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• Journal article
  Bootsma MCJ, Ferguson NM, 2007,

  The effect of public health measures on the 1918 influenza pandemic in U.S. cities.

  , Proc Natl Acad Sci U S A, Vol: 104, Pages: 7588-7593, ISSN: 0027-8424

  During the 1918 influenza pandemic, the U.S., unlike Europe, put considerable effort into public health interventions. There was also more geographic variation in the autumn wave of the pandemic in the U.S. compared with Europe, with some cities seeing only a single large peak in mortality and others seeing double-peaked epidemics. Here we examine whether differences in the public health measures adopted by different cities can explain the variation in epidemic patterns and overall mortality observed. We show that city-specific per-capita excess mortality in 1918 was significantly correlated with 1917 per-capita mortality, indicating some intrinsic variation in overall mortality, perhaps related to sociodemographic factors. In the subset of 23 cities for which we had partial data on the timing of interventions, an even stronger correlation was found between excess mortality and how early in the epidemic interventions were introduced. We then fitted an epidemic model to weekly mortality in 16 cities with nearly complete intervention-timing data and estimated the impact of interventions. The model reproduced the observed epidemic patterns well. In line with theoretical arguments, we found the time-limited interventions used reduced total mortality only moderately (perhaps 10-30%), and that the impact was often very limited because of interventions being introduced too late and lifted too early. San Francisco, St. Louis, Milwaukee, and Kansas City had the most effective interventions, reducing transmission rates by up to 30-50%. Our analysis also suggests that individuals reactively reduced their contact rates in response to high levels of mortality during the pandemic.

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• Journal article
  Watts H, Gregson S, Saito S, Lopman B, Beasley M, Monasch Ret al., 2007,

  Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe

  , TROPICAL MEDICINE & INTERNATIONAL HEALTH, Vol: 12, Pages: 584-593, ISSN: 1360-2276
  • Author Web Link
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  • Citations: 45
• Conference paper
  Hinsley W, Field T, Woods J, 2007,

  Creating Individual Based Models of the Plankton Ecosystem

  , International Conference on Computational Science, Publisher: Springer-Verlag, LNCS, Pages: 111-118, ISSN: 0302-9743
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• Journal article
  Jewell NP, Lei X, Ghani AC, Donnelly CA, Leung GM, Ho L-M, Cowling BJ, Hedley AJet al., 2007,

  Non-parametric estimation of the case fatality ratio with competing risks data: An application to Severe Acute Respiratory Syndrome (SARS)

  , STATISTICS IN MEDICINE, Vol: 26, Pages: 1982-1998, ISSN: 0277-6715
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  • Citations: 33
• Journal article
  Sherr L, Lopman B, Kakowa M, Dube S, Chawira G, Nyamukapa C, Oberzaucher N, Cremin I, Gregson Set al., 2007,

  Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort

  , AIDS, Vol: 21, Pages: 851-860, ISSN: 0269-9370
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  • Citations: 166
• Journal article
  Grassly NC, Wenger J, Durrani S, Bahl S, Deshpande JM, Sutter RW, Heymann DL, Aylward RBet al., 2007,

  Protective efficacy of a monovalent oral type 1 poliovirus vaccine: a case-control study

  , LANCET, Vol: 369, Pages: 1356-1362, ISSN: 0140-6736
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  • Citations: 114
• Journal article
  Ferguson NM, 2007,

  Capturing Human Behaviour

  , Nature, Vol: 446, Pages: 733-733
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• Journal article
  Garske T, Clarke P, Ghani AC, 2007,

  The Transmissibility of Highly Pathogenic Avian Influenza in Commercial Poultry in Industrialised Countries

  , PLOS ONE, Vol: 2, ISSN: 1932-6203
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  • Citations: 52
• Journal article
  Boily MC, Asghar Z, Garske T, Ghani AC, Poulin Ret al., 2007,

  Influence of Selected Formation Rules for Finite Population Networks with Fixed Macrostructures: Implications for Individual-Based Model of Infectious Diseases

  , Mathematical Population Studies, Vol: 14, Pages: 237-267

  Individual-based network models are increasingly being applied to understand the transmission dynamics of infectious diseases. Research in this area has mostly focused on networks defined under a limited set of rules (e.g., preferential attachment, sexual partner formation and dissolution) that are supposed to mimic the real world but are often defined heuristically due to lack of empirical knowledge. Here, two different mechanisms (M- and λ2-rules) were used to generate a wide range of networks and to show the extent to which microstructures such as the mean component size, the size of the giant component and the cumulative nomination centrality index may vary between networks with fixed predetermined macrostructure characteristics (size, node degree distribution and mixing pattern) and influence disease transmission. It is important to carefully consider the limitations of network models and to appreciate the extent to which a given degree distribution and mixing pattern will be consistent with a wide range of underlying network microstructures.

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• Journal article
  Gregson S, Adamson S, Papaya S, Mundondo J, Nyamukapa CA, Mason PR, Garnett GP, Chandiwana SK, Foster G, Anderson RMet al., 2007,

  Impact and Process Evaluation of Integrated Community and Clinic-Based HIV-1 Control: A Cluster-Randomised Trial in Eastern Zimbabwe

  , PLOS Medicine, Vol: 4, Pages: 545-555, ISSN: 1549-1277

  BackgroundHIV-1 control in sub-Saharan Africa requires cost-effective and sustainable programmes that promote behaviour change and reduce cofactor sexually transmitted infections (STIs) at the population and individual levels.Methods and FindingsWe measured the feasibility of community-based peer education, free condom distribution, income-generating projects, and clinic-based STI treatment and counselling services and evaluated their impact on the incidence of HIV-1 measured over a 3-y period in a cluster-randomised controlled trial in eastern Zimbabwe. Analysis of primary outcomes was on an intention-to-treat basis. The income-generating projects proved impossible to implement in the prevailing economic climate. Despite greater programme activity and knowledge in the intervention communities, the incidence rate ratio of HIV-1 was 1.27 (95% confidence interval [CI] 0.92–1.75) compared to the control communities. No evidence was found for reduced incidence of self-reported STI symptoms or high-risk sexual behaviour in the intervention communities. Males who attended programme meetings had lower HIV-1 incidence (incidence rate ratio 0.48, 95% CI 0.24–0.98), and fewer men who attended programme meetings reported unprotected sex with casual partners (odds ratio 0.45, 95% CI 0.28–0.75). More male STI patients in the intervention communities reported cessation of symptoms (odds ratio 2.49, 95% CI 1.21–5.12).ConclusionsIntegrated peer education, condom distribution, and syndromic STI management did not reduce population-level HIV-1 incidence in a declining epidemic, despite reducing HIV-1 incidence in the immediate male target group. Our results highlight the need to assess the community-level impact of interventions that are effective amongst targeted population sub-groups.

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