Imperial College London

ProfessorNicholasGrassly

Faculty of MedicineSchool of Public Health

Prof of Infectious Disease & Vaccine Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3264n.grassly Website

 
 
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Location

 

G36Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{O'Reilly:2018:10.1186/s12879-018-3070-4,
author = {O'Reilly, KM and Grassly, N and Verity, R},
doi = {10.1186/s12879-018-3070-4},
journal = {BMC Infectious Diseases},
title = {Population sensitivity of acute flaccid paralysis and environmental surveillance for serotype 1 poliovirus in Pakistan: an observational study},
url = {http://dx.doi.org/10.1186/s12879-018-3070-4},
volume = {18},
year = {2018}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BackgroundTo support poliomyelitis eradication in Pakistan, environmental surveillance (ES) of wastewater has been expanded alongside surveillance for acute flaccid paralysis (AFP). ES is a relatively new method of surveillance, and the population sensitivity of detecting poliovirus within endemic settings requires estimation.MethodsData for wild serotype 1 poliovirus from AFP and ES from January 2011 to September 2015 from 14 districts in Pakistan were analysed using a multi-state model framework. This framework was used to estimate the sensitivity of poliovirus detection from each surveillance source and parameters such as the duration of infection within a community.ResultsThe location and timing of poliomyelitis cases showed spatial and temporal variability. The sensitivity of AFP surveillance to detect serotype 1 poliovirus infection in a district and its neighbours per month was on average 30.0% (95% CI 24.8–35.8) and increased with the incidence of poliomyelitis cases. The average population sensitivity of a single environmental sample was 59.4% (95% CI 55.4–63.0), with significant variation in site-specific estimates (median varied from 33.3–79.2%). The combined population sensitivity of environmental and AFP surveillance in a given month was on average 98.1% (95% CI 97.2–98.7), assuming four samples per month for each site.ConclusionsES can be a highly sensitive supplement to AFP surveillance in areas with converging sewage systems. As ES for poliovirus is expanded, it will be important to identify factors associated with variation in site sensitivity, leading to improved site selection and surveillance system performance.
AU - O'Reilly,KM
AU - Grassly,N
AU - Verity,R
DO - 10.1186/s12879-018-3070-4
PY - 2018///
SN - 1471-2334
TI - Population sensitivity of acute flaccid paralysis and environmental surveillance for serotype 1 poliovirus in Pakistan: an observational study
T2 - BMC Infectious Diseases
UR - http://dx.doi.org/10.1186/s12879-018-3070-4
UR - http://hdl.handle.net/10044/1/58611
VL - 18
ER -