JMIR Public Health and Surveillance

Early diagnosis and treatment initiation for tuberculosis (TB) not only improve individual patient outcomes, but also reduce circulation within communities. Active case-finding (ACF), a cornerstone of TB control programs, aims to achieve this by targeting symptom screening and laboratory testing to individuals at high risk of infection. However, its efficiency is dependent on its ability to accurately identify such high risk individuals and communities. The socio-economic determinants of TB include difficulties in accessing healthcare and high within-household contact rates. These two determinants are common in the poorest neighborhoods of many sub-Saharan cities, where household crowding and lack of healthcare access often coincide with malnutrition and HIV infection, further contributing to the burden of tuberculosis.

Social norms provided a framework for understanding a variety of behaviors. Cultural tightness was introduced to measure the level of adherence to social norms and tolerance of deviant behavior.

The AIDS epidemic among older people is becoming more serious. Evidence-based, acceptable and effective preventive interventions are urgently needed. Video-based intervention has become an innovative way to change healthy behaviors, and we have developed a brief video-based intervention named Sunset Without AIDS.

Concerns have been raised about discrepancies in COVID-19 mortality data, particularly between preliminary and final vital statistics datasets for Serbia. In the original preliminary dataset, released daily during the ongoing pandemic, there was an underestimation of deaths in contrast to those reported in the subsequently released yearly vital statistics.

Social distancing behavior has been a critical non-pharmaceutical measure for mitigating the COVID-19 pandemic. For this reason, there has been widespread interest in the factors determining social distancing violations, with a particular focus on individual-based factors.

As more humanitarian relief organizations are beginning to use electronic medical records in their operations, data from clinical encounters can be leveraged for public health planning. Currently, medical data from humanitarian medical workers are infrequently available in a format that can be analyzed, interpreted, and used for public health.

Negative attitudes towards vaccines and suboptimal vaccination rates among African American and Black (Black) Americans has been well documented due to a history of medical racism and human rights violations in the United States (US). However, digital health interventions (DHIs) have been shown to address racial disparities in several health outcomes like cardiovascular disease, HIV, and maternal health. The Tough Talks COVID (TT-C) study was a randomized controlled trial of a DHI designed to empower Black young adults (YA) in the US South to make informed, autonomous decisions about COVID-19 vaccine uptake by addressing structural barriers and misinformation about vaccines.

Introduction: In 2017, Uganda implemented an electronic Integrated Disease Surveillance and Response System (eIDSR) to improve data completeness and reporting timelines. However, the eIDSR system had limited functionality and was implemented on a small scale. The Ministry of Health (MOH), with support from the Infectious Disease Institute, Makerere University (IDI) and Health Information Systems Program Uganda (HISP-Uganda), upgraded the system functionality and scaled up its implementation. This study describes the process and impact of upgrading eIDSR functionality and expanding its implementation across additional districts. Methods: The Ministry of Health, through its Integrated Epidemiology, Surveillance & Public Health Emergency (IES&PHE) department, coordinated the implementation of eIDSR. User requirements were identified through consultations with national surveillance stakeholders. The feedback informed the design and development of the upgraded eIDSR functionalities The eIDSR rollout followed a consultative workshop to create awareness of the system among stakeholders. A curriculum was developed, and a national training of trainers (TOT) was conducted. These trainers cascaded the training to the District Health Teams (DHTs), who later cascaded the training to health workers. The training adopted an on-site training approach, where a group of national or district trainers would train new users at their desks. Results: The eIDSR system was upgraded to the DHIS2 2.35 platform, featuring faster reading and writing tracker data, handling over 100 concurrent users, and enhanced case-based surveillance features on Android and web platforms. From October 2020 to September 2022, eIDSR was rolled out in 68% (100/146) districts. Additionally, the system permitted prompt reporting of signals of epidemic-prone diseases. Conclusion: Improving the functionality and the expanded geographical scope of the eIDSR system enhanced disease surveillance. Stakeholder commitment and leveraging existing structures will be needed to scale up eIDSR.

GPFirst is a primary care partnership program designed to encourage patients with nonurgent conditions to seek care at participating general practitioner clinics instead of visiting the emergency department. In 2019, a digital media campaign (DMC) was launched to raise awareness and knowledge about GPFirst among residents in eastern Singapore.

Molecular HIV surveillance (MHS) can be used to help identify and respond to emerging clusters of rapidly spreading HIV transmissions, a practice known as Cluster Detection and Response (CDR). In the US, MHS relies on HIV gene sequences obtained from routine clinical antiretroviral resistance testing (ARVRT). By law, ARVRT results are reported to public health agencies for MHS and individuals are not asked for their specific consent to do so. This practice has raised ethical concerns, including the lack of consent for, and transparency surrounding, public health uses of these clinical data and spurred debate. Such concerns could have a chilling effect on the willingness of people living with HIV (PLWH) to agree to ARVRT when recommended clinically and jeopardize the utility of MHS-informed HIV prevention efforts. In response to concerns about the lack of transparency surrounding the use of ARVRT results for MHS, in 2022, the Presidential Advisory Council on HIV AIDS (PACHA) issued a resolution calling on the US Centers for Disease Control to “require that providers explain MHS/CDR and the laboratory test results that are collected and used in these surveillance activities to their patients” as this disclosure is not routinely provided.

Effective dissemination of federal risk communication by news media during multi-jurisdictional enteric illness outbreaks can increase message reach to rapidly contain outbreaks, limit adverse outcomes, and promote informed decision-making by the public. However, dissemination of risk communication from the federal government by mass media has not been evaluated.

Incorporating youth perspectives into health research can enhance quality, relevance, and ethics while also providing youth with mentorship, exposure to academic research, and professional development opportunities. This has led to a growing number of youth advisory boards (YABs). Despite increased attention to YABs, however, mentions of YABs remain low in the published research on youth and health. Further, little published work has reflected on the importance of engaging with youth of color in YABs. This is critical both for the perspectives and insight they bring to the research process and to help close the participation gap in extracurriculars among youth from minoritized groups. To contribute to the literature on YABs and health equity, we offer an overview and reflection on the development and implementation of the Midwest Youth Wellness Initiative on Technology (MYWIT), a one-week virtual, financially compensated summer YAB for youth of color ages 13 to 17 centered on amplifying youth voices on questions related to digital technology and mental health. MYWIT youth advisors successfully co-developed a novel research question and semi-structured interview guide on the topic of navigating social media algorithms. The MYWIT process also highlighted the importance of youth compensation levels, scheduling, recruitment strategies, and overall resource constraints. We hope to encourage researchers to reflect on the value that even short duration YABs can add to the research process and how YABs can be structured to better recruit and support advisors from minoritized backgrounds given economic, institutional, and structural barriers.