IoT and Blockchain-Based Mask Surveillance System for COVID-19 Prevention Using Deep Learning

On the edge of the worldwide public health crisis,the COVID-19 disease has become a serious headache for its destructive nature on humanity worldwide.Wearing a facial mask can be an effective possible solution to mitigate the spreading of the virus and reduce the death rate.Thus,wearing a face mask in public places such as shopping malls,hotels,restaurants,homes,and offices needs to be enforced.This research work comes up with a solution of mask surveillance system utilizing the mechanism of modern computations like Deep Learning(DL),Internet of things(IoT),and Blockchain.The absence or displacement of the mask will be identified with a raspberry pi,a camera module,and the operations of DL and Machine Learning(ML).The detected information will be sent to the cloud server with the mechanism of IoT for real-time data monitoring.The proposed model also includes a Blockchain-based architecture to secure the transactions of mask detection and create efficient data security,monitoring,and storage fromintruders.This research further includes an IoT-based mask detection scheme with signal bulbs,alarms,and notifications in the smartphone.To find the efficacy of the proposed method,a set of experiments has been enumerated and interpreted.This research work finds the highest accuracy of 99.95%in the detection and classification of facial masks.Some related experiments with IoT and Block-chain-based integration have also been performed and calculated the corresponding experimental data accordingly.ASystemUsability Scale(SUS)has been accomplished to check the satisfaction level of use and found the SUS score of 77%.Further,a comparison among existing solutions on three emergent technologies is included to track the significance of the proposed scheme.However,the proposed system can be an efficient mask surveillance system for COVID-19 and workable in real-time mask detection and classification.

Evaluation of Perinatal Mortality Surveillance System in the City of Bulawayo, Zimbabwe

Background: In Zimbabwe, the perinatal mortality surveillance system is based on passive reporting of perinatal deaths using the perinatal death notification forms. Mpilo hospital recorded 74 perinatal deaths from January to September. No death was reported to the city and no perinatal mortality forms were found at the health information section. We aimed to assess the performance of perinatal mortality surveillance system in Bulawayo city. Methods: We conducted a descriptive cross-sectional study in all the maternity centres in Bulawayo City in 2011 using Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. We used interviewer-administrated questionnaires to collect data. We used a checklist to assess availability of resources. Perinatal death notification forms were reviewed. Results: We interviewed 67 workers. Knowledge on the system was poor. Eight (12%) were trained in IDSR (Integrated Disease Surveillance Response) and three (4.5%) were inducted on the perinatal mortality surveillance system. Sixty-one (91%) regarded the system as useful. City and private maternity centres were not notifying perinatal deaths due to lack of forms. In central hospitals, delay in notification was due to workload and shortage of trained staff. Conclusion: Poor knowledge on the system, lack of induction and trained staff could have contributed to the non-performance of the system in the City of Bulawayo. Most participants reported the system as useful. Lack of documentation made it difficult to follow up on actions plans.

Intelligent Video Surveillance System for Elderly People Living Alone Based on ODVS

Intelligent video surveillance for elderly people living alone using Omni-directional Vision Sensor (ODVS) is an important application in the field of intelligent video surveillance. In this paper, an ODVS is utilized to provide a 360° panoramic image for obtaining the real-time situation for the elderly at home. Some algorithms such as motion object detection, motion object tracking, posture detection, behavior analysis are used to implement elderly monitoring. For motion detection and object tracking, a method based on MHoEI(Motion History or Energy Images) is proposed to obtain the trajectory and the minimum bounding rectangle information for the elderly. The posture of the elderly is judged by the aspect ratio of the minimum bounding rectangle. And there are the different aspect ratios in accordance with the different distance between the object and ODVS. In order to obtain activity rhythm and detect variously behavioral abnormality for the elderly, a detection method is proposed using time, space, environment, posture and action to describe, analyze and judge the various behaviors of the elderly in the paper. In addition, the relationship between the panoramic image coordinates and the ground positions is acquired by using ODVS calibration. The experiment result shows that the above algorithm can meet elderly surveillance demand and has a higher recognizable rate.

Mapping the high burden areas of cholera in Nepal for potential use of oral cholera vaccine: An analysis of data from publications and routine surveillance systems

Objective:To assess the extent of existing published evidence on cholera and to characterize the epidemiologic data of cholera in Nepal.Methods:We conducted a literature scoping review by summarizing published literature reporting on cholera in Nepal from January 1946 to March 2019 in online databases:MEDLINE,Embase,Cochrane,and Global Health.Additionally,we reviewed national surveillance data on clinically diagnosed and laboratory confirmed cholera reported by the Ministry of Health and Population.Results:Most of the published studies were conducted predominantly in Kathmandu Valley during the rainy season;however,outbreaks have been reported in other parts of Nepal including Terai,Hilly and Mountain regions.Our literature review exhibited that all age groups were affected by cholera,but particularly children and young adults were at-risk age groups in Nepal.Vibrio cholerae serogroup O1,biotype El Tor,serotype Ogawa has been predominantly isolated with an emergence of resistant strains since 1996.Two mass vaccination campaigns using oral cholera vaccines were conducted:Rautahat district in 2014 and Banke district in 2017.Conclusions:Capacity building for a nation wide systematic cholera surveillance with rapid and reliable diagnosis is needed to better estimate the burden of cholera and identify geographically at-risk areas associated with the disease in Nepal.It is essential for developing an adequate policy on oral cholera vaccine introduction and effective water,sanitation and hygiene interventions.

Performance analysis of legitimate UAV surveillance system with suspicious relay and anti-surveillance technology

We propose a legal Unmanned Aerial Vehicle(UAV)surveillance system to perform passive surveillance or active jamming while in the presence of a suspicious relay or source,where a UAV works in half-duplex mode and the relay/source deploys artificial noise to prevent monitoring.Three schemes are considered for a Multiple-Input Multiple-Output(MIMO)UAV:surveilling followed by jamming;jamming followed by surveilling;and two-stage surveilling.For each scheme,a closed-form expression of surveilling non-outage probability is derived,and surveilling performance under different system configurations is analyzed.Monte Carlo(MC)simulation validates derivation correctness.

Surveillance system-based physician reporting of pneumonia of unknown etiology in China:A cross-sectional study

Objective:To describe the current reporting of pneumonia of unknown etiology(PUE)and factors that affect reporting by clinicians in China using the PUE surveillance system in order to provide a reference for improving PUE reporting rates in the future.Methods:Clinicians were recruited via the Sojump platform and requested to complete an anonymous self-administered questionnaire.Multivariate logistic regression analysis was used to assess factors influencing clinicians’reporting activities.Results:This study showed a low PUE case reporting rate and a poor understanding of PUE reporting among the investigated clinicians.Of the 136 clinicians who had diagnosed PUE cases,multivariate logistic regression analysis results showed that clinicians who had attended in-hospital training were more likely to report PUE than those who had not(OR 4.48,95%CI 1.49-13.46).Clinicians with an expert panel on PUE in their hospital were more likely to report PUE cases than those without(OR 5.46,95%CI 1.85-16.11).Conclusions:There is a need to promote and reinforce PUE surveillance system training among medical staff.In addition,PUE testing technologies in hospital laboratories should be upgraded,especially in primary and unclassified hospitals,to increase surveillance efficiency and improve PUE reporting rates.

Descriptive Epidemiology for <i>Mycoplasma pneumoniae</i>Infection Using (Nursery) School Absenteeism Surveillance System, and Proposal for Countermeasures

Objective: We present descriptive epidemiology of Mycoplasma infection using the (Nursery) School Absenteeism Surveillance System ((N)SASSy) in addition to national official sentinel surveillance for infectious diseases (NOSSID). It is expected to be helpful for early detection and response to outbreak of Mycoplasma infection and also to be useful for antimicrobial resistance measures. Method: The study period was 2010-2014 seasons. The study area was the whole of Ibaraki prefecture, Japan. NOSSID reports the number of patients with Mycoplasma pneumonia from 13 sentinel hospitals. We compare the number of patients and the incidence rate of NOSSID with the same information in (N)SASSy. Result: In NOSSID, the largest number of patients by age was 27 patients of one year old in 2012. (N)SASSy showed that the incidence rate in the elementary schools is high in 2011 and 2012. Especially, the second grade students were the highest. Discussion: Even though Mycoplasma infection is well known as a pediatric disease, we showed that second grade was the highest in incidence at first. Because (N)SASSy is timely and real-time information collection, evaluation and sharing countermeasures with (nursery) schools, public health centers, and physicians are useful for students and nursery school children, and communities. Conclusion: Because mycoplasma infection is common pediatric infectious diseases and because some patients rarely develop severe infections, we must prevent larger outbreaks. (N)SASSy can provide timely intervention at the initial phase of outbreak by monitoring situations in (nursery) schools and comparing data to baseline information.

The Potential Role of a Health and Demographic Surveillance System in Rural Northern Nigeria to Reduce Maternal and Child Deaths

There exist a huge gap between generation of evidence-based research findings and its use to inform policies in most developing countries. Further, it is evident that most developing countries are lagging behind in formulating appropriate policies aimed at improving people’s lives due to lack of evidence-based research findings. We describe the potential of a Health and Demographic Surveillance System (HDSS) in informing appropriate health interventions towards reducing the high maternal and child deaths in rural communities of north western Nigeria through the Verbal Autopsy (VA) data collection. VA data collection involves the use of VA questionnaires—set of open ended and closed ended questions adapted from the World Health Organization (WHO) module— administered to the caregivers, parents or family members of a deceased person to elicit information on signs and symptoms and their durations, and other pertinent information about the deceased in the period before death. VA interviews were conducted by trained VA enumerators on all 2100 deaths reported during the update round 4 of routine data collection (July-December, 2012) and returned forms were checked for consistencies and completeness by a trained research officer. The forms were later coded by trained medical doctors for possible cause of death using the WHO International Classification of Diseases (ICD 10) codes. Fifty cases of neonatal deaths, 1650 cases of infant and child deaths, and 400 cases of adult deaths were reported during the update round 4 data collection. Neonatal sepsis was reported as the leading cause of neonatal deaths (58%) while malaria and intestinal infectious diseases were reported as the leading cause of infant and child deaths and adult deaths respectively (45% and 17%, respectively). The study provides documented evidence of high neonatal deaths due to neonatal sepsis in an area with low hygiene and high home delivery rates. The findings from the VA data collection at Nahuche HDSS inform the intervention study on home distribution of chlorhexidine to pregnant women. The findings from this study call on government and other stakeholders to strengthen research capacity to generate timely data and findings returned to policy makers within the shortest period of time for decision making.

Characteristics of Acute Flaccid Paralysis Reported by the Surveillance System and Verified by WHO Officer in Akwa Ibom State-Nigeria, 2006-2012

Background: Acute Flaccid Paralysis (AFP) was adopted by World Health Organization (WHO) in 1988 as a key pillar used in monitoring progress towards the global polio eradication initiative. High quality AFP surveillance is essential to support this global initiative. We applied recently developed case verification methods for the quantitative evaluation of AFP cases reported to the surveillance systems to evaluate the quality of AFP reports in Akwa Ibom State, Nigeria. Objectives: The aim of this study is to identify the demographic, clinical and epidemiological attributes and quality of acute flaccid paralysis surveillance. Methods: All AFP cases reported in children 0 - 14 years during January 2006 to December 2012 were investigated and verified by WHO surveillance officers, using standard questionnaire. Two stool samples 24 - 48 hours apart from a total of 1184 AFP cases were collected within 14 days of onset of paralysis with the prior oral/verbal informed consent and transported to the national polio laboratory under reverse cold chain. Result: In all, 885/1184 representing 75% of the AFP cases reported were verified by WHO officers in the period under review. Overall, 534/885 (60.3%) of AFP cases had more than >3 doses of Oral Polio Vaccine (OPV), while 196/885 (22.2%) received 3 dose of OPV and 128/885 (14.5%) received between 1 - 2 doses of OPV. It was interesting that 27/885 (3%) never received OPV before. Overall, 743/885 (84.0%) were reported within ≤14 days of paralysis onset, while 142/885 (16%) were reported after ≥14 days of paralysis onset. In total, 797/885 (90.1%) of cases were found to have fever at the onset of paralysis;paralysis was found to be asymmetric in 805/885 (91%). Wasting or diminished muscle tone was observed in 34.0% of cases verified, while deep tendon reflexes were good (normal) in 79% of cases. Gullain-Barre syndrome was observed in 50.9% of the reported cases followed by injection neuritis (25.0%) and transverse myelitis (2.0%). However, other causes recorded 22.1%. The legs (90.2%) are the parts of the body mostly affected, while arm recorded 9.8% of the AFP cases reported and verified. Conclusions: The result of this study indicates that the characterization of AFP cases reported to the surveillance network could provide better understanding of age, and sex distribution, common clinical causes of AFP and impact of distance to health facilities on the health seeking behaviours of AFP cases.

Distribution Pattern of the Non Polio Enterovirus (NPEV) Rate in Children with Acute Flaccid Paralysis Reported to the Surveillance System in Nigeria 2010-2015

Objective: This study focuses on the reverse cold chain system of stool sample management from cases reported to the AFP surveillance system between 2010 and 2015. Through the distribution of their NPEV isolation rates, we identify lapses in the reverse cold chain management and provide recommendations that should help improve the reverse cold chain system and the AFP surveillance system in general as Nigeria once again matches towards a polio free certification. Methods: A descriptive retrospective study was conducted using AFP surveillance data routinely collected between January 2010 and December 2015 by the Disease Surveillance and Notification Officers (DSNOs) in Nigeria and the WHO accredited Polio Laboratories. All AFP cases reported to the Disease Surveillance network during this period from all the states were included in the study. EPIINFO—veritable customized software was used to run queries on the access database and obtain the specific data sets required. Results: A total of 52,879 AFP cases were reported from 2010-2015, in which 7288 non-polio enteroviruses were isolated. NPEV isolation rate ranged from 10.8% in the southeast to 20.3% in the northeast with the states in the northern geopolitical zones having higher NPEV rates in comparison to the states in the southern geopolitical zones. The WHO Polio laboratory in Ibadan serves twenty-seven states in the country;the average non-polio AFP rate among states served by this laboratory is 11.7% from a total of 4012 AFP cases recorded. The WHO Polio laboratory in Maiduguri recorded 3276 with an average non-polio AFP rate of 19.2%. Conclusion: Though the country’s NPEV isolation rate remain slightly higher above the 10% recommended by WHO, steps should be taken to enhance the reverse cold-chain system particularly in the southern states. This would increase confidence in the AFP surveillance system in Nigeria as she proceeds once again towards complete polio eradication and meeting certification standards.

Strengthening District Health Teams Capacity in Surveillance Systems and Response to Public Health Threats in Western Uganda through Field Epidemiology Training Program (FETP)

Aim: To strengthen the District Capacity in surveillance for effective detection, Reporting and Response to Public Health threats. Background: The overall aim of a good surveillance system is to strengthen the capacity of a Health system through training of health personnel who can conduct effective surveillance activities. A good surveillance system is achieved through improved use of complete and timely health information to detect changes in time to institute a rapid response to the suspected outbreak of Public Health events. This assessment followed a 3-month Field Epidemiology Training program undertaken by the investigator who applied the acquired knowledge and skills in completion of the assessment. Study Design: It was a descriptive cross-sectional, institutional based epidemiological investigation conducted at district level and Health Centre 1V in Kabarole from 15th December 2019-March 2020. eReports were retrieved from DHIS-2 for epidemiological weeks 44 in 2019 to week 3 in 2020. Data analysis: Micro soft word excel program was used to determine the reporting rates, epidemic disease trends and construction of malaria channel. SWOT analysis was done to identify poor HMIS reporting as the lead surveillance quality challenge and route cause analysis done to determine underlying causes. Results: Weekly reports analyzed were from a total of 53 Health facilities and one Health Centre four for malaria channel construction. Of the 53 functional Health facilities assessed in the district, the average reporting Timeliness was 32% and Completeness at 63% from week 44 in 2019 to week 3 in 2020. This finding shows that the district was not achieving the 80% Timeliness and 80% Completeness national target. The poor reporting situation implies that the district may not detect an emerging Public Health Event and respond in time. Poor reporting rate was linked to knowledge gap among reporting staff in completion of the newly revised HMIS tools and lack of support supervision. The analyzed data revealed that the district had increased dysentery, measles and typhoid fever cases. The dysentery and typhoid fever cases had reached and surpassed the Alert and Action thresh hold levels however there was no reported death from these diseases. Further inquiry revealed that Typhoid fever was being diagnosed using WIDAL test as opposed to WHO recommendation of stool or blood culture. The noted typhoid fever outbreak in the district was therefore being based on wrong laboratory tests hence regarded by the researcher as speculative. Findings on malaria channel revealed a normal and expected trend of malaria in Kabarole district in 2020. Conclusion: knowledge and skills from FETP-training enabled the investigator to establish the fact that the district’s surveillance system was less sensitive in detecting Public Health events for a quick response. Intensified targeted support supervision and mentorships of all health workers on reporting could help improve the districts surveillance system.

Evaluation of the Babies At Risk Surveillance System in Rushinga District, Mashonaland Central Province, Zimbabwe, 2015

Background: About 15% of world’s population lives with some disability. Zimbabwe’s prevalence of disability was at 7% in 2013. ARSS is a paper-based system to monitor and detect neuro-developmental conditions and childhood disability early. Indicators for registering a baby into ARSS include: low Apgar score, low birth weight and birth asphyxia. Active case finding in Rushinga District in July 2015 identified nine cerebral palsy cases that were missed by the system out of 14 randomly chosen babies delivered at Chimhanda District Hospital. We evaluated the performance of the ARSS in Rushinga District. Methods: We evaluated the system using CDC guidelines for surveillance systems evaluation. All 12 health facilities in Rushinga were included. Health workers involved in ARSS were purposively recruited. Interviewer administered questionnaire, key informant interview guide, checklists and records review were used for data collection. Knowledge of participants on the system was assessed using five-point Likert scale. Data were analyzed using Epi Info 7. Results: Fifty-one participants were recruited for the study. Median years in service for all participants was 7 (Q1 = 6;Q3 = 12). Average knowledge score was 3. Majority participants (82.4%) were not trained on ARSS and cited lack of: knowledge, reporting guidelines, induction and focal persons as reasons for missing AR cases. Currently, ARSS is able to detect only 12.5% of cases. Prevalence of AR babies in Rushinga for period November 2014 to November 2015 was 21.1%. Monthly cost of detecting and registering a case was USD$52.46. Conclusions: ARSS was found to be useful, simple, acceptable and affordable, however was found to be unstable and not sensitive. Training of health workers particularly village health workers and integrating ARSS with the DHIS2 could improve system performance. As a result of the evidence from this evaluation, it has been agreed to include ARSS data on the monthly return form (T5) beginning June 2016.

Low Resolution Face Recognition in Surveillance Systems

In surveillance systems, the captured facial images are often very small and different from the low-resolution images down-sampled from high-resolution facial images. They generally lead to low performance in face recognition. In this paper, we study specific scenarios of face recognition with surveillance cameras. Three important factors that influence face recognition performance are investigated: type of cameras, distance between the object and camera, and the resolution of the captured face images. Each factor is numerically investigated and analyzed in this paper. Based on these observations, a new approach is proposed for face recognition in real surveillance environment. For a raw video sequence captured by a surveillance camera, image pre-processing techniques are employed to remove the illumination variations for the enhancement of image quality. The face images are further improved through a novel face image super-resolution method. The proposed approach is proven to significantly improve the performance of face recognition as demonstrated by experiments.

Evaluation of the Notifiable Diseases Surveillance System in Beitbridge District, Zimbabwe 2015

Back ground: Notifiable Disease Surveillance system serves as an early warning system for public health emergencies. Since January 2013 to August 2014, Beitbridge never submitted T2 forms to the province. Four suspected cases of rabies were reported through the generic report. The electronic District Health Information System 2, T2 forms had not been updated. This discrepancy may imply under reporting of Notifiable Diseases. The study was conducted to evaluate the NDSS in Beitbridge district. Methods: Descriptive cross-sectional study was conducted. Health workers in sampled health facilities were interviewed using questionnaires. Checklists were used to assess resource availability. Epi InfoTM was used to calculate frequencies and proportions. Results: From 11 facilities, 53 respondents were interviewed of which the 59% were females. For Knowledge, 57% recalled at least 9 Notifiable diseases, 11% knew the T1 form required to notify. Respondents willing to participate in the NDSS were 87%. Responsibility to notify was placed other health workers other than themselves by 55% of the respondents. All facilities did not have completed T1 forms. T1 forms were available in 1/11 health facilities. Three outbreaks were reported using the Weekly Disease Surveillance System (WDSS). NDSS information was used for planning and mobilizing resources for indoor residual spraying. It costs an average $12.15 to notify a single case, against $1.50 if it was electronic. Conclusion: NDSS is acceptable, simple, flexible, unstable, not sensitive and useful. Reasons for under reporting were lack of forms, lack of induction and poor knowledge on the NDSS. The cost of operating the NDSS could be reduced if the system is electronic. T1 forms and guidelines for completing the forms should be distributed to all health facilities. On the job training of health workers through tutorials, supervision is recommended.

Evaluation of Notifiable Disease Surveillance System in Centenary District, Zimbabwe, 2016

Background: Notifiable disease surveillance system (NDSS) data guides immediate action for events of public health importance. In July 2016, 12 patients suspected of typhoid were reported to Centenary District Medical Officer by phone. Following reporting, notification forms (T1) were not submitted to district, hence province did not receive district consolidated report (T2) for the notifications. This implies underreporting of notifiable diseases. Study was conducted to evaluate NDSS in Centenary district. Methods: Using updated Centres for Disease Control and Prevention (CDC) guidelines, descriptive cross sectional study was conducted among health workers sampled from all health facilities in Centenary district. Interviewer administered questionnaire and checklists were used to collect data, assess data quality and resource availability. Epi InfoTM 7 generated frequencies and proportions. Results: We interviewed 50 respondents from 13 health facilities and 64% were females. Health worker knowledge was rated low, 26% knew whom to notify and 40% knew forms are completed in triplicate. Reasons for failure to notify notifiable diseases included, unavailability of reporting forms 32% and lack of reporting guidelines 16%. Ninety-two percent were willing to participate. Four health facilities had at least six standard case definitions. The first two patients were only diagnosed at district level. NDSS information was used to procure antirabies vaccine and implement control measures. Conclusion: NDSS is useful, acceptable, unstable and not sensitive. Failure to notify was mainly due to lack of knowledge on NDSS. We recommend training of health workers and mentoring. Fifteen (IEC) case definitions and reporting guidelines were distributed to five health facilities.

Incomplete Reporting of HIV/AIDS by Uganda’s Surveillance System and the Associated Factors

Introduction: The United States government supported Ugandan government by introducing the District Health Information Software 2 (DHIS2) in 2012 to improve HIV/AIDS surveillance. Districts have yet to fully adopt this relatively new system given a 70.2% reporting completeness achieved nationally between April-June 2013. Methods: The study examined one dependent variable of districts’ reporting completeness against four independent variables: 1) Number of client visits;2) Number of district health units;3) Number of NGOs delivering HIV/AIDS services;and 4) Regional location. The study employed cross-sectional study design which allowed researchers to compare many different variables at the same time. HIV/AIDS program data that were reported by districts into DHIS2 during the period of April to June 2013 were used to assess for reporting completeness. Findings: Districts with the lowest number of client visits (under 2500) achieved the highest mean reporting completeness (81.6%), whereas a range of 2501 - 5000, or over 5001client visits recorded 72.4% and 51.7% respectively. The higher the number of client visits is, the lower the reporting completeness is (p < 0.05). Those districts that were receiving support from only one and two NGO recorded 56.7% and 67.2% respectively. Districts supported by over three NGOs had the highest (80.6%) mean reporting completeness. NGOs-district support was statistically associated with reporting completeness (p < 0.05). The number of health units operated by a district was also significantly associated with reporting completeness (p < 0.05). The regional location of a district was not associated with reporting completeness (p = 0.674). Conclusion: The study results led us to recommend targeted future NGO support to districts with higher patient volume for HIV/AIDS services. Particularly, newly funded NGOs are to be established in districts operating over 40 health units. Incomplete reporting undermines identification of HIV-affected individuals and limits the ability to make evidence-based decisions regarding HIV/AIDS program planning and service delivery.

An Evaluation of the Adverse Events Following Voluntary Medical Male Circumcision Surveillance System in Zvimba District, Zimbabwe, 2020

Background: The Adverse Events following Voluntary Medical Male Circumcision Surveillance System (VMMC AESS) serves to identify adverse events (AEs) for safe provision of VMMC. In 2019, Zvimba District reported two adverse events out of 542 circumcisions translating to a 0.4% AE rate against an acceptable threshold of 2% and this is suggestive of underreporting. We evaluated the system to verify existence of underreporting of AEs, assess the surveillance system attributes and evaluate data quality. Methods: A descriptive cross-sectional study was conducted using the updated Center for Disease Control (CDC) guidelines for surveillance system evaluation. We proportionately sampled VMMC client intake records and purposively selected health workers involved in the VMMC programme into the study. An interviewer-administered questionnaire was used to collect data from 14 - 30 December 2020 on knowledge of the VMMC AESS among health care workers and surveillance system attributes. We used a checklist to check for data quality. Data were analysed using Epi Info 7 statistical software. Results: Of the 31 health workers that participated in the study, 21 (68%) had fair knowledge of the surveillance system. Out of 384 records reviewed, 104 had missing data on AE monitoring days 7 and 42. Sixteen (52%) of participants regarded filling AE reporting forms as difficult and the process as time-consuming. The surveillance system was not representative as only two out of eight facilities were conducting outreaches in hard-to-reach areas. Conclusion: There was possible underreporting of adverse events as about a quarter of reviewed records had missing data on AE monitoring days and the system’s performance was threatened by poor data quality and unavailability of reporting forms. The system was rendered acceptable though unstable, not representative and not simple and the health workers were not making use of the surveillance system. We recommended retraining on the surveillance system for all health care workers involved in VMMC in Zvimba District.

Evaluation of the HIV Case-Based Surveillance System: A Pilot of the Electronic Health Record System in Mutare District, Zimbabwe, 2021

Background: Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. Methods: We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. Results: The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). Conclusion: The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.

A framework of force of information influence and application for C4KISR system

The subversive nature of information war lies not only in the information itself, but also in the circulation and application of information. It has always been a challenge to quantitatively analyze the function and effect of information flow through command, control, communications, computer, kill, intelligence,surveillance, reconnaissance (C4KISR) system. In this work, we propose a framework of force of information influence and the methods for calculating the force of information influence between C4KISR nodes of sensing, intelligence processing,decision making and fire attack. Specifically, the basic concept of force of information influence between nodes in C4KISR system is formally proposed and its mathematical definition is provided. Then, based on the information entropy theory, the model of force of information influence between C4KISR system nodes is constructed. Finally, the simulation experiments have been performed under an air defense and attack scenario. The experimental results show that, with the proposed force of information influence framework, we can effectively evaluate the contribution of information circulation through different C4KISR system nodes to the corresponding tasks. Our framework of force of information influence can also serve as an effective tool for the design and dynamic reconfiguration of C4KISR system architecture.

Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.