How has Guinea learnt from the response to outbreaks? A learning health system analysis

Millimouno, Tamba Mina; Meessen, Bruno; Put, Willem van de; Garcia, Marlon; Camara, Bienvenu Salim; Christou, Aliki; Delvaux, Thérèse; Sidibé, Sidikiba; Béavogui, Abdoul Habib; Délamou, Alexandre

doi:10.1136/bmjgh-2022-010996

Cited by 4 publications

(14 citation statements)

References 130 publications

(203 reference statements)

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“…Twenty papers included a definition of an LHS [2,31,37,38,40,41,44,46,48,52,54,[57][58][59][60][61][62][63][64][65] (Table 2). Twenty-seven unique references were used to cite these LHS definitions.…”

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

“…Of 17 studies (53%) that reported use of an LHS framework, 11 used existing frameworks that were not explicitly modified from their original structure [37,38,40,41,43,46,48,51,56,57,62], 4 adapted an existing framework in response to the COVID-19 pandemic [44,49,59,64], and 2 developed new frameworks [52,54] (Table 2).…”

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

“…Transparency around decision-making, data usage and management, or the involvement of AI, was discussed in eight papers (38%) [31,38,45,48,50,54,59,64]. Five papers (24%) discussed the need for incentives aligned to improve LHS processes [38,46,48,54,55], such as using performance indicators that measure the time from evidence release to clinical uptake [38]. Two papers (10%) raised concerns about the sustainability of the advances made by the LHS during the COVID-19 pandemic [2,62], due to limited funding or reimbursement.…”

Section: Incentivesmentioning

confidence: 99%

“…The Structure and Governance (n = 12, 41%) [37-41, 45, 46, 53, 55, 59, 64, 65] of the LHSs facilitated streamlining of ethics and research processes [38,41,45,64,65] and the ability to develop and deploy public health strategies [37,39,55,59]. It also enabled working groups that can be commissioned and decommissioned as the course of a pandemic changes [37,46,53].…”

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

“…However, pandemics also presented challenges to the development or advancement of an LHS (n = 22, 69%). The pace of the pandemic spread created the need for rapid changes to policies and procedures in limited time frames [37,38,46,57,58,61,64] and brought the added difficulty of managing diverse stakeholders (such as the coordinating local and national level resources). The existing Structure and Governance of some LHSs struggled to adjust rapidly to these demands (n = 13, 59%) [2,31,37,38,46,54,55,57,58,61,64].…”

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

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Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Smith,

Fisher,

Dharmayani

et al. 2024

BMC Med

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Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0. Methods Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance. Results The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges. Conclusions An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events. Trial registration PROSPERO pre-registration: CRD42023408896.

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Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

Section: Lhs Definitions and Frameworkmentioning

confidence: 99%

Section: Incentivesmentioning

confidence: 99%

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

Section: The Reciprocal Relationship Between Pandemics and Lhssmentioning

confidence: 99%

See 3 more Smart Citations

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Smith,

Fisher,

Dharmayani

et al. 2024

BMC Med

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Translational success of fundamental virology: a VSV-vectored Ebola vaccine

Anderson,

Coller

2024

J Virol

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Ebola virus disease (EVD) caused by Ebola virus (EBOV) is a severe, often fatal, hemorrhagic disease. A critical component of the public health response to curb EVD epidemics is the use of a replication-competent, recombinant vesicular stomatitis virus (rVSV)-vectored Ebola vaccine, rVSVΔG-ZEBOV-GP (ERVEBO). In this Gem, we will discuss the past and ongoing development of rVSVΔG-ZEBOV-GP, highlighting the importance of basic science and the strength of public-private partnerships to translate fundamental virology into a licensed VSV-vectored Ebola vaccine.

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Epidemiological profiles and outcomes of healthcare workers hospitalized for COVID-19 in five Sub-Saharan African countries: a cohort study

Millimouno,

Grovogui,

Kourouma

et al. 2024

F1000Res

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Background The COVID-19 pandemic placed immense strain on global health systems and healthcare workers (HCWs). This study aimed to analyze the epidemiological profiles and outcomes of HCWs hospitalized for COVID-19 across five sub-Saharan African countries. Methods This was a cohort study using secondary data collected between January 30, 2020, and December 31, 2022, as part of the International Severe Acute Respiratory and emerging Infection Consortium study. The study population consisted of HCWs who were hospitalized due to clinically suspected or laboratory-confirmed SARS-CoV-2 infection. Demographic and clinical characteristics and case management were summarized using proportions or medians and interquartile ranges. Factors associated with risk of mortality among HCWs were assessed using a Cox proportional hazards model, adjusted for age and sex. Results Findings showed that South Africa recorded a lower percentage (2.4%) of patients who were HCWs compared to Gambia, Ghana, Guinea, and Malawi. Overall, many HCWs were aged ≥50 years and the majority were females (66.8%). In three of the five countries, however, the majority of the HCWs were <39 years old and were males. Antibiotics were the most commonly used medical treatments across three countries (Ghana, 67.8%; Guinea, 97.3%; Malawi, 80%), while antimalarials were commonly used in Guinea (87.8%) and Ghana (30.4%). Guinea and South Africa reported deaths with case-fatality rates varying from 22% in March 2020 to 1.4% in February 2022. Risk factors for mortality included age over 50 years, hypertension, diabetes mellitus, and chronic kidney disease. Conclusions Our study underscores the critical need for continuous protection and enhanced readiness for HCWs, particularly during epidemics and pandemics. Strengthening infection prevention and control measures and focusing on vulnerable groups such as older and female HCWs are essential for mitigating the impact of future health crises. Further research is required to fully comprehend the implications of these findings.

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How has Guinea learnt from the response to outbreaks? A learning health system analysis

Cited by 4 publications

References 130 publications

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Progress with the Learning Health System 2.0: a rapid review of Learning Health Systems’ responses to pandemics and climate change

Translational success of fundamental virology: a VSV-vectored Ebola vaccine

Epidemiological profiles and outcomes of healthcare workers hospitalized for COVID-19 in five Sub-Saharan African countries: a cohort study

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