Background Yemen has faced one of the worst humanitarian crises in the world since the start of t... more Background Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The aims are to characterize the outbreak and address the gaps predisposing the emergence and circulation of VDPV1 in Saadah governorate, Yemen. Method A retrospective descriptive study of confirmed cases of VDPV1 between January and December 2020 was performed. Surveillance staff collected data from patient cases, contacts, as well as stool specimens that shipped to WHO accredited polio labs. Data of population immunity was also reviewed. The difference in days between the date of sample collection, shipment, and receiving lab result was used to calculate the average of delayed days for lab confirmation. Results From January to December 2020, a total of 114 cases of acute flaccid paralysis (AFP) were reported from 87% (13/15) districts, and cVDPV1 was confirmed among 26% ...
BACKGROUND Yemen has been increasingly reporting public health emergencies (eg, cholera). The Min... more BACKGROUND Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Public Health and Population (MoPH&P) has put in place the Rapid Response Teams (RRTs) mechanism from the national to district level to investigate and initiate the response to public health emergencies. An RRT is a technical, multidisciplinary team that is readily available for quick mobilization and deployment in case of emergencies. OBJECTIVE The aim of this analysis was to summarize the role of RRTs in response to outbreaks in Yemen during 2020. METHODS Data were obtained from the electronic Diseases Early Warning System (eDEWS) in Excel format covering the period from January to December 2020, including governorates, diseases, and other variables. Data were cleaned and analyzed using Excel 2013. Qualitative data are summarized as percentages. Data are presented using tables, graphs, and maps. RESULTS A total of 39,451 field descents were performed. Nearly half of the activi...
Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Pu... more Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Public Health and Population (MoPH&P) has put in place the Rapid Response Teams (RRTs) mechanism from the national to district level to investigate and initiate the response to public health emergencies. An RRT is a technical, multidisciplinary team that is readily available for quick mobilization and deployment in case of emergencies. The aim of this analysis was to summarize the role of RRTs in response to outbreaks in Yemen during 2020. Data were obtained from the electronic Diseases Early Warning System (eDEWS) in Excel format covering the period from January to December 2020, including governorates, diseases, and other variables. Data were cleaned and analyzed using Excel 2013. Qualitative data are summarized as percentages. Data are presented using tables, graphs, and maps. A total of 39,451 field descents were performed. Nearly half of the activities (n=18,565, 47.06%) were for outb...
BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was ... more BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of national surveillance are being met, this study aimed to examine the level of usefulness and the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention guidelines were used for the purposes of our evaluation. Related documents and reports were reviewed. Data were collected from 4 central-level managers and stakeholders and from 10 focal points at 4 sentinel sites by using a semistructured questionnaire. For each attribute, percent scores were calculated and ranked as follows: very poor (≤20%), poor (20%-40%), average (40%-60%), good (60%-80%), and excellent (>80%). RESULTS As rated by the evaluators, the SARI surveillance system achieved its objectives. The system’s flexibility (percent score: 86%) and acceptability (percent score: 82%) were rated as “excellent,” and simplicity (percent score: 74%) and stability (percent score: 75%) were rated as “good.” The percent score for timeliness was 23% in 2018, which indicated poor timeliness. The overall data quality percent score of the SARI system was 98.5%. Despite its many strengths, the SARI system has some weaknesses. For example, it depends on irregular external financial support. CONCLUSIONS The SARI surveillance system was useful in estimating morbidity and mortality, monitoring the trends of the disease, and promoting research for informing prevention and control measures. The overall performance of the SARI surveillance system was good. We recommend expanding the system by promoting private health facilities’ (eg, private hospitals and private health centers) engagement in SARI surveillance, establishing an electronic database at central and peripheral sites, and providing the National Central Public Health Laboratory with the reagents needed for disease confirmation.
Background Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depe... more Background Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depends on strengthened health systems. Efficient health information systems provide a stimulus to reaching the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs that are hinged on the optimal performance of surveillance system attributes. Objective The aim of this study was to assess the usefulness and performance of the National Leishmania Control Program (NLCP), and to estimate the strength and weakness points of the system. Methods We followed the updated six steps of Centers for Diseases Control and Prevention (CDC) guidelines for evaluating public health surveillance systems. Data were collected using in-depth interviews with relevant stakeholders at the central level and semistructured questionnaires at the peripheral level. We used questions (yes, no) to assess the usefulness and a 5-...
BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% o... more BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% of all deaths globally. The burden of NCDs is rising faster in developing countries of the Middle East than in other regions. The morbidity and mortality of NCDs are still not well-studied in Yemen. OBJECTIVE The aim of this study was to describe the epidemiology of NCDs in Sana’a City, Yemen, for 2017. METHODS Raw data of a house-to-house survey that was conducted by the Ministry of Public Health and Population in 2017 were analyzed. Data were collected from household heads who were asked if any household member had one of the following five NCDs: hypertension (HTN), diabetes (DM), bronchial asthma (BA), mental disorders (MD), and epilepsy. Data were entered and analyzed using Epi info 7.2. For calculations of prevalence, 2017 projections from the 2004 census were used. RESULTS A total of 241,310 households were surveyed (1,592,646 household members), 59,061 (24.48%) of which included 70...
BACKGROUND Varicella zoster virus (VZV) causes chickenpox. Epidemiological profile of chickenpox ... more BACKGROUND Varicella zoster virus (VZV) causes chickenpox. Epidemiological profile of chickenpox varies considerably across countries, healthcare systems and immunization policies. In Yemen, chickenpox remains an important public health issue and outbreaks are not uncommon, since vaccination is not universal. On 23 February 2019, a medical doctor from AL kafji area of Assabain district notified to the Ministry of public Health& population Chickenpox infection among his family members and neighbors. OBJECTIVE To confirm the existence, describe epidemiological characteristics of the outbreak, and recommend prevention, and control measures. METHODS A door-to-door search was made for case finding and line listing with detailed epidemiological, clinical and vaccination history. Four blood samples were collected and sent for laboratory confirmation by ELISA. Data analyzed Epi info 7.2. RESULTS A total of 26 cases met the case definition. The outbreak started on 19 January 2019 at one hous...
BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was ... more BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of national surveillance are being met, this study aimed to examine the level of usefulness and the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention guidelines were used for the purposes of our evaluation. Related documents and reports were reviewed. Data were collected from 4 central-level managers and stakeholders and from 10 focal points at 4 sentinel sites by using a semistructured questionnaire. For each attribute, percent scores were calculated and ranked as follows: very poor (≤20%), poor (20%-40%), average (40%-60%), good (60%-80%), and excellent (>80%). RESULTS As rated by the evaluators, the SARI surveillance system achieved its objectives. The system’s flexi...
BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to id... more BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strengths and weaknesses to recommend improvements. METHODS The US Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. Stakeholders at the central, district, and facility levels were interviewed to rate the attributes of the NTSS. The percentage scores for attributes were ranked as poor (<60%), average (≥60% to <80%) and good (≥80%). RESULTS The overall usefulness score percentage was 38%, which indicates a poor performance. The performance of the NTSS was rated as average on flexibility (score percent: 68%) and acceptability (score percent: 64%) attributes and poor on stability (score percentage: 33%), simplicity (score percentage:...
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2019
Yemen is classified as high malaria endemic area with two-thirds of population at risk. Currently... more Yemen is classified as high malaria endemic area with two-thirds of population at risk. Currently, the National Malaria Control Program (NMCP) uses two malaria surveillance systems: the Integrated Malaria Surveillance System (IMSS) and the Early Disease Electronic Warning System (eDEWS). This study aimed to assess and compare the usefulness and attributes of the two malaria surveillance systems. The systems were evaluated according to the US Centers for Disease Control and Prevention (CDC) updated guidelines. Data were collected from 10 stakeholders through interviews and from 10 districts’ coordinators and 20 health facilities’ focal points using semistructured questionnaire. The score of the system attributes were interpreted as very poor, poor, average, good, and excellent according to the mean percent score. Both systems were found to be useful. The IMSS overall performance score was poor where flexibility was average and simplicity, acceptability, representativeness, and stabil...
Background Yemen has faced one of the worst humanitarian crises in the world since the start of t... more Background Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The aims are to characterize the outbreak and address the gaps predisposing the emergence and circulation of VDPV1 in Saadah governorate, Yemen. Method A retrospective descriptive study of confirmed cases of VDPV1 between January and December 2020 was performed. Surveillance staff collected data from patient cases, contacts, as well as stool specimens that shipped to WHO accredited polio labs. Data of population immunity was also reviewed. The difference in days between the date of sample collection, shipment, and receiving lab result was used to calculate the average of delayed days for lab confirmation. Results From January to December 2020, a total of 114 cases of acute flaccid paralysis (AFP) were reported from 87% (13/15) districts, and cVDPV1 was confirmed among 26% ...
BACKGROUND Yemen has been increasingly reporting public health emergencies (eg, cholera). The Min... more BACKGROUND Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Public Health and Population (MoPH&P) has put in place the Rapid Response Teams (RRTs) mechanism from the national to district level to investigate and initiate the response to public health emergencies. An RRT is a technical, multidisciplinary team that is readily available for quick mobilization and deployment in case of emergencies. OBJECTIVE The aim of this analysis was to summarize the role of RRTs in response to outbreaks in Yemen during 2020. METHODS Data were obtained from the electronic Diseases Early Warning System (eDEWS) in Excel format covering the period from January to December 2020, including governorates, diseases, and other variables. Data were cleaned and analyzed using Excel 2013. Qualitative data are summarized as percentages. Data are presented using tables, graphs, and maps. RESULTS A total of 39,451 field descents were performed. Nearly half of the activi...
Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Pu... more Yemen has been increasingly reporting public health emergencies (eg, cholera). The Ministry of Public Health and Population (MoPH&P) has put in place the Rapid Response Teams (RRTs) mechanism from the national to district level to investigate and initiate the response to public health emergencies. An RRT is a technical, multidisciplinary team that is readily available for quick mobilization and deployment in case of emergencies. The aim of this analysis was to summarize the role of RRTs in response to outbreaks in Yemen during 2020. Data were obtained from the electronic Diseases Early Warning System (eDEWS) in Excel format covering the period from January to December 2020, including governorates, diseases, and other variables. Data were cleaned and analyzed using Excel 2013. Qualitative data are summarized as percentages. Data are presented using tables, graphs, and maps. A total of 39,451 field descents were performed. Nearly half of the activities (n=18,565, 47.06%) were for outb...
BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was ... more BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of national surveillance are being met, this study aimed to examine the level of usefulness and the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention guidelines were used for the purposes of our evaluation. Related documents and reports were reviewed. Data were collected from 4 central-level managers and stakeholders and from 10 focal points at 4 sentinel sites by using a semistructured questionnaire. For each attribute, percent scores were calculated and ranked as follows: very poor (≤20%), poor (20%-40%), average (40%-60%), good (60%-80%), and excellent (&amp;gt;80%). RESULTS As rated by the evaluators, the SARI surveillance system achieved its objectives. The system’s flexibility (percent score: 86%) and acceptability (percent score: 82%) were rated as “excellent,” and simplicity (percent score: 74%) and stability (percent score: 75%) were rated as “good.” The percent score for timeliness was 23% in 2018, which indicated poor timeliness. The overall data quality percent score of the SARI system was 98.5%. Despite its many strengths, the SARI system has some weaknesses. For example, it depends on irregular external financial support. CONCLUSIONS The SARI surveillance system was useful in estimating morbidity and mortality, monitoring the trends of the disease, and promoting research for informing prevention and control measures. The overall performance of the SARI surveillance system was good. We recommend expanding the system by promoting private health facilities’ (eg, private hospitals and private health centers) engagement in SARI surveillance, establishing an electronic database at central and peripheral sites, and providing the National Central Public Health Laboratory with the reagents needed for disease confirmation.
Background Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depe... more Background Control of preventive chemotherapy-targeted neglected tropical diseases (PC-NTDs) depends on strengthened health systems. Efficient health information systems provide a stimulus to reaching the sustainable development goal aimed at ending PC-NTD epidemics. However, there is limited assessment of surveillance system functions linked to PC-NTDs that are hinged on the optimal performance of surveillance system attributes. Objective The aim of this study was to assess the usefulness and performance of the National Leishmania Control Program (NLCP), and to estimate the strength and weakness points of the system. Methods We followed the updated six steps of Centers for Diseases Control and Prevention (CDC) guidelines for evaluating public health surveillance systems. Data were collected using in-depth interviews with relevant stakeholders at the central level and semistructured questionnaires at the peripheral level. We used questions (yes, no) to assess the usefulness and a 5-...
BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% o... more BACKGROUND Noncommunicable diseases (NCDs) kill 41 million people each year, accounting for 71% of all deaths globally. The burden of NCDs is rising faster in developing countries of the Middle East than in other regions. The morbidity and mortality of NCDs are still not well-studied in Yemen. OBJECTIVE The aim of this study was to describe the epidemiology of NCDs in Sana’a City, Yemen, for 2017. METHODS Raw data of a house-to-house survey that was conducted by the Ministry of Public Health and Population in 2017 were analyzed. Data were collected from household heads who were asked if any household member had one of the following five NCDs: hypertension (HTN), diabetes (DM), bronchial asthma (BA), mental disorders (MD), and epilepsy. Data were entered and analyzed using Epi info 7.2. For calculations of prevalence, 2017 projections from the 2004 census were used. RESULTS A total of 241,310 households were surveyed (1,592,646 household members), 59,061 (24.48%) of which included 70...
BACKGROUND Varicella zoster virus (VZV) causes chickenpox. Epidemiological profile of chickenpox ... more BACKGROUND Varicella zoster virus (VZV) causes chickenpox. Epidemiological profile of chickenpox varies considerably across countries, healthcare systems and immunization policies. In Yemen, chickenpox remains an important public health issue and outbreaks are not uncommon, since vaccination is not universal. On 23 February 2019, a medical doctor from AL kafji area of Assabain district notified to the Ministry of public Health& population Chickenpox infection among his family members and neighbors. OBJECTIVE To confirm the existence, describe epidemiological characteristics of the outbreak, and recommend prevention, and control measures. METHODS A door-to-door search was made for case finding and line listing with detailed epidemiological, clinical and vaccination history. Four blood samples were collected and sent for laboratory confirmation by ELISA. Data analyzed Epi info 7.2. RESULTS A total of 26 cases met the case definition. The outbreak started on 19 January 2019 at one hous...
BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was ... more BACKGROUND The national severe acute respiratory illness (SARI) surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of national surveillance are being met, this study aimed to examine the level of usefulness and the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention guidelines were used for the purposes of our evaluation. Related documents and reports were reviewed. Data were collected from 4 central-level managers and stakeholders and from 10 focal points at 4 sentinel sites by using a semistructured questionnaire. For each attribute, percent scores were calculated and ranked as follows: very poor (≤20%), poor (20%-40%), average (40%-60%), good (60%-80%), and excellent (>80%). RESULTS As rated by the evaluators, the SARI surveillance system achieved its objectives. The system’s flexi...
BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to id... more BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strengths and weaknesses to recommend improvements. METHODS The US Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. Stakeholders at the central, district, and facility levels were interviewed to rate the attributes of the NTSS. The percentage scores for attributes were ranked as poor (<60%), average (≥60% to <80%) and good (≥80%). RESULTS The overall usefulness score percentage was 38%, which indicates a poor performance. The performance of the NTSS was rated as average on flexibility (score percent: 68%) and acceptability (score percent: 64%) attributes and poor on stability (score percentage: 33%), simplicity (score percentage:...
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2019
Yemen is classified as high malaria endemic area with two-thirds of population at risk. Currently... more Yemen is classified as high malaria endemic area with two-thirds of population at risk. Currently, the National Malaria Control Program (NMCP) uses two malaria surveillance systems: the Integrated Malaria Surveillance System (IMSS) and the Early Disease Electronic Warning System (eDEWS). This study aimed to assess and compare the usefulness and attributes of the two malaria surveillance systems. The systems were evaluated according to the US Centers for Disease Control and Prevention (CDC) updated guidelines. Data were collected from 10 stakeholders through interviews and from 10 districts’ coordinators and 20 health facilities’ focal points using semistructured questionnaire. The score of the system attributes were interpreted as very poor, poor, average, good, and excellent according to the mean percent score. Both systems were found to be useful. The IMSS overall performance score was poor where flexibility was average and simplicity, acceptability, representativeness, and stabil...
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