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Journal articleLeelavanich D, Dorigatti I, Turner H, 2026,
The economic burden of dengue: a systematic literature review of unit costs for non-fatal episodes treated in the formal healthcare system
, BMC Infectious Diseases, ISSN: 1471-2334Background: Dengue, a vector-borne disease caused by the dengue virus, has emerged as a global public health concern, given the tenfold rise in reported cases over the last two decades. In light of the upcoming dengue interventions, country-specific cost-of-illness estimates are required to evaluate the cost-effectiveness of new interventions against dengue. This study aims to conduct an updated systematic review of dengue cost-of-illness studies, extracting the relevant data, and conducting regression analysis to explore potential factors contributing to the cost variations among countries. Methods: We used the MEDLINE, EMBASE, PubMed, and Web of Science databases to systematically search for published dengue cost-of-illness studies reporting primary data on costs per dengue episode. A descriptive analysis was conducted across all extracted studies. Linear regression analysis was performed to investigate the association between the GDP per capita and cost per episode. The quality of the included studies was also assessed. Results: Fifty-six studies were included, of which 22 used the societal perspective. The reported total cost per episode ranged from $15.0 for outpatients in Burkina Faso to $9,386.1 for intensive care unit patients in Mexico. Linear regression analysis revealed that the cost of dengue illness varies significantly across countries and regions, and was positively related to the setting’s GDP per capita. The quality assessment demonstrated that improvements are needed in future studies, particularly in the reporting of the methodology. Conclusions: Cost of dengue illness varies widely across countries and regions. Future research should focus on understanding other drivers of cost variations beyond GDP per capita to improve the cost estimates for economic evaluation studies. The results presented in this study can serve as crucial input parameters for future economic evaluations, supporting decision makers in allocating resources for dengue in
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Journal articleKoemen S, Faria NR, Bastos LS, et al., 2026,
Fast and trustworthy nowcasting of dengue fever: A case study using attention-based probabilistic neural networks in São Paulo, Brazil
, EPIDEMICS, Vol: 54, ISSN: 1755-4365 -
Journal articleHowes A, Stringer A, Flaxman SR, et al., 2026,
Fast approximate Bayesian inference of HIV indicators using PCA adaptive Gauss-Hermite quadrature
, Journal of Theoretical Biology, Vol: 618, ISSN: 0022-5193Naomi is a spatial evidence synthesis model used to produce district-level HIV epidemic indicators in sub-Saharan Africa. Multiple outcomes of policy interest, including HIV prevalence, HIV incidence, and antiretroviral therapy treatment coverage are jointly modelled using both household survey data and routinely reported health system data. The model is provided as a tool for countries to input their data to and generate estimates with during a yearly process supported by UNAIDS. Previously, inference has been conducted using empirical Bayes and a Gaussian approximation, implemented via the TMB R package. We propose a new inference method based on an extension of adaptive Gauss-Hermite quadrature to deal with more than 20 hyperparameters. Using data from Malawi, our method improves the accuracy of inferences for model parameters, while being substantially faster to run than Hamiltonian Monte Carlo with the No-U-Turn sampler. Our implementation leverages the existing TMB C++ template for the model’s log-posterior, and is compatible with any model with such a template.
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Journal articleBose I, Hadida G, Green R, et al., 2026,
Rainfall and water-related diseases, malnutrition and mortality in Low- and Middle- Income Countries: a systematic review of the epidemiological evidence
, Heliyon, Vol: 12Background Climate change is altering rainfall patterns. Rainfall has been linked to numerous health outcomes, through the impacts on water quality and quantity, but the coherence and strength of evidence across outcomes remain unclear. Objectives Understand and evaluate the strength of evidence on associations between rainfall (both low and heavy events) and health outcomes in Low- and Middle- Income Countries (LMICs). Methods A systematic review of peer-reviewed epidemiological studies quantifying associations between rainfall and human health outcomes in LMIC populations was conducted. Seven databases were searched including MEDLINE and EMBASE. Study quality was evaluated using 9 modified criteria that were previously used to assess environmental epidemiology studies. The strength of evidence for each health outcome was assessed across rainfall exposures. Results Of 23,579 papers identified, 177 met the inclusion criteria. Health outcomes included diarrheal diseases (n = 119); malnutrition (n = 35); mortality (n = 21); helminth infections (n = 6), and eye infections (n = 4). There was moderately strong evidence for positive associations between both heavy and low rainfall and all-cause diarrhea. Evidence for undernutrition was mixed, with moderate evidence of a positive association with low rainfall. Despite sharing causal pathways, diarrheal disease and nutrition studies found contrasting results for heavy rainfall, likely due to differing study designs. Studies were heterogenous in design, rainfall exposure definitions, and lag times. Studies also often lacked a clear hypothesis. Discussion There is substantial evidence that rainfall affects health in LMICs through multiple pathways. Limitations in the data (often from cross-sectional surveys) and study designs, limit the strength of evidence for several health outcomes. Specifically, studies frequently used inappropriate exposures or lags to reflect the causal pathways. In future studies, efforts should be dir
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Journal articleRoche M, Zhu J, Olney J, et al., 2026,
Taxation of foods high in fat, sugar, and sodium in India: A modelling study of health and economic impacts.
, PLoS Med, Vol: 23BACKGROUND: Consumption of foods high in fat, sugar, and sodium (HFSS) and obesity are rapidly increasing in India. Taxing HFSS foods has been proposed as one of the policy interventions to promote healthier diets globally. This study estimates the effect of this approach on nutrient intake, diet-related disease, and associated health and economic burdens in India. METHODS AND FINDINGS: We use a nationally representative expenditure survey of 261,746 households, dietary requirements, and food composition tables to model individual nutrient intake. Consumer responsiveness to food price changes for three income terciles, captured in price elasticities, is estimated using an Almost Ideal Demand System model. Longer-term policy impacts are estimated through a novel dynamic microsimulation model, Health-GPS. Modelled policy outcomes include changes in risk exposures, disease incidence and burden, and total health expenditure. On average, 9.9% of total energy intake comes from HFSS items, based on the definition by the Food Safety and Standards Authority of India's Labelling and Display Amendment Draft Regulations 2022. Applying the highest Goods and Services Tax (GST) rate of 40% on HFSS items is associated with a persistent average per capita decrease of 0.1705 kg/m2 (95% CI: -0.1709, -0.1700) in body mass index and 45.8 mg (95% CI: -45.9, -45.7) in daily sodium intake. Over 30 years, this could reduce annual disease incidence by up to 1.72% (95% CI: -1.78%, -1.66%) on average and prevent 0.63 million (95% CI: -0.71, -0.55) disability-adjusted life years per year from ischaemic heart disease, chronic kidney disease, stroke, diabetes, and asthma, reducing total health expenditure by US$601 million (95% CI: -624, -578) per year. Larger absolute health gains accrue to higher-income individuals, reflecting higher baseline HFSS food intake. Given substitution patterns and a price-inelastic demand, the tax change is expected to generate a 92.0% (95% CI: 88.2%, 9
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Journal articleRECOVERY Collaborative Group, 2026,
Sotrovimab versus usual care in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.
, Lancet Infect Dis, Vol: 26, Pages: 34-45BACKGROUND: Sotrovimab is a neutralising monoclonal antibody targeting the SARS-CoV-2 spike protein. We aimed to evaluate the efficacy and safety of sotrovimab in the RECOVERY trial, an investigator-initiated, individually randomised, controlled, open-label, adaptive platform trial testing treatments for patients admitted to hospital with COVID-19. METHODS: Patients admitted with COVID-19 pneumonia to 107 UK hospitals were randomly assigned (1:1) to either usual care alone or usual care plus a single 1 g infusion of sotrovimab, using web-based unstratified randomisation. Participants were eligible if they were aged at least 18 years, or aged 12-17 years if weighing at least 40kg, and had confirmed COVID-19 pneumonia with no medical history that would put them at significant risk if they participated in the trial. Participants were retrospectively categorised as having a high antigen level if baseline serum SARS-CoV-2 nucleocapsid antigen was above the median concentration (the prespecified primary efficacy population), otherwise they were categorised as having a low antigen level. The primary outcome was 28-day mortality assessed by intention to treat. Safety outcomes were assessed among all participants, regardless of antigen level. Recruitment closed on March 31, 2024, when funding ended. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). FINDINGS: From Jan 4, 2022, to March 19, 2024, 1723 patients were enrolled in the RECOVERY sotrovimab comparison. Of these, 828 (48%) were assigned to usual care plus sotrovimab and 895 (52%) were assigned to usual care only. Mean patient age was 70·7 years (SD 14·8) and 1033 (60%) were male. 720 (42%) patients were classified as having a high antigen level, 717 (42%) as having a low antigen level, and 286 (17%) had unknown antigen status. 1389 (81%) patients were vaccinated, 1179 (82%) of 1438 patients with known serostatus had anti-spike antibodies at randomisation, and 1021 (>
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Journal articleLamberte LE, Darby EM, Kiu R, et al., 2025,
<i>Staphylococcus haemolyticus</i> is a reservoir of antibiotic resistance genes in the preterm infant gut
, GUT MICROBES, Vol: 17, ISSN: 1949-0976 -
Journal articleSteyn N, Chadeau M, Whitaker M, et al., 2025,
Pandemic-risk-related behaviour change in England from June 2020 to March 2022: the cross-sectional REACT-1 study among over 2 million people
, BMJ Public Health, ISSN: 2753-4294 -
Journal articleYoung NW, Meier-Scherling CPG, Cuomo-Dannenburg G, et al., 2025,
Mapping the prevalence of molecular markers of Plasmodium falciparum artemisinin partial resistance in Africa: a spatial-temporal modelling study.
, medRxivBACKGROUND: Plasmodium falciparum kelch13 (k13) mutations in Africa signal emerging artemisinin partial resistance (ART-R), endangering malaria control by undermining artemisinin-based combination therapies (ACTs). Sparse surveillance obscures whether rising k13 ART-R prevalence reflects local emergence or geographic expansion. We aimed to model and infer high-resolution spatial-temporal prevalence of k13 ART-R and ACT partner-drug markers to inform public health policy. METHODS: We conducted a systematic literature review (PROSPERO-ID CRD42024593923) spanning the years 2014-2025, complementing existing data from WWARN, MalariaGEN Pf7, and the WHO Malaria Threats Map. This integrated dataset, comprising 3,806 distinct molecular epidemiology surveys and 182,071 genotyped samples, was harmonized using a standardized data schema. We applied a spatial-temporal Gaussian process model to estimate the continuous prevalence of WHO k13 ART-R mutations, mdr1 86Y, and crt 76T. FINDINGS: ART-R increases were driven by distinct emergences of k13 561H in Rwanda, k13 675V in Uganda, and k13 622I in Ethiopia and Eritrea. From 2012 to 2024, predicted k13 prevalence rose steadily in Northern Province, Uganda (1.81% per year) and Northern Province, Rwanda (3.49% per year), reaching 26.36% in Uganda and 39.44% in Rwanda by 2024. Modelling indicated a rapid transition from localized k13 ART-R mutation emergence to entrenched regional hotspots centred on Uganda-Rwanda and the Ethiopia-Eritrea border. Partner drug amodiaquine marker mdr1 86Y is fading, but crt 76T remains prevalent in the Horn of Africa. INTERPRETATION: The rapid and multicentric expansion of k13 ART-R mutations in East Africa threatens ACT efficacy, especially where ART-R k13 and partner drug markers co-occur, mirroring early patterns observed before ACT failure in Southeast Asia. This study provides an updated k13 ART-R mutation database and high-resolution resistance maps with uncertainty quantification, demonstrating
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Journal articleTapsoba M, Guelbeogo WM, Sanou A, et al., 2025,
Differential effects of dual and synergist-based insecticide-treated bed nets on pyrethroid resistance and L995F/S knockdown resistance mutation dynamics in Anopheles gambiae s.l. populations in south-western Burkina Faso
, Parasites and Vectors, ISSN: 1756-3305BackgroundThe introduction of next-generation insecticide-treated nets (ITNs) in Burkina Faso aims to mitigate pyrethroid resistance in malaria vectors. This study evaluated the impact of different ITN types on phenotypic resistance and kdr mutation frequencies in Anopheles gambiae sensus lacto (s.l.) populations across three health districts over 3 years.MethodsAnnual mosquito collections were conducted in Banfora (where pyrethroid–chlorfenapyr nets had been distributed), Gaoua (pyrethroid-only ITNs) and Orodara (pyrethroid–piperonyl butoxide [PBO] ITNs). Two populations were analysed: adult females collected directly from the field and those reared from field-collected larvae. World Health Organization (WHO) susceptibility bioassays measured 24-h mortality after exposure to 1×, 5× and 10× concentrations of deltamethrin and alphacypermethrin, with and without pre-exposure to piperonyl butoxide. Frequencies of kdr mutations L995F and L995S were determined by polymerase chain reaction (PCR).ResultsHigh-intensity resistance was observed in each study district, with mortality consistently below 45% and not reaching WHO thresholds even at 10× doses. PBO increased mortality, indicating metabolic resistance, but failed to restore full susceptibility. L995F predominated across all districts, years and mosquito populations. L995S remained low and variable. Pyr-only nets were associated with rising L995F frequencies and lower mortality in resistance assays. Pyrethroid (Pyr)–chlorfenapyr (CFR) nets improved mortality in resistance assays without increasing kdr prevalence. Pyr–PBO nets showed partial and inconsistent efficacy, with mosquitoes having mixed patterns in resistance assays. Similar patterns between field and laboratory-reared populations were observed.ConclusionsITN type strongly influenced resistance dynamics. Dual-active ingredient (AI) nets, particularly Pyr–CFR, appear more effective in managin
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