Alex Greninger, MD, PhD, MS, MPhil, is the Larry Corey Endowed Professor in the Department of Laboratory Medicine and Pathology at the University of Washington Medical Center, assistant director of the clinical virology labs, and director of the clinical trials and Retrovirology lab.
Dr. Greninger is interested in building laboratory capacity to support global health initiatives for everything from quality management systems to bioinformatics for pathogen genomics and metagenomics for pandemic preparedness.
The Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT to Action) project is a five-year cooperative agreement with the ... Read More
The event included a final in-person workshop and a certificate ceremony, celebrating 12 months of intensive learning and collaboration. The fellowship program included in-person workshops, mentorship, and communities of practice to support applied learning, as well as completion of capstone projects that aligned with respective countries’ health priorities.
“IDASH has been a novel training approach to bridge the gap between public health informatics and data science to improve population health,” says Jennifer Gilvydis, INSIGHT Project Director. “The fellowship is a unique blend of applied learning and supports multidisciplinary workforce development.”
The final workshop covered topics such as evaluating surveillance system performance, public health informatics communication, developing effective poster presentations, and maintaining connections with fellow program graduates. Fellows presented their capstone projects, showcasing the application of newly acquired skills and knowledge.
Each interdisciplinary country team included members from Ministry of Health (MOH) units responsible for digital health and disease surveillance and response, such as mid-senior level epidemiologists, informaticians, data scientists, IT specialists, and public health policy personnel. This diverse mix of disciplines was integral to the fellows’ experience and the success of their capstone projects.
“What was unique [about this fellowship] was that this scholarship included the integration of systems as well as public health and technology,” says Nuraiym Zhumakunova, a fellow and epidemiologist with the Department of Disease Prevention and State Sanitary-Epidemiological Surveillance in Kyrgyzstan. Her team was working on a unified platform for disease surveillance data analysis.
“Overall, [the program] was good because we understood the work as analysts and as IT specialists,” she continues.
Stacey Lissit, Senior Technical Advisor for the IDASH fellowship, agrees that collaboration across disciplines was key to the program’s success: “The fact that IDASH brought together professionals from disciplines that may not typically collaborate and communicate with each other – public health/epidemiologist and IT/Data scientists – was an integral part of the fellowship,” she says. “It enabled fellows to get out of their silos and understand the priorities, needs, and ‘language’ of their colleagues, and see how communication and collaboration are so vital to achieving the desired public health outcomes. The relationships and community that was built among the fellows from different countries was an invaluable component of the program.”
The fellowship not only enriched the participating professionals but also had tangible benefits for their agencies and organizations. “We trained health workers on how to maintain quality data,” said Farhod Akbarov, First Deputy CEO at IT-Med LLC under the MOH of Uzbekistan, whose team was working on reporting, mapping, and forecasting of infectious disease. “These are already new skills for us. We can already filter, sort, and show better quality data.”
As the COVID-19 pandemic has demonstrated, robust information systems that can collect, analyze, interpret, and act on high-quality data are critical to public health. The IDASH fellowship program aims to close knowledge gaps in the global public health workforce, better preparing regions for future health threats.
The fellowship program is set to launch in five countries in South America this June, expanding its reach and impact on global health initiatives.
Migrating waterfowl from Asia, Africa, and Europe intersect in Georgia, which increases the potential for novel avian-origin influenzas to emerge. I-TECH, through the INSIGHT project, is working with the Centers for Disease Control and Prevention Georgia, the Georgia National Food Agency, and the Georgia Ministry of Environmental Protection and Agriculture, through September 2024 to assess biosecurity and influenza outbreak readiness on commercial poultry farms in Georgia, and support capacity building for and development of a national wild bird surveillance strategy. Activities include a farm biosecurity survey and peri-domestic wild bird capture, sampling, and testing, as well as training in genomic surveillance and design of surveillance programs.
At a February 5-8 meeting in Bogotá, the International Training and Education Center for Health (I-TECH) convened with global health leaders from 5 countries to inform the adaptation of the Informatics and Data Science for Health (IDASH) training program to South American contexts.
IDASH–part of I-TECH’s Integrated Next-generation Surveillance in Global Health: Translation to Action (INSIGHT) project–is a training program for current and future leaders in public health that aims to strengthen regional capacity to use public health information and data systems to improve health outcomes at the population level, detect and respond effectively to threats to public health, and promote health equity.
The objectives of the intensive, weeklong Executive Committee meeting included identifying priorities and key capabilities; adapting the structure of the IDASH course to local needs as well as government priorities and initiatives; and identifying government and academic resources to support teaching.
IDASH South America Director Fernanda Freistadt addresses the participants on Day 1 of the meeting. Photo courtesy of Maíra Pessoa/FVS-RCP.
In a a website post of IDASH partner Fundação de Vigilância em Saúde do Amazonas – Dra. Rosemary Costa Pinto, INSIGHT Regional Director for South America Fernanda Freistadt said: “This initiative has the potential to create health professionals who have advanced knowledge in both epidemiology and information technology, an area in which there is a great lack today. Furthermore, IDASH can strengthen technical relations and collaborations in the area of surveillance between countries.”
The Executive Committee Meeting included representatives from Colombia, Brazil, Paraguay, Peru, and Ecuador, as well as international partners including Georgia’s National Center for Disease Control and Public Health (which has been an important partner in the IDASH training program for Eastern Europe/Central Asia). It is anticipated that the South America expansion implementation to happen later this year.
Despite establishing COVID-19 monitoring measures within the existing routine national surveillance system and significant efforts to conduct testing, contact tracing, and case investigations, Government of Malawi institutions at both the national and district levels faced many challenges in mounting an effective response to the COVID-19 pandemic. The existing COVID-19 surveillance system relied on retrospective data and it struggled to establish the magnitude of community transmission or identify emerging variants.
In June 2022, in collaboration with the Public Health Institute of Malawi and support from the US Centers for Disease Control and Prevention, I-TECH began sentinel surveillance monitoring of COVID-19 in seven sites. The COVID-19 sentinel surveillance system in Malawi was able to quickly detect changes in positivity rates and the emergence of variants. Read more about key findings and methods in I-TECH’s Sentinel Surveillance program brief.
IDASH fellows engage in group work during an October workshop in Almaty, Kazakhstan. Photo credit: Jamey Gentry/CDC.
Last month, the International Training and Education Center for Health (I-TECH), in collaboration with the U.S. Centers for Disease Control (CDC) and with support from the World Health Organization (WHO), facilitated the second of three in-person workshops for the Informatics and Data Science for Health (IDASH) fellowship.
Held in Almaty, Kazakhstan, the workshop marked the mid-point of the 12-month fellowship—and a chance for participants to come together to advance their ability to apply public health informatics and data science concepts and approaches.
“This workshop included a lot of hands-on practical exercises, and it was fun to observe how engaged the participants were with these activities and with the learning in general,” said Stacey Lissit, MPH, MS, Senior Technical Advisor for the IDASH program.
Content included all things data (quality, cleaning, analysis, visualization, governance, security, privacy, and confidentiality); interoperability; project management; business process analysis; and systems architecture. Sessions were a mix of didactic lecture, small group activities to practice application of skills and concepts, peer feedback, and guided hands-on learning in R and PowerBI. Over the course of the two weeks, participants collaborated to develop a data dashboard, a database schema, and a data quality workplan.
The first cohort of the IDASH fellowship, with I-TECH instructors. Photo credit: Jamey Gentry/CDC.
The current fellowship, launched in April 2023, comprises a cohort of four participants each from Georgia, Kazakhstan, Kyrgyzstan, Ukraine, and Uzbekistan—a total of 20 fellows. Each four-person team includes a mix of mid-senior level epidemiologists, informaticians, data scientists, IT, and public health policy personnel.
Fellow Zhanibek Yerubayev, Director of Public Health Emergency Operations at the Kazakhstan Ministry of Health’s National Center of Public Health, says the team mix is an integral part of IDASH’s impact. “[IDASH] connects people from the public health side with people from the IT side,” he says. “These people have a lot of projects to do [together], but they are not always well connected, and they do not always understand each other well.”
“It was exciting to see the relationships and community that are being built through the IDASH Fellowship – both within the country teams where fellows can collaborate closely with colleagues outside of their typical ‘work silos,’ and across countries within the region,” said Lissit. “That peer learning element is such an important part of the fellowship.”
And all efforts were made to ensure multi-directional collaboration. The Ukrainian team did not receive permission to travel to the workshop, so I-TECH made arrangements for them to participate via Zoom. A location was identified in southwest Ukraine where the team could attend the workshop together remotely, experience fewer daily safety issues related to the war, and avoid the distractions of being in their own workplace. A simultaneous translator for the Ukrainian language was provided on the Zoom call.
While remote participation is not ideal, the Ukraine team was able to attend and hear most of the workshop sessions and engage in the group work in meaningful ways. “A lot of effort went into setting up the technology that enabled this participation,” said Lissit. “At one point the Ukraine team was participating in a peer feedback activity with two country teams in Almaty—there were live cameramen, screen sharing, Zoom translators…and it worked mostly seamlessly!”
Fellow Durbek Aliyev, Deputy CEO at IT-Med LLC, which works under the Uzbekistan Ministry of Health, was especially appreciative of the chance to learn from a wide range experts across the region. “The digitalization of health care cannot be done by only one country itself,” said Aliyev. “The advantage of IDASH over other programs is that it brings [together] specialists from neighbor countries. We are talking to each other….We are learning from each other directly.”
And these relationships will be a lasting benefit of the program, he continued. “IDASH is a place where we can establish very good networking with other countries,” said Aliyev. “Any time I can contact them and learn from their expertise.”
IDASH is a project within the Integrated Next-Generation Surveillance in Global Health: Translation to Action (INSIGHT) program. In addition to acquiring new skills and knowledge in public health informatics and data science, IDASH country teams are developing and will implement a collaborative team project that demonstrates key competencies and is aligned with their country’s needs and priorities.
The World Health Organization recommends countries routinely implement nationally representative HIV drug resistance (HIVDR) surveys among people infected with HIV to measure the level of drug resistance. The results of HIVDR surveys are a critical component of HIV programs and can guide changes to pediatric and adult antiretroviral therapy (ART) treatment regimens, including first- and second-line regimen decisions. I-TECH has been implementing HIVDR surveys in Malawi since 2016.
HIV DR Surveys Conducted Since 2016:
Infant HIVDR Survey: An HIVDR survey was conducted among infants aged 18 months and younger to determine the level of pediatric resistance to nonnucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI), and protease inhibitors (PI) ART drugs through exposure during pregnancy and breastfeeding. A total of 232 eligible remnant dried blood spot (DBS) samples from nine early infant diagnosis (EID)-approved laboratories were used for the diagnosis of HIV in infants between June 2016 and December 2017.
Antenatal Care (ANC)/Pregnant Women HIVDR Survey: An HIVDR survey was conducted to measure resistance to NNRTI, NRTI and PI drugs among ANC clients who were found to have a recent HIV infection. A total of 45 DBS samples from women with recent HIV infection were collected as part of the 2016 HIV sentinel surveillance survey and were successfully amplified and sequenced.
The next step in HIV surveillance activity is monitoring HIVDR among pregnant women initiating dolutegravir (DTG)-based regimens, as well as the potential emergence of DTG resistance in infants via mother-to-child transmission. A study of DTG resistance is currently underway in Malawi and will determine the level of DTG resistance in adults who are unable to achieve viral load suppression and DTG resistance in children < 15 years old who are unable to achieve viral load suppression.
The 2023 IAS Conference on HIV Science logo. Read the full background and inspiration behind the 2023 IAS Logo. Image credit: IAS
The International AIDS Society (IAS) hosted the 12th IAS Conference on HIV Science on 23 – 26 July 2023 in Brisbane, Australia, and virtually. This biennial conference brings together top HIV researchers, experts, and scientists for presentations and discussions on the latest advances in HIV research and practice.
This year, representatives from the International Training and Education Center for Health (I-TECH), I-TECH’s partner network organizations, and the Centers for Disease Control and Prevention (CDC) shared findings from I-TECH-supported programs in India, Malawi, and Zimbabwe. Read the ePoster abstracts below.
John Lynch, MD, MPH is an infectious diseases physician focused on improving the operations and capacities of healthcare teams to improve patient care and safety. He is an Associate Medical Director at Harborview Medical Center (HMC), a mission-driven, Level-1 burn and trauma teaching hospital that is part of the University of Washington (UW) School of Medicine. At HMC, he leads the hospital’s Infection Prevention & Control (IPC), Employee Health, and Sepsis Programs, and was the lead clinician for UW Medicine’s COVID-19 emergency response. Dr. Lynch is also a Professor of Medicine in the Division of Allergy & Infectious Diseases in the University of UW Department of Medicine.
Dr. Lynch co-leads the Center for Stewardship in Medicine (CSiM), a group of physicians and pharmacists working to bridge knowledge gaps (in both directions) between academic medical centers and rural health care facilities. Their work is mainly in antimicrobial stewardship and infection prevention but also extends to building quality improvement programs in those facilities. CSiM is composed of three main activities, including UW Tele-Antimicrobial Stewardship, a telementoring program, the Intensive Quality Improvement Cohorts, and resource/tool development to support the goals of the program.
In addition, Dr Lynch also works with Dr. Peter Rabinowitz (PI) to provide subject matter expertise on a long-running project to build IPC capacity in hospitals in Kenya as part of the I-TECH Global Health Security Agendaproject.
I-TECH Kenya’s Global Health Security Agenda (GHSA)-funded programs aim to advance the GHSA goals of preventing , detecting, and responding ... Read More
Population movement, limited public health infrastructure, different country reporting systems, and poor environmental conditions increase incidence of certain infectious diseases across borders. Communities living in border areas are at increased vulnerability for and worse outcomes from infectious diseases such as COVID-19 and other priority pathogens.
