Suchergebnisse

Abstract
Public health communication strategies to protect against the health impacts of air pollution due to landscape fire are becoming increasingly urgent in Australia. How well the public, particularly susceptible populations, are receiving, understanding and acting upon health protection messages related to smoke events is poorly understood. This integrative review sought literature relevant to health protection messaging for smoke events, including appropriate message content and suitable message delivery, with a focus on vulnerable and sensitive populations. Using an exhaustive search strategy of databases and grey literature, 26 relevant articles were identified and thematically analysed to produce a synthesis of findings on key themes. Findings indicated that a variety of traditional and modern communication channels are needed to ensure health messages are received by those most at-risk and should consider locally relevant information. A key theme to emerge in this review was the need for health messaging to susceptible populations to commence in advance of bushfire seasons to facilitate health protective actions being taken. During the acute-phase of smoke events, messages that were short with non-technical advice, were recalled and complied with more often. The need to improve the consistency of message content was a recurrent theme in the literature and suggested a need for greater interagency collaboration and communication. Preliminary evidence from smartphone app studies show promising results for targeted communication, however, more robust research is needed on the efficacy of these communication channels. Further research is also needed on the health impacts of smoke events, related compounding issues and strategies to reduce health risks, to better inform health protection messaging to susceptible populations.

Introduction: Elimination of kala-azar is planned for South Asia requiring good surveillance along with other strategies. We assessed surveillance in Gaffargaon upazila (a subdistrict of 13 unions) of Mymensingh district, Bangladesh highly endemic for kala-azar. Methods: In 4703 randomly sampled households, within nine randomly sampled villages, drawn from three randomly sampled unions, we actively searched for kala-azar cases that had occurred between January 2010 and December 2011. We then searched for medical records of these cases in the patient registers of Gaffargaon upazila health complex (UHC). We investigated factors associated with the medical recording by interviewing the cases and their families. We also did a general observation of UHC recording systems and interviewed health staff responsible for the monthly reports of kala-azar cases. Results: Our active case finding detected 58 cases, but 29 were not recorded in the Gaffargaon UHC. Thus, only 50% (95% CI: 37%–63%) of kala-azar cases were reported via the government passive surveillance system. Interviews with health staff based in the study UHC revealed the heavy reporting burden for multiple diseases, variation in staff experience, high demands on the staff time and considerable complexity in the recording system. After adjusting for kala-azar treatment drug, recording was found more likely for those aged 18 years or more, males, receiving supply and administration of drug at the UHC, and more recent treatment. Discussion: Fifty percent of kala-azar cases occurring in one highly endemic area of Bangladesh were recorded in registers that were the source for monthly reports to the national surveillance system. Recording was influenced by patient, treatment, staff and system factors. Our findings have policy implications for the national surveillance system. Future studies involving larger samples and including interviews with health authorities at more central level and surveillance experts at the national level will generate more precise and representative evidence on the performance of kala-azar surveillance in Bangladesh.