| 1. |
- Citron, Isabelle, et al.
(författare)
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Towards equitable surgical systems : Development and outcomes of a national surgical, obstetric and anaesthesia plan in Tanzania
- 2019
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Ingår i: BMJ Global Health. - : BMJ. - 2059-7908. ; 4:2
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Tidskriftsartikel (refereegranskat)abstract
- Despite emergency and essential surgery and anaesthesia care being recognised as a part of Universal Health Coverage, 5 billion people worldwide lack access to safe, timely and affordable surgery and anaesthesia care. In Tanzania, 19% of all deaths and 17 % of disability-adjusted life years are attributable to conditions amenable to surgery. It is recommended that countries develop and implement National Surgical, Obstetric and Anesthesia Plans (NSOAPs) to systematically improve quality and access to surgical, obstetric and anaesthesia (SOA) care across six domains of the health system including (1) service delivery, (2) infrastructure, including equipment and supplies, (3) workforce, (4) information management, (5) finance and (6) Governance. This paper describes the NSOAP development, recommendations and lessons learnt from undertaking NSOAP development in Tanzania. The NSOAP development driven by the Ministry of Health Community Development Gender Elderly and Children involved broad consultation with over 200 stakeholders from across government, professional associations, clinicians, ancillary staff, civil society and patient organisations. The NSOAP describes time-bound, costed strategic objectives, outputs, activities and targets to improve each domain of the SOA system. The final NSOAP is ambitious but attainable, reflects on-the-ground priorities, aligns with existing health policy and costs an additional 3% of current healthcare expenditure. Tanzania is the third country to complete such a plan and the first to report on the NSOAP development in such detail. The NSOAP development in Tanzania provides a roadmap for other countries wishing to undertake a similar NSOAP development to strengthen their SOA system.
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| 2. |
- Karlsson, Philip, et al.
(författare)
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Using a One Health Case-Based Investigation for Improved Control of Brucellosis in Isiolo, Kenya
- 2021
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Ingår i: Frontiers in Tropical Diseases. - Switzerland : Frontiers Media S.A.. - 2673-7515. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Brucella is a highly pathogenic bacteria endemic in Kenya, and in spite of its severity in humans, the highly inadequate Febrile Antigen Brucella Agglutination Test (FBAT) remains a primary tool for its diagnosis. Blood samples were collected from febrile patients in Kinna health center and screened by the local routine. Milk samples were purchased from local milk hawkers and analyzed for Brucella antibodies using the milk ring test (MRT). The MRT-positive milk was traced to farms, and lactating cattle were sampled for milk and blood. Milk was MRT-tested and the serum was analyzed using the Rose Bengal test (RBT) and iELISA. Available patient and farm samples were stored on FTA cards for qPCR analyses. Despite a limited sample size, our study, in line with previous reports, shows a low diagnostic sensitivity (67%) and specificity (40%) of FBAT when compared to qPCR. As many as 48% of the raw bulk cattle milk samples were MRT-positive for Brucella antibodies and 60% of cattle on three visited farms were IS711 qPCR-positive. This case-based One Health investigation confirms the suspected Brucella presence, suggesting a targeted vaccination at high-prevalence farms, urgent interventions on milk safety, and a re-evaluation of the diagnostic and treatment regimen.
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