Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 28;9(Suppl 3):e013815.
doi: 10.1136/bmjgh-2023-013815.

Supporting a rapid primary care response to emergent communicable disease threats with PACK (Practical Approach to Care Kit) in Florianópolis, Brazil

Ronaldo Zonta  1   2 , Mariela Zaros Galana  2 , Jorge Zepeda  3 , Filipe de Barros Perini  2   4 , Lara R Fairall  5   6 , Fernanda K Karolinne Melchior Silva Pinto  2   4 , Matheus Pacheco de Andrade  7 , Bernardo Manata Eloi  8 , João Paulo Mello da Silveira  9 , Elizimara Ferreira Siqueira  9 , Ana Cristina Magalhães Fernandes Báfica  10 , Ajibola Awotiwon  5 , Pearl Wendy Spiller  5 , Camilla Wattrus  5 , Christy Joy Ras  5 , Daniella Georgeu-Pepper  5 , Ruth Vania Cornick  11
Affiliations

Supporting a rapid primary care response to emergent communicable disease threats with PACK (Practical Approach to Care Kit) in Florianópolis, Brazil

Ronaldo Zonta et al. BMJ Glob Health. .

Abstract

Emerging infectious diseases present a significant challenge to healthcare systems with their need for a rapid response and reallocation of resources. This paper explores the implementation of the Practical Approach to Care Kit (PACK) programme in Florianópolis, Brazil as a strategic tool for reinforcing primary healthcare (PHC) responses to emergent communicable diseases. With its focus on enhancing PHC delivery in resource-limited settings, PACK provides a flexible, evidence-based framework that integrates into local health systems. The paper describes experiences adapting PACK to provide rapid responses to outbreaks of Zika, leishmaniasis, COVID-19, Mpox and dengue in primary care between 2014 and 2023. Key features of PACK, including its flexibility to incorporate new clinical content, responsive implementation strategy and health system strengthening approach, are highlighted. The paper emphasises how PACK supported responses to specific disease outbreaks and helped maintain mainstream PHC delivery, preventing the system from becoming condition-centric during crises. We describe the limitations of the PACK approach in an outbreak scenario, the challenges experienced and efforts to tackle these. The lessons learnt from Florianópolis underscore the adaptability and relevance of comprehensive primary care approaches like PACK in supporting PHC professionals and local health systems to navigate emerging health challenges.

Keywords: COVID-19; Diagnostics and tools; Global Health; Other infection, disease, disorder, or injury.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Timeline of infectious disease outbreaks and PACK responses. PACK, Practical Approach to Care Kit.
Figure 2
Figure 2. A page from the PACK Brasil Adulto 2016 guide that provides an approach to the patient with eye symptoms with the prompt: ‘If patient (especially pregnant woman) has any of fever, rash or pain/swelling in joints, notify and discuss to exclude Zika virus’. PACK, Practical Approach to Care Kit.
See this image and copyright information in PMC

Similar articles

  • Applying lessons of COVID-19 and other emerging infectious diseases to future outbreaks.
    Bloch EM, Sullivan DJ, Casadevall A, Shoham S, Tobian AAR, Gebo K. Bloch EM, et al. mBio. 2024 Jun 12;15(6):e0110924. doi: 10.1128/mbio.01109-24. Epub 2024 May 23. mBio. 2024. PMID: 38780294 Free PMC article.
  • Preparing for Emerging Infectious Diseases in the Perinatal Population.
    O'Rourke K, Murphy T, Srinivas SK, Pegues DA. O'Rourke K, et al. J Obstet Gynecol Neonatal Nurs. 2018 Mar;47(2):245-253. doi: 10.1016/j.jogn.2017.06.005. Epub 2017 Jul 19. J Obstet Gynecol Neonatal Nurs. 2018. PMID: 28736265 Review.
  • Development of an amplicon-based sequencing approach in response to the global emergence of mpox.
    Chen NFG, Chaguza C, Gagne L, Doucette M, Smole S, Buzby E, Hall J, Ash S, Harrington R, Cofsky S, Clancy S, Kapsak CJ, Sevinsky J, Libuit K, Park DJ, Hemarajata P, Garrigues JM, Green NM, Sierra-Patev S, Carpenter-Azevedo K, Huard RC, Pearson C, Incekara K, Nishimura C, Huang JP, Gagnon E, Reever E, Razeq J, Muyombwe A, Borges V, Ferreira R, Sobral D, Duarte S, Santos D, Vieira L, Gomes JP, Aquino C, Savino IM, Felton K, Bajwa M, Hayward N, Miller H, Naumann A, Allman R, Greer N, Fall A, Mostafa HH, McHugh MP, Maloney DM, Dewar R, Kenicer J, Parker A, Mathers K, Wild J, Cotton S, Templeton KE, Churchwell G, Lee PA, Pedrosa M, McGruder B, Schmedes S, Plumb MR, Wang X, Barcellos RB, Godinho FMS, Salvato RS, Ceniseros A, Breban MI, Grubaugh ND, Gallagher GR, Vogels CBF. Chen NFG, et al. PLoS Biol. 2023 Jun 13;21(6):e3002151. doi: 10.1371/journal.pbio.3002151. eCollection 2023 Jun. PLoS Biol. 2023. PMID: 37310918 Free PMC article.
  • Deciphering emerging Zika and dengue viral epidemics: Implications for global maternal-child health burden.
    Tambo E, Chuisseu PD, Ngogang JY, Khater EI. Tambo E, et al. J Infect Public Health. 2016 May-Jun;9(3):240-50. doi: 10.1016/j.jiph.2016.02.005. Epub 2016 Apr 2. J Infect Public Health. 2016. PMID: 27052794 Free PMC article. Review.
  • Using a mentorship model to localise the Practical Approach to Care Kit (PACK): from South Africa to Brazil.
    Wattrus C, Zepeda J, Cornick RV, Zonta R, Pacheco de Andrade M, Fairall L, Georgeu-Pepper D, Anderson L, Eastman T, Bateman ED, Cruz AA, Bachmann MO, Natal S, Doherty T, Stelmach R. Wattrus C, et al. BMJ Glob Health. 2018 Oct 25;3(Suppl 5):e001016. doi: 10.1136/bmjgh-2018-001016. eCollection 2018. BMJ Glob Health. 2018. PMID: 30483415 Free PMC article.
See all similar articles

Cited by

References

    1. Emerging and reemerging infectious diseases. [9-Nov-2023]. https://research-and-innovation.ec.europa.eu/research-area/health/emergi... Available. Accessed.
    1. World Health Organization . WHO Regional Office for South-East Asia; 2014. [10-Aug-2024]. A brief guide to emerging infectious diseases and zoonoses.https://iris.who.int/handle/10665/204722 Available. Accessed.
    1. Walker PGT, Whittaker C, Watson OJ, et al. The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries. Science. 2020;369:413–22. doi: 10.1126/science.abc0035. - DOI - PMC - PubMed
    1. Lowe R, Barcellos C, Brasil P, et al. The Zika Virus Epidemic in Brazil: from Discovery to Future Implications. Int J Environ Res Public Health. 2018;15:96. doi: 10.3390/ijerph15010096. - DOI - PMC - PubMed
    1. Tadeu L, Figueiredo LTM. Dengue in Brazil: past, present and future perspective. Dengue bulletin. 2003;27:25–33.

MeSH terms

LinkOut - more resources