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  • Results from the present study also showed improvement

    2019-05-23

    Results from the present study also showed improvement in timelines for measles immunisation, which is scheduled at 9 months of age, almost a gap of 6 months from the last vaccine according to EPI schedule for LMICs. Although the major focus up until now has been on reminder messages, the impact of educational or provoking messages and automated calls for DMOG coverage improvement might also have a high bearing and should be further explored. Furthermore, very few studies have looked at the feasibility of conditional cash transfer through mobile phones for improving immunisation timelines. One major reservation for SMS-based interventions is the level of literacy of the caregivers receiving the message. Preference for phone calls over text messages in populations with low literacy and resource-constrained settings has been shown in a few studies. Findings from a pilot study assessing the supplementary immunisation coverage using SMS text and automated calls showed a much higher response to the automated call (78%) than SMS text messages (3%; personal communication). Mobile phone text messages in local languages, pictorial messages, and automated phone calls or interactive voice recording according to the local settings can also play an important part in improvement of routine childhood immunisation. Additionally, adding incentives, both as mobile money or airtime, can also have a positive influence on the immunisation coverage. Gibson and colleagues showed the greatest effect for improvement in coverage and timelines in the incentive group that received the equivalent of US$2. However, there is a cost implication for scaling and sustainability of this model at the country or programme level. Nonetheless, improving immunisation uptake according to the schedule and in time will not only decrease mortality and morbidity but also reduce supplementary immunisation activities.
    Globalisation can impose major public health challenges in local contexts. Because of human migration, Chagas disease—a condition endemic in Latin-American countries—has become a concern in the developed world. Chagas disease cannot be transmitted by direct contact with an infected person; in fact, the relevant mechanisms of transmission in non-endemic countries are transfusion with infected blood and congenital transmission from mother-to-child during pregnancy. To date, the natural history of Chagas ( has been widely disseminated, but prognosis is impossible to predict at the individual level. Most infected people (60–80%) never develop symptoms and when diagnosed symptoms-free, are considered to be in the so-called indeterminate phase. Only between 20% and 40% of people infected with Chagas disease reach the so-called chronic symptomatic phase, presenting with cardiac or digestive complications. The chronic phase occurs between 10 years and 30 years after infection and severity of pathologies varies, as do the overall presentation and prevalence of the cardiac and the digestive form across endemic countries.
    The response to the west African Ebola virus disease epidemic in 2016 illustrated the stark dichotomy of both the failings and the remarkable potential of global public health architecture. A stuttering, uncoordinated early response, which exposed the overwhelmed public health capacity of the region and claimed the lives of thousands, was followed by one of the most successful global partnerships between foreign and local governments and multinational aid organisations to stem an international health crisis. After the region was declared free from an active epidemic in January, 2016, any accolades were intermixed with warnings that the greatest work was left to be done: rebuilding an infrastructure and workforce capable of preventing future epidemics from enacting similar devastation and enabling provision of quality health care in the region. Fortunately, a panoply of global health-care bodies, including the UN, World Bank, and the African Development Bank have expressed their commitments to this goal, but whether it will be met remains an open question.