Monthly Archives: February 2017

Spatial Dynamics of TB Within a Highly Urbanised Asian Metropolis Using Point Patterns


Singapore is a high-income country in a region with a high prevalence of tuberculosis. The Singapore Tuberculosis (TB) Elimination Program (STEP) was set up in 1997, and the better surveillance and clinical management practices initiated under STEP led to a decade-long decline in the incidence levels. However, incidence rates started to rise again since 2008. The reasons for this rise are unclear. This study involved a spatial analysis of the epidemiology of TB among Singapore residents. More than 30 000 cases reported during 1995–2011 and their residential addresses were analysed for spatial risk and spatial clustering, using spatial point pattern methodology. The principal factor responsible for the increasing resident TB incidence in Singapore is the changing age profile of the population. In particular the burgeoning population aged above 65 years accounts for the increase in reported cases. Singapore’s population has one of the world’s lowest fertility and mortality rates, and the elderly population is projected to grow substantially over the next few decades. Tuberculosis rates may therefore continue to rise even with static or improving case management and surveillance.

Citation: Das, S., Cook, A. R., Wah, W., Win, K. M. K., Chee, C. B. E., Wang, Y. T., & Hsu, L. Y. (2017). Spatial dynamics of TB within a highly urbanised Asian metropolis using point patterns. Scientific reports7(1), 1-9.

Full-Text Available Here

The Impact of Hand, Foot and Mouth Disease Control Policies in Singapore: A Qualitative Analysis of Public Perceptions


Hand foot and mouth disease (HFMD) is a widespread pediatric disease in Asia. Most cases are relatively mild and caused by Coxsackie viruses, but in epidemics caused by Enterovirus 71, severe complications can occur. In response to the deaths of dozens of children in a 1997 outbreak (Podin in BMC Public Health 6:180,1 Abubakar in Virus Res 61(1):1-9,2 WHO in3), Singapore practices childcare centre surveillance, case-isolation, and short-term closure of centres. We conducted 44 in-depth interviews with teachers, principals, and parents at four childcare centres in Singapore to better understand experiences with current control policies. We used applied thematic analysis to identify recurrent and unique themes. Participants were conflicted by perceiving HFMD as a severe illness and reported a sense of helplessness when hygiene and social-isolation efforts failed. They perceived that severity of HFMD influenced Singapore’s choice of existing policies despite a lack of evidence of their effectiveness. Documenting stakeholders’ perspectives clarifies the impact of control measures and how to communicate policy changes.

Citation: Siegel K, Cook AR, La H. The impact of hand, foot and mouth disease control policies in Singapore: A qualitative analysis of public perceptions. J Public Health Policy. 2017;38(2):271–287. doi:10.1057/s41271-017-0066-z

Full-Text Available Here

Weekly Updates – 11 March

In this week’s update:

  1. Zika virus
  2. Avian influenza – H7N9, H5N1
  3. Ebola virus disease (EVD)
  4. MERS-CoV
  5. Polio
  6. Influenza
  7. Yellow fever
  8. Hepatitis E
  9. Hantavirus
  10. Measles
  11. Elizabethkingia anophelis
  12. Lassa fever
  13. Cholera
  14. Anthrax
  15. Salmonellosis


Researchers have found associations between Zika and Meningoencephalitis as well as Myelitis. The first known isolation of Zika virus in saliva from an Italian patient raises concerns about the potential risk of human-to-human transmission through saliva. A new experimental Zika drug developed by BioCryst Pharmaceuticals and tested on mice have generated positive results.
The Aedes aegpti in Puerto Rico and Mexico have developed resistance to permethrin, and the insecticide is likely going to lose its effectiveness in places where it has been used as the main insecticide for years. The latest total of microcephaly cases in Brazil is 745. A timeline that charts Zika virus’ origin and subsequent spread from its discovery nearly 70 years ago has been published.

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