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  • Journal article
    Schmit N, Topazian H, Pianella M, Charles G, Winskill P, Hancock P, Sherrard-Smith E, Hauck K, Churcher T, Ghani Aet al., 2025,

    Quantifying the potential value of entomological data collection for programmatic decision-making on malaria control in sub-Saharan African settings

    , Malaria Journal, ISSN: 1475-2875
  • Journal article
    Fu M, Lambert G, Cook A, Ndow G, Haddadin Y, Shimakawa Y, Hallett TB, Harvala H, Sicuri E, Lemoine M, Nayagam ASet al., 2025,

    Quality of life in patients with HBV infection: a systematic review and meta-analysis

    , JHEP Reports, ISSN: 2589-5559

    Background & AimsDespite nearly 250 million people worldwide estimated to have chronic hepatitis B virus (HBV) infection, health-related quality of life (HRQOL) in HBV-related disease has not been well characterised. We aimed to summarise existing data on HBV-related HRQOL and quantify summary utility values by stage of disease.MethodsEmbase, Global Health, PubMed, and Web of Science were searched for articles investigating HBV HRQOL. Meta-analyses for utility scores were pooled by stage of disease and utility instrument; meta-regression was further adjusted for the effect of current health expenditure as a percentage of gross domestic product (CHE/GDP) as a proxy of the importance of healthcare perceived by different countries.ResultsTwenty-two articles from nineteen studies, comprising 10,311 patients, were included. 74% of studies were performed in the Western Pacific Region, and 47% used the EuroQoL-5D-3L instrument. HRQOL was found to decrease with advancing stages of HBV-related disease. Meta-regression showed the following predicted mean utility scores for the different stages of chronic HBV infection: non-cirrhotic 0.842, compensated cirrhosis 0.820 (p=0.474 compared to non-cirrhotic), decompensated cirrhosis 0.722 (p=0.001) and hepatocellular carcinoma 0.749 (p=0.008). The type of tool used affected HRQOL and studies in populations where there was a higher CHE/GDP were associated with higher predicted utility values.ConclusionsChronic HBV infection impairs patients' HRQOL, even when there is no evidence of cirrhosis, and HRQOL is particularly impaired in the advanced stages of decompensated cirrhosis and hepatocellular carcinoma. These results have important implications for global hepatitis elimination efforts and are useful for economic analyses. However, further research is needed, particularly in high-burden, low-income settings where data is lacking.Impact and ImplicationsThis study's findings from 22 articles and 10,311 patients contribute to the

  • Journal article
    Voller C, Perrin LD, Gibbens JC, Donnelly CA, Delahay RJ, Heasman L, Vial F, Prosser A, Heard J, Robertson A, Brunton L, Enticott G, Downs SHet al., 2025,

    Can biosecurity on farms reduce bovine tuberculosis risks in cattle in England? A review of observational and literature-based evidence

    , Veterinary Record, Vol: 196, ISSN: 0042-4900

    Background: Bovine tuberculosis (TB) is a burden to cattle farming in Great Britain. Poor biosecurity has been identified as contributing to the epidemic. Methods: We conducted a systematic review of epidemiological studies published in the scientific literature between 1921 and 2024 that measured the association between farm biosecurity and cattle TB. Eligible studies controlled for confounding factors and reported statistically significant association/s between biosecurity and TB (p < 0.05) and/or an effect ratio/s of more than 3. Biosecurity uptake in England was assessed using official Disease Report Forms (DRFs) from 4074 TB incidents occurring in 2018 and 2019. Results: Thirty-three papers with 116 effect estimates met the inclusion criteria and were grouped according to a five-point biosecurity plan. There was consistent evidence for TB risk being reduced by reducing contact with neighbouring herds and preventing cattle at higher TB risk from entering herds. The evidence for the effectiveness of measures for reducing contact between badgers and cattle was inconsistent. The DRF data showed a low uptake of biosecurity to reduce contact between badgers and cattle. Limitations: All the studies identified were retrospective. Biosecurity was measured using different instruments, for example, questionnaires. Conclusions: There is analytical epidemiological evidence supporting guidance for improving biosecurity, but there are some limitations. Further research is needed to identify the most effective wildlife-focused measures.

  • Journal article
    Wariri O, Utazi CE, Okomo U, Dotse-Gborgbortsi W, Sogur M, Fofana S, Murray KA, Grundy C, Kampmann Bet al., 2025,

    Multi-level determinants of timely routine childhood vaccinations in The Gambia: Findings from a nationwide analysis.

    , Vaccine, Vol: 43

    INTRODUCTION: Achieving the ambitious goals of the Immunisation Agenda 2030 (IA2030) requires a deeper understanding of factors influencing under-vaccination, including timely vaccination. This study investigates the demand- and supply-side determinants influencing the timely uptake of key childhood vaccines scheduled throughout the first year of life in The Gambia. METHODS: We used two nationally-representative datasets: the 2019-20 Gambian Demographic and Health Survey and the 2019 national immunisation facility mapping. Using Bayesian multi-level binary logistic regression models, we identified key factors significantly associated with timely vaccination for five key vaccines: birth dose of hepatitis-B (HepB0), first, second, and third doses of the pentavalent vaccine (Penta1, Penta2, Penta3), and first-dose of measles-containing vaccine (MCV1) in children aged 12-35 months. We report the adjusted Odds Ratios (aORs) and 95 % Credible Intervals (95 % CIs) in each case. RESULTS: We found that demand-side factors, such as ethnicity, household wealth status, maternal education, maternal parity, and the duration of the household's residency in its current location, were the most common drivers of timely childhood vaccination. However, supply-side factors such as travel time to the nearest immunisation clinic, availability of cold-storage and staffing numbers in the nearest immunisation clinic were also significant determinants. Furthermore, the determinants varied across specific vaccines and the timing of doses. For example, delivery in a health facility (aOR = 1.58, 95 %CI: 1.02-2.53), living less than 30 min (aOR = 2.11, 95 %CI: 1.2-8.84) and living between 30 and 60 min (aOR = 3.68, 95 %CI: 1.1-14.99) from a fixed-immunisation clinic was associated with timely HepB0, a time-sensitive vaccine that must be administered within 24 h of birth. On the other hand, children who received Penta1 and

  • Journal article
    Murray KA, 2025,

    Keep it in the ground: climate change could prompt the reemergence of zombie pathogens

    , BMJ, ISSN: 0959-8146
  • Journal article
    Hallett TB, Mangal TD, Tamuri AU, Arinaminpathy N, Cambiano V, Chalkley M, Collins JH, Cooper J, Gillman MS, Giordano M, Graham MM, Graham W, Hawryluk I, Janoušková E, Jewell BL, Lin IL, Manning Smith R, Manthalu G, Mnjowe E, Mohan S, Molaro M, Ng'ambi W, Nkhoma D, Piatek S, Revill P, Rodger A, Salmanidou D, She B, Smit M, Twea PD, Colbourn T, Mfutso-Bengo J, Phillips ANet al., 2025,

    Estimates of resource use in the public-sector health-care system and the effect of strengthening health-care services in Malawi during 2015–19: a modelling study (Thanzi La Onse)

    , The Lancet Global Health, Vol: 13, Pages: E28-E37, ISSN: 2572-116X

    BackgroundIn all health-care systems, decisions need to be made regarding allocation of available resources. Evidence is needed for these decisions, especially in low-income countries. We aimed to estimate how health-care resources provided by the public sector were used in Malawi during 2015–19 and to estimate the effects of strengthening health-care services.MethodsFor this modelling study, we used the Thanzi La Onse model, an individual-based simulation model. The scope of the model was health care provided by the public sector in Malawi during 2015–19. Health-care services were delivered during health-care system interaction (HSI) events, which we characterised as occurring at a particular facility level and requiring a particular number of appointments. We developed mechanistic models for the causes of death and disability that were estimated to account for approximately 81% of deaths and approximately 72% of disability-adjusted life-years (DALYs) in Malawi during 2015–19, according to the Global Burden of Disease (GBD) estimates; we computed DALYs incurred in the population as the sum of years of life lost and years lived with disability. The disease models could interact with one another and with the underlying properties of each person. Each person in the Thanzi La Onse model had specific properties (eg, sex, district of residence, wealth percentile, smoking status, and BMI, among others), for which we measured distribution and evolution over time using demographic and health survey data. We also estimated the effect of different types of health-care system improvement.FindingsWe estimated that the public-sector health-care system in Malawi averted 41·2 million DALYs (95% UI 38·6–43·8) during 2015–19, approximately half of the 84·3 million DALYs (81·5–86·9) that the population would otherwise have incurred. DALYs averted were heavily skewed to children aged 0–4 years due to s

  • Journal article
    Oliveira LMA, Costa NS, Mestrovic T, Jauneikaite E, Pinto TCAet al., 2025,

    The battle against antimicrobial resistance is more important now than ever: time to educate, advocate and act

    , International Journal of Infectious Diseases, Vol: 150, ISSN: 1201-9712
  • Journal article
    Paschoalotto MAC, Cima J, Costa E, Valente de Almeida S, Gomes da Costa J, Santos JV, Passador CS, Passador JL, Barros PPet al., 2024,

    Politics and confidence toward the COVID-19 vaccination: A Brazilian cross-sectional study.

    , Hum Vaccin Immunother, Vol: 20

    This study has the aim of assessing the Brazilian perceptions, influencing factors and political positioning on the confidence concerning COVID-19 vaccination. To achieve the objective, the methods rely on a cross-sectional survey of Brazilian citizens, distributed through different social networks. The sample is composed of 1,670 valid responses, collected from almost all Brazilian states and state capitals. To analyze the data and give a clear view of the variables' relationship, the study used bivariate and comparative graphs. Results show a higher level of confidence in vaccines from Pfizer and AstraZeneca, while the lower level of confidence is associated with vaccines from Sinopharm and Sputinik5. Vaccine efficacy is the most significant influencing factor that helps in the decision to get vaccinated. Also, individuals are less willing to get vaccinated if their political preferences are related to the right-wing. The results led to three main health and social implications: i) the vaccination strategy campaigns should take in count vaccine efficacy and political aspects; ii) the vaccination process should be adapted to regions with different political positions; and iii) a reinforcement in the educational policies of the vaccine's importance to the public health, to avoid the politization of a health issue.

  • Journal article
    Monteirinho Leitao RA, Leitao R, Wan IU, Chown H, Williams TJ, Fisher MC, Rhodes Jet al., 2024,

    Detection of fungal sequences in human brain: rDNA locus amplification and deep sequencing

    , Scientific Reports, Vol: 14, ISSN: 2045-2322

    The aetiology of Alzheimer’s disease (AD) and Parkinson’s disease (PD) are unknown and tend to manifest at a late stage in life; even though these neurodegenerative diseases are caused by different affected proteins, they are both characterized by neuroinflammation. Links between bacterial and viral infection and AD/PD has been suggested in several studies, however, few have attempted to establish a link between fungal infection and AD/PD. In this study we adopted a nanopore-based sequencing approach to characterise the presence or absence of fungal genera in both human brain tissue and cerebrospinal fluid (CSF). We observed the presence of small fungal burden DNA in two AD brains and a control case (extensive amyloid angiopathy). This approach would be well-placed to investigate potential links between microbial infection and neurodegenerative disease.

  • Journal article
    Denkel LA, Arnaud I, Brekelmans M, Puig-Asensio M, Amin H, Gubbels S, Iversen P, Abbas M, Presterl E, Astagneau P, van Rooden S, PRAISE SSI working groupet al., 2024,

    Automated surveillance for surgical site infections (SSI) in hospitals and surveillance networks-expert perspectives for implementation.

    , Antimicrob Resist Infect Control, Vol: 13

    BACKGROUND: This work aims at providing practical recommendations for implementing automated surveillance (AS) of surgical site infections (SSI) in hospitals and surveillance networks. It also provides an overview of the steps, choices, and obstacles that need to be taken into consideration when implementing such surveillance. Hands-on experience with existing automated surveillance systems of SSI (AS SSI systems) in Denmark, France, the Netherlands and Spain is described regarding trend monitoring, benchmarking, quality control, and research for surveillance purposes. METHODS: Between April and October 2023, specific aspects/options of various surveillance purposes for AS SSI were identified during regular meetings of the SSI working group in the PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network. Expert discussions provided the basis for this perspective article. RESULTS: Decisions for implementation of AS SSI systems highly depend on the purpose of the surveillance. AS SSI systems presented here differ according to study population, setting, central or local implementation; the level of automation, design, and the data sources used. However, similarities were found for the rationales of automation, design principles and obstacles that were identified. There was consensus among all the experts that shortcomings in interoperability of databases, limited time, a want of commitment on the part of stakeholders, and a shortage of resources for information technology (IT) specialists represent the main obstacles for implementing AS SSI. To overcome obstacles, various solutions were reported, including training in the development of AS systems and the interpretation of AS SSI results, early consultation of end-users, and regular exchanges between management levels, IT departments, infection prevention and control (IPC) teams, and clinicians. CONCLUSION: Clarity on the intended application (e.g. purpose of surveillance) and information on

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