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JH-IIRU Invites Renowned Neurosurgeon to Visit Uganda

Professor Rashid Jooma, a renowned neurosurgeon from Aga Khan University, Pakistan and former Director-General Health of the country visited Markerere University School of Public Health as part of the “Traumatic Brain Injury Across the Lifespan in Uganda” project. This project is a partnership between the Johns Hopkins International Injury Research Unit (JH-IIRU) at Johns Hopkins University and the Makerere University School of Public Health and its affiliated Mulago National Referral Hospital in Uganda, funded by the Fogarty International Center of the U.S. National Institutes of Health.

During the visit, Dr. Jooma engaged with several neurosurgery colleagues through lectures, as well as teaching sessions. In addition to visiting Makerere University, Dr. Jooma and associates toured Mulago Hospital in Kampala, Uganda, where he reviewed the proposed traumatic brain injury management protocol for the hospital.

“Kampala was exciting and our colleagues were very welcoming,” said Dr. Jooma. “I spent some time with the neuro surgical team and got a good sense of their work and challenges. Thus, when it came to reviewing the head injury guidelines, we were in a better position to factor in the local context and produce a final product that may be more useful.”

Dr. Jooma’s visit supports the overall goal of the traumatic brain injury (TBI) program to strengthen research capacity on the prevention, hospital based care, and economic consequences of traumatic brain injuries across the lifespan in Uganda through an innovative model of sustainable capacity development.

Dr. Amber Mehmood, Assistant Scientist at JH-IIRU and project manager said, “Dr. Jooma’s visit is one of the culminating experiences of our TBI project and shows how we have enabled south-south interactions as part of this study.”

For more information, see the TBI project description here.

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Dr. Rashid Jooma presents on traumatic brain injuries at Makerere University School of Public Health. 

Johns Hopkins International Injury Research Unit receives NIH Grant on Trauma and Injury Research Training in Afghanistan and Pakistan

Recently, the Johns Hopkins International Injury Research Unit (JH-IIRU) was awarded a D43 grant on trauma and injury research training in Afghanistan and Pakistan from the Fogarty International Center of the National Institutes of Health (NIH). The grant will build on previous Johns Hopkins-Pakistan International Collaborative Trauma and Injury Research Training (JHU-Pak-ICTIRT) programs running since 2005. The purpose of these previous grants was to develop trauma and injury research capacity at Aga Khan University (AKU) and then Khyber Medical University (KMU) in Pakistan through a combination of strategies. The focus was on injury research training through long-term (master’s) and short-term (workshops) training at AKU.  

The Johns Hopkins-Afghanistan-Pakistan International Collaborative Trauma and Injury Research Training Program (JHU-AfPak ICTIRT) will be based on a partnership of institutions – JHU, AKU, and Aga Khan University Programs in Afghanistan (AKU-PA) – each with a great commitment to trauma and injury research.

The five-year grant is led by three principal investigators – Professors Adnan Hyder (director JH-IIRU), and Junaid Razzak (emergency medicine at Johns Hopkins School of Medicine and senior technical advisor of JH-IIRU) from USA and Dr. Nadeem Ullah Khan (Associate Professor Emergency Medicine at AKU). Dr. Parvez Nayani (director of Academic Projects Afghanistan at AKU) will serve as the senior foreign investigator.

The grant will focus on using US expertise to further strengthen Pakistani institutions for doctoral training, enhance injury research capacity in Afghanistan, promote a sustainable research enterprise in western Asia, and enable regional dissemination of research evidence to influence policy and investments in Afghanistan and Pakistan.

The main objectives of the Johns Hopkins-Afghanistan-Pakistan International Collaborative Trauma and Injury Research Training Program (JHU-AfPak ICTIRT) include: the development of a core group of researchers focused on trauma and injuries for Afghanistan; to help develop doctoral training programs in injury research; and to promote research around key regional priorities for trauma and injuries.

For more information, please click here.

JH-IIRU Director meets with Dean of AKU
JH-IIRU director, Dr. Adnan Hyder, meets with Dean Abbas at AKU

JH-IIRU Director Publishes Commentary on Injuries and Trauma in Pakistan

In Pakistan, injuries and trauma are among the top ten contributors to the burden of disease and disabilities. Other related factors, such as poverty, political instability, and natural disasters as well as the lack of legislation or enforcement of preventative measures contribute to the population’s susceptibility to injuries.

While police and hospital records provide some data on injuries, a recent commentary published in Public Health suggests that it is essential that the public health sector invest in injury prevention by creating a strong, evidence-based strategy, improving national polices, and collaborating with the private sector to promote injury prevention.

In “The challenges of injuries and trauma in Pakistan: An opportunity for concerted action,” JH-IIRU director, Adnan Hyder and Aga Khan University professor, Junaid Razzak, examine the current status of injury prevention and control in Pakistan  as well as the burden and the policy context for interventions in the country.

The commentary goes on to suggest that, because injury prevention and emergency care have been proven to be some of the most cost-effective interventions in the health sector, investing in such measures as traffic enforcement, speed control, helmets, child resistant containers and trained emergency personnel makes sense from both an economic and public health viewpoint.

Drs. Hyder and Razzak are directors of the JHU-Pakistan Fogarty International Collaborative Trauma and Injury Research Training Program (JHU-Pakistan ICIRT). The goal of JHU-Pakistan ICIRT is to build a strong network of professionals and help develop sustainable research capacity on acute care of trauma and injuries and emergency medicine in Pakistan.  For additional information on the program, click here:

http://www.jhsph.edu/faculty/research/map/PK/1227

To access the paper, click here: http://www.sciencedirect.com/science/article/pii/S0033350612004696#

New Lancet Publication Examines Non-Communicable Disease Burden in Pakistan

Non-communicable diseases like cardiovascular diseases, cancers, diabetes and injuries have become the major causes of disability and death in Pakistan, according to a report by a group of researchers that included Johns Hopkins Bloomberg School of Public Health professor, Adnan A. Hyder. Furthermore, while rates of death and disability from non-communicable diseases are expected to continue to increase, Pakistan’s health care system is unprepared to handle the rising burden. The report suggests that if current trends continue, nearly 4 million people between the ages of 30-69 will die from cardiovascular disease, cancers and chronic respiratory disease by 2025.

The study, “Non-Communicable Diseases and Injuries in Pakistan: Strategic Priorities,” published as part of The Lancet series on Health Transitions in Pakistan, also examined the prevalence of non-communicable diseases  such as road traffic injuries, noting that enforcement of traffic safety laws is weak. Both seat belt and speeding laws are enforced poorly, as is the helmet law for bicycle and motorcycle riders, where hospital-based surveillance data indicates that more than 90 percent of riders do not wear helmets. No legislation exists for vehicle standards, road safety audits or promotion of safer transportation systems.

“Pakistan is the sixth most populous country in the world. The recognition of injuries as a key component of the national disease burden is an important first step. This issue needs some serious attention from policy makers,” said Hyder, director of the Health Systems program in the Bloomberg School’s Department of International Health and head of the Johns Hopkins International Injury Research Unit.

According to the report, Pakistan was one of the first developing countries to implement an integrated national action plan for non-communicable diseases, but the high-level, government buy-in the plan had initially was withdrawn. The report goes on to explain that the economic effect of non-communicable diseases and injuries is devastating, estimating a cumulative production loss at approximately $3.47 billion.

Hyder and his colleagues recommend several strategies for preventing non-communicable diseases, which includes implementing policy, legislation and programs to support and promote healthy diet and physical activity; directing generated revenue from the increased excise tax on cigarette sales toward prevention initiatives, thereby mitigating the cost of the suggested measures; and re-prioritizing of funds from international donor agencies to fund non-communicable diseases and injuries. The target goal is to reduce the number of premature deaths due to cardiovascular, cancers and respiratory diseases by 20 percent in 2025. The researchers also stress that efforts must also be directed towards prevention of injuries and mental disorders.

The report was published as part of four papers in the Lancet Series which examine the transitions in Pakistan’s health system and focus on the country’s past and present performance in health, specifically after the 18th amendment to the Constitution abolished the federal Ministry of Health. The series also calls for a unified vision for universal and equitable health access across the nation.  Other papers in the Series focus on reproductive and maternal health, non-communicable diseases and injuries, and recommendations for future health reforms.

New Data on Unintentional Childhood Injuries in Pakistan

In a recently published article, Johns Hopkins International Injury Research Unit (JH-IIRU) and collaborators from the Department of Emergency Medicine at Aga Khan University (DEM-AKU) examine unintentional childhood home injuries in Karachi, Pakistan. JH-IIRU director, Adnan Hyder and AKU-DEM director, Junaid Razzak amongst other colleagues participated in this surveillance study.
The article, “Understanding Unintentional Childhood Home Injuries: Pilot Surveillance Data from Karachi, Pakistan,” which appears BMC Research Notes, analyzed results of a previous pilot surveillance study done on unintentional childhood injuries presenting to emergency departments in both public and private hospitals in Karachi. Their findings revealed that of the approximately 400 injuries that occurred in the home, falls made up the majority at 59%, followed by dog bites, burn injuries and road traffic injuries. Most of these injuries occurred during play time. Fifty-four percent of the children were between 5-11 years old and 41% were between 1-4 years old.
This kind of analysis not only helps to define the kinds of unintentional injuries that are most prominent among hospitals in a particular area, but also help researchers concentrate intervention and control strategies, such as defining and adhering to building standards for homes, controlling stray dogs and installing traffic calming measures in residential areas.
Like JH-IIRU, the Department of Emergency Medicine at Aga Khan University (DEM-AKU) is a World Health Organization Collaborating Center for Emergency Medicine and this collaborative project represents collaborating centers working together to better understand the burden of injuries in low income countries.
To access this article, click here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337295/?tool=pubmed
To find out more about unintentional childhood injuries, contact us at
IIRU@jhsph.edu