Faglig innhold

The major challenges of our time, climate change, pollution, loss of biodiversity and exploitation of natural resources, are identified as some of the biggest threats to human health globally, and are linked with increased risk of epidemics. Several have emerged in recent years as the ongoing COVID-19 pandemic, and communicable diseases are receiving extensive attention. Pandemics strike everywhere, but outbreaks of communicable diseases affect populations differently and with a social gradient. Microorganisms have had major impacts on humankind and have repeatedly been decisive for the course of history.

The aim of this course is to increase the knowledge on causes, preventive measures, management, consequences and challenges in control of communicable disease and epidemics, especially in resource-constrained settings and for vulnerable populations.

Nearly half of all deaths in low-income countries (LIC) are due to communicable diseases, and many vulnerable populations in HIC and MIC are also prone to these diseases. Most occur from just six groups: diarrheal diseases, acute respiratory tract infections, malaria and measles among children; and AIDS and tuberculosis among adults. At the same time there are other emerging infectious health threats that can become large scale problems and possible new global pandemics. Climate changes can affect health globally and be a particular threat to populations in various vulnerable settings, both urban and rural.

While understanding key concepts of epidemiology, health management and statistics are common topics to the study of global health, this course focus on the importance of infection prevention and control of emerging epidemics in resource-constrained settings and for vulnerable populations.

This course will give the students a basic understanding of causes and spread of a variety of communicable diseases with the main purpose to understand the importance of preventive measures and correct handling of epidemics at an early stage. We will look at how various infectious agents are transmitted, how they can be avoided, the importance of antimicrobial resistance (AMR), and the global, political and economic consequences of epidemics.

The student will learn how epidemics easily can spread in vulnerable populations in resource-limited settings, and how the economic resources available, and the distribution of those, set the premises for how diseases spread in a population. The course will focus on importance of good governance, good health systems, the quality, availability and appropriateness of health services, education and prior knowledge in the population set the scene for how various diseases can be tackled.

Areas where there are research gaps, the reasons for these gaps and the effect of them, will be discussed and the students will be challenged to formulate research questions that will address the problems of vulnerable populations, and stipulate possible research projects that possible to conduct in research-constrained settings. Students will be taught the multidisciplinary aspects of this field of research that includes disciplines like epidemiology, global health, microbiology, infectious diseases, ecology, social medicine, implementation research, as well as communication and other social sciences. The complexity of the topics addressed in this course requires a multidisciplinary approach.

This course will be a contribution to improve quality, effectiveness, and sustainability of international response to epidemics and communicable diseases in resource-limited settings.

Læringsutbytte

Knowledge:

• Understand how the health of ecosystems can affect animal- and human health.
• Understand the models for estimating how infectious diseases spread (calculating Ro)
• Know the mode of transmission of the most important infectious diseases including possible emerging diseases and how they can be prevented.
• Understand how infectiousness, exposure, duration and behaviour influence disease patterns in populations
• The global, political and economic consequences of epidemics, and understand how they affect populations with a social gradient.
• Understand the basic mechanisms for vaccination, immunology and immunity at group level
• Methods for disease control in populations. Learn the major principles in how to prevent infectious diseases to spread in refugee settings, among migrants, under extreme poverty, and in other vulnerable situations. How to handle an outbreak as soon as a contagious disease is emerging. Case management of affected people, setting up clinical testing and treatment centres
• Understand the importance of the clinical and public health systems for countries to be able to prevent, detect and respond to communicable diseases and epidemics, and understand the interdependencies between universal health coverage, health preparedness and health promotion, and some of the major factors like prioritization and utilization of limited resources and education.

Skills:

• After the course, they will be able to guide frontline field workers in international NGOs and local and national health professionals in prioritizing in emergencies where communicable diseases may emerge or already are spreading.
• Through group hands-on projects and group presentations the students will learn how to conduct rapid needs assessments, establish public health program priorities, work closely with affected communities and coordinate between various NGOs, organize and manage health facilities and essential medical supplies, train local workers, monitor and evaluate the impact of their programs, and efficiently manage scarce resources.
• In addition, they will know that there is a need to take into consideration political, social and cultural aspects, including safety in dangerous and hostile environments.
• Put together the knowledge in a broad range of medical disciplines, including which infectious disease can potentially spread in a particular setting, how does this disease spread and how can it most effectively be prevented.
• Be able to design an implementation research plan to follow the development of an outbreak.

General competence:

• Upon finishing the course, the students will have knowledge on epidemic surveillance, management, immunization, communicable disease and outbreak control, food and nutrition, maternal and child health, access to healthcare for vulnerable groups. The students should be able to put the knowledge from all these disciplines together.
• They will have knowledge on the major communicable killers in the world today, emerging communicable threats, their mode of transmission and how they most effectively can be prevented and how to do operational priorities in today’s complex humanitarian emergencies.
• They will be able to analyse how the political, economic, social and cultural settings influence the prevention of spread of communicable diseases.
• Identify areas with research gaps and formulate research questions that will address the problems of vulnerable populations, and stipulate possible research projects that possible to conduct in research-constrained settings.

Læringsformer og aktiviteter

The language of teaching and examination is English. The course will be lectured digital.

Lectures, discussion of concepts, and group work with practical case examples. Participation in group work is obligatory.

Working in groups of 3-4, the students will analyse a case study of an emerging infectious disease with epidemic potential in a given setting. Medical aspects, preventive measures, public health, implementation, global impact and ethical and social issues will be discussed.

The group work will be divided in areas of: Airborne disease, vector-borne diseases, water- and soil transmitted diseases, HIV and TB, hepatitis B and C and other blood- and sexually transmitted diseases, antimicrobial resistance, COVID-19 and other diseases with pandemic potential.

Each group presents the following aspect of their disease group to the rest of the students:

1. Describing the problem: Transmission of the actual group of diseases, global burden, the social and economic consequences and affected vulnerable groups.
2. Prevention and handling of outbreaks.
3. What can be done to improve the situation of this group of diseases globally regarding policy, awareness, preparedness, and further research.

Mer om vurdering

Participation in group work is obligatory, and 80% of the lectures need to be attended.

Exam: A home assignment of 5-7 pages (12p) estimated to 3 days of work, needs to be passed.

The students get a choice of three different cases, writing an essay covering all aspects of the case, ex. causes, epidemic potential, vulnerable groups, as well as global aspects.

Forkunnskapskrav

Admission to a PhD-program. The course is open to PhD candidates who are members of the Norwegian Research School of Global health (NRSGH) https://www.ntnu.edu/nrsgh

Master students and medical students may be admitted, based on individual assessment. The maximum number of participants is 30.

Kursmateriell

Course literature will be announced well before the start of the course.