Search Results (227)

This study aimed at proposing a predictive model for real-time monitoring of epidemic dynamics at the municipal scale in Lombardy region, in northern Italy, leveraging Emergency Medical Services (EMS) dispatch data and Geographic Information Systems (GIS) methodologies. Unlike traditional epidemiological models that rely on official diagnoses and offer limited spatial granularity, our approach uses EMS call data (rapidly collected, geo-referenced, and unbiased by institutional delays) as an early proxy for outbreak detection. The model integrates spatial filtering and machine learning (random forest classifier) to categorize municipalities into five epidemic scenarios: from no diffusion to active spread with increasing trends. Developed in collaboration with the Lombardy EMS agency (AREU), the system is designed for operational applicability, emphasizing simplicity, speed, and interpretability. Despite the complexity of the phenomenon and the use of a five-class output, the model shows promising predictive capacity, particularly for identifying outbreak-free areas. Performance is affected by changing epidemic dynamics, such as those induced by widespread vaccination, yet remains informative for early warning. The framework supports health decision-makers with timely, localized insights, offering a scalable tool for epidemic preparedness and response. Full article

Rapid vaccine availability is essential for effective epidemic and pandemic response. Building on the Coalition for Epidemic Preparedness Innovations (CEPI) 100 Days Mission, which aims to have new vaccines ready for initial authorization and manufacturing at scale within 100 days of recognition of a pandemic pathogen, the CEPI has developed a Chemistry, Manufacturing and Controls (CMC) Rapid Response Framework to define technical and logistical CMC requirements to enable rapid vaccine availability. Central to this framework is the availability of adaptable vaccine platforms that can be readily tailored to emerging pathogens. To support strategic decision-making and identify gaps in platform capabilities, CEPI has created the Platform Readiness Dashboard. This tool provides a structured, multi-dimensional initial assessment of platform maturity across six key categories: Adaptability, Compatibility, Suitability, Regulatory, Manufacturing, and Facility Readiness. Each category includes specific technical and operational considerations scored using a color-coded system to reflect outbreak response readiness level. This Dashboard aims to enable vaccine developers, manufacturers, funders, and outbreak response teams to evaluate platform strengths and limitations at any given time, informing funding, preparedness and response activities. By offering a dynamic view of essential platform readiness indicators, the dashboard can communicate progress supporting faster responses to future health emergencies. Full article

Climate change is profoundly impacting human health in South Africa, aggravating existing health challenges and creating new threats, particularly in vulnerable populations. This scoping review aims to comprehensively map existing evidence of climate change and diverse human health impacts to assist in the equipping of health systems to address evolving challenges of climate change. The scoping review will inform the development of evidence-based policy, improve public health preparedness, and ensure that adaptation strategies are effectively tailored to South Africa’s socio-economic and environmental conditions. This scoping review protocol will be conducted using the Joanna Briggs Institute (JBI) methodology, following five steps: (1) defining the research question, (2) search strategy, (3) setting inclusion criteria, (4) extracting data, (5) assessing, summarizing, and presenting findings. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) tool will be used. A comprehensive peer-reviewed literature search, including PubMed, Scopus, ScienceDirect, and Google Scholar, will be conducted by two independent reviewers. The review will be conducted over eight weeks, focusing on English studies published between 2015 and 2025, and conducted within South Africa. A two-stage screening process will determine article eligibility. Disagreements will be resolved through consensus and consultation of a third reviewer. The results of this review will be presented as tables, including a narrative synthesis of the findings. Full article

The preparedness of healthcare workers for disaster situations depends on their technical skills, disaster knowledge, and psychosocial strength, including teamwork and emotional regulation. This study aims to assess disaster preparedness among healthcare professionals in primary healthcare centers (PHCs) in Alqurayat, Saudi Arabia, with a specific focus on evaluating technical competencies, psychosocial readiness, and predictive modeling of preparedness levels. A mixed-methods approach was employed, incorporating structured questionnaires, semi-structured interviews, and observational data from disaster drills to evaluate the preparedness levels of 400 healthcare workers, including doctors, nurses, and administrative staff. The results showed that while knowledge (mean: 3.9) and skills (mean: 4.0) were generally moderate to high, notable gaps in overall preparedness remained. Importantly, 69.5% of participants reported enhanced readiness following simulation drills. Machine learning models, including Random Forest and Artificial Neural Networks, were used to predict preparedness outcomes based on psychosocial variables such as emotional intelligence, teamwork, and stress management. Sentiment analysis and topic modeling of qualitative responses revealed key themes including communication barriers, psychological safety, and the need for ongoing training. The findings highlight the importance of integrating both technical competencies and psychosocial resilience into disaster management programs. This study contributes an innovative framework for evaluating preparedness and offers practical insights for policymakers, disaster planners, and health training institutions aiming to strengthen the sustainability and responsiveness of primary healthcare systems. Full article

The COVID-19 pandemic has disrupted the progress toward Sustainable Development Goal 3, particularly in developing countries, exacerbating existing health disparities and creating new challenges for health systems worldwide. This study explores the role of university research in advancing SDG 3 targets in a post-pandemic context using the University of the Western Cape as a case study. Through qualitative data analysis of research titles and abstracts registered between 2020 and 2022, we applied the WHERETO model of McTighe and Bloom’s Taxonomy to categorize research according to the SDG 3 targets and indicators. This approach provides insight into which health priorities were addressed through scholarly research at UWC in alignment with the UN 2030 Agenda, particularly during pandemic recovery. Our findings indicate that research priorities largely corresponded with South Africa’s health challenges, with the highest concentration of studies addressing non-communicable diseases and mental health (Target 3.4), infectious diseases (Target 3.3), and medicine development (Target 3.b). These priorities align with the National Health Research Committee’s identified health priorities for disadvantaged communities in the Western Cape. Notably, research on mental health and emergency preparedness (Target 3.d) increased significantly during the pandemic period, reflecting shifting priorities in response to COVID-19. This study offers critical insights into how university research shifted priorities adapted during the pandemic and identifies areas requiring focused attention to support post-pandemic recovery. By highlighting research gaps and opportunities, our findings provide a foundation for developing more comprehensive approaches to health research that address the disparities exacerbated by COVID-19 while advancing the 2030 agenda. This model could inform research prioritization at other institutions facing similar challenges in both local and global contexts. Full article

Background: Disasters pose significant challenges to public health by disrupting essential services, especially during mass gatherings such as the Hajj pilgrimage. These complex events demand swifts coordinated action from healthcare professionals. However, many remain insufficiently equipped for large-scale emergencies due to gaps in triage training, disaster knowledge, and established response protocols—issues that are particularly critical in high-risk settings. Aim: This systematic literature review aims to explore the clinical insights of registered nurses and other healthcare professionals in disaster preparedness and response during the Hajj pilgrimage in Saudi Arabia. Methods: A systematic literature review was conducted following PRISMA guidelines. A comprehensive database search was performed across CINAHL, Scopus, Medline, Embase, and APA PsycINFO, focusing on studies published between 2012 and 2025. Eligible studies addressed disaster nursing education, preparedness, and response. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. Results: Twenty-three studies met the inclusion criteria. Three main themes emerged: disaster preparedness, experiences and challenges in disaster response, and education and training. The review revealed lack in nurses’ readiness, policy awareness, and real-world disaster experience. Training and curriculum improvements are essential to enhance disaster response capabilities. Conclusions: This review highlights the urgent need for standardized disaster nursing curricula to enhance preparedness and response competencies. Incorporating structured disaster training into nursing education will strengthen healthcare system resilience. Future research should adopt qualitative methods to capture healthcare professionals lived experiences during the Hajj. Including diverse participants and focusing on the unique cultural context can enhance disaster preparedness and response strategies. Full article

Introduction: The health emergency caused by the pandemic led to severe health issues in populations across many countries worldwide, including widespread morbidity and significant mortality. Nevertheless, several countries succeeded in keeping infection rates remarkably low before the approval of vaccines and the initiation of vaccinations in early 2021. We aim to identify the success factors of health policies in managing the impact of the health emergency across a selection of countries, focusing on how they protected their populations. Our study presents outcomes of sustainable health policy measures, along with health and social system challenges, and economic responses during the global health emergency. We sometimes found it difficult to define what counted as a success factor in some countries. Method: Our study draws upon a selection of reports and documents published by various ministries and economic, social, and health authorities, which we collected online. We structured our study into three phases to frame and contextualize the impact of health policy measures and countermeasures as follows: (i) observations and content analysis; (ii) empirical support through illustrative examples; and (iii) development of a health emergency toolkit of assessment. The documents were not always easy to compare because they differed in format and detail. Results: Our study outlines ten success factors for sustainable health policy measures and countermeasures: (i) preparedness; (ii) control; (iii) precaution; (iv) proactive decision-making; (v) synchronization; (vi) adequate legislation; (vii) goal fulfillment; (viii) digital health technology; (ix) empirical evidence; (x) ethical and moral virtues. Sometimes we struggled to separate what was ethical guidance from what was simply practical advice. Conclusion: We argue that the relevance of the health emergency toolkit of assessment outlined in our study demonstrates clearly that the success factors related to sustainable health policy measures and countermeasures can be applied and adapted to the societal conditions of individual countries. These factors may form a foundation for the development of a health emergency toolkit of assessment for future health emergencies. We also maintain that these factors may serve as a platform for establishing sustainable plans across health, social, and economic domains, with clear guidelines for implementation, management, and control. It is our hope that future health systems will make use of these findings before the next crisis emerges. Full article

Background: Despite ongoing global elimination efforts, measles remains a persistent public health threat. Methods: This retrospective observational study examines trends in crude measles incidence and vaccination coverage from 1948 to 2024 in the northern region of Serbia—Autonomous Province of Vojvodina (AP Vojvodina)—which accounts for 26.9% of the national population. This study further explores measles vaccination coverage across the province’s seven districts, along with the number of reported measles cases, age distribution, and vaccination status of affected individuals from 2000 to 2024. Data were obtained from official annual immunization records maintained by public health institutions within the framework of Serbia’s national mandatory immunization program. Results: A notable resurgence of measles occurred in Serbia during 2017–2018, following a decline in vaccination coverage. In AP Vojvodina, outbreaks were recorded in 2007, 2014–2015, and 2017–2018, predominantly affecting unvaccinated children and adults aged 20–39 years. Since 2019, the measles incidence has significantly declined. During the 2018 outbreak, the highest incidence was observed among children aged 1–4 years (40.6 per 100,000), followed by infants under 1 year (17.3 per 100,000) and adults aged 20–39 years (12.5 per 100,000). An analysis of the data from 2000 to 2024 revealed substantial age- and dose-related differences in measles incidence, particularly among unvaccinated individuals, those who had received one or two doses of a measles-containing vaccine (MCV), and those with unknown vaccination status. During the 2017–2018 epidemic, unvaccinated children under 1 year and those aged 1–4 years were the most affected. A marked increase in cases among single-dose recipients was noted in 2018, especially in adults aged 20–39 years (9.5%) and those ≥40 years (13.5%). A considerable proportion of measles cases in these age groups had unknown vaccination status: 33.1% among individuals aged 20–39 years and 18.2% among those aged ≥ 40 years. Epidemiological investigation linked the 2007 and 2014–2015 outbreaks in AP Vojvodina to importations from Bosnia and Herzegovina. No specific source was identified for the 2017–2018 outbreak, suggesting possible endemic transmission. Conclusions: These findings underscore the impact of fluctuating vaccination coverage on measles resurgence. Sustaining high two-dose MCV coverage, strengthening routine immunization programs, enhancing surveillance systems, and ensuring timely outbreak preparedness are critical measures for achieving effective measles control. Full article

The H5N1 avian influenza virus continues to evolve into genetically diverse and highly pathogenic clades with increased potential for cross-species transmission. Recent scientific advances have included the development of next-generation vaccine platforms, promising antiviral compounds, and more sensitive diagnostic tools, alongside strengthened surveillance systems in both animals and humans. However, persistent structural challenges hinder global readiness. Vaccine production is heavily concentrated in high-income countries, limiting equitable access during potential pandemics. Economic and logistical barriers complicate the implementation of control strategies such as vaccination, culling, and compensation schemes. Gaps in international coordination, public communication, and standardization of protocols further exacerbate vulnerabilities. Although sustained human-to-human transmission has not been documented, the severity of confirmed infections and the rapid global spread among wildlife and domestic animals underscore the urgent need for robust preparedness. International organizations have called for comprehensive pandemic response plans, enhanced multisectoral collaboration, and investment in targeted research. Priorities include expanding surveillance to asymptomatic animal hosts, evaluating viral shedding and transmission routes, and developing strain-specific and universal vaccines. Strengthening global cooperation and public health infrastructure will be critical to mitigate the growing threat of H5N1 and reduce the risk of a future influenza pandemic. Full article

Background: Mental health issues among youth are a growing public health concern. Schools play a vital role in the early detection and prevention of mental health issues, with principals being central to the implementation of mental health initiatives. This study assessed the attitudes, preparedness, and practices of school principals regarding mental health promotion and prevention among school-aged children. Methods: A cross-sectional survey using computer-assisted web interviewing (CAWI) was conducted between March and April 2025. A 19-item questionnaire was sent to all 1564 primary and secondary school principals in the Lodz region. Data from 605 respondents (response rate: 38.7%) were analyzed. Results: A total of 94.9% of the principals reported an increase in student mental health problems over the past five years. Over one-quarter of school principals (26.3%) declared a very good or rather good level of preparation for teachers to work with students diagnosed with a mental disorder. Moreover, 42.3% declared a very good or rather good level of preparation of teachers for conversations with parents about mental health problems observed in their children. Mental health education was conducted in 94.7% of schools, and teacher training in 73.2% of schools. Secondary schools more often offered such training (81.9% vs. 70.7%; p = 0.01) and reported stronger support from specialist teachers (79.7% vs. 67.7%; p = 0.01) than primary schools did. Rural schools rated teacher-parent communication more positively (47.0% vs. 37.7%; p = 0.02) despite fewer training initiatives (68.7% vs. 77.7%; p = 0.01). Suicide response procedures were implemented in 78.5% of schools. Conclusions: The findings confirm a marked rise in student mental health needs and reveal structural disparities in providing school-based support. Enhancing school leadership, expanding teacher training, and ensuring systemic support may facilitate mental health promotion interventions in schools. Full article

Background and Objectives: Infectious disease outbreaks are a major challenge for public health systems worldwide, especially for healthcare workers (HCWs). Taif city, in Saudi Arabia, has a high population density and is a tourist destination, which puts it at a high risk of infectious disease outbreaks. Despite its geographical importance, no previous study has been conducted that focuses on assessing the preparedness of healthcare workers in Taif city for managing infectious disease outbreaks. Therefore, we aimed to assess the overall level of preparedness among HCWs in healthcare facilities across Taif city and identify the challenges they face when managing infectious disease outbreaks. Materials and Methods: We conducted a cross-sectional study from October to December 2024 among 294 healthcare workers, using a structured questionnaire. We assessed the sociodemographic characteristics, infection prevention and control (IPC) training received by HCWs, the level of preparedness for managing infectious disease outbreaks, and their level of knowledge (low, moderate, or high). The association between sociodemographic characteristics and knowledge from having received IPC training and the level of preparedness was assessed using binary logistic regression. A p-value of ≤ 0.05 was considered as significant. Results: Around 31.7% of the participants were aged 31–40 years, with 59.2% of them being female. Among the HCWs we assessed, 44.6% were nurses and 31.3% of the HCWs were from hospitals with a bed capacity of over 500. Only 16.3% of HCWs felt fully prepared on a personal level and only 20.7% believed their facility was fully prepared for managing an outbreak. A low level of knowledge was reported among 71.8% of the participants. The odds of having received IPC training were significantly higher among HCWs aged 41–50 years (AOR = 15.7; 95% CI = 4.26–58.1), for those working in the inpatient department (AOR = 6.3; 95% CI = 1.46–27.05), and for those with a moderate level of knowledge (AOR = 0.12; 95% CI = 0.03–0.5). The odds of being fully prepared for an infectious disease outbreak were significantly higher for males (AOR = 2.58; 95% CI = 1.18–5.63) and those working in the in-patient department (AOR = 6.87; 95% CI = 1.7–27.8) and significantly lower for those with a low level of knowledge (AOR = 0.19; 95% CI = 0.06–0.61). Conclusion: Even though many HCWs have undergone IPC training, our findings highlight gaps in both knowledge and overall preparedness among healthcare workers in Taif city. Regular refresher courses, improved resource allocation, and implementing scenario-based emergency drills may help in improving the overall knowledge and preparedness of HCWs. Full article

Background: This commentary analyzes demographic, clinical, and occupational characteristics associated with Ebola virus disease (EVD) outcomes during the 2018–2020 outbreak in the Democratic Republic of Congo (DRC). Methods: A total of 3477 EVD cases were included. Descriptive statistics and univariate and multivariate Cox regression analyses were performed to evaluate associations between clinical outcomes and patient characteristics. Comorbidity estimates and healthcare worker (HCW) occupational exposure data were incorporated based on the literature. Results: The median age was 26.5 years (SD = 16.1), with the majority (59.7%) aged 20–59. Males represented 51.3% of the cohort. Most patients (81.8%) worked in occupations that were not disease-exposing. Overall, 450 patients (12.9%) died. Although comorbidities initially appeared predictive of mortality (unadjusted HR: 3.05; 95% CI: 2.41–3.87), their effect was not statistically significant after adjustment (adjusted HR: 1.17; 95% CI: 0.87–1.59; p = 0.301). The strongest predictor of death was clinical status at admission: patients classified as “very sick” had an alarmingly high adjusted hazard ratio (HR) of 236.26 (95% CI: 33.18–1682.21; p < 0.001). Non-disease-exposing occupations were also associated with increased mortality (adjusted HR: 1.75; 95% CI: 1.33–2.31; p < 0.001). Conclusions: Despite improvements in outbreak response, mortality remains disproportionately high among patients presenting in critical condition and those outside the health sector. These findings underscore the importance of early detection strategies and enhanced protection for all occupational groups during EVD outbreaks. Full article

This qualitative study explored the development of an innovative simulation training program designed to bolster the preparedness and resilience of healthcare teams during the unprecedented challenges of the COVID-19 pandemic. Focus groups with interprofessional clinicians illuminated key educational priorities, revealing a need for enhanced safety protocols, clear in communication, and targeted training to address knowledge gaps specific to the novel coronavirus. Recognizing the profound emotional toll of the pandemic, the program also emphasized cultivating compassion and fostering emotional resilience alongside the essential clinical skills. By immersing participants in realistic, evolving scenarios that were reflective of the dynamic COVID-19 landscape, the simulations offered a safe space to rehearse critical skills, practice crisis resource management, and build confidence in navigating the complexities of pandemic care. This tailored approach aimed to empower healthcare teams not only with enhanced knowledge and expertise but also with the emotional fortitude and resilience necessary to provide optimal patient care while safeguarding their own well-being throughout the ongoing COVID-19 pandemic. The findings highlight the profound potential of simulation-based training to strengthen both individual and systemic resilience within healthcare systems facing the enduring strain of this global health crisis. Full article

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted healthcare systems worldwide. As a result, remote areas such as the Penghu Islands have encountered unique challenges related to pediatric care. This study examined the effects of the pandemic on the emergency air medical transport (EAMT) of pediatric patients from the Penghu Islands to Taiwan. Materials and Methods: This retrospective study analyzed 40 pediatric patients who received EAMT from the Penghu Islands to Taiwan between January 2017 and December 2022. This study compared patients before and during the COVID-19 pandemic and focused on patient demographics, reasons for EAMT, and clinical outcomes. Due to the small sample size, non-parametric statistical methods were applied, including the Mann–Whitney U-test for continuous variables and Fisher’s exact test for categorical variables. Results: Among the 40 pediatric patients analyzed, the median age decreased from 3 years (IQR, 0–5 years) before the pandemic to 1 year (IQR, 0–5 years) during the pandemic. While the overall increase in hospital length of stay during the pandemic was not statistically significant, a significant prolongation was observed in preschool-aged children and neonates without trauma (20 days vs. 9 days; p < 0.05). The lack of specialist physicians became an increasingly prominent factor for EAMT during the pandemic (p = 0.056). The most common medical reasons for EAMT were critical illness (35%), neonatal diseases (30%), and neurological conditions (27.5%), with similar distributions across both time periods. Conclusions: The COVID-19 pandemic heightened existing healthcare disparities in the Penghu Islands, particularly by increasing reliance on EAMT due to a shortage of pediatric specialists. Hospital stays for preschool children and neonates significantly increased during the pandemic, suggesting delayed or prolonged care. These findings underscore the need to strengthen local pediatric infrastructure, decentralize specialist services, and improve emergency preparedness to better support vulnerable populations in remote areas during future public health emergencies. Full article

In early 2025, the Santorini–Amorgos area (Aegean Volcanic Arc, Greece) experienced a seismic swarm, with dozens of M ≥ 4.0 earthquakes and a maximum magnitude of M = 5.2. Beyond its seismological interest, the sequence was notable for triggering rare increased preparedness actions by Greek Civil Protection operational structures in anticipation of an imminent destructive earthquake. These actions included (i) risk communication, (ii) the reinforcement of operational structures with additional personnel and equipment on the affected islands, (iii) updates to local emergency plans, (iv) the dissemination of self-protection guidance, (v) the activation of emergency alert systems, and (vi) volunteer mobilization, including first aid and mental health first aid courses. Although it was in line with contingency plans, public participation was limited. Volunteers helped bridge this gap, focusing on vulnerable groups. The implemented actions in Greece are also compared with increased preparedness during the 2024–2025 seismic swarms in Ethiopia, as well as preparedness before the highly anticipated major earthquake in Istanbul (Turkey). In Greece and Turkey, legal and technical frameworks enabled swift institutional responses. In contrast, Ethiopia highlighted the risks of limited preparedness and the need to embed disaster risk reduction in national development strategies. All cases affirm that preparedness, through infrastructure, planning, communication, and community engagement, is vital to reducing earthquake impacts. Full article