The current humanitarian crises in Ukraine and Gaza, along with the chronic crises, and the climate-related disasters, have exposed the limitations of the humanitarian system. Within these contexts, humanitarian organisations frequently struggle with collecting, analysing, interpreting, and utilising health data, due to the challenging environments in which they operate and funding constraints. It is precisely in these contexts that field epidemiology plays a crucial, but often overlooked role.Field epidemiologists face unique challenges, including rapidly changing conditions, poor-quality data, and biases. Despite these difficulties, accurate epidemiological data are essential for needs assessment, guidance on interventions, and advocacy. Conventional methods often need adaptation for crisis settings, and there are still gaps in measurement.This article discusses the role of epidemiology in such contexts, noting a shortage of trained \'humanitarian epidemiologists\' and specialised training as major issues.To address these needs, the Italian Association of Epidemiology organised a course in early 2024 to enhance the epidemiological skills of staff working in humanitarian crises and introduce traditional epidemiologists to crisis-specific challenges. The course covered key concepts and methods of field epidemiology, emphasising the use of secondary health data. Its positive reception underscored the demand for such specialised training.Improving public health information collection and use in humanitarian crises is an ethical and practical necessity. Indeed, investing in field epidemiology and recognising its importance can enhance humanitarian interventions and better serve vulnerable populations.

UNASSIGNED: Field Epidemiology Training Programs (FETPs) are competency-based training programs that play a critical role in strengthening global health security and enhancing the epidemiological capabilities of public health professionals. This scoping review examined available published literature on the evaluations of FETPs globally.
UNASSIGNED: A literature review was conducted to evaluate FETPs globally. Keywords specific to the evaluation of FETPs were utilized to search the PubMed, Scopus, and Web Science databases. After applying the inclusion and exclusion criteria, 12 relevant studies from an initial pool of 60 were included in this study. Data extraction included key details, and a qualitative synthesis organized diverse findings using a narrative approach to draw appropriate conclusions and generate recommendations.
UNASSIGNED: The review covered findings from 12 studies covering all three FETP modalities and spanning countries in various regions. Evaluations explored gained skills, engagement in FETP activities, and improvements in field epidemiological functions. Gained skills and knowledge, engagement in FETP activities, and improvements in field epidemiological functions were evident, with specific expectations for each FETP tier. Positive outcomes were consistent across studies, revealing improvements in surveillance activities, outbreak response, data management, and other system functions.
UNASSIGNED: This review confirmed the positive impact of FETPs on trainees and graduates, which emphasized competency enhancements across different modalities. Various strategies are recommended to improve the evaluation of FETPs. For effective evaluation, it is necessary to develop robust evaluation tools and establish standardized metrics to compare FETPs across regions or countries.

BACKGROUND: Following the first locally transmitted case in Sukhbaatar soum, Selenge Province, we aimed to investigate the ultimate scale of the epidemic in the scenario of uninterrupted transmission.
METHODS: This was a prospective case study following the locally modified WHO FFX cases generic protocol. A rapid response team collected data from November 14 to 29, 2020. We created a stochastic process to draw many transmission chains from this greater distribution to better understand and make inferences regarding the outbreak under investigation.
RESULTS: The majority of the cases involved household transmissions (35, 52.2%), work transmissions (20, 29.9%), index (5, 7.5%), same apartment transmissions (2, 3.0%), school transmissions (2, 3.0%), and random contacts between individuals transmissions (1, 1.5%). The posterior means of the basic reproduction number of both the asymptomatic cases R 0 Asy $$ {R}_0^{Asy} $$ and the presymptomatic cases R 0 Pre $$ {R}_0^{Pre} $$ (1.35 [95% CrI 0.88-1.86] and 1.29 [95% CrI 0.67-2.10], respectively) were lower than that of the symptomatic cases (2.00 [95% Crl 1.38-2.76]).
CONCLUSIONS: Our study highlights the heterogeneity of COVID-19 transmission across different symptom statuses and underscores the importance of early identification and isolation of symptomatic cases in disease control. Our approach, which combines detailed contact tracing data with advanced statistical methods, can be applied to other infectious diseases, facilitating a more nuanced understanding of disease transmission dynamics.

BACKGROUND: During COVID-19 pandemic in Japan, nightclubs were identified as high-risk locations for COVID-19 outbreaks, but an outbreak investigation in this setting is challenging because of the anonymous and opportunistic nature of interactions.
METHODS: The joint rapid response team collected epidemiological data, conducted descriptive epidemiology to determine the characteristics of cases associated with the nightclub, and implemented countermeasures. Polymerase chain reaction (PCR) tests were performed by the Local Institute of Public Health, Kagoshima University, and several commercial laboratories.
RESULTS: Between June 15 and July 20, 2020, 121 individuals tested positive for SARS-CoV-2 (59 confirmed and 62 asymptomatic) of whom 8 were nightclub staff who had no travel history of outside Kagoshima, 66 were guests, and 47 were subsequent contacts. The median age was 32 years (interquartile range: 24-43 years). One individual showed severe symptoms but there were no fatal. The epidemic curve showed one peak on June 30 and July 1 with a limited number of cases subsequently. Of the 121 cases, 116 and 5 were in individuals living in and outside Kagoshima Prefecture, respectively. Haplotype network analysis showed 5 genome-wide single-nucleotide variants between the isolates before and during this outbreak.
CONCLUSIONS: There is a possibility that unidentified guests from outside Kagoshima Prefecture could infect staff who could subsequently spread the virus to guests and other staff, who were mainly a younger population. The rapid outbreak response enabled onward transmission in the community to be minimized. This outbreak investigation could provide insights for effective responses to challenging situations in future pandemic.

UNASSIGNED: Previous studies have predominantly examined the micro-level aspects of women aging inflection points, while macro-level research using big data on the inflection points of aging among middle-aged and elderly women in China is currently limited.
UNASSIGNED: This study determined the inflection ages for physiological, psychological, social, and total dimensions in middle-aged, young elderly, and elderly women [(48.0-53.2) vs. (66.3-70.0) vs. (78.4-81.2) years old].
UNASSIGNED: This study is important for gaining a deeper understanding of aging, identifying patterns of aging, and implementing targeted interventions to promote the overall health of Chinese women.

On April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation\'s public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region.
Employing a blend of quantitative and qualitative methodologies, we investigated the SFETP\'s contributions to the public health response during the initial 4 months of the conflict (April-July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires.
A total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response.
The study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.

BACKGROUND: The Hospital Muñiz\'s \"Strengthening Epidemiological Surveillance in Tuberculosis (VET) Project\" is focused on improving operational outcomes, specifically by enhancing early TB diagnosis. Our primary aim is to promptly identify individuals with tuberculosis (TB) who seek care at our institution following the COVID-19 pandemic.
METHODS: A SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) was carried out. It is an essential tool in strategic planning, which provides information for the implementation of actions and corrective measures in the generation of new improvement projects. The internal situation of the institution was evaluated to determine SWOT after the COVID-19 pandemic, in order to strengthen VET, through field epidemiological surveillance.
RESULTS: There are trained personnel, the possibility of early diagnosis and its opportune control generated from the Febrile Emergency Unit. The on-call service has an adequate control of the TB population that enables coordination and joint work with other programs (HIV), response capacity of the institution to outbreaks, epidemics and pandemics.
CONCLUSIONS: The application of this project will incorporate a strengthening activity in epidemiological surveillance, where the Muñiz Hospital, through a comprehensive approach and the identification of new cases, responds to the needs of the local population with TB. This will provide valid and reliable information for the prevention and control of TB in the institution after the COVID-19 pandemic.
Introducción: El proyecto de fortalecimiento en Vigilancia Epidemiológica en Tuberculosis (VET) del Hospital Muñiz, Buenos Aires (Argentina), busca mejorar los resultados operacionales relacionados en mayor medida al diagnóstico precoz de la enfermedad, estableciendo como objetivo la identificación oportuna de personas enfermas de tuberculosis (TB) que consultan posterior a la pandemia por COVID-19. Métodos: Se realizó un análisis FODA (Fortalezas, Oportunidades, Debilidades, Amenazas): una herramienta esencial en la planeación estratégica, que proporciona información necesaria para la implementación de acciones y medidas correctivas, generación de nuevos proyectos de mejora, donde se evaluó la situación interna de la institución para determinar las FODA presentadas después de la pandemia COVID-19, a fin de desarrollar un fortalecimiento en VET, mediante vigilancia epidemiológica de campo. Resultados: Se cuenta con personal capacitado, posibilidad de diagnóstico precoz y control oportuno, generado desde la Unidad Febril de Urgencias. El servicio de guardia presenta adecuado control de la población con TB, que posibilita la coordinación y trabajo en conjunto con otros programas ministeriales. Existe capacidad de respuesta de la institución ante los brotes, epidemias y pandemias. Discusión: La aplicación de este proyecto incorporará una actividad de fortalecimiento en vigilancia epidemiológica, donde el Hospital Muñiz, mediante el abordaje integral y la identificación de casos nuevos de respuesta a las necesidades de la población con TB. Se proporcionará así información válida y confiable para la prevención y control de la TB en la institución después de la pandemia por COVID-19.

Over the last 30 years, there has been significant investment in research and infrastructure aimed at mitigating the threat of newly emerging infectious diseases (NEID). Core epidemiological processes, such as outbreak investigations, however, have received little attention and have proceeded largely unchecked and unimproved. Using ethnographic material from an investigation into a cryptic encephalitis outbreak in the Brong-Ahafo Region of Ghana in 2010-2013, in this paper we trace processes of hypothesis building and their relationship to the organizational structures of the response. We demonstrate how commonly recurring features of NEID investigations produce selective pressures in hypothesis building that favor iterations of pre-existing \"exciting\" hypotheses and inhibit the pursuit of alternative hypotheses, regardless of relative likelihood. These findings contribute to the growing anthropological and science and technology studies (STS) literature on the epistemic communities that coalesce around suspected NEID outbreaks and highlight an urgent need for greater scrutiny of core epidemiological processes.

UNASSIGNED: the goal of the Field Epidemiology Training Program (FETP) - Frontline is to strengthen the country\'s surveillance capacity at the district level to prepare and respond to health emergencies, including outbreaks, by training a skilled frontline public health workforce. We describe the FETP - Frontline program, including implementation, structure, achievements, impact, and its role in improving the epidemiological workforce capacity of Guinea-Bissau.
UNASSIGNED: this cross-sectional descriptive study uses 2015-2019 program data collected through record reviews and historical narratives from FETP students and graduates. We generated descriptive summary statistics using the Guinea-Bissau\'s FETP-Frontline program database, student assignments, and investigation reports, after reviewing the FETP standardized curriculum and program guidelines.
UNASSIGNED: since its inception in 2016, FETP Frontline has implemented 14 cohorts and trained 198 frontline surveillance officers. Program participants improved surveillance data quality, investigated 51 outbreaks at national and regional levels, and contributed to disease research and surveillance in 227 separate field investigations. Participants frequently responded to priority health emergencies, including clusters or outbreaks of Zika, microencephalies, dengue, yellow fever, anthrax, malaria, and tuberculosis.
UNASSIGNED: Guinea-Bissau\'s FETP - Frontline program provides a practical example of an effective strategy to strengthen health systems through a well-prepared workforce trained to quickly detect and respond to health threats.

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