Ponce, Puerto Rico. Multinational Injury Surveillance Study

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Organizing a pilot project on injury
surveillance.Opportunities and Obstacles

• Diego E Zavala, M.Sc., Ph.D.
• Director- Epidemiology and Biostatistics Core
  Program
• Public Health Program
• Ponce School of Medicine
• Ponce, Puerto Rico

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Multinational Injury Surveillance Study

• Background
• Initiative emerged out of the last two World
  Conferences on Injury Prevention and Control
• And pre-conferences on war related injuries

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Multinational Injury Surveillance Study

• In collaboration with
• Pan American Health Organization/ WHO
• Alberto Concha, MD, MPH
• Regional Advisor on Injury Prevention
• Centers of Disease Prevention and Control
• Carme Clavel-Arcas, MD, MPH
• National Center for Injury Prevention and Control
  
• CDC, U.S.

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Multinational Injury Surveillance Study
Puerto Rico
Uganda
El Salvador
Nigeria
Colombia
Kenya
Brazil
Bolivia
DRC
Zambia

• PI Diego E Zavala, MSc, PhD, Ponce Medical
  School, Puerto Rico
• Project Administrator Maria Valenti,
• International Physicians for the Prevention of
  Nuclear War (IPPNW)

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Participating Countries
LATIN AMERICA CARIBBEAN
Bolivia

• Population 8,724,156 (2004)
• Area 
• La Paz Hospital de Clínicas
• Co-PI Eduardo Dominguez- Qhana (NGO)

Brazil

• Population 184,101,109 (2004)
• Area
• Sao Paulo Hospital do Grajaú
• Co-Pi Maria Fernanda Tourinho Peres, PhD
• Vilma Pinheiro Gawryszewski, MD
• Nucleo de Estudos da Violencia

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Participating Countries
LATIN AMERICA CARIBBEAN
El Salvador

• Population 6,587,541 (2004)
• Area 
• Ilopango Hospital Bartolo
• Co-PI Emperatriz Crespín, MD -IPPNW

Puerto Rico

• Population 3,897,960 (2004)
• Area 
• Ponce Hospital San Lucas II
• Co-PI Carlos García, MD

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Participating Countries
LATIN AMERICA CARIBBEAN
Colombia

• Population 42,310,775 (2004)
• Area 
• Bucaramanga two public hospitals
• Co-PI Marta H León Franco, MD

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Participating Countries
AFRICA

• Population 58,317,930 (2004)
• Area 
• Kisangani K.U.T. Hospital
• Bukavu Bukavu General Hospital
• Panzi Panzi General Hospital
• Goma/Katwa Goma Katwa Gen. Hosp
• Bunia Bunia General Hospital
• Kindu Kindu General Hospital
• Co-PI Simon Bokongo, MD (IPPNW)

DRC
Kenya

• Population 32,021,856 (2004)
• Area 
• Nairobi Kenyatta Nacional Hospital
• Rift Valley Naivasha District Hospital
• Eastern Prov Machakos Provincial Hospital
• Co-PI Walter Odhiambo, MD (IPPNW)

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Participating Countries
AFRICA

• Population 26,404,543 (2004)
• Area 
• Mbale Mbale Regional Hospital
• Kumi Kumi Hospital
• Toroto Toroto Hospital
• Co-PI Peter Olupot, MD (IPPNW)

Uganda

• Population 10,462,436 (2004)
• Area
• Lusaka Univ. Hospital
• Kafue Nangonwe Hospital
• KalomoKalomo District Hospital
• Co-PI Robert Mtonga, MD (IPPNW)

Zambia
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Participating Countries
AFRICA

• Population 137,253,133
• Area 
• Dala Nacional Orthopedic Hosp
• KanoAminu Kano Hospital
• Co-PI Ime John, MD (IPPNW)

Nigeria
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Multinational Injury Surveillance Study

• Phase I
• Development of Questionnaire
• Retrospective review of 30 cases in last six
  months
• Presentation of results to ED medical
  professionals.

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Multinational Injury Surveillance Study

• Phase II
• Secure funding
• Regional training (TOT)
• Begin 12 month prospective data collection in all
  sites.

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Multinational Injury Surveillance Study

• Opportunities
• Response to WHO recommendations.
• Interest enthusiasm.
• Develop experience in international collaboration
  efforts.
• Foundation for further research efforts.

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Multinational Injury Surveillance Study

• Opportunities
• Response to WHO recommendations/observations in
  that
• Many countries, specially in underdeveloped
  regions lack injury surveillance systems that
  would provide reliable data on injury.
• Call for enhancing capacity for collecting data
  on violence at the national level in developing
  countries
• Lack of data has made multinational comparisons
  difficult.

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Multinational Injury Surveillance Study

• Opportunities
• Response to WHO recommendations.
• Interest commitment.
• Develop experience in international collaboration
  efforts.
• Foundation for further research efforts.

• Obstacles
• Communication
• Funding
• Coordination via internet?
• Local socio-political realities

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Multinational Injury Surveillance Study

• Opportunities
• reliable information on cervical cancer incidence
  and mortality data that demonstrates the extent
  of the problem and the financial implications of
  the disease for the country.
• this information together with provision of
  technical assistance is needed to develop
  sustainable cervical cancer prevention
  initiatives in developing countries
• for which donors may be more willing to support

• Barriers
• limited availability of funds, particularly from
  donor organizations
• absence or deficient infrastructure for cervical
  cancer prevention
• lack of reliable data of cancer incidence and
• limited understanding by health officials about
  the disease itself and of its impact, specially
  in older women.

Herdman, C., Sherris, J., Bingham, A. Bringing
about change Policy development for cervical
cancer prevention in low-resource countries.
Abstract No. O-49. 19th International
Papillomavirus Conference. Florianópolis, Brazil.
September 1-7, 2001.
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Multinational Injury Surveillance Study

• Funding
• FIA application 50
• IPPNW Govt. of Canada
• Other ?

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Multinational Injury Surveillance Study

• Output
• National
• Hospital
• Government
• Community?
• International
• Conferences
• Journals

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Puerto Rico