Results
- Showing results for:
- Reset all filters
Search results
-
Journal articleHartner A-M, Li X, Gaythorpe K, 2024,
COVID-19 related disruption and resilience in immunisation activities in LMICs: a rapid review
, BMJ Open, Vol: 14, ISSN: 2044-6055OBJECTIVES: We conducted a rapid review to determine the extent that immunisation services in low-income and middle-income countries (LMICs) were disrupted by the COVID-19 pandemic and synthesised the factors that can be used to build resilience in future. DESIGN: Rapid review reported in accordance with the Preferred reporting for Systematic reviews and Meta-Analyses (PRISMA) guidelines. DATA SOURCES: PubMed and Web of Science were searched through 6 October 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included studies that focused on disruption to immunisation activities due to the COVID-19 pandemic in LMICs. Outcomes included routine vaccine coverage, supplementary immunisation activities, vaccine doses, timing of vaccination, supply chain changes, and factors contributing to disruption or resilience. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and code studies. Quality assessment was performed using a modified version of the Critical Appraisal Skills Programme for qualitative research. Findings were summarised qualitatively. RESULTS: Of 4978 identified studies, 85 met the eligibility criteria. Included studies showed declines in immunisation activities across LMICs related to the COVID-19 pandemic. These included reductions in achieved routine coverage, cancellation or postponement of campaigns and underimmunised cohorts. Immunisation was most disrupted in the early months of the pandemic; however, recovery varied by country, age-group and vaccine. Though many countries observed partial recovery in 2020, disruption in many countries continued into 2021. It has also been noted that clinician staff shortages and vaccine stock-outs caused by supply chain disruptions contributed to immunisation delays, but that concern over COVID-19 transmission was a leading factor. Key resiliency factors included community outreach and healthcare worker support. CONCLUSIONS: There is limited information on whether re
-
Journal articleMullins E, McCabe R, Bird SM, et al., 2024,
Correction: Tracking the incidence and risk factors for SARS-CoV-2 infection using historical maternal booking serum samples
, PLoS One, Vol: 19, ISSN: 1932-6203[This corrects the article DOI: 10.1371/journal.pone.0273966.].
-
Journal articleMills CL, Woodroffe R, Donnelly CA, 2024,
An extensive re-evaluation of evidence and analyses of the Randomised Badger Culling Trial II: In neighbouring areas.
, R Soc Open Sci, Vol: 11, ISSN: 2054-5703In the second investigation in a pair of analyses which re-evaluates the Randomised Badger Culling Trial (RBCT), we estimate the effects of proactive badger culling on the incidence of tuberculosis (TB) in cattle populations in unculled neighbouring areas. Throughout peer-reviewed analyses of the RBCT, proactive culling was estimated to have detrimental effects on the incidence of herd breakdowns (i.e. TB incidents) in neighbouring areas. Using previously published, publicly available data, we appraise a variety of frequentist and Bayesian models as we estimate the effects of proactive culling on confirmed herd breakdowns in unculled neighbouring areas. For the during trial period from the initial culls until 4 September 2005, we estimate consistently high probabilities that proactive culling had adverse effects on confirmed herd breakdowns in unculled neighbouring areas, thus supporting the theory of heightened risk of TB for the neighbouring cattle populations. Negligible culling effects are estimated in the post-trial period across the statistical approaches and imply unsustained long-term effects for unculled neighbouring areas. Therefore, when considered alongside estimated beneficial effects within proactive culling areas, these conflicting adverse side effects render proactive culling complex, and thus, decision making regarding potential culling strategies should include (i) ecological, geographical and scientific considerations and (ii) cost-benefit analyses.
-
Journal articleMills CL, Woodroffe R, Donnelly CA, 2024,
An extensive re-evaluation of evidence and analyses of the Randomised Badger Culling Trial (RBCT) I: Within proactive culling areas.
, R Soc Open Sci, Vol: 11, ISSN: 2054-5703Here, in the first of two investigations, we evaluate and extend the analyses of the Randomised Badger Culling Trial (RBCT) to estimate the effectiveness of proactive badger culling for reducing incidence of tuberculosis (TB) in cattle within culling areas. Using previously reviewed, publicly available data, alongside frequentist and Bayesian approaches, we re-estimate culling effects for confirmed incidence of herd breakdowns (TB incidents in cattle) within proactive culling areas. We appraise the varying assumptions and statistical structures of individual models to determine model appropriateness. Our re-evaluation of frequentist models provides results consistent with peer-reviewed analyses of RBCT data, due to the consistency of beneficial effects across three analysis periods. Furthermore, well-fitting Bayesian models with weakly informative prior distribution assumptions produce high probabilities (91.2%-99.5%) of beneficial effects of proactive culling on confirmed herd breakdowns within culling areas in the period from the initial culls (between 1998 and 2002) until 2005. Similarly high probabilities of beneficial effects were observed post-trial (from 1 year after last culls until March 2013). Thus, irrespective of statistical approach or study period, we estimate substantial beneficial effects of proactive culling within culling areas, consistent with separate, existing, peer-reviewed analyses of the RBCT data.
-
Journal articleKuchukhidze S, Walters MK, Panagiotoglou D, et al., 2024,
The contribution of intimate partner violence to vertical HIV transmission: a modelling analysis of 46 African countries.
, Lancet HIV, Vol: 11, Pages: e542-e551BACKGROUND: Addressing gender inequities could be key to the elimination of vertical transmission of HIV. Women experiencing intimate partner violence (IPV) might be at an increased risk of vertical transmission due to their vulnerability to HIV acquisition and barriers to access to and retention in care. Sub-Saharan Africa, where IPV burden is among the highest globally, accounts for most new paediatric HIV infections. We aimed to examine the proportion of excess vertical transmission attributable to IPV in this region. METHODS: In this modelling analysis, we created a probability tree model of vertical HIV transmission among women aged 15-49 years in 46 African countries. We estimated the proportion of vertical transmission attributable to past-year physical or sexual IPV, or both, as an age-standardised population attributable fraction (PAF) and as excess vertical transmission risk per 1000 births among women experiencing IPV. We incorporated perinatal and postnatal vertical transmission among women who acquired HIV before pregnancy, during pregnancy, and during breastfeeding. Fertility, HIV prevalence, HIV incidence, antiretroviral therapy (ART) uptake, and ART retention varied in the model by women's IPV experience. The model was parameterised using UNAIDS' 2023 Spectrum model data, WHO's Global Database on Violence Against Women, and the peer-reviewed literature. Uncertainty intervals (95% UI) were calculated through 1000 Monte Carlo simulations. FINDINGS: Across 46 countries 13% (95% UI 6-21) of paediatric HIV infections in 2022 were attributed to IPV, corresponding to over 22 000 paediatric infections. The PAF ranged from 4% (2-7) in Niger to 28% (13-43) in Uganda. The PAF was highest among girls aged 15-19 years (20%, 8-33) and lowest among women aged 45-49 years (6%, 3-9). In southern Africa, where women's HIV prevalence is highest (23%), IPV led to 11 (5-20) additional infections per 1000 births among women affected by IPV. INTERPRETATION: IPV migh
-
Journal articleScachetti GC, Forato J, Claro IM, et al., 2024,
Reemergence of Oropouche virus between 2023 and 2024 in Brazil.
, medRxivBACKGROUND: Oropouche virus (OROV; species Orthobunyavirus oropoucheense) is an arthropod-borne virus that has caused outbreaks of Oropouche fever in Central and South America since the 1950s. This study investigates virological factors contributing to the reemergence of Oropouche fever in Brazil between 2023 and 2024. METHODS: In this study, we combined OROV genomic, molecular, and serological data from Brazil from 1 January 2015 to 29 June 2024, along with in vitro and in vivo characterization. Molecular screening data included 93 patients with febrile illness between January 2023 and February 2024 from the Amazonas State. Genomic data comprised two genomic OROV sequences from patients. Serological data were obtained from neutralizing antibody tests comparing the prototype OROV strain BeAn 19991 and the 2024 epidemic strain. Epidemiological data included aggregated cases reported to the Brazilian Ministry of Health from 1 January 2014 to 29 June 2024. FINDINGS: In 2024, autochthonous OROV infections were detected in previously non-endemic areas across all five Brazilian regions. Cases were reported in 19 of 27 federal units, with 83.2% (6,895 of 8,284) of infections in Northern Brazil and a nearly 200-fold increase in incidence compared to reported cases over the last decade. We detected OROV RNA in 10.8% (10 of 93) of patients with febrile illness between December 2023 and May 2024 in Amazonas. We demonstrate that the 2023-2024 epidemic was caused by a novel OROV reassortant that replicated approximately 100-fold higher titers in mammalian cells compared to the prototype strain. The 2023-2024 OROV reassortant displayed plaques earlier than the prototype, produced 1.7 times more plaques, and plaque sizes were 2.5 larger compared to the prototype. Furthermore, serum collected in 2016 from previously OROV-infected individuals showed at least a 32-fold reduction in neutralizing capacity against the reassortment strain compared to the prototype. INTERPRETATION: These
-
Journal articleParag K, 2024,
How to measure the controllability of an infectious disease?
, Physical Review X, ISSN: 2160-3308Quantifying how difficult it is to control an emerging infectious disease is crucial to public health decision-making, providing valuable evidence on if targeted interventions e.g., quarantine and isolation, can contain spread or when population-wide controls e.g., lockdowns, are warranted. The disease reproduction number, R, or growth rate, r, are universally assumed to measure controllability because R=1 and r=0 define when infections stop growing and hence the state of critical stability. Outbreaks with larger R or r are therefore interpreted as less controllable and requiring more stringent interventions. We prove this common interpretation is impractical and incomplete. We identify a positive feedback loop among infections intrinsically underlying disease transmission and evaluate controllability from how interventions disrupt this loop. The epidemic gain and delay margins, which respectively define how much we can scale infections (this scaling is known as gain) or delay interventions on this loop before stability is lost, provide rigorous measures of controllability. Outbreaks with smaller margins necessitate more control effort. Using these margins, we quantify how presymptomatic spread, surveillance limitations, variant dynamics and superspreading shape controllability and demonstrate that R and r only measure controllability when interventions do not alter timings between the infections and are implemented without delay. Our margins are easily computed, interpreted and reflect complex relationships among interventions, their implementation and epidemiological dynamics.
-
Journal articleJohnston C, Scheele S, Bachmann L, et al., 2024,
Vaccine value profile for herpes simplex virus
, Vaccine, Vol: 42, Pages: S82-S100, ISSN: 0264-410XHerpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are chronic, highly prevalent viral infections that cause significant morbidity around the world. HSV-2 is sexually transmitted and is the leading cause of genital ulcer disease (GUD). It also increases the risk of HIV acquisition, fueling the HIV epidemic. HSV-1 is typically acquired in childhood through nonsexual contact and contributes to oral and ocular disease, but it can also be sexually transmitted to cause GUD. Both HSV-1 and HSV-2 cause neonatal herpes and neurologic disease. Given the ubiquitous nature of HSV-1 and HSV-2 infections and the limited existing prevention and control measures, vaccination would be the most efficient strategy to reduce the global burden of morbidity related to HSV infection. Vaccine strategies include prophylactic vaccination, which would prevent infection among susceptible persons and would likely be given to adolescents, and therapeutic vaccinations, which would be given to people with symptomatic genital HSV-2 infection. This document discusses the vaccine value profile of both types of vaccines.This ‘Vaccine Value Profile’ (VVP) for HSV is intended to provide a high-level, holistic assessment of the information and data that are currently available to inform the potential public health, economic and societal value of pipeline vaccines and vaccine-like products. This VVP was developed by subject matter experts from academia, non-profit organizations, government agencies and multi-lateral organizations. All contributors have extensive expertise on various elements of the HSV VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using only existing and publicly available information.
-
Journal articleStapley JN, Hamley JID, Walker M, et al., 2024,
Modelling onchocerciasis-associated epilepsy and the impact of ivermectin treatment on its prevalence and incidence
, Nature Communications, Vol: 15, ISSN: 2041-1723Retrospective cohort studies in Cameroon found an association between Onchocerca volvulus microfilarial load in childhood (measured in 1991–1993) and risk of developing epilepsy later in life (measured in 2017). We parameterised and integrated this relationship (across children aged 3–15 years) into the previously published, stochastic transmission model, EPIONCHO-IBM, for Simulium damnosum sensu lato-transmitted onchocerciasis. We simulated 19 years (1998–2017) of annual ivermectin mass drug administration (MDA) reflecting coverage in the study area, and modelled epilepsy prevalence and incidence. Scenario-based simulations of 25 years of (annual and biannual) MDA in hyper- and holoendemic settings, with 65% and 80% therapeutic coverage, were also conducted. EPIONCHO-IBM predicted 7.6% epilepsy prevalence (compared to 8.2% in the Cameroon study) and incidence of 317 cases/100,000 person-years (compared to 350). In hyperendemic areas, 25 years of biannual MDA (80% coverage) eliminated onchocerciasis-associated epilepsy (OAE) and protected untreated under-fives from its development. Strengthening onchocerciasis programmes, implementing alternative strategies, and evaluating treatment for under-fives and school-age children are crucial to prevent OAE in highly-endemic settings.
-
Journal articleMorris R, Gregson S, Maswera R, et al., 2024,
The impact of COVID-19 on sexual risk behaviour for HIV acquisition in east Zimbabwe: an observational study
, PLOS Global Public Health, Vol: 4, ISSN: 2767-3375The Covid-19 pandemic and associated restrictions have the potential to alter sexual risk behaviours for HIV acquisition with important implications for HIV prevention programmes in sub-Saharan Africa. To date, no large-scale data have been published to substantiate hypothesised changes in sexual risk behaviours. We used longitudinal survey data to assess the impact of Covid-19 on sexual risk behaviours in east Zimbabwe. Data on sexual behaviours in HIV-negative adults aged 15-54 years were collected in two rounds of a general population open-cohort survey conducted in Manicaland, Zimbabwe shortly before (July 2018 to December 2019; N = 7316) and several months into the Covid-19 epidemic (February to July 2021; N = 6356). Descriptive statistics and logistic regression models of serial cross-sectional and prospective cohort data were used to assess changes in sexual risk behaviours. The proportion of females aged 15-19 years reporting sexual debut declined from 29.7% before Covid-19 to 20.3% during Covid-19 (adjusted odds ratio (AOR) = 0.49, 95% confidence interval (95% CI), 0.38-0.63). Fewer sexually-active females reported multiple sexual partners during Covid-19 (3.35% versus 6.07%; AOR = 0.55, 95% CI, 0.43-0.72). No population-level changes in male behaviour between survey rounds were recorded but the cohort analysis revealed a complex pattern of behaviour change with HIV risk behaviours increasing for some individuals and decreasing for others. Overall HIV risk behaviours remained high in a sub-Saharan African population with a generalised HIV epidemic over a period of Covid-19 lockdowns when movements and social contacts were restricted.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.
Contact us
For any enquiries related to the MRC Centre please contact:
Scientific Manager
Susannah Fisher
mrc.gida@imperial.ac.uk
External Relationships and Communications Manager
Dr Sabine van Elsland
s.van-elsland@imperial.ac.uk