Publications
362 results found
Anderson RM, Fraser C, Ghani AC, et al., 2005, Epidemiology, transmission dynamics, and control of SARS: the 2002-2003 epidemic., SARS: a case study in emerging infections., Editors: McLean, May, Pattison, Weiss, Publisher: Oxford University Press, Pages: 61-80
Leung GM, Hedley AJ, Lam TH, et al., 2005, Transmission Dynamics and Control of the Viral Aetiological Agent of SARS, SEVERE ACUTE RESPIRATORY SYNDROME, Editors: Peiris, Anderson, Osterhaus, Stohr, Yuen, Publisher: BLACKWELL SCIENCE PUBL, Pages: 111-130
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- Citations: 1
Donnelly C, Ghani A, 2004, Real-time epidemiology: Understanding the spread of SARS., Signif (Oxf), Vol: 1, Pages: 176-179, ISSN: 1740-9705
Fitting transmission models to outbreak data allows key epidemiological parameters to be estimated and the impact of control measures to be evaluated. Christl Donnelly and Azra Ghani describe the use of such models in the 2003 SARS epidemic in Hong Kong.
Turner KME, Garnett GP, Ghani AC, et al., 2004, Investigating ethnic inequalities in the incidence of sexually transmitted infections: mathematical modelling study, SEXUALLY TRANSMITTED INFECTIONS, Vol: 80, Pages: 379-385, ISSN: 1368-4973
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- Citations: 27
Donnelly CA, Fisher MC, Fraser C, et al., 2004, Epidemiological and genetic analysis of severe acute respiratory syndrome, Lancet Infectious Diseases, Vol: 4, Pages: 672-683, ISSN: 1473-3099
The severe acute respiratory syndrome (SARS) epidemics in 2002–2003 showed how quickly a novel infectious disease can spread both within communities and internationally. We have reviewed the epidemiological and genetic analyses that have been published both during and since these epidemics, and show how quickly data were collected and analyses undertaken. Key factors that determine the speed and scale of transmission of an infectious disease were estimated using statistical and mathematical modelling approaches, and phylogenetic analyses provided insights into the origin and evolution of the SARS-associated coronavirus. The SARS literature continues to grow, and it is hoped that international collaboration in the analysis of epidemiological and contact-network databases will provide further insights into the spread of this newly emergent infectious disease.
Leung GM, Chung P-H, Tsang T, et al., 2004, SARS-CoV antibody prevalence in all Hong Kong patient contacts, Emerging Infectious Diseases, Vol: 10, Pages: 1653-1656, ISSN: 1080-6040
A total of 1,068 asymptomatic close contacts of patients with severe acute respiratory (SARS) from the 2003 epidemic in Hong Kong were serologically tested, and 2 (0.19%) were positive for SARS coronavirus immunoglobulin G antibody. SARS rarely manifests as a subclinical infection, and at present, wild animal species are the only important natural reservoirs of the virus.
Donnelly CA, Ghani AC, Leung GM, 2004, Epidemiological determinants of the spread of the causal agent of severe acute respiratory syndrome in Hong Kong. (vol 361, pg 1761, 2003), LANCET, Vol: 364, Pages: 140-140, ISSN: 0140-6736
Hilton DA, Ghani AC, Conyers L, et al., 2004, Prevalence of lymphoreticular prion protein accumulation in UK tissue samples, JOURNAL OF PATHOLOGY, Vol: 203, Pages: 733-739, ISSN: 0022-3417
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- Citations: 313
Anderson RM, Fraser C, Ghani AC, et al., 2004, Epidemiology, transmission dynamics and control of SARS: the 2002-2003 epidemic, Philos Trans R Soc Lond, B, Biol Sci, Vol: 359, Pages: 1091-1105
Ferguson NM, Fraser C, Donnelly CA, et al., 2004, Public health risk from the avian H5N1 influenza epidemic, SCIENCE, Vol: 304, Pages: 968-969, ISSN: 0036-8075
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- Citations: 124
G M Leung, A J Hedley, L M Ho, et al., 2004, The epidemiology of severe acute respiratory syndrome in the 2003 Hong Kong epidemic: an analysis of all 1755 patients, Ann Intern Med, Vol: 141, Pages: 662-673, ISSN: 0003-4819
Ghani AC, 2003, Use of observational data in evaluating treatments: antiretroviral therapy and HIV., Expert Rev Anti Infect Ther, Vol: 1, Pages: 551-562, ISSN: 1478-7210
Observational data are increasingly used in various therapeutic areas to evaluate the use, effectiveness and side effects of new treatments. Whilst randomized clinical trials remain the gold standard for evaluating the efficacy of new agents, they have a number of limitations for HIV, including the limited number of combinations that are compared and the costs of long-term follow-up. Observational data from seroconverter and clinical cohorts have been used to compare the short- and longer-term effectiveness of different therapy combinations and to evaluate the longer-term risks associated with antiretroviral therapy. Furthermore, they provide the opportunity to evaluate the relative success of more complex patterns of therapy, such as sequencing of different regimens over time. However, because of the nature of these data, a number of potential biases may arise which can influence interpretation.
Martin IMC, Ghani A, Bell G, et al., 2003, Persistence of two genotypes of <i>Neisseria gonorrhoeae</i> during transmission, JOURNAL OF CLINICAL MICROBIOLOGY, Vol: 41, Pages: 5609-5614, ISSN: 0095-1137
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- Citations: 12
Harney MS, Ghani AC, Donnelly CA, et al., 2003, vCJD risk in the Republic of Ireland, BMC Infectious Diseases, Vol: 3, ISSN: 1471-2334
Background: The Republic of Ireland has the second highest incidence of BSE worldwide. Only a single case of vCJD has been identified to date.Methods: We estimate the total future number of clinical cases of vCJD using an established mathematical model, and based on infectivity of bovine tissue calculated from UK data and on the relative exposure to BSE contaminated meat.Results: We estimate 1 future clinical case (95% CI 0 – 15) of vCJD in the Republic of Ireland. Irish exposure is from BSE infected indigenous beef products and from imported UK beef products. Additionally, 2.5% of the Irish population was exposed to UK beef through residing in the UK during the 'at-risk' period. The relative proportion of risk attributable to each of these three exposures individually is 2:2:1 respectively.Conclusions: The low numbers of future vCJD cases estimated in this study is reassuring for the Irish population and for other countries with a similar level of BSE exposure.
van Sighem AI, van de Wiel MA, Ghani AC, et al., 2003, Mortality and progression to AIDS after starting highly active antiretroviral therapy, AIDS, Vol: 17, Pages: 2227-2236, ISSN: 0269-9370
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- Citations: 138
Ghani AC, 2003, Commentary: Predicting the unpredictable: the future incidence of variant Creutzfeldt-Jakob disease, INTERNATIONAL JOURNAL OF EPIDEMIOLOGY, Vol: 32, Pages: 792-793, ISSN: 0300-5771
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- Citations: 9
Riley S, Fraser C, Donnelly CA, et al., 2003, Transmission dynamics of the etiological agent of SARS in Hong Kong: impact of public health interventions, Science, Vol: 300, Pages: 1961-1966
Donnelly CA, Ghani AC, Leung GM, et al., 2003, Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong, The Lancet, Vol: 361, Pages: 1761-1766, ISSN: 0140-6736
BackgroundHealth authorities worldwide, especially in the Asia Pacific region, are seeking effective public-health interventions in the continuing epidemic of severe acute respiratory syndrome (SARS). We assessed the epidemiology of SARS in Hong Kong.MethodsWe included 1425 cases reported up to April 28, 2003. An integrated database was constructed from several sources containing information on epidemiological, demographic, and clinical variables. We estimated the key epidemiological distributions: infection to onset, onset to admission, admission to death, and admission to discharge. We measured associations between the estimated case fatality rate and patients’age and the time from onset to admission.FindingsAfter the initial phase of exponential growth, the rate of confirmed cases fell to less than 20 per day by April 28. Public-health interventions included encouragement to report to hospital rapidly after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, and restricting the travel of contacts. The mean incubation period of the disease is estimated to be 6.4 days (95% Cl 5.2–7.7). The mean time from onset of clinical symptoms to admission to hospital varied between 3 and 5 days, with longer times earlier in the epidemic. The estimated case fatality rate was 13.2% (9.8–16.8) for patients younger than 60 years and 43.3% (35.2–52.4) for patients aged 60 years or older assuming a parametric γ distribution. A non-parametric method yielded estimates of 6.8% (4.0–9.6) and 55.0% (45.3–64.7), respectively. Case clusters have played an important part in the course of the epidemic.InterpretationPatients’age was strongly associated with outcome. The time between onset of symptoms and admission to hospital did not alter outcome, but shorter intervals will be important to the wider population by restricting the infectious period before patients are placed in quaranti
Donnelly CA, Ghani AC, Leung GM, 2003, Erratum: Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong (Lancet (2003) 361 (1761-1766)), Lancet, Vol: 361, ISSN: 0140-6736
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- Citations: 8
Donnelly CA, Ghani AC, Leung GM, 2003, Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong (vol 361, pg 1761, 2003), LANCET, Vol: 361, Pages: 1832-1832, ISSN: 0140-6736
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- Citations: 18
Ghani AC, Donnelly CA, Ferguson NM, et al., 2003, Updated projections of future vCJD deaths in the UK, BMC Infectious Diseases, Vol: 3, ISSN: 1471-2334
Background: Past projections of the future course of the vCJD epidemic in the UK have shown considerable uncertainty, with wide confidence bounds. However, recent vCJD case data have indicated a decrease in the annual incidence of deaths over the past two years.Methods: A detailed survival model is fitted to the 121 vCJD deaths reported by the end of 2002 stratified by age and calendar time to obtain projections of future incidence. The model is additionally fitted to recent results from a survey of appendix tissues.Results: Our results show a substantial decrease in the uncertainty of the future course of the primary epidemic in the susceptible genotype (MM-homozygous at codon 129 of the prion protein gene), with a best estimate of 40 future deaths (95% prediction interval 9–540) based on fitting to the vCJD case data alone. Additional fitting of the appendix data increases these estimates (best estimate 100, 95% prediction interval 10–2,600) but remains lower than previous projections.Conclusions: The primary vCJD epidemic in the known susceptible genotype in the UK appears to be in decline.
Ghani AC, Ferguson NM, Donnelly CA, et al., 2003, Factors determining the pattern of the variant Creutzfeldt-Jakob disease (vCJD) epidemic in the UK, PROCEEDINGS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES, Vol: 270, Pages: 689-698, ISSN: 0962-8452
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- Citations: 36
Ghani AC, Donnelly CA, Anderson RM, 2003, Patterns of antiretroviral use in the United States of America: analysis of three observational databases., HIV Med, Vol: 4, Pages: 24-32, ISSN: 1464-2662
OBJECTIVE: To characterize patterns of antiretroviral use in HIV-infected patients and explore variation by patient characteristics and disease stage. METHODS: Three large patient databases recording information derived from routine clinical attendance were analyzed: HIV Insight (n = 10 873), Target Management Services (n = 2226) and Clinical Partners (n = 1505). Each database records the dates of starting and stopping individual antiretroviral agents over time, measurements of CD4 T-cell counts and HIV-RNA levels at approximately 6-monthly intervals, and the demographic characteristics of patients. The number, frequency and duration of different antiretroviral combinations over time and their relationship to stage of HIV-disease and demographic characteristics were explored. RESULTS: Over 2000 different combinations of antiretroviral agents are recorded. From 1987 onwards, the use of zidovudine increased, with 23% of patients receiving monotherapy by 1990. The majority of treated patients remained on monotherapy until the introduction of highly active antiretroviral therapy (HAART) in 1996. By 1999, the standard of care was HAART, with 84% of patients beginning antiretroviral therapy with HAART. Those of African American race (odds ratio 0.59) and funded by Medicaid (odds ratio 0.72) were significantly less likely to begin antiretroviral therapy on HAART. Until 1995, there was a significant decrease in CD4 T-cell count when starting antiretroviral therapy. No significant trend was observed in either CD4 T-cell count or viral load after this time. Those starting on HAART therapies were significantly less likely to stop or switch regimens than those on nucleoside reverse transcriptase inhibitor (NRTI)-only therapies (P < 0.001). CONCLUSIONS: Complex patterns of antiretroviral treatment are observed in this large population. Changes over time mirror the introduction of the new antiretroviral agents.
Ghani AC, Ferguson NM, Donnelly CA, et al., 2003, Short-term projections for variant Creutzfeldt-Jakob disease onsets, STATISTICAL METHODS IN MEDICAL RESEARCH, Vol: 12, Pages: 191-201, ISSN: 0962-2802
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- Citations: 8
Donnelly CA, Ferguson NM, Ghani AC, et al., 2003, Extending backcalculation to analyse BSE data, STATISTICAL METHODS IN MEDICAL RESEARCH, Vol: 12, Pages: 177-190, ISSN: 0962-2802
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- Citations: 16
Fraser C, Ferguson NM, de Wolf F, et al., 2002, Antigen-driven T-cell turnover, JOURNAL OF THEORETICAL BIOLOGY, Vol: 219, Pages: 177-192, ISSN: 0022-5193
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- Citations: 8
Donnelly CA, Ferguson NM, Ghani AC, et al., 2002, Implications of BSE infection screening data for the scale of the British BSE epidemic and current European infection levels, PROCEEDINGS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES, Vol: 269, Pages: 2179-2190, ISSN: 0962-8452
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- Citations: 80
Hilton DA, Ghani AC, Conyers L, et al., 2002, Accumulation of prion protein in tonsil and appendix: review of tissue samples, BRITISH MEDICAL JOURNAL, Vol: 325, Pages: 633-634, ISSN: 0959-535X
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- Citations: 109
Glatzel M, Rogivue C, Ghani A, et al., 2002, Incidence of Creutzfeldt-Jakob disease in Switzerland, LANCET, Vol: 360, Pages: 139-141, ISSN: 0140-6736
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- Citations: 72
Ghani AC, Ferguson NM, Fraser C, et al., 2002, Viral replication under combination antiretroviral therapy: A comparison of four different regimens, JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, Vol: 30, Pages: 167-176, ISSN: 1525-4135
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- Citations: 12
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