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An outbreak of measles is ongoing in northern Serbia. The first cases were in January 2007 in the area of Novi Sad in the autonomous province of Vojvodina. As of 12 March 2007, 121 suspected cases had been reported to the regional Institute of Public Health.

BackgroundVulnerable individuals with tuberculosis (TB) struggle to access and stay on treatment. While patient-related and social barriers to TB treatment adherence are well documented, less is known about how the organisation and delivery of TB care influences adherence behaviour.AimTo examine the influence of TB service organisation and culture on patients’ experience of starting and staying on treatment in Riga, Latvia.MethodsAn intervention package to support adherence to TB treatment amongst vulnerable patients in Riga, Latvia was piloted between August 2016 and March 2017. Qualitative observations (5), interviews with staff (20) and with TB patients (10) were conducted mid-way and at the end of the intervention to understand perceptions, processes, and experiences of TB care.ResultsThe organisation of TB services is strongly influenced by a divide between medical and social aspects of TB care. Communication and care practices are geared towards addressing individual risk factors for non-adherence rather than the structural vulnerabilities that patients experience in accessing care. Support for vulnerable patients is limited because of standardised programmatic approaches, resource constraints and restricted job descriptions for non-medical staff.ConclusionProviding support for vulnerable patients is challenged in this setting by the strict division between medical and social aspects of TB care, and the organisational focus on patient-related rather than systems-related barriers to access and adherence. Potential systems interventions include the introduction of multi-disciplinary approaches and teams in TB care, strengthening patient literacy at the point of treatment initiation, as well as stronger linkages with social care organisations.

BackgroundTanzania remains among the countries with the highest burden of infectious diseases (notably HIV, Malaria and Tuberculosis) during pregnancy. In response, the country adopted World Health Organization’s (WHO) latest antenatal care (ANC) guidelines which recommend comprehensive services including diagnostic screening and treatment for pregnant women during antenatal. However, as Tanzania makes efforts to scale up these services under the existing health system resources, it is crucial to understand its capacity to deliver these services in an integrated fashion. Using the WHO’s service availability and readiness assessment(SARA) framework, this study assesses the capacity of the Tanzanian Health System to provide integrated Malaria, Tuberculosis and HIV services.MethodsComposite indicators of the five components of integration were constructed from primary datasets of the Tanzanian Service Provision Assessments (SPA) under the Demographic and Health Survey (DHS) programs. Chi-squared analysis, T test and ANOVA were conducted to determine the associations of each of the defined components and background characteristics of facilities/health workers. A logistic regression model was further used to explore strength of relationships between availability of service readiness components and a pregnant women’s receipt of HIV, Malaria and TB services by reporting adjusted odds ratios.ResultsGenerally, capacity to integrate malaria services was significantly higher (72.3 95% CI 70.3–74.4 p = 0.02) compared to Tuberculosis (48.9 95% CI 48.4–50.7) and HIV (54.8 95% CI 53.1–56.9) services. Diagnostic capacity was generally higher than treatment commodities. Regarding the components of SARA integration, logistic regression found that the adjusted odds ratio of having all five components of integration and receiving integrated care was 1.9 (95% CI 0.8–2.7). Among these components, the strongest determinant (predictor) to pregnant women’s receipt of integrated care was having trained staff on site (AOR 2.6 95% CI 0.6–4.5).ConclusionToward a successful integration of these services under the new WHO guidelines in Tanzania, efforts should be channelled into strengthening infectious disease care especially HIV and TB. Channelling investments into training of health workers (the strongest determinant to integrated care) is likely to result in positive outcomes for the pregnant woman and unborn child.

Salmonella enterica is one of the most common causes of food-borne infection in human beings. Cases of Salmonella infection have been decreasing in Europe in the last ten years, yet, Salmonella infections are still the main cause of acute diarrhea syndrome. Globalization has caused the international food industry to increase the production of collective nutrition produce and products. This has intensified the need for authorized and accredited laboratories to monitor microbiological food safety. All parameters indicate the necessity of a multi-sector approach to this problem. Food safety supervision involves the analysis and identification of risk management, as well as the monitoring, evaluating, and regulating of crop irrigation. We can be more certain with a multi-sector approach that the number of Salmonella infections caused by plant-originated food stuffs will not increase in the future.