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Abraham D, Premkumar PS, Platts-Mills JA, Tewari T, Bhat N, Rajendiran R, Gunalan H, Kang G. Effect of Non-Rotavirus Enteric Infections on Vaccine Efficacy in a ROTASIIL Clinical Trial. Am J Trop Med Hyg 2024; 110:1201-1209. [PMID: 38626750 PMCID: PMC11154053 DOI: 10.4269/ajtmh.23-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 01/14/2024] [Indexed: 04/18/2024] Open
Abstract
This study examined the relative proportion of enteric pathogens associated with severe gastroenteritis (GE) among children younger than 2 years in a phase III efficacy trial of the ROTASIIL® vaccine in India, evaluated the impact of co-infections on vaccine efficacy (VE), and characterized the association between specific pathogens and the clinical profile of severe GE. Stored stool samples collected from cases of severe GE in the phase III trial were tested by quantitative polymerase chain reaction using TaqMan™ Array Cards. Etiology was attributed by calculating the adjusted attributable fraction (AF) for each pathogen. A test-negative design was used to estimate VE. The pathogens with the highest AFs for severe diarrhea were rotavirus (23.5%), adenovirus 40/41 (17.0%), Shigella spp./enteroinvasive Escherichia coli, norovirus GII, enterotoxigenic E. coli, and Cryptosporidium spp. A considerable proportion of the disease in these children could not be explained by the pathogens tested. Severe GE cases associated with rotavirus and Shigella spp. were more likely to have a longer duration of vomiting and diarrhea, respectively. Cases attributed to Cryptosporidium spp. were more severe and required hospitalization. In the intention-to-treat population, VE was estimated to be 43.9% before and 46.5% after adjustment for co-infections; in the per-protocol population, VE was 46.7% before and 49.1% after adjustments. Rotavirus continued to be the leading cause of severe GE in this age group. The adjusted VE estimates obtained did not support co-infections as a major cause of lower vaccine performance in low- and middle-income countries.
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Affiliation(s)
- Dilip Abraham
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Prasanna Samuel Premkumar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - James A. Platts-Mills
- Infectious Diseases and International Health, University of Virginia, Charlottsville, Virginia
| | - Tushar Tewari
- Center for Vaccine Innovation and Access, PATH, New Delhi, India
| | - Niranjan Bhat
- Center for Innovation and Access, PATH, Washington, District of Columbia
| | - Revathi Rajendiran
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Hemavathi Gunalan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India
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2
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Matanza XM, Clements A. Pathogenicity and virulence of Shigella sonnei: A highly drug-resistant pathogen of increasing prevalence. Virulence 2023; 14:2280838. [PMID: 37994877 PMCID: PMC10732612 DOI: 10.1080/21505594.2023.2280838] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/01/2023] [Indexed: 11/24/2023] Open
Abstract
Shigella spp. are the causative agent of shigellosis (or bacillary dysentery), a diarrhoeal disease characterized for the bacterial invasion of gut epithelial cells. Among the 4 species included in the genus, Shigella flexneri is principally responsible for the disease in the developing world while Shigella sonnei is the main causative agent in high-income countries. Remarkably, as more countries improve their socioeconomic conditions, we observe an increase in the relative prevalence of S. sonnei. To date, the reasons behind this change in aetiology depending on economic growth are not understood. S. flexneri has been widely used as a model to study the pathogenesis of the genus, but as more research data are collected, important discrepancies with S. sonnei have come to light. In comparison to S. flexneri, S. sonnei can be differentiated in numerous aspects; it presents a characteristic O-antigen identical to that of one serogroup of the environmental bacterium Plesiomonas shigelloides, a group 4 capsule, antibacterial mechanisms to outcompete and displace gut commensal bacteria, and a poorer adaptation to an intracellular lifestyle. In addition, the World Health Organization (WHO) have recognized the significant threat posed by antibiotic-resistant strains of S. sonnei, demanding new approaches. This review gathers knowledge on what is known about S. sonnei within the context of other Shigella spp. and aims to open the door for future research on understanding the increasing spread of this pathogen.
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Affiliation(s)
- Xosé M. Matanza
- Centre for Bacterial Resistance Biology, Department of Life Sciences, Imperial College London, London, UK
| | - Abigail Clements
- Centre for Bacterial Resistance Biology, Department of Life Sciences, Imperial College London, London, UK
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Abdoulahi MII, Yanick Kevin MD, Lauve Rachel TY, Habibou HH, Sahabi B, Abdelkader AS, Boyom FF, Tidjani IA. Antibacterial Activity of Eight Medicinal Plants from the Traditional Pharmacopoeia of Niger. J Trop Med 2023; 2023:6120255. [PMID: 37529122 PMCID: PMC10390259 DOI: 10.1155/2023/6120255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/29/2023] [Accepted: 07/07/2023] [Indexed: 08/03/2023] Open
Abstract
The emergence of multidrug bacterial resistance poses a great public health problem and requires a constant search for new antibacterial agents. However, Niger's flora possesses several medicinal plants used in traditional medicine to cure infectious diseases and can be used as sources of bioactive ingredients. This current study was designed to evaluate the antibacterial activity of eight plants used in the traditional pharmacopeia of Niger. The extracts were prepared by maceration using ethanol, methanol, and distilled water. The obtained extracts were screened against Salmonella spp., Shigella spp., and Escherichia coli using the microdilution method coupled with a resazurin-based assay. Phytochemical screening was performed using colorimetry, while the quantification of total polyphenols, total flavonoids, and total tannins was determined by spectrophotometry. Out of the eight plants obtained, five named Cassia italica, Limeum pterocarpum, Phyllanthus pentandrus, Strychnos innocua, and Ximenia americanum exhibited antibacterial activity with MICs ranging from 500 μg/mL to 2000 μg/mL. Phytochemical screening showed the presence of alkaloids, saponosides, tannins, flavonoids, terpenes/sterols, quinones, and polyphenols. The ethanolic and methanolic extracts of X. americana contained important quantities of total polyphenols, with 43.59 ± 0.15 and 41.97 ± 0.02 mg EAG/100 mg of extract, respectively. These extracts showed the highest contents of total tannins at 46.49 g/L and 45.52 g/L, respectively. For total flavonoids, the highest content was obtained with the methanolic extract of P. pentandrus, with 3.12 ± 0.01 mg QE/100 mg of extract. These findings justify the uses of these plants in traditional medicine for the treatment of infectious diseases such as diarrhea and can be used as starting points for the development of phytodrugs against infectious diarrhea.
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Affiliation(s)
- Mahamane Idi Issa Abdoulahi
- Laboratory of Natural Substances and Organic Synthesis, FAST, Abdou Moumouni University, BP 10662, Niamey, Niger
- Laboratory for Phytobiochemistry and Medicinal Plants Studies, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
- Pharmacology Laboratory, Institute of Medical Research and Medicinal Plant Studies (IMPM), B.P. 6163, Yaounde, Cameroon
| | - Melogmo Dongmo Yanick Kevin
- Laboratory for Phytobiochemistry and Medicinal Plants Studies, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | | | - Hama Hamadou Habibou
- Laboratory of Natural Substances and Organic Synthesis, FAST, Abdou Moumouni University, BP 10662, Niamey, Niger
| | - Bakasso Sahabi
- Laboratory of Natural Substances and Organic Synthesis, FAST, Abdou Moumouni University, BP 10662, Niamey, Niger
| | - Alio Sanda Abdelkader
- Laboratory for Management and Valorization of Biodiversity in Sahel, Faculty of Science and Technology, Abdou Moumouni University, BP 10662 Niamey, Niger
| | - Fabrice Fekam Boyom
- Laboratory for Phytobiochemistry and Medicinal Plants Studies, University of Yaoundé I, P.O. Box 812, Yaoundé, Cameroon
| | - Ilagouma Amadou Tidjani
- Laboratory of Natural Substances and Organic Synthesis, FAST, Abdou Moumouni University, BP 10662, Niamey, Niger
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Chehelgerdi M, Chehelgerdi M. The use of RNA-based treatments in the field of cancer immunotherapy. Mol Cancer 2023; 22:106. [PMID: 37420174 PMCID: PMC10401791 DOI: 10.1186/s12943-023-01807-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/13/2023] [Indexed: 07/09/2023] Open
Abstract
Over the past several decades, mRNA vaccines have evolved from a theoretical concept to a clinical reality. These vaccines offer several advantages over traditional vaccine techniques, including their high potency, rapid development, low-cost manufacturing, and safe administration. However, until recently, concerns over the instability and inefficient distribution of mRNA in vivo have limited their utility. Fortunately, recent technological advancements have mostly resolved these concerns, resulting in the development of numerous mRNA vaccination platforms for infectious diseases and various types of cancer. These platforms have shown promising outcomes in both animal models and humans. This study highlights the potential of mRNA vaccines as a promising alternative approach to conventional vaccine techniques and cancer treatment. This review article aims to provide a thorough and detailed examination of mRNA vaccines, including their mechanisms of action and potential applications in cancer immunotherapy. Additionally, the article will analyze the current state of mRNA vaccine technology and highlight future directions for the development and implementation of this promising vaccine platform as a mainstream therapeutic option. The review will also discuss potential challenges and limitations of mRNA vaccines, such as their stability and in vivo distribution, and suggest ways to overcome these issues. By providing a comprehensive overview and critical analysis of mRNA vaccines, this review aims to contribute to the advancement of this innovative approach to cancer treatment.
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Affiliation(s)
- Mohammad Chehelgerdi
- Novin Genome (NG) Lab, Research and Development Center for Biotechnology, Shahrekord, Iran.
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
| | - Matin Chehelgerdi
- Novin Genome (NG) Lab, Research and Development Center for Biotechnology, Shahrekord, Iran
- Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
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Libby TE, Delawalla MLM, Al-Shimari F, MacLennan CA, Vannice KS, Pavlinac PB. Consequences of Shigella infection in young children: a systematic review. Int J Infect Dis 2023; 129:78-95. [PMID: 36736579 PMCID: PMC10017352 DOI: 10.1016/j.ijid.2023.01.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/07/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES We conducted a systematic review of the longitudinal consequences of Shigella infection in children to inform the value proposition for an effective vaccine. METHODS We searched PubMed and Embase for studies published from January 01, 1980 to December 12, 2022 and conducted in low- and middle-income countries that included longitudinal follow-up after Shigella detection among children aged <5 years, irrespective of language. We collected data on all outcomes subsequent to Shigella detection, except mortality. RESULTS Of 2627 papers identified, 52 met inclusion criteria. The median sample size of children aged <5 years was 66 (range 5-2172). Data were collected in 20 countries; 56% (n = 29) of the publications included Bangladesh. The most common outcomes related to diarrhea (n = 20), linear growth (n = 14), and the mean total cost of a Shigella episode (n = 4; range: $ 6.22-31.10). Among children with Shigella diarrhea, 2.9-61.1% developed persistent diarrhea (≥14 days); the persistence was significantly more likely among children who were malnourished, had bloody stool, or had multidrug-resistant Shigella. Cumulative Shigella infections over the first 2 years of life contributed to the greatest loss in length-for-age z-score. CONCLUSION We identified evidence that Shigella is associated with persistent diarrhea, linear growth faltering, and economic impact to the family.
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Affiliation(s)
- Tanya E Libby
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.
| | | | - Fatima Al-Shimari
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | | | | | - Patricia B Pavlinac
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Pinchoff J, Dougherty L, Dadi C. Water and Handwashing in a Drought-Prone Region of Southern Niger: How Environment, Household Infrastructure, and Exposure to Social and Behavior Change Messages Interact. Am J Trop Med Hyg 2023; 108:536-542. [PMID: 36746660 PMCID: PMC9978540 DOI: 10.4269/ajtmh.22-0473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/22/2022] [Indexed: 02/08/2023] Open
Abstract
This study aims to inform multisectoral development programs by exploring the extent to which social and behavior change (SBC) messages, environment, and household infrastructure are associated with knowledge and practice of handwashing behaviors. A cross-sectional survey of 2,708 households in the Maradi and Zinder districts of Niger was collected in April 2021. Household data were integrated with two local environmental measures: 1) water level at the nearest waterhole point, and 2) anomalous rainfall for the previous rainy season derived from climate hazards infrared precipitation with station rainfall (CHIRPS) data. Logistic regression models were constructed to explore how environment, household infrastructure, and exposure to SBC messages were associated with two hygiene-related outcomes: 1) observed water and soap available at household handwashing stations, a behavior, and 2) knowledge of critical moments for handwashing, a behavioral determinant. We find that in households near a water point with higher water depth, households were statistically significantly more likely (odds ratio [OR] = 1.25); (confidence interval [CI] = 1.12-1.49) to have water and soap observed at the handwashing station. Women in households near a water point with increased water depth (more water) were more likely to know three or more critical handwashing moments (OR = 1.07; CI = 1.03-1.11). Exposure to messages about the importance of handwashing was significantly associated with knowledge of critical handwashing moments and having water and soap observed at a handwashing station. Multisectoral programming should consider layering efforts so that development projects that increase access to water sources are complemented with SBC approaches focused on hygiene.
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Affiliation(s)
- Jessie Pinchoff
- Population Council, New York, New York
- Address correspondence to Jessie Pinchoff, Population Council, One Dag Hammarskjold Plaza, New York, NY 10017. E-mail:
| | | | - Chaibou Dadi
- Conception Etudes Suivi Evaluation Appuis Formation, Niamey, Niger
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7
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Mero S, Lääveri T, Ursing J, Rombo L, Kofoed PE, Kantele A. Seasonal variation of diarrhoeal pathogens among Guinea-Bissauan children under five years of age. PLoS Negl Trop Dis 2023; 17:e0011179. [PMID: 36913409 PMCID: PMC10035853 DOI: 10.1371/journal.pntd.0011179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/23/2023] [Accepted: 02/17/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Diarrhoea remains a major cause of childhood morbidity and mortality in low-income countries (LICs). The frequency of diarrhoeal episodes may vary by season, yet few prospective cohort studies have examined seasonal variation among various diarrhoeal pathogens using multiplex qPCR to analyse bacterial, viral and parasitic pathogens. METHODS We combined our recent qPCR data of diarrhoeal pathogens (nine bacterial, five viral and four parasitic) among Guinea-Bissauan children under five years old with individual background data, dividing by season. The associations of season (dry winter and rainy summer) and the various pathogens were explored among infants (0-11 months) and young children (12-59 months) and those with and without diarrhoea. RESULTS Many bacterial pathogens, especially EAEC, ETEC and Campylobacter, and parasitic Cryptosporidium, prevailed in the rainy season, whereas many viruses, particularly the adenovirus, astrovirus and rotavirus proved common in the dry season. Noroviruses were found constantly throughout the year. Seasonal variation was observed in both age groups. CONCLUSION In childhood diarrhoea in a West African LIC, seasonal variation appears to favour EAEC, ETEC, and Cryptosporidium in the rainy and viral pathogens in the dry season.
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Affiliation(s)
- Sointu Mero
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tinja Lääveri
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Johan Ursing
- Department of Infectious Diseases, Danderyds Hospital, Stockholm, Sweden
- Department of Clinical Science, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
| | - Lars Rombo
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Sörmland County Council, Eskilstuna, Sweden and Uppsala University, Uppsala, Sweden
| | - Poul-Erik Kofoed
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Anu Kantele
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Meilahti Infectious Diseases and Vaccine Research Center, MeiVac, Department of Infectious Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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8
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Caravedo MA, White AC. Treatment of cryptosporidiosis: nitazoxanide yes, but we can do better. Expert Rev Anti Infect Ther 2023; 21:167-173. [PMID: 36533398 DOI: 10.1080/14787210.2023.2160704] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Cryptosporidiosis was initially recognized as an important cause of diarrhea in AIDS patients. It has been underdiagnosed in other populations. Recent studies have highlighted the importance of Cryptosporidium as a cause of diarrhea and malnutrition in young children in resource-poor countries and an emerging pathogen in organ-transplant recipients. AREAS COVERED Nitazoxanide is FDA approved for treatment of cryptosporidiosis in immunocompetent people. However, it is less effective in HIV and transplant patients and malnourished children. In transplant recipients, there is emerging data on antiparasitic combinations for cryptosporidiosis, including combinations of nitazoxanide, azithromycin, and in one case rifaximin. High-throughput phenotypic screens have identified some potential treatments. Among them, clofazimine was no better than placebo in a trial in AIDS patients. There have also been efforts to develop drug versus specific parasite targets. However, in part due to safety issues, none of these compounds have advanced into clinical trials. EXPERT OPINION Development of new and more efficacious therapies for cryptosporidium is imperative. Current approve therapy is far from optimal and lacks efficacy in high-risk populations, such as, patients living with HIV. Additionally, there is limited data on patients with other types of immunosuppression (Transplanted, autoimmune conditions, etc).
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Affiliation(s)
- Maria A Caravedo
- Infectious Disease Division Department of Internal Medicine University of Texas Medical Branch, Galveston, Texas, USA
| | - A Clinton White
- Infectious Disease Division Department of Internal Medicine University of Texas Medical Branch, Galveston, Texas, USA
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9
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Alabedi RF, Aljebouri AH, Al-Maaroof ZW. Acute Otitis Media-Associated Diarrhea in Children Less than 2 Years Old. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: the reported incidence of diarrhea in non-enteric infections can be questioned because many cases of diarrhea are adverse events associated with antibiotics. Although it is well known that one of the none-enteric infections that has diarrhea as one of its manifestations is acute otitis media, its sometimes missed as a possible cause. Objectives: to estimate the prevalence of acute otitis media in children presented with diarrhea and to describe the characteristics of acute otitis media-associated diarrhea after exclusion of antibiotics use. Method: sixty patients (age < 2 years) complaining from diarrhea as their chief complaint were included in this cross sectional study. Their ears had been examined using pneumatic otoscopy, looking for evidence of acute otitis media. Mother-directed specific questions related to the characters of diarrhea, constitutional symptoms, and associated symptoms had been used, in addition to laboratory stool exam. Results: patients involved in this study were 60, 22 (36.7%) females and 38 (63.3%) males. Their ages range from 1-19 months (8.31± 4.30). Acute otitis media was present in 27 cases (45%). There was significant association between acute otitis media-associated diarrhea and age under 1 year (p 0.017), underweight (p 0.012), and ear pain (p <0.001). Conclusions: acute otitis media is a very possible diagnosis for any young baby presented with diarrhea, especially in underweight infant with ear pain, so pneumatic otoscopic ear examination is recommended to be a routine for them.
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Pavlinac PB, Rogawski McQuade ET, Platts-Mills JA, Kotloff KL, Deal C, Giersing BK, Isbrucker RA, Kang G, Ma LF, MacLennan CA, Patriarca P, Steele D, Vannice KS. Pivotal Shigella Vaccine Efficacy Trials-Study Design Considerations from a Shigella Vaccine Trial Design Working Group. Vaccines (Basel) 2022; 10:489. [PMID: 35455238 PMCID: PMC9032541 DOI: 10.3390/vaccines10040489] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 01/27/2023] Open
Abstract
Vaccine candidates for Shigella are approaching phase 3 clinical trials in the target population of young children living in low- and middle-income countries. Key study design decisions will need to be made to maximize the success of such trials and minimize the time to licensure and implementation. We convened an ad hoc working group to identify the key aspects of trial design that would meet the regulatory requirements to achieve the desired indication of prevention of moderate or severe shigellosis due to strains included in the vaccine. The proposed primary endpoint of pivotal Shigella vaccine trials is the efficacy of the vaccine against the first episode of acute moderate or severe diarrhea caused by the Shigella strains contained within the vaccine. Moderate or severe shigellosis could be defined by a modified Vesikari score with dysentery and molecular detection of vaccine-preventable Shigella strains. This report summarizes the rationale and current data behind these considerations, which will evolve as new data become available and after further review and consultation by global regulators and policymakers.
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Affiliation(s)
- Patricia B. Pavlinac
- Departments of Global Health and Epidemiology, University of Washington, Seattle, WA 98105, USA
| | | | - James A. Platts-Mills
- Department of Medicine, Infectious Diseases and International Health, University of Virginia, Charlottesville, VA 22908, USA;
| | - Karen L. Kotloff
- Department of Pediatrics, Medicine, Epidemiology, and Public Health, University of Maryland, Baltimore, MD 21201, USA;
| | - Carolyn Deal
- Enteric and Sexually Transmitted Infections Branch, National Institutes of Health, Rockvile, MD 20892, USA;
| | - Birgitte K. Giersing
- Immunization, Vaccines, and Biologicals Department, World Health Organization, 1211 Geneva, Switzerland; (B.K.G.); (R.A.I.)
| | - Richard A. Isbrucker
- Immunization, Vaccines, and Biologicals Department, World Health Organization, 1211 Geneva, Switzerland; (B.K.G.); (R.A.I.)
| | - Gagandeep Kang
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, Tamil Nadu, India;
| | - Lyou-Fu Ma
- Enteric and Diarrheal Diseases Program Strategy Team, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA; (L.-F.M.); (C.A.M.); (D.S.); (K.S.V.)
| | - Calman A. MacLennan
- Enteric and Diarrheal Diseases Program Strategy Team, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA; (L.-F.M.); (C.A.M.); (D.S.); (K.S.V.)
| | - Peter Patriarca
- Bill & Melinda Gates Medical Research Institute, Cambridge, MA 02139, USA;
| | - Duncan Steele
- Enteric and Diarrheal Diseases Program Strategy Team, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA; (L.-F.M.); (C.A.M.); (D.S.); (K.S.V.)
| | - Kirsten S. Vannice
- Enteric and Diarrheal Diseases Program Strategy Team, Bill & Melinda Gates Foundation, Seattle, WA 98102, USA; (L.-F.M.); (C.A.M.); (D.S.); (K.S.V.)
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11
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Platts-Mills JA, Ayoub E, Zhang J, McQuade ETR, Arzika AM, Maliki R, Abdou A, Keenan JD, Lietman TM, Liu J, Houpt ER. Impact of biannual mass azithromycin treatment on enteropathogen carriage in children younger than 5 years in Niger. Clin Infect Dis 2022; 75:515-518. [PMID: 35020888 PMCID: PMC9427139 DOI: 10.1093/cid/ciab1046] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 01/22/2023] Open
Abstract
We analyzed samples obtained at baseline and 24 months in a mass azithromycin administration trial in Niger using quantitative polymerase chain reaction. In villages randomized to azithromycin, Shigella was the only pathogen reduced at 24 months (prevalence ratio, 0.36 [95% confidence interval: .17–.79]; difference in log quantity, −.42 [−.75 to −.10]).
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Affiliation(s)
- James A Platts-Mills
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA, USA
| | - Elias Ayoub
- University of Virginia School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jixian Zhang
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA, USA
| | | | | | - Ramatou Maliki
- Centre de Recherche et d'Intervention en Santé Publique, Niamey, Niger
| | - Amza Abdou
- Programme National de la Santé Oculaire, Ministere de la Santé Publique, Niamey, Niger
| | - Jeremy D Keenan
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - Thomas M Lietman
- Francis I Proctor Foundation, University of California, San Francisco, CA, USA
| | - Jie Liu
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA, USA
| | - Eric R Houpt
- Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA, USA
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