Capacity building of public health laboratories in Afghanistan: challenges and successes [2007-2011]

Elyan, Diaa; Monestersky, Jesse; Wasfy, Momtaz O.; Noormal, Bashir; Oyofo, Buhari A.

doi:10.26719/2014.20.2.112

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…The shortage of medical staff at all levels of the healthcare system hampers the implementation of epidemiological surveillance and makes it difficult to reduce the number of the sick and carriers. The Afghan healthcare system is heavily dependent on humanitarian aid provided by international NGOs [1]. It is estimated that the risk of developing food-or waterborne diseases in Afghanistan is high [2].…”

Section: Introductionmentioning

confidence: 99%

Current status of intestinal parasitic infections among inhabitants of the Ghazni and Parwan provinces, Afghanistan

Korzeniewski¹,

Chung²,

Augustynowicz³

et al. 2017

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Background. The prevalence rates of food-and waterborne parasitic infections in Afghanistan are unknown. Cases of invasive diseases found in Afghans are rarely laboratory-confirmed. Objectives. The aim of the study was to present the current status of intestinal parasitic infections in Afghan inhabitants on the example of patients hospitalized in two healthcare facilities in eastern Afghanistan. Material and methods. Fecal samples were collected from 548 patients (children aged 1-17 years and adults) with internal complaints, treated in Ghazni Provincial Hospital (Afghan civilian medical center, Ghazni province, 180 south-west of Kabul) and in Bagram Korean Hospital (Korean military medical center for Afghan patients, Parwan province, 60 km north of Kabul) between 2013 and 2014. One to three stool specimens from Afghan patients were fixed in 10% formalin, transported to the Military Institute of Medicine in Poland and tested by light microscopy using three diagnostic methods (direct smear in Lugol's solution, decantation in distilled water and Fül-leborn's flotation). Results. Intestinal parasites were found in 144/386 of tested patients from the Ghazni province (37.3% infected, mainly with Ascaris lumbricoides, Giardia intestinalis, Hymenolepis nana) and in 49/162 patients from the Parwan province (30.2% infected, mainly with G. intestinalis, A. lumbricoides, H. nana). Conclusions. The rates of intestinal parasitic infections among Afghans are high. The wide range of the detected parasites (protozoa, nematodes, cestodes) should result in the introduction of general screening to be conducted regularly among inhabitants of Afghanistan and the application of targeted antiparasitic chemotherapy aiming to eliminate intestinal helminths and protozoa from the local community.

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Section: Introductionmentioning

confidence: 99%

Current status of intestinal parasitic infections among inhabitants of the Ghazni and Parwan provinces, Afghanistan

Korzeniewski¹,

Chung²,

Augustynowicz³

et al. 2017

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“…The insecurity and shortage of medical staff at all levels of the healthcare system hinders the implementation of epidemiological surveillance [ 15 ]. Healthcare system in Afghanistan is mostly dependent of international humanitarian aid [ 16 ]. The risk of parasitic diseases is estimated to be very high in Afghanistan [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated risk factors of soil-transmitted helminth infections in Kandahar, Afghanistan

et al. 2022

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Background Soil-transmitted helminth (STH) infections are still a major health problem, especially in resource-limited countries. The community-based prevalence of STH is unknown in Afghanistan. Main objectives of this study were to estimate the prevalence and associated factors of STH among children in Daman district of Kandahar province in Afghanistan. Methods This was a community-based cross-sectional study, with data collected during five months (June–October, 2020) from children living in five villages of Daman district in Kandahar, Afghanistan. All the stool samples were examined by saline wet mount method. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. Results A total of 1426 children were studied, with majority (61.8%) of males and the mean age of 6.3 years. The overall prevalence of any intestinal parasitic infection was 39.8%. The overall prevalence of STH infection was 22.7%, with Ascaris lumbricoides (18.7%) as the most prevalent STH species, followed by hookworm (7.5%) and Trichuris trichiura (1.4%). Single, double, and triple STH infections were present in 14.9%, 7.2%, and 0.6% of the children, respectively. Multivariate logistic regression revealed that not washing hands after defecating/before eating (AOR 7.0, 95% CI 3.4–14.0), living in mud house (AOR 3.5, 95% CI 1.6–7.4), walking barefoot (AOR 2.2, 95% CI 1.6–3.1), living in overcrowded house (AOR 1.6, 95% CI 1.1–2.3), and practicing open defecation (AOR 1.4, 95% CI 1.1–2.0) as the risk factors associated with the predisposition of rural children for getting STH in Daman district of Afghanistan. Conclusions Prevalence of STH is high among children of Daman district in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan. Also, government and international donor agencies in Afghanistan should help in improving socio-economic status of the rural areas through provision of basic facilities such as piped water, electricity, good housing, and proper toilets.

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“…Studies which have examined laboratory capacity building in such settings, point to a number of barriers to improvement, including but not limited to, poor infrastructure, lack of qualified laboratory staff, insufficient maintenance of equipment, poor internal QA and limited written SOPs. [12,14,[16][17][18][19][20][21]. Many of these challenges were also present in the laboratories assessed here, which was evident in the types of recommendations made.…”

Section: Discussionmentioning

confidence: 86%

“…While laboratory testing is considered essential to disease diagnostics and surveillance, it is also recognized as a weak link in public health systems in resourcechallenged settings [12][13][14][15][16]. Studies which have examined laboratory capacity building in such settings, point to a number of barriers to improvement, including but not limited to, poor infrastructure, lack of qualified laboratory staff, insufficient maintenance of equipment, poor internal QA and limited written SOPs.…”

Section: Discussionmentioning

confidence: 99%

Capacity building in national influenza laboratories – use of laboratory assessments to drive progress

et al. 2015

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BackgroundLaboratory testing is a fundamental component of influenza surveillance for detecting novel strains with pandemic potential and informing biannual vaccine strain selection. The United States (U.S.) Centers for Disease Control and Prevention (CDC), under the auspices of its WHO Collaborating Center for Influenza, is one of the major public health agencies which provides support globally to build national capacity for influenza surveillance. Our main objective was to determine if laboratory assessments supported capacity building efforts for improved global influenza surveillance.MethodsIn 2010, 35 national influenza laboratories were assessed in 34 countries, using a standardized tool. Post-assessment, each laboratory received a report with a list of recommendations for improvement. Uptake of recommendations were reviewed 3.2 mean years after the initial assessments and categorized as complete, in-progress, no action or no update. This was a retrospective study; follow-up took place through routine project management rather than at a set time-point post-assessment. WHO data on National Influenza Centre (NIC) designation, External Quality Assessment Project (EQAP) participation and FluNet reporting was used to measure laboratory capacity longitudinally and independently of the assessments. All data was further stratified by World Bank country income category.ResultsAt follow-up, 81 % of 614 recommendations were either complete (350) or in-progress (145) for 32 laboratories (91 % response rate). The number of countries reporting to FluNet and the number of specimens they reported annually increased between 2005, when they were first funded by CDC, and 2010, the assessment year (p < 0.01). Improvements were also seen in EQAP participation and NIC designation over time and more so for low and lower-middle income countries.ConclusionsAssessments using a standardized tool have been beneficial to improving laboratory-based influenza surveillance. Specific recommendations helped countries identify and prioritize areas for improvement. Data from assessments helped CDC focus its technical assistance by country and region. Low and lower-middle income countries made greater improvements in their laboratories compared with upper-middle income countries. Future research could include an analysis of annual funding and technical assistance by country. Our approach serves as an example for capacity building for other diseases.

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Capacity building of public health laboratories in Afghanistan: challenges and successes [2007-2011]

Cited by 6 publications

References 13 publications

Current status of intestinal parasitic infections among inhabitants of the Ghazni and Parwan provinces, Afghanistan

Current status of intestinal parasitic infections among inhabitants of the Ghazni and Parwan provinces, Afghanistan

Prevalence and associated risk factors of soil-transmitted helminth infections in Kandahar, Afghanistan

Capacity building in national influenza laboratories – use of laboratory assessments to drive progress

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