mirzabekova G , Rakhimov K , Koekeev J , Kartabayev K , Mamadaliyev S , Guerra M , Blanton C , Shoemaker T , Singer D , Moffett DB . Am J Trop Med Hyg 2022 106 (5) 1478-85 Crimean-Congo hemorrhagic fever (CCHF) is a highly fatal zoonotic disease endemic to Kazakhstan. Previous work estimated the seroprevalence of CCHF virus (CCHFV) among livestock owners in the Zhambyl region of southern Kazakhstan at 1.2%. To estimate CCHFV seroprevalence among cattle and sheep, we selected 15 villages with known history of CCHFV circulation (endemic) and 15 villages without known circulation (nonendemic) by cluster sampling with probability proportional to livestock population size. We collected whole blood samples from 521 sheep and 454 cattle from randomly selected households within each village and collected ticks found on the animals. We tested livestock blood for CCHFV-specific IgG antibodies by ELISA; ticks were screened for CCHFV RNA by real-time reverse transcription polymerase chain reaction and CCHFV antigen by antigen-capture ELISA. We administered questionnaires covering animal demographics and livestock herd characteristics to an adult in each selected household. Overall weighted seroprevalence was 5.7% (95% CI: 3.1, 10.3) among sheep and 22.5% (95% CI: 15.8, 31.2) among cattle. CCHFV-positive tick pools were found on two sheep (2.4%, 95% CI: 0.6, 9.5) and three cattle (3.8%, 95% CI: 1.2, 11.5); three CCHFV-positive tick pools were found in nonendemic villages. Endemic villages reported higher seroprevalence among sheep (15.5% versus 2.8%, P < 0.001) but not cattle (25.9% versus 20.1%, P = 0.42). Findings suggest that the current village classification scheme may not reflect the geographic distribution of CCHFV in Zhambyl and underscore that public health measures must address the risk of CCHF even in areas without a known history of circulation. |
Etiology of acute meningitis and encephalitis from hospital-based surveillance in South Kazakhstan oblast, February 2017-January 2018.
Bumburidi Y , Utepbergenova G , Yerezhepov B , Berdiyarova N , Kulzhanova K , Head J , Moffett D , Singer D , Angra P , Whistler T , Sejvar J . PLoS One 2021 16 (5) e0251494 Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Blood and cerebrospinal fluid (CSF) samples were collected for bacterial culture, and CSF samples were additionally tested by PCR for four bacterial species and three viruses using a cascading algorithm. We enrolled 556 patients. Of these, 494 were of viral etiology (including 4 probable rabies cases), 37 were of bacterial etiology, 19 were of unknown etiology and 6 were not tested. The most commonly identified pathogens included enterovirus (73%, n = 406 cases), herpes simplex virus (12.8%, n = 71), and Neisseria meningitidis (3.8%, n = 21). The incidence rates (IRs) for enteroviral and meningococcal EM were found to be 14.5 and 0.7 per 100,000 persons, respectively. The IR for bacterial EM using both PCR and culture results was 3-5 times higher compared to culture-only results. Antibacterial medicines were used to treat 97.2% (480/494) of virus-associated EM. Incorporation of PCR into routine laboratory diagnostics of EM improves diagnosis, pathogen identification, ensures IRs are not underestimated, and can help avoid unnecessary antibacterial treatment. |
Progress toward poliovirus containment implementation - worldwide, 2019-2020
Moffett DB , Llewellyn A , Singh H , Saxentoff E , Partridge J , Boualam L , Pallansch M , Wassilak S , Asghar H , Roesel S , Grabovac V , Rey-Benito G , Barnor J , Theo A , Swan J , Iakovenko M , Baig N , Gurung S , Pandel E , Zaffran M . MMWR Morb Mortal Wkly Rep 2020 69 (37) 1330-1333 Since 1988, when World Health Organization (WHO) Member States and partners launched the Global Polio Eradication Initiative, the number of wild poliovirus (WPV) cases has declined from 350,000 in 125 countries to 176 in only two countries in 2019 (1). The Global Commission for the Certification of Poliomyelitis Eradication (GCC) declared two of the three WPV types, type 2 (WPV2) and type 3 (WPV3), eradicated globally in 2015 and 2019, respectively (1). Wild poliovirus type 1 (WPV1) remains endemic in Afghanistan and Pakistan (1). Containment under strict biorisk management measures is vital to prevent reintroduction of eradicated polioviruses into communities from poliovirus facilities. In 2015, Member States committed to contain type 2 polioviruses (PV2) in poliovirus-essential facilities (PEFs) certified in accordance with a global standard (2). Member states agreed to report national PV2 inventories annually, destroy unneeded PV2 materials, and, if retaining PV2 materials, establish national authorities for containment (NACs) and a PEF auditing process. Since declaration of WPV3 eradication in October 2019, these activities are also required with WPV3 materials. Despite challenges faced during 2019-2020, including the coronavirus disease 2019 (COVID-19) pandemic, the global poliovirus containment program continues to work toward important milestones. To maintain progress, all WHO Member States are urged to adhere to the agreed containment resolutions, including officially establishing legally empowered NACs and submission of PEF Certificates of Participation. |
Risk factors for and seroprevalence of tickborne zoonotic diseases among livestock owners, Kazakhstan
Head JR , Bumburidi Y , Mirzabekova G , Rakhimov K , Dzhumankulov M , Salyer SJ , Knust B , Berezovskiy D , Kulatayeva M , Zhetibaev S , Shoemaker T , Nicholson WL , Moffett D . Emerg Infect Dis 2020 26 (1) 70-80 Crimean-Congo hemorrhagic fever (CCHF), Q fever, and Lyme disease are endemic to southern Kazakhstan, but population-based serosurveys are lacking. We assessed risk factors and seroprevalence of these zoonoses and conducted surveys for CCHF-related knowledge, attitudes, and practices in the Zhambyl region of Kazakhstan. Weighted seroprevalence for CCHF among all participants was 1.2%, increasing to 3.4% in villages with a known history of CCHF circulation. Weighted seroprevalence was 2.4% for Lyme disease and 1.3% for Q fever. We found evidence of CCHF virus circulation in areas not known to harbor the virus. We noted that activities that put persons at high risk for zoonotic or tickborne disease also were risk factors for seropositivity. However, recognition of the role of livestock in disease transmission and use of personal protective equipment when performing high-risk activities were low among participants. |
Progress toward poliovirus containment implementation - worldwide, 2018-2019
Moffett DB , Llewellyn A , Singh H , Saxentoff E , Partridge J , Iakovenko M , Roesel S , Asghar H , Baig N , Grabovac V , Gurung S , Gumede-Moeletsi N , Barnor J , Theo A , Rey-Benito G , Villalobos A , Boualam L , Swan J , Sutter RW , Pandel E , Wassilak S , Oberste MS , Lewis I , Zaffran M . MMWR Morb Mortal Wkly Rep 2019 68 (38) 825-829 Among the three wild poliovirus (WPV) types, type 2 (WPV2) was declared eradicated globally by the Global Commission for the Certification of Poliomyelitis Eradication (GCC) in 2015. Subsequently, in 2016, a global withdrawal of Sabin type 2 oral poliovirus vaccine (OPV2) from routine use, through a synchronized switch from the trivalent formulation of oral poliovirus vaccine (tOPV, containing vaccine virus types 1, 2, and 3) to the bivalent form (bOPV, containing types 1 and 3), was implemented. WPV type 3 (WPV3), last detected in 2012 (1), will possibly be declared eradicated in late 2019.* To ensure that polioviruses are not reintroduced to the human population after eradication, World Health Organization (WHO) Member States committed in 2015 to containing all polioviruses in poliovirus-essential facilities (PEFs) that are certified to meet stringent containment criteria; implementation of containment activities began that year for facilities retaining type 2 polioviruses (PV2), including type 2 oral poliovirus vaccine (OPV) materials (2). As of August 1, 2019, 26 countries have nominated 74 PEFs to retain PV2 materials. Twenty-five of these countries have established national authorities for containment (NACs), which are institutions nominated by ministries of health or equivalent bodies to be responsible for poliovirus containment certification. All designated PEFs are required to be enrolled in the certification process by December 31, 2019 (3). When GCC certifies WPV3 eradication, WPV3 and vaccine-derived poliovirus (VDPV) type 3 materials will also be required to be contained, leading to a temporary increase in the number of designated PEFs. When safer alternatives to wild and OPV/Sabin strains that do not require containment conditions are available for diagnostic and serologic testing, the number of PEFs will decrease. Facilities continuing to work with polioviruses after global eradication must minimize the risk for reintroduction into communities by adopting effective biorisk management practices. |
Applying a new framework for public health systems recovery following emergencies and disasters: The example of Haiti following a major earthquake and cholera outbreak
Fitter DL , Delson DB , Guillaume FD , Schaad AW , Moffett DB , Poncelet JL , Lowrance D , Gelting R . Am J Trop Med Hyg 2017 97 4-11 Emergencies can often directly impact health systems of an affected region or country, especially in resource-constrained areas. Health system recovery following an emergency is a complex and dynamic process. Health system recovery efforts have often been structured around the World Health Organization's health systems building blocks as demonstrated by the Post-Disaster Needs Assessment. Although this structure is valuable and well known, it can overlook the intricacies of public health systems. We retrospectively examine public health systems recovery, a subset of the larger health system, following the 2010 Haiti earthquake and cholera outbreak, through the lens of the 10 essential public health services. This framework illustrates the comprehensive nature of and helps categorize the activities necessary for a well-functioning public health system and can complement other assessments. Outlining the features of a public health system for recovery in structured manner can also help lay the foundation for sustainable long-term development leading to a more robust and resilient health system. |
Assessment of the quality of anti-tuberculosis medicines in Almaty, Kazakhstan, 2014
Nabirova D , Schmid G , Yusupova R , Kantarbayeva M , Ismailov SI , Moffett D , Jahnke RWO , Nuorti JP . Int J Tuberc Lung Dis 2017 21 (10) 1161-1168 SETTING: In 2009, the World Health Organization (WHO) conducted a survey of the quality of four anti-tuberculosis drugs in the former Soviet Union countries. Kazakhstan had the highest proportion of substandard drugs. OBJECTIVE: To assess the quality of anti-tuberculosis drugs used in Kazakhstan in 2014. DESIGN: Fourteen anti-tuberculosis drugs from the Almaty Interdistrict TB Dispensary were randomly selected and screened for quality using Global Pharma Health Fund Minilab testing. First, the product and packaging were physically inspected to determine whether tablets/capsules were intact (i.e., whether they contained the full amount of the drug, and whether the packaging was genuine). Second, the tablets/capsules were dissolved in water to test whether they could be adequately absorbed by the body. Finally, semi-quantitive analyses were undertaken using thin-layer chromatography to verify the presence and concentration of the active pharmaceutical ingredient and to detect impurities. RESULTS: We discovered no counterfeit medicines. However, 163 (19%) of the 854 anti-tuberculosis drugs sampled failed at least one of the three tests. These samples were found among 24/50 (48%) batches of 14 anti-tuberculosis drugs. CONCLUSION: Our study identified a high proportion of poor-quality first- and second-line anti-tuberculosis drugs. Use of these medicines may lead to treatment failure and the development of drug resistance. Confirmatory testing should be performed to determine if they should be removed from the market. |
Establishment of an Ebola treatment unit and laboratory - Bombali District, Sierra Leone, July 2014-January 2015
Gleason B , Redd J , Kilmarx P , Sesay T , Bayor F , Mozalevskis A , Connolly A , Akpablie J , Prybylski D , Moffett D , King M , Bass M , Joseph K , Jones J , Ocen F . MMWR Morb Mortal Wkly Rep 2015 64 (39) 1108-1111 The first confirmed case of Ebola virus disease (Ebola) in Sierra Leone related to the ongoing epidemic in West Africa occurred in May 2014, and the outbreak quickly spread. To date, 8,704 Ebola cases and 3,955 Ebola deaths have been confirmed in Sierra Leone. The first Ebola treatment units (ETUs) in Sierra Leone were established in the eastern districts of Kenema and Kailahun, where the first Ebola cases were detected, and these districts were also the first to control the epidemic. By September and October 2014, districts in the western and northern provinces, including Bombali, had the highest case counts, but additional ETUs outside of the eastern province were not operational for weeks to months. Bombali became one of the most heavily affected districts in Sierra Leone, with 873 confirmed patients with Ebola during July-November 2014. The first ETU and laboratory in Bombali District were established in late November and early December 2014, respectively. T- evaluate the impact of the first ETU and laboratory becoming operational in Bombali on outbreak control, the Bombali Ebola surveillance team assessed epidemiologic indicators before and after the establishment of the first ETU and laboratory in Bombali. After the establishment of the ETU and laboratory, the interval from symptom onset to laboratory result and from specimen collection to laboratory result decreased. By providing treatment to Ebola patients and isolating contagious persons to halt ongoing community transmission, ETUs play a critical role in breaking chains of transmission and preventing uncontrolled spread of Ebola (4). Prioritizing and expediting the establishment of an ETU and laboratory by pre-positioning resources needed to provide capacity for isolation, testing, and treatment of Ebola are essential aspects of pre-outbreak planning. |
Dengue virus infections among Haitian and expatriate non-governmental organization workers - Leogane and Port-au-Prince, Haiti, 2012
Salyer SJ , Ellis EM , Salomon C , Bron C , Juin S , Hemme RR , Hunsperger E , Jentes ES , Magloire R , Tomashek KM , Desormeaux AM , Munoz-Jordan JL , Etienne L , Beltran M , Sharp TM , Moffett D , Tappero J , Margolis HS , Katz MA . PLoS Negl Trop Dis 2014 8 (10) e3269 In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Leogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Leogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves. |
Epidemic cholera in a crowded urban environment, Port-au-Prince, Haiti
Dunkle SE , Mba-Jonas A , Loharikar A , Fouche B , Peck M , Ayers T , Archer WR , Beau De Rochars VM , Bender T , Moffett DB , Tappero JW , Dahourou G , Roels TH , Quick R . Emerg Infect Dis 2011 17 (11) 2143-2146 We conducted a case-control study to investigate factors associated with epidemic cholera. Water treatment and handwashing may have been protective, highlighting the need for personal hygiene for cholera prevention in contaminated urban environments. We also found a diverse diet, a possible proxy for improved nutrition, was protective against cholera. |
Evaluating and regulating lead in synthetic turf
Van Ulirsch G , Gleason K , Gerstenberger S , Moffett DB , Pulliam G , Ahmed T , Fagliano J . Environ Health Perspect 2010 118 (10) 1345-9 BACKGROUND: In 2007, a synthetic turf recreational field in Newark, New Jersey, was closed because lead was found in synthetic turf fibers and in surface dust at concentrations exceeding hazard criteria. Consequently, public health professionals across the country began testing synthetic turf to determine whether it represented a lead hazard. Currently, no standardized methods exist to test for lead in synthetic turf or to assess lead hazards. OBJECTIVES: Our objectives were to increase awareness of potential lead exposure from synthetic turf by presenting data showing elevated lead in fibers and turf-derived dust; identify risk assessment uncertainties; recommend that federal and/or state agencies determine appropriate methodologies for assessing lead in synthetic turf; and recommend an interim standardized approach for sampling, interpreting results, and taking health-protective actions. DISCUSSION: Data collected from recreational fields and child care centers indicate lead in synthetic turf fibers and dust at concentrations exceeding the Consumer Product Safety Improvement Act of 2008 statutory lead limit of 300 mg/kg for consumer products intended for use by children, and the U.S. Environmental Protection Agency's lead-dust hazard standard of 40 microg/ft2 for floors. CONCLUSIONS: Synthetic turf can deteriorate to form dust containing lead at levels that may pose a risk to children. Given elevated lead levels in turf and dust on recreational fields and in child care settings, it is imperative that a consistent, nationwide approach for sampling, assessment, and action be developed. In the absence of a standardized approach, we offer an interim approach to assess potential lead hazards when evaluating synthetic turf. EDITOR'S SUMMARY: A recreational field in Newark, New Jersey, was closed in 2007 because lead concentrations found in synthetic turf fibers and in surface dust exceeded hazard criteria. Consequently, public health professionals across the country began testing synthetic turf to determine whether it represented a lead hazard. Data collected from recreational fields and child care centers indicated lead in synthetic turf fibers and dust at concentrations that exceed the Consumer Product Safety Improvement Act of 2008 statutory lead limit of 300 mg/kg for consumer products intended for use by children and the U.S. Environmental Protection Agency's lead-dust hazard standard of 40 microg/ft2 for floors. The authors conclude that synthetic turf can deteriorate to form dust containing lead at levels that may pose a risk to children. Currently, no standardized methods exist to test for lead in synthetic turf or to assess lead. Ulirsch et al. (p. 1345) summarize data on lead in fibers and turf-derived dust and discuss risk assessment uncertainties. They also note the need for regulatory agencies to develop standardized methods for assessing lead in synthetic turf and recommend an interim approach for sampling, interpreting results, and taking health-protective actions. |
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