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Kaburi BB, Harries M, Hauri AM, Kenu E, Wyss K, Silenou BC, Klett-Tammen CJ, Ressing C, Awolin J, Lange B, Krause G. Availability of published evidence on coverage, cost components, and funding support for digitalisation of infectious disease surveillance in Africa, 2003-2022: a systematic review. BMC Public Health 2024; 24:1731. [PMID: 38943132 PMCID: PMC11214246 DOI: 10.1186/s12889-024-19205-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 06/19/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND The implementation of digital disease surveillance systems at national levels in Africa have been challenged by many factors. These include user applicability, utility of IT features but also stable financial support. Funding closely intertwines with implementations in terms of geographical reach, disease focus, and sustainability. However, the practice of evidence sharing on geographical and disease coverage, costs, and funding sources for improving the implementation of these systems on the continent is unclear. OBJECTIVES To analyse the key characteristics and availability of evidence for implementing digital infectious disease surveillance systems in Africa namely their disease focus, geographical reach, cost reporting, and external funding support. METHODS We conducted a systematic review of peer-reviewed and grey literature for the period 2003 to 2022 (PROSPERO registration number: CRD42022300849). We searched five databases (PubMed, MEDLINE over Ovid, EMBASE, Web of Science, and Google Scholar) and websites of WHO, Africa CDC, and public health institutes of African countries. We mapped the distribution of projects by country; identified reported implementation cost components; categorised the availability of data on cost components; and identified supporting funding institutions outside Africa. RESULTS A total of 29 reports from 2,033 search results were eligible for analysis. We identified 27 projects implemented in 13 countries, across 32 sites. Of these, 24 (75%) were pilot projects with a median duration of 16 months, (IQR: 5-40). Of the 27 projects, 5 (19%) were implemented for HIV/AIDs and tuberculosis, 4 (15%) for malaria, 4 (15%) for all notifiable diseases, and 4 (15%) for One Health. We identified 17 cost components across the 29 reports. Of these, 11 (38%) reported quantified costs for start-up capital, 10 (34%) for health personnel compensation, 9 (31%) for training and capacity building, 8 (28%) for software maintenance, and 7(24%) for surveillance data transmission. Of 65 counts of external funding sources, 35 (54%) were governmental agencies, 15 (23%) foundations, and 7 (11%) UN agencies. CONCLUSIONS The evidence on costing data for the digitalisation of surveillance and outbreak response in the published literature is sparse in quantity, limited in detail, and without a standardised reporting format. Most initial direct project costs are substantially donor dependent, short lived, and thus unsustainable.
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Affiliation(s)
- Basil Benduri Kaburi
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- PhD Programme "Epidemiology" Braunschweig-Hannover, Helmholtz Centre for Infection Research, Braunschweig, Germany.
- Hannover Medical School, Hannover, Germany.
| | - Manuela Harries
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Anja M Hauri
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Ernest Kenu
- Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Bernard Chawo Silenou
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | | | - Cordula Ressing
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
| | - Jannis Awolin
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
| | - Gérard Krause
- Department of Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
- Hannover Medical School, Hannover, Germany
- German Center for Infection Research partner site, Hannover-Braunschweig, Germany
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Agboh HNK, Adjei GA, Okai GA, Awotwe C, Ossom BM, Yarney L. Infection prevention and control: Qualitative study of the preparedness and response of Christian health Association of Ghana to Marburg virus disease in Ghana. Heliyon 2024; 10:e31953. [PMID: 38882285 PMCID: PMC11176786 DOI: 10.1016/j.heliyon.2024.e31953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
Objective Recent disease outbreaks underscore the importance of robust disease surveillance and infection prevention and control (IPC) programmes to bolster Africa's public health response system. Yet, available evidence shows extensive gaps in the emergency response capacity of faith-based healthcare providers on the continent. Accordingly, this study examines the IPC and surveillance strategies adopted by a faith-based healthcare provider and the challenges encountered during Marburg Virus Disease outbreak (MVD) in Ghana. Method We collected data from 15 clinical and nonclinical health workers from the Christian Health Association of Ghana (CHAG) and the Ghana Health Service (GHS). Data was collected through online interviews to examine two pillars of the WHO COVID-19 SPRP-AFR (2021) framework. We analyzed the data using Braun and Clarke's thematic analysis. Findings The facility performed creditably well with contact tracing and other quarantine protocols during MVD outbreak in Ghana. However, it also encountered several challenges in the enforcement of IPC protocols, including human resource constraints, the lack of decontamination equipment, and limited infrastructure, among others. Given these limitations, we assessed that the facility cannot handle major outbreaks. Conclusion Due to numerous infectious disease outbreaks in Sub-Saharan Africa in recent years, the government of Ghana and faith-based healthcare providers must resource their facilities with the relevant equipment and qualified human resources against future disease outbreaks.
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Affiliation(s)
| | | | - Grace Adjei Okai
- Catholic Health Service Trust, Ghana, P. O. Box 9712, Airport, Accra, Ghana
| | - Caroline Awotwe
- Catholic Health Service Trust, Ghana, P. O. Box 9712, Airport, Accra, Ghana
| | | | - Lily Yarney
- University of Ghana Business School, P. O. Box LG 78, Legon, Accra, Ghana
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Coulborn RM, Bastard M, Peyraud N, Gignoux E, Luquero F, Guai B, Bateyi Mustafa SH, Mukamba Musenga E, Ahuka-Mundeke S. Case fatality risk among individuals vaccinated with rVSVΔG-ZEBOV-GP: a retrospective cohort analysis of patients with confirmed Ebola virus disease in the Democratic Republic of the Congo. THE LANCET. INFECTIOUS DISEASES 2024; 24:602-610. [PMID: 38340736 DOI: 10.1016/s1473-3099(23)00819-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/27/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND The rVSVΔG-ZEBOV-GP vaccine constitutes a valuable tool to control Ebola virus disease outbreaks. This retrospective cohort study aimed to assess the protective effect of the vaccine against death among patients with confirmed Ebola virus disease. METHODS In this retrospective cohort analysis of patients with confirmed Ebola virus disease admitted to Ebola health facilities in the Democratic Republic of the Congo between July 27, 2018, and April 27, 2020, we performed univariate and multivariate analyses to assess case fatality risk and cycle threshold for nucleoprotein according to vaccination status, Ebola virus disease-specific treatments (eg, mAb114 and REGN-EB3), and other risk factors. FINDINGS We analysed all 2279 patients with confirmed Ebola virus disease. Of these 2279 patients, 1300 (57%) were female and 979 (43%) were male. Vaccination significantly lowered case fatality risk (vaccinated: 25% [106/423] vs not vaccinated: 56% [570/1015]; p<0·0001). In adjusted analyses, vaccination significantly lowered the risk of death compared with no vaccination, with protection increasing as time elapsed from vaccination to symptom onset (vaccinated ≤2 days before onset: 27% [27/99], adjusted relative risk 0·56 [95% CI 0·36-0·82, p=0·0046]; 3-9 days before onset: 20% [28/139], 0·44 [0·29-0·65, p=0·0001]; ≥10 days before onset: 18% [12/68], 0·40 [0·21-0·69; p=0·0022]; vaccination date unknown: 33% [39/117], 0·69 [0·48-0·96; p=0·0341]; and vaccination status unknown: 52% [441/841], 0·80 [0·70-0·91, p=0·0011]). Longer time from symptom onset to admission significantly increased risk of death (49% [1117/2279], 1·03 [1·02-1·05; p<0·0001]). Cycle threshold values for nucleoprotein were significantly higher-indicating lower viraemia-among patients who were vaccinated compared with those who were not vaccinated; the highest difference was observed among those vaccinated 21 days or longer before symptom onset (median 30·0 cycles [IQR 24·6-33·7]) compared with patients who were not vaccinated (21·4 cycles [18·4-25·9], p<0·0001). INTERPRETATION To our knowledge, this is the first observational study describing the protective effect of rVSVΔG-ZEBOV-GP vaccination against death among patients with confirmed Ebola virus disease admitted to an Ebola health facility. Vaccination was protective against death for all patients, even when adjusted for Ebola virus disease-specific treatment, age group, and time from symptom onset to admission. FUNDING Médecins Sans Frontières. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Rebecca M Coulborn
- Department of Epidemiology, Intervention, and Training, Epicentre, Paris, France.
| | - Mathieu Bastard
- Department of Epidemiology, Intervention, and Training, Epicentre, Paris, France
| | - Nicolas Peyraud
- Medical Department, Médecins Sans Frontières, Geneva, Switzerland
| | - Etienne Gignoux
- Department of Epidemiology, Intervention, and Training, Epicentre, Paris, France
| | - Francisco Luquero
- Department of Epidemiology, Intervention, and Training, Epicentre, Paris, France
| | - Bérengère Guai
- Department of Emergencies, Médecins Sans Frontières, Paris, France
| | - Stephane Hans Bateyi Mustafa
- Ministry of Public Health, Hygiene, and Prevention, Expanded Programme on Immunization, Goma, Democratic Republic of the Congo; Department of Public Health, Faculty of Medicine, University of Goma, North Kivu, Democratic Republic of the Congo; Department of Epidemiology, Faculty of Health and Community Development, Université de Pays de Grand Lacs, Goma, Democratic Republic of the Congo
| | - Elisabeth Mukamba Musenga
- Ministry of Public Health, Hygiene, and Prevention, Expanded Programme on Immunization, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Department of Medical Biology, Cliniques Universitaires de Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; Department of Virology, Institut National de la Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
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Bourke BP, Dusek RJ, Ergunay K, Linton YM, Drovetski SV. Viral pathogen detection in U.S. game-farm mallard ( Anas platyrhynchos) flags spillover risk to wild birds. Front Vet Sci 2024; 11:1396552. [PMID: 38860005 PMCID: PMC11163284 DOI: 10.3389/fvets.2024.1396552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/06/2024] [Indexed: 06/12/2024] Open
Abstract
The threat posed by emerging infectious diseases is a major concern for global public health, animal health and food security, and the role of birds in transmission is increasingly under scrutiny. Each year, millions of mass-reared game-farm birds are released into the wild, presenting a unique and a poorly understood risk to wild and susceptible bird populations, and to human health. In particular, the shedding of enteric pathogens through excrement into bodies of water at shared migratory stop-over sites, and breeding and wintering grounds, could facilitate multi-species long-distance pathogen dispersal and infection of high numbers of naive endemic birds annually. The Mallard (Anas platyrhynchos) is the most abundant of all duck species, migratory across much of its range, and an important game species for pen-rearing and release. Major recent population declines along the US Atlantic coast has been attributed to game-farm and wild mallard interbreeding and the introduction maladaptive traits into wild populations. However, pathogen transmission and zoonosis among game-farms Mallard may also impact these populations, as well as wildlife and human health. Here, we screened 16 game-farm Mallard from Wisconsin, United States, for enteric viral pathogens using metatranscriptomic data. Four families of viral pathogens were identified - Picobirnaviridae (Genogroup I), Caliciviridae (Duck Nacovirus), Picornaviridae (Duck Aalivirus) and Sedoreoviridae (Duck Rotavirus G). To our knowledge, this is the first report of Aalivirus in the Americas, and the first report of Calicivirus outside domestic chicken and turkey flocks in the United States. Our findings highlight the risk of viral pathogen spillover from peri-domestically reared game birds to naive wild bird populations.
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Affiliation(s)
- Brian P. Bourke
- Walter Reed Biosystematics Unit, Museum Support Center MRC-534, Smithsonian Institution, Suitland, MD, United States
- One Health Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
- Department of Entomology, Smithsonian Institution—National Museum of Natural History, Washington, DC, United States
| | - Robert J. Dusek
- U.S. Geological Survey, National Wildlife Health Center, Madison, WI, United States
| | - Koray Ergunay
- Walter Reed Biosystematics Unit, Museum Support Center MRC-534, Smithsonian Institution, Suitland, MD, United States
- One Health Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
- Department of Entomology, Smithsonian Institution—National Museum of Natural History, Washington, DC, United States
- Hacettepe University, Department of Medical Microbiology, Ankara, Türkiye
| | - Yvonne-Marie Linton
- Walter Reed Biosystematics Unit, Museum Support Center MRC-534, Smithsonian Institution, Suitland, MD, United States
- One Health Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
- Department of Entomology, Smithsonian Institution—National Museum of Natural History, Washington, DC, United States
| | - Sergei V. Drovetski
- U.S. Geological Survey, Eastern Ecological Science Center at the Patuxent Research Refuge, Laurel, MD, United States
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Akoi Boré J, Timothy JWS, Tipton T, Kekoura I, Hall Y, Hood G, Longet S, Fornace K, Lucien MS, Fehling SK, Koivogui BK, Coggins SA, Laing ED, Broder CC, Magassouba NF, Strecker T, Rossman J, Konde K, Carroll MW. Serological evidence of zoonotic filovirus exposure among bushmeat hunters in Guinea. Nat Commun 2024; 15:4171. [PMID: 38755147 PMCID: PMC11099012 DOI: 10.1038/s41467-024-48587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
Human Ebola virus (EBOV) outbreaks caused by persistent EBOV infection raises questions on the role of zoonotic spillover in filovirus epidemiology. To characterise filovirus zoonotic exposure, we collected cross-sectional serum samples from bushmeat hunters (n = 498) in Macenta Prefecture Guinea, adjacent to the index site of the 2013 EBOV-Makona spillover event. We identified distinct immune signatures (20/498, 4.0%) to multiple EBOV antigens (GP, NP, VP40) using stepwise ELISA and Western blot analysis and, live EBOV neutralisation (5/20; 25%). Using comparative serological data from PCR-confirmed survivors of the 2013-2016 EBOV outbreak, we demonstrated that most signatures (15/20) were not plausibly explained by prior EBOV-Makona exposure. Subsequent data-driven modelling of EBOV immunological outcomes to remote-sensing environmental data also revealed consistent associations with intact closed canopy forest. Together our findings suggest exposure to other closely related filoviruses prior to the 2013-2016 West Africa epidemic and highlight future surveillance priorities.
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Affiliation(s)
| | - Joseph W S Timothy
- Faulty of Infectious & Tropical Diseases, London School of Hygiene Tropical Medicine, London, UK
| | - Tom Tipton
- Centre for Human Genetics & Pandemic Sciences Inst, University of Oxford, Oxford, UK
| | - Ifono Kekoura
- Ministère de la Santé et de l'hygiène publique, Conakry, Guinea
| | - Yper Hall
- UK Health Security Agency, Porton Down, UK
| | - Grace Hood
- Centre for Human Genetics & Pandemic Sciences Inst, University of Oxford, Oxford, UK
| | - Stephanie Longet
- Centre for Human Genetics & Pandemic Sciences Inst, University of Oxford, Oxford, UK
| | - Kimberly Fornace
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | | | | | - Si'Ana A Coggins
- Department of Microbiology and Immunology, Uniformed Services University, MD, USA
| | - Eric D Laing
- Department of Microbiology and Immunology, Uniformed Services University, MD, USA
| | - Christopher C Broder
- Department of Microbiology and Immunology, Uniformed Services University, MD, USA
| | | | - Thomas Strecker
- Institute of Virology, Philipps University, Marburg, Germany
| | - Jeremy Rossman
- School of Bioscience, University of Kent, Canterbury, UK
| | - Kader Konde
- Centre for Training and Research on Priority Diseases including Malaria in Guinea, Conakry, Guinea
| | - Miles W Carroll
- Centre for Human Genetics & Pandemic Sciences Inst, University of Oxford, Oxford, UK.
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Huang J, Morsomme R, Dunson D, Xu J. Detecting changes in the transmission rate of a stochastic epidemic model. Stat Med 2024; 43:1867-1882. [PMID: 38409877 DOI: 10.1002/sim.10050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/26/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024]
Abstract
Throughout the course of an epidemic, the rate at which disease spreads varies with behavioral changes, the emergence of new disease variants, and the introduction of mitigation policies. Estimating such changes in transmission rates can help us better model and predict the dynamics of an epidemic, and provide insight into the efficacy of control and intervention strategies. We present a method for likelihood-based estimation of parameters in the stochastic susceptible-infected-removed model under a time-inhomogeneous transmission rate comprised of piecewise constant components. In doing so, our method simultaneously learns change points in the transmission rate via a Markov chain Monte Carlo algorithm. The method targets the exact model posterior in a difficult missing data setting given only partially observed case counts over time. We validate performance on simulated data before applying our approach to data from an Ebola outbreak in Western Africa and COVID-19 outbreak on a university campus.
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Affiliation(s)
- Jenny Huang
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Raphaël Morsomme
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - David Dunson
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Jason Xu
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
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Yang L. From isolation to revival: trade recovery amid global health crises. Global Health 2024; 20:38. [PMID: 38711086 DOI: 10.1186/s12992-024-01048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the importance of designing effective trade recovery measures in response to global health events (GHEs). This study combines international trade risk management theory and multi-case comparative analysis of past GHEs to present a theoretical framework for designing national trade recovery measures for future events. RESULTS The research finds that during GHEs, trade risks shift to fundamental uncertainty, requiring spatial-temporal-subject dimension recovery measures. The study suggests changing the focus of trade recovery policy design from emergency-oriented and single-dimension measures to reserve-oriented and enduring-effect measures of comprehensive dimensions at micro- and macroeconomic levels. CONCLUSION The study contributes to the debate on managing trade risks in times of crisis, where there is a need to develop effective trade recovery measures that account for the complexities of global trade and the unique challenges of GHEs. The findings provide practical guidance for trade officials and policymakers to design measures in response to GHEs to improve a country's overall trade recovery.
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Affiliation(s)
- Lijuan Yang
- School of Economics, Lanzhou University, Lanzhou, 730000, China.
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Guo Y, Song W, Dong Y, Wang X, Nie G, Li F. A Poly Aptamer Encoded DNA Nanocatcher Informs Efficient Virus Trapping. NANO LETTERS 2024; 24:3614-3623. [PMID: 38497742 DOI: 10.1021/acs.nanolett.3c04510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Broad-spectrum antiviral platforms are always desired but still lack the ability to cope with the threats to global public health. Herein, we develop a poly aptamer encoded DNA nanocatcher platform that can trap entire virus particles to inhibit infection with a broad antiviral spectrum. Ultralong single-stranded DNA (ssDNA) containing repeated aptamers was synthesized as the scaffold of a nanocatcher via a biocatalytic process, wherein mineralization of magnesium pyrophosphate on the ssDNA could occur and consequently lead to the formation of nanocatcher with interfacial nanocaves decorated with virus-binding aptamers. Once the viruses were recognized by the apatmers, they would be captured and trapped in the nanocaves via multisite synergistic interactions. Meanwhile, the size of nanocatchers was optimized to prevent their cellular uptake, which further guaranteed inhibition of virus infection. By taking SARS-CoV-2 variants as a model target, we demonstrated the broad virus-trapping capability of a DNA nanocatcher in engulfing the variants and blocking the infection to host cells.
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Affiliation(s)
- Yunhua Guo
- State Key Laboratory of Chemical Resource Engineering, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China
| | - Wenzhe Song
- State Key Laboratory of Chemical Resource Engineering, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yuhang Dong
- State Key Laboratory of Chemical Resource Engineering, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China
| | - Xuejun Wang
- Bioinformatics Center of AMMS, Taiping Rd, Haidian District, Beijing, 100850, China
| | - Guangjun Nie
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, P. R. China
| | - Feng Li
- State Key Laboratory of Chemical Resource Engineering, Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Chemistry, Beijing University of Chemical Technology, Beijing 100029, China
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Lin MR, Guo X, Azizi A, Fewell JH, Milner F. Mechanistic modeling of alarm signaling in seed-harvester ants. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:5536-5555. [PMID: 38872547 DOI: 10.3934/mbe.2024244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Ant colonies demonstrate a finely tuned alarm response to potential threats, offering a uniquely manageable empirical setting for exploring adaptive information diffusion within groups. To effectively address potential dangers, a social group must swiftly communicate the threat throughout the collective while conserving energy in the event that the threat is unfounded. Through a combination of modeling, simulation, and empirical observations of alarm spread and damping patterns, we identified the behavioral rules governing this adaptive response. Experimental trials involving alarmed ant workers (Pogonomyrmex californicus) released into a tranquil group of nestmates revealed a consistent pattern of rapid alarm propagation followed by a comparatively extended decay period [1]. The experiments in [1] showed that individual ants exhibiting alarm behavior increased their movement speed, with variations in response to alarm stimuli, particularly during the peak of the reaction. We used the data in [1] to investigate whether these observed characteristics alone could account for the swift mobility increase and gradual decay of alarm excitement. Our self-propelled particle model incorporated a switch-like mechanism for ants' response to alarm signals and individual variations in the intensity of speed increased after encountering these signals. This study aligned with the established hypothesis that individual ants possess cognitive abilities to process and disseminate information, contributing to collective cognition within the colony (see [2] and the references therein). The elements examined in this research support this hypothesis by reproducing statistical features of the empirical speed distribution across various parameter values.
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Affiliation(s)
- Michael R Lin
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe 85281, USA
| | - Xiaohui Guo
- Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot 7632706, Israel
| | - Asma Azizi
- Department of Mathematics, Kennesaw State University, Marietta 30062, USA
| | | | - Fabio Milner
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe 85281, USA
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe 85287, USA
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Watts S, Hänni E, Smith GN, Mahmoudi N, Freire RVM, Lim S, Salentinig S. Human antimicrobial peptide inactivation mechanism of enveloped viruses. J Colloid Interface Sci 2024; 657:971-981. [PMID: 38096780 DOI: 10.1016/j.jcis.2023.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 01/02/2024]
Abstract
HYPOTHESIS Enveloped viruses are pivotal in causing various illnesses, including influenza and COVID-19. The antimicrobial peptide LL-37, a critical part of the human innate immune system, exhibits potential as an antiviral agent capable of thwarting these viral threats. Its mode of action involves versatile and non-specific interactions that culminate in dismantling the viral envelope, ultimately rendering the viruses inert. However, the exact mechanism of action is not yet understood. EXPERIMENTS Here, the mechanism of LL-37 triggered changes in the structure and function of an enveloped virus is investigated. The bacteriophage "Phi6" is used as a surrogate for pathogenic enveloped viruses. Small angle X-ray and neutron scattering combined with light scattering techniques demonstrate that LL-37 actively integrates into the virus's lipid envelope. FINDINGS LL-37 addition to Phi6 leads to curvature modification in the lipid bilayer, ultimately separating the envelope from the nucleocapsid. Additional biological assays confirm the loss of virus infectivity in the presence of LL-37, which coincides with the structural transformations. The results provide a fundamental understanding of the structure-activity relationship related to enveloped viruses. The knowledge of peptide-virus interactions can guide the design of future peptide-based antiviral drugs and therapies.
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Affiliation(s)
- Samuel Watts
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, 1700 Fribourg, Switzerland; School of Chemistry, Chemical Engineering and Biotechnology, 70 Nanyang Drive, Block N1.3, Nanyang Technological University, Singapore 637457, Singapore
| | - Eliane Hänni
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, 1700 Fribourg, Switzerland
| | - Gregory N Smith
- ISIS Neutron and Muon Souce, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Didcot OX11 0QX, United Kingdom
| | - Najet Mahmoudi
- ISIS Neutron and Muon Souce, Science and Technology Facilities Council, Rutherford Appleton Laboratory, Didcot OX11 0QX, United Kingdom
| | - Rafael V M Freire
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, 1700 Fribourg, Switzerland
| | - Sierin Lim
- School of Chemistry, Chemical Engineering and Biotechnology, 70 Nanyang Drive, Block N1.3, Nanyang Technological University, Singapore 637457, Singapore
| | - Stefan Salentinig
- Department of Chemistry, University of Fribourg, Chemin du Musée 9, 1700 Fribourg, Switzerland.
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Lehnert T, Gijs MAM. Microfluidic systems for infectious disease diagnostics. LAB ON A CHIP 2024; 24:1441-1493. [PMID: 38372324 DOI: 10.1039/d4lc00117f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Microorganisms, encompassing both uni- and multicellular entities, exhibit remarkable diversity as omnipresent life forms in nature. They play a pivotal role by supplying essential components for sustaining biological processes across diverse ecosystems, including higher host organisms. The complex interactions within the human gut microbiota are crucial for metabolic functions, immune responses, and biochemical signalling, particularly through the gut-brain axis. Viruses also play important roles in biological processes, for example by increasing genetic diversity through horizontal gene transfer when replicating inside living cells. On the other hand, infection of the human body by microbiological agents may lead to severe physiological disorders and diseases. Infectious diseases pose a significant burden on global healthcare systems, characterized by substantial variations in the epidemiological landscape. Fast spreading antibiotic resistance or uncontrolled outbreaks of communicable diseases are major challenges at present. Furthermore, delivering field-proven point-of-care diagnostic tools to the most severely affected populations in low-resource settings is particularly important and challenging. New paradigms and technological approaches enabling rapid and informed disease management need to be implemented. In this respect, infectious disease diagnostics taking advantage of microfluidic systems combined with integrated biosensor-based pathogen detection offers a host of innovative and promising solutions. In this review, we aim to outline recent activities and progress in the development of microfluidic diagnostic tools. Our literature research mainly covers the last 5 years. We will follow a classification scheme based on the human body systems primarily involved at the clinical level or on specific pathogen transmission modes. Important diseases, such as tuberculosis and malaria, will be addressed more extensively.
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Affiliation(s)
- Thomas Lehnert
- Laboratory of Microsystems, École Polytechnique Fédérale de Lausanne, Lausanne, CH-1015, Switzerland.
| | - Martin A M Gijs
- Laboratory of Microsystems, École Polytechnique Fédérale de Lausanne, Lausanne, CH-1015, Switzerland.
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Smith ED. Sustaining Preparedness in Hospitals. Adv Health Care Manag 2024; 22:161-178. [PMID: 38262015 DOI: 10.1108/s1474-823120240000022008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents. SEARCH METHODS This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 - SARS, MERS, Ebola, and COVID-19. SEARCH RESULTS The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study. DISCUSSION AND CONCLUSIONS Comparison of key issues and lessons learned among the four major events described in this article - SARS, MERS, Ebola, and COVID-19 - highlight that several lessons are "relearned" with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.
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Collier KM, Klein EK, Sevalie S, Molleh B, Kabba Y, Kargbo A, Bangura J, Gbettu H, Simms S, O'Leary C, Drury S, Schieffelin JS, Betancourt TS, Crea TM. Ebola Virus Disease Sensitization: Community-Driven Efforts in Sierra Leone. J Community Health 2024; 49:108-116. [PMID: 37531047 DOI: 10.1007/s10900-023-01265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 08/03/2023]
Abstract
The 2014-2016 West Africa Ebola outbreak was the largest in history, resulting in approximately 11,000 deaths. Despite the outbreak's eventual end, national and international health sensitization and containment efforts were subject to criticism. This study investigates disease-related knowledge and beliefs, as well as trusted sources of health information among EVD-survivors and their family members, highlighting the importance of community-informed public health responses. Participants (n = 134) were adults who were either EVD-infected, affected families/caregivers, or community leaders. In-depth interviews and focus groups explored EVD-related experiences, including health effects, stigma, and community relationships. Using a grounded theory and thematic content analysis approach, transcripts were coded for evidence of health sensitization, as well as compliance with mitigation measures and trusted sources of information. Participants displayed a high level of knowledge around EVD and reported compliance with mandated and personal prevention measures. Levels of health sensitization and subsequent reintegration of survivors were reported to be largely the products of community-based efforts, rather than the top-down, national public health response. Primary sources of trusted information included EVD survivors acting as peer educators; local leaders; and EVD sensitization by community health workers. This study highlights the importance of a community-based response for increasing the effectiveness of public health campaigns. Participants expressed that relying on the experiences of trusted cultural insiders led to a deeper understanding of Ebola compared to top-down public health campaigns, and helped infected and affected community members reintegrate. Future public health efforts should incorporate community-based participatory approaches to address infectious disease outbreaks.
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Affiliation(s)
- K Megan Collier
- School of Social Work, Boston College, Chestnut Hill, MA, USA.
| | | | | | | | - Yusuf Kabba
- Sierra Leone Association of Ebola Survivors, Freetown, Sierra Leone
| | - Abdulai Kargbo
- Sierra Leone Association of Ebola Survivors, Freetown, Sierra Leone
| | | | | | - Stewart Simms
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Clara O'Leary
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Stacy Drury
- School of Medicine, Tulane University, New Orleans, LA, USA
| | | | | | - Thomas M Crea
- School of Social Work, Boston College, Chestnut Hill, MA, USA
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Soni M, Tulsian K, Barot P, Vyas VK. Recent Advances in Therapeutic Approaches Against Ebola Virus Infection. RECENT ADVANCES IN ANTI-INFECTIVE DRUG DISCOVERY 2024; 19:276-299. [PMID: 38279760 DOI: 10.2174/0127724344267452231206061944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Ebola virus (EBOV) is a genus of negative-strand RNA viruses belonging to the family Filoviradae that was first described in 1976 in the present-day Democratic Republic of the Congo. It has intermittently affected substantial human populations in West Africa and presents itself as a global health menace due to the high mortality rate of patients, high transmission rate, difficult patient management, and the emergence of complicated autoimmune disease-like conditions post-infection. OBJECTIVE EBOV or other EBOV-like species as a biochemical weapon pose a significant risk; hence, the need to develop both prophylactic and therapeutic medications to combat the virus is unquestionable. METHODS In this review work, we have compiled the literature pertaining to transmission, pathogenesis, immune response, and diagnosis of EBOV infection. We included detailed structural details of EBOV along with all the available therapeutics against EBOV disease. We have also highlighted current developments and recent advances in therapeutic approaches against Ebola virus disease (EVD). DISCUSSION The development of preventive vaccines against the virus is proving to be a successful effort as of now; however, problems concerning logistics, product stability, multi- dosing, and patient tracking are prominent in West Africa. Monoclonal antibodies that target EBOV proteins have also been developed and approved in the clinic; however, no small drug molecules that target these viral proteins have cleared clinical trials. An understanding of clinically approved vaccines and their shortcomings also serves an important purpose for researchers in vaccine design in choosing the right vector, antigen, and particular physicochemical properties that are critical for the vaccine's success against the virus across the world. CONCLUSION Our work brings together a comprehensive review of all available prophylactic and therapeutic medications developed and under development against the EBOV, which will serve as a guide for researchers in pursuing the most promising drug discovery strategies against the EBOV and also explore novel mechanisms of fighting against EBOV infection.
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Affiliation(s)
- Molisha Soni
- Department of Pharmacology, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Kartik Tulsian
- Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Parv Barot
- Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Vivek Kumar Vyas
- Department of Pharmaceutical Chemistry, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
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15
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Dobbs KR, Lobb A, Dent AE. Ebola virus disease in children: epidemiology, pathogenesis, management, and prevention. Pediatr Res 2024; 95:488-495. [PMID: 37903937 DOI: 10.1038/s41390-023-02873-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023]
Abstract
Ebola disease is a severe disease with extremely high case-fatality rates ranging from 28-100%. Observations made during the 2013-2016 West African epidemic improved our understanding of the clinical course of Ebola disease and accelerated the study of therapeutic and preventative strategies. The epidemic also highlighted the unique challenges associated with providing optimal care for children during Ebola disease outbreaks. In this review, we outline current understanding of Ebola disease epidemiology, pathogenesis, management, and prevention, highlighting data pertinent to the care of children. IMPACT: In this review, we summarize recent advancements in our understanding of Ebola disease epidemiology, clinical presentation, and therapeutic and preventative strategies. We highlight recent data pertinent to the care of children and pregnant women and identify research gaps for this important emerging viral infection in children.
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Affiliation(s)
- Katherine R Dobbs
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
- UH Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
| | - Alyssa Lobb
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Arlene E Dent
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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16
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Salmanton-García J, Wipfler P, Leckler J, Nauclér P, Mallon PW, Bruijning-Verhagen PCJL, Schmitt HJ, Bethe U, Olesen OF, Stewart FA, Albus K, Cornely OA. Predicting the next pandemic: VACCELERATE ranking of the WorldHealth Organization's Blueprint forAction toPreventEpidemics. Travel Med Infect Dis 2024; 57:102676. [PMID: 38061408 DOI: 10.1016/j.tmaid.2023.102676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION The World Health Organization (WHO)'s Research and Development (R&D) Blueprint for Action to Prevent Epidemics, a plan of action, highlighted several infectious diseases as crucial targets for prevention. These infections were selected based on a thorough assessment of factors such as transmissibility, infectivity, severity, and evolutionary potential. In line with this blueprint, the VACCELERATE Site Network approached infectious disease experts to rank the diseases listed in the WHO R&D Blueprint according to their perceived risk of triggering a pandemic. VACCELERATE is an EU-funded collaborative European network of clinical trial sites, established to respond to emerging pandemics and enhance vaccine development capabilities. METHODS Between February and June 2023, a survey was conducted using an online form to collect data from members of the VACCELERATE Site Network and infectious disease experts worldwide. Participants were asked to rank various pathogens based on their perceived risk of causing a pandemic, including those listed in the WHO R&D Blueprint and additional pathogens. RESULTS A total of 187 responses were obtained from infectious disease experts representing 57 countries, with Germany, Spain, and Italy providing the highest number of replies. Influenza viruses received the highest rankings among the pathogens, with 79 % of participants including them in their top rankings. Disease X, SARS-CoV-2, SARS-CoV, and Ebola virus were also ranked highly. Hantavirus, Lassa virus, Nipah virus, and henipavirus were among the bottom-ranked pathogens in terms of pandemic potential. CONCLUSION Influenza, SARS-CoV, SARS-CoV-2, and Ebola virus were found to be the most concerning pathogens with pandemic potential, characterised by transmissibility through respiratory droplets and a reported history of epidemic or pandemic outbreaks.
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Affiliation(s)
- Jon Salmanton-García
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Pauline Wipfler
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Janina Leckler
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Pontus Nauclér
- Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Patrick W Mallon
- School of Medicine, University College Dublin, Dublin, Ireland; Department of Infectious Diseases, St. Vincent's University Hospital, Dublin, Ireland; Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Dublin, Ireland
| | - Patricia C J L Bruijning-Verhagen
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Heinz-Joseph Schmitt
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; Global Health Press Pte. Ltd., Singapore
| | - Ullrich Bethe
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Ole F Olesen
- European Vaccine Initiative (EVI), Heidelberg, Germany
| | - Fiona A Stewart
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Kerstin Albus
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - Oliver A Cornely
- Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University Hospital Cologne, Faculty of Medicine, University of Cologne, Cologne, Germany; Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, Faculty of Medicine), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany
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Khan G, Perveen N. The 2022 monkeypox outbreak 1 year on: The 5 Ws. Rev Med Virol 2024; 34:e2489. [PMID: 37930054 DOI: 10.1002/rmv.2489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
In May 2022, World Health Organization (WHO) reported an outbreak of Mpox in several European countries which were previously Mpox free. Mpox (formerly known as monkeypox) is a zoonotic viral disease endemic in Central and West Africa. The sudden emergence of Mpox outside Africa and its subsequent rapid spread lead the WHO to declare the outbreak as Public Health Emergency of International Concern. By 15 May 2023, a total of 87,704 confirmed cases and 140 deaths had been reported from 111 countries and territories worldwide. Looking back on this outbreak 1 year later, several important questions have arisen. Here, we address these questions using the classic 5 Ws: What, When, Where, Who and Why? We discuss these questions to understand how this outbreak emerged and how it was effectively managed. We outline what needs to be done to prevent, or at least minimise, outbreaks due to emerging and re-emerging viral infections.
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Affiliation(s)
- Gulfaraz Khan
- Department of Microbiology & Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Nighat Perveen
- Department of Biology, College of Science, United Arab Emirates University, Al-Ain, United Arab Emirates
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18
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Gonzalez A, Nikparvar B, Matson MJ, Seifert SN, Ross HD, Munster V, Bharti N. Human movement and transmission dynamics early in Ebola outbreaks. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.18.23300175. [PMID: 38196653 PMCID: PMC10775320 DOI: 10.1101/2023.12.18.23300175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Human movement drives the transmission and spread of communicable pathogens. It is especially influential for emerging pathogens when population immunity is low and spillover events are rare. We digitized serial printed maps to measure transportation networks (roads and rivers) in Central and West Africa as proxies for population mobility to assess relationships between movement and Ebola transmission. We find that the lengths of roads and rivers in close proximity to spillover sites at or near the time of spillover events are significantly correlated with the number of EVD cases, particularly in the first 100 days of each outbreak. Early management and containment efforts along transportation networks may be beneficial in mitigation during the early days of transmission and spatial spread for Ebola outbreaks.
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Affiliation(s)
- Alexandria Gonzalez
- Biology Department and Center for Infectious Disease Dynamics, Penn State University, University Park, PA, 16802, USA
| | - Behnam Nikparvar
- Biology Department and Center for Infectious Disease Dynamics, Penn State University, University Park, PA, 16802, USA
| | - M. Jeremiah Matson
- University of Utah Health, Department of Internal Medicine, Salt Lake City, UT 84132, USA
| | - Stephanie N. Seifert
- Paul G. Allen School for Global Health, Washington State University, Pullman, WA, 99164 USA
| | - Heather D. Ross
- Donald W. Hamer Center for Maps and Geospatial Information, Penn State University Libraries, Penn State University, University Park, PA, 16802, USA
| | - Vincent Munster
- Division of Intramural Research, Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, Montana, 59840 USA
| | - Nita Bharti
- Biology Department and Center for Infectious Disease Dynamics, Penn State University, University Park, PA, 16802, USA
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Handel A, Miller JC, Ge Y, Fung ICH. If Long-Term Suppression is not Possible, how do we Minimize Mortality for Infectious Disease Outbreaks? Disaster Med Public Health Prep 2023; 17:e547. [PMID: 38037811 DOI: 10.1017/dmp.2023.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE For any emerging pathogen, the preferred approach is to drive it to extinction with non-pharmaceutical interventions (NPI) or suppress its spread until effective drugs or vaccines are available. However, this might not always be possible. If containment is infeasible, the best people can hope for is pathogen transmission until population level immunity is achieved, with as little morbidity and mortality as possible. METHODS A simple computational model was used to explore how people should choose NPI in a non-containment scenario to minimize mortality if mortality risk differs by age. RESULTS Results show that strong NPI might be worse overall if they cannot be sustained compared to weaker NPI of the same duration. It was also shown that targeting NPI at different age groups can lead to similar reductions in the total number of infected, but can have strong differences regarding the reduction in mortality. CONCLUSIONS Strong NPI that can be sustained until drugs or vaccines become available are always preferred for preventing infection and mortality. However, if people encounter a worst-case scenario where interventions cannot be sustained, allowing some infections to occur in lower-risk groups might lead to an overall greater reduction in mortality than trying to protect everyone equally.
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Affiliation(s)
- Andreas Handel
- Department of Epidemiology and Biostatistics, The University of Georgia, Athens, GA, USA
| | - Joel C Miller
- School of Computing, Engineering and Mathematical Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Yang Ge
- School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Kuroda M, Halfmann PJ, Thackray LB, Diamond MS, Feldmann H, Marzi A, Kawaoka Y. An Antiviral Role for TRIM14 in Ebola Virus Infection. J Infect Dis 2023; 228:S514-S521. [PMID: 37562033 PMCID: PMC10651195 DOI: 10.1093/infdis/jiad325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/12/2023] Open
Abstract
Ebola virus (EBOV) is a highly pathogenic virus that encodes 7 multifunctional structural proteins. Multiple host factors have been reported to interact with the EBOV proteins. Here, we found that tripartite motif-containing 14 (TRIM14), an interferon-stimulated gene that mediates cellular signaling pathways associated with type I interferon and inflammatory cytokine production, interacts with EBOV nucleoprotein to enhance interferon-β (IFN-β) and nuclear factor-κB (NF-κB) promotor activation. Moreover, TRIM14 overexpression reduced viral replication in an infectious but biologically contained EBOVΔVP30 system by approximately 10-fold without affecting viral protein expression. Furthermore, TRM14-deficient mice were more susceptible to mouse-adapted EBOV infection than wild-type mice. Our data suggest that TRIM14 is a host factor with anti-EBOV activity that limits EBOV pathogenesis.
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Affiliation(s)
- Makoto Kuroda
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Peter J Halfmann
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Larissa B Thackray
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
| | - Michael S Diamond
- Department of Medicine, Washington University School of Medicine, St Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri, USA
- Department of Molecular Microbiology, Washington University School of Medicine, St Louis, Missouri, USA
- The Andrew M. and Jane M. Bursky Center for Human Immunology and Immunotherapy Programs, Washington University School of Medicine, St Louis, Missouri, USA
- Center for Vaccines and Immunity to Microbial Pathogens, Washington University School of Medicine, St Louis, Missouri, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana, USA
| | - Yoshihiro Kawaoka
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, University of Tokyo, Tokyo, Japan
- The Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
- Pandemic Preparedness, Infection and Advanced Research Center, University of Tokyo, Tokyo, Japan
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Vucetic A, Lafleur A, Côté M, Kobasa D, Chan M, Alvarez F, Piccirillo C, Dong G, Olivier M. Extracellular vesicle storm during the course of Ebola virus infection in primates. Front Cell Infect Microbiol 2023; 13:1275277. [PMID: 38035334 PMCID: PMC10684970 DOI: 10.3389/fcimb.2023.1275277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Ebola virus (EBOV) is an RNA virus of the Filoviridae family that is responsible for outbreaks of hemorrhagic fevers in primates with a lethality rate as high as 90%. EBOV primarily targets host macrophages leading to cell activation and systemic cytokine storm, and fatal infection is associated with an inhibited interferon response, and lymphopenia. The EBOV surface glycoprotein (GP) has been shown to directly induce T cell depletion and can be secreted outside the virion via extracellular vesicles (EVs), though most studies are limited to epithelial cells and underlying mechanisms remain poorly elucidated. Methods To assess the role of GP on EBOV-induced dysregulation of host immunity, we first utilized EBOV virus-like particles (VLPs) expressing VP40 and NP either alone (Bald-VLP) or in conjunction with GP (VLP-GP) to investigate early inflammatory responses in THP-1 macrophages and in a murine model. We then sought to decipher the role of non-classical inflammatory mediators such as EVs over the course of EBOV infection in two EBOV-infected rhesus macaques by isolating and characterizing circulatory EVs throughout disease progression using size exclusion chromatography, nanoparticle tracking-analysis, and LC-MS/MS. Results While all VLPs could induce inflammatory mediators and recruit small peritoneal macrophages, pro-inflammatory cytokine and chemokine gene expression was exacerbated by the presence of GP. Further, quantification of EVs isolated from infected rhesus macaques revealed that the concentration of vesicles peaked in circulation at the terminal stage, at which time EBOV GP could be detected in host-derived exosomes. Moreover, comparative proteomics conducted across EV populations isolated from serum at various time points before and after infection revealed differences in host-derived protein content that were most significantly pronounced at the endpoint of infection, including significant expression of mediators of TLR4 signaling. Discussion These results suggest a dynamic role for EVs in the modification of disease states in the context of EBOV. Overall, our work highlights the importance of viral factors, such as the GP, and host derived EVs in the inflammatory cascade and pathogenesis of EBOV, which can be collectively further exploited for novel antiviral development.
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Affiliation(s)
- Andrea Vucetic
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Andrea Lafleur
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Marceline Côté
- Department of Biochemistry, Microbiology and Immunology and Centre for Infection, Immunity and Inflammation, University of Ottawa, Ottawa, ON, Canada
| | - Darwyn Kobasa
- Special Pathogen Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Mable Chan
- Special Pathogen Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Fernando Alvarez
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Federation of Clinical Immunology (FOCiS) Centres of Excellence in Translational Immunology (CETI), Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Ciriaco Piccirillo
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Federation of Clinical Immunology (FOCiS) Centres of Excellence in Translational Immunology (CETI), Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - George Dong
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Martin Olivier
- Department of Microbiology and Immunology, McGill University, Montréal, QC, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Federation of Clinical Immunology (FOCiS) Centres of Excellence in Translational Immunology (CETI), Research Institute of the McGill University Health Centre, Montréal, QC, Canada
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Prasad AN, Agans KN, Geisbert JB, Borisevich V, Deer DJ, Dobias NS, Comer JE, Woolsey C, Fenton KA, Geisbert TW, Cross RW. Natural History of Nonhuman Primates After Oral Exposure to Ebola Virus Variant Makona. J Infect Dis 2023; 228:S571-S581. [PMID: 37348509 PMCID: PMC10651204 DOI: 10.1093/infdis/jiad225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/03/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The primary route of infection by Ebola virus (EBOV) is through contact of mucosal surfaces. Few studies have explored infection of nonhuman primates (NHPs) via the oral mucosa, which is a probable portal of natural infection in humans. METHODS To further characterize the pathogenesis of EBOV infection via the oral exposure route, we challenged cohorts of cynomolgus monkeys with low doses of EBOV variant Makona. RESULTS Infection with 100 or 50 PFU of EBOV Makona via the oral route resulted in 50% and 83% lethality, respectively. Animals that progressed to fatal disease exhibited lymphopenia, marked coagulopathy, high viral loads, and increased levels of serum markers of inflammation and hepatic/renal injury. Survival in these cohorts was associated with milder fluctuations in leukocyte populations, lack of coagulopathy, and reduced or absent serum markers of inflammation and/or hepatic/renal function. Surprisingly, 2 surviving animals from the 100- and 50-PFU cohorts developed transient low-level viremia in the absence of other clinical signs of disease. Conversely, all animals in the 10 PFU cohort remained disease free and survived to the study end point. CONCLUSIONS Our observations highlight the susceptibility of NHPs, and by extension, likely humans, to relatively low doses of EBOV via the oral route.
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Affiliation(s)
- Abhishek N Prasad
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Viktoriya Borisevich
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Daniel J Deer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Natalie S Dobias
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jason E Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Courtney Woolsey
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Karla A Fenton
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
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23
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Prasad AN, Fenton KA, Agans KN, Borisevich V, Woolsey C, Comer JE, Dobias NS, Peel JE, Deer DJ, Geisbert JB, Lawrence WS, Cross RW, Geisbert TW. Pathogenesis of Aerosolized Ebola Virus Variant Makona in Nonhuman Primates. J Infect Dis 2023; 228:S604-S616. [PMID: 37145930 PMCID: PMC10651212 DOI: 10.1093/infdis/jiad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Highly pathogenic filoviruses such as Ebola virus (EBOV) hold capacity for delivery by artificial aerosols, and thus potential for intentional misuse. Previous studies have shown that high doses of EBOV delivered by small-particle aerosol cause uniform lethality in nonhuman primates (NHPs), whereas only a few small studies have assessed lower doses in NHPs. METHODS To further characterize the pathogenesis of EBOV infection via small-particle aerosol, we challenged cohorts of cynomolgus monkeys with low doses of EBOV variant Makona, which may help define risks associated with small particle aerosol exposures. RESULTS Despite using challenge doses orders of magnitude lower than previous studies, infection via this route was uniformly lethal across all cohorts. Time to death was delayed in a dose-dependent manner between aerosol-challenged cohorts, as well as in comparison to animals challenged via the intramuscular route. Here, we describe the observed clinical and pathological details including serum biomarkers, viral burden, and histopathological changes leading to death. CONCLUSIONS Our observations in this model highlight the striking susceptibility of NHPs, and likely humans, via small-particle aerosol exposure to EBOV and emphasize the need for further development of diagnostics and postexposure prophylactics in the event of intentional release via deployment of an aerosol-producing device.
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Affiliation(s)
- Abhishek N Prasad
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Karla A Fenton
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Viktoriya Borisevich
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Courtney Woolsey
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jason E Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Natalie S Dobias
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Jennifer E Peel
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Daniel J Deer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - William S Lawrence
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, USA
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McMahon DE, Schuetz AN, Kovarik CL. Emerging infectious diseases of the skin: a review of clinical and histologic findings. Hum Pathol 2023; 140:196-213. [PMID: 37454994 DOI: 10.1016/j.humpath.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Emerging infectious diseases are of great importance to public health and clinical practice. This review aims to characterize the clinical and histopathologic features of emerging infectious diseases with cutaneous manifestations in order to increase awareness of these entities among dermatologists, pathologists, and dermatopathologists.
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Affiliation(s)
- Devon E McMahon
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Audrey N Schuetz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carrie L Kovarik
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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25
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Topluoglu S, Taylan-Ozkan A, Alp E. Impact of wars and natural disasters on emerging and re-emerging infectious diseases. Front Public Health 2023; 11:1215929. [PMID: 37727613 PMCID: PMC10505936 DOI: 10.3389/fpubh.2023.1215929] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/17/2023] [Indexed: 09/21/2023] Open
Abstract
Emerging Infectious Diseases (EIDs) and Re-Emerging Infectious Diseases (REIDs) constitute significant health problems and are becoming of major importance. Up to 75% of EIDs and REIDs have zoonotic origin. Several factors such as the destruction of natural habitats leading humans and animals to live in close proximity, ecological changes due to natural disasters, population migration resulting from war or conflict, interruption or decrease in disease prevention programs, and insufficient vector control applications and sanitation are involved in disease emergence and distribution. War and natural disasters have a great impact on the emergence/re-emergence of diseases in the population. According to a World Bank estimation, two billion people are living in poverty and fragility situations. Wars destroy health systems and infrastructure, curtail existing disease control programs, and cause population movement leading to an increase in exposure to health risks and favor the emergence of infectious diseases. A total of 432 catastrophic cases associated with natural disasters were recorded globally in 2021. Natural disasters increase the risk of EID and REID outbreaks by damaging infrastructure and leading to displacement of populations. A Generic National Action Plan covering risk assessment, mechanism for action, determination of roles and responsibilities of each sector, the establishment of a coordination mechanism, etc. should be developed.
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Affiliation(s)
- Seher Topluoglu
- Provincial Health Directorate of Ankara, Republic of Türkiye Ministry of Health, Ankara, Türkiye
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology, Medical Faculty, TOBB University of Economics and Technology, Ankara, Türkiye
| | - Emine Alp
- Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, Ankara Yildirim Beyazit University, Ankara, Türkiye
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26
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Mohamud AK, Ali IA, Ali AI, Dirie NI, Inchon P, Ahmed OA, Mohamud AA. Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey. BMC Public Health 2023; 23:1650. [PMID: 37641041 PMCID: PMC10464228 DOI: 10.1186/s12889-023-16562-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In September 2022, a new Ebola outbreak was reported in Uganda, East Africa, and 142 confirmed cases, including 19 Healthcare workers (HCWs) reported. Ebola is not endemic in Somalia, but the country is at a reasonable risk of the virus being introduced due to the direct connection with daily flights from Uganda without border health control and prevention activities. Therefore, evaluating HCWs' Knowledge and attitude is crucial since this is the first time being evaluated in Somalia. The study's objective is to evaluate the HCWs' Knowledge and attitude toward the Ebola virus disease in Somalia. METHOD An online self-administrated cross-sectional survey was conducted among HCWs (n = 1103) in all six federal member states of Somalia using a validated, reliable, well-structured questionnaire. Data we analyzed using descriptive statistics and Logistic regression were used to determine sociodemographic characteristics associated with poor Knowledge and negative attitude. RESULT Over one-third (37.3%) of HCWs had poor Knowledge; the mean knowledge score was 7.97 SD ± 2.15. Almost 40.1% of the HCWs had a negative attitude; the mean attitude was 27.81 SD ± 8.06. Low-income HCWs (AOR = 2.06, 95%CI:1.01-4.19), Married HCWs (AOR = 1.39, 95%CI: 1.110-1.963), Midwives (AOR = 2.76, 95%CI: 1.74-4.39), Lab technicians (AOR = 2.43, 95%CI: 1.43-4.14), HCWs work in Jubaland state of Somalia (AOR = 3.69, 95%CI: 2.39-5.70), Galmudug state (AOR = 8.50, 95%CI: 4.59-15.77), Hirshabelle state (AOR = 3.18, 95%CI: 2.15-4.71) were more likely to have poor Knowledge compared to their counterparts. HCWs who work in Hirshabelle state (AOR = 5.44,95%CI: 3.58-8.27), Jubaland state (AOR = 8.47, 95%CI: 4.69-15.29), and Galmudug state (AOR = 4.43, 95%CI: 3.03-6.48) was more likely to have a negative attitude than those working in the Banadir region administration. CONCLUSION Most Somali healthcare workers showed good Knowledge and a positive attitude toward the Ebola virus. The implementation to enhance Knowledge and attitude must specifically focus on low-income HCWs, Midwives, Lab technicalities, and those who work in Hirshabelle, Jubaland, and Galmudug states of Somalia.
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Affiliation(s)
| | - Ikran Abdulkadir Ali
- Department of Neonatal Intensive Care Unit in Yardimeli Hospital Mogadishu, Mogadishu, Somalia
| | - Ahmed Isse Ali
- Dermatology of Department, Mogadishu-Somali Turkey Training and Research Hospital, Mogadishu, Somalia
| | - Najib Isse Dirie
- Department of Urology, Dr Sumait Hospital, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia
| | - Pamornsri Inchon
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
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27
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Shannon FQ, Bawo LL, Crump JA, Sharples K, Egan R, Hill PC. Evaluation of Ebola virus disease surveillance system capability to promptly detect a new outbreak in Liberia. BMJ Glob Health 2023; 8:e012369. [PMID: 37532462 PMCID: PMC10401241 DOI: 10.1136/bmjgh-2023-012369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/09/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Liberia was heavily affected by the 2014-2016 Ebola virus disease (EVD) outbreak. With substantial investments in interventions to combat future outbreaks, it is hoped that Liberia is well prepared for a new incursion. We assessed the performance of the current EVD surveillance system in Liberia, focusing on its ability to promptly detect a new EVD outbreak. METHODS We integrated WHO and US Centers for Disease Control and Prevention guidelines for public health surveillance system evaluation and used standardised indicators to measure system performance. We conducted 23 key informant interviews, 150 health facility assessment surveys and a standardised patient (SP) study (19 visits) from January 2020 to January 2021. Data were summarised and a gap analysis conducted. RESULTS We found basic competencies of case detection and reporting necessary for a functional surveillance system were in place. At the higher (national, county and district) levels, we found performance gaps in 2 of 6 indicators relating to surveillance system structure, 3 of 14 indicators related to core functions, 1 of 5 quality indicators and 2 of 8 indicators related to support functions. The health facility assessment found performance gaps in 9 of 10 indicators related to core functions, 5 of 6 indicators related to support functions and 3 of 7 indicators related to quality. The SP simulations revealed large gaps between expected and actual practice in managing a patient warranting investigation for EVD. Major challenges affecting the system's operations across all levels included limited access to resources to support surveillance activities, persistent stock out of sample collection materials and attrition of trained staff. CONCLUSION The EVD surveillance system in Liberia may fail to promptly detect a new EVD outbreak. Specific improvements are required, and regular evaluations recommended. SP studies could be crucial in evaluating surveillance systems for rarely occurring diseases that are important to detect early.
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Affiliation(s)
- Fulton Quincy Shannon
- Centre for International Health, University of Otago, Dunedin, New Zealand
- Planning Research and Development, Republic of Liberia Ministry of Health, Monrovia, Liberia
| | - Luke L Bawo
- Planning Research and Development, Republic of Liberia Ministry of Health, Monrovia, Liberia
| | - John A Crump
- Centre for International Health, University of Otago, Dunedin, New Zealand
| | - Katrina Sharples
- Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Richard Egan
- Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Philip C Hill
- Centre for International Health, University of Otago, Dunedin, New Zealand
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Abdul-Rahman T, Lawal L, Meale E, Ajetunmobi OA, Toluwalashe S, Alao UH, Ghosh S, Garg N, Aborode AT, Wireko AA, Mehta A, Sikora K. Inequitable access to Ebola vaccines and the resurgence of Ebola in Africa: A state of arts review. J Med Virol 2023; 95:e28986. [PMID: 37534818 DOI: 10.1002/jmv.28986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/29/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023]
Abstract
The Ebola virus, a member of the filoviridae family of viruses, is responsible for causing Ebola Virus Disease (EVD) with a case fatality rate as high as 50%. The largest EVD outbreak was recorded in West Africa from March 2013 to June 2016, leading to over 28 000 cases and 11 000 deaths. It affected several countries, including Nigeria, Senegal, Guinea, Liberia, and Sierra Leone. Until then, EVD was predominantly reported in remote villages in central and west Africa close to tropical rainforests. Human mobility, behavioral and cultural norms, the use of bushmeat, burial customs, preference for traditional remedies and treatments, and resistance to health interventions are just a few of the social factors that considerably aid and amplify the risk of transmission. The scale and persistence of recent ebola outbreaks, as well as the risk of widespread global transmission and its ability for bioterrorism, have led to a rethinking of public health strategies to curb the disease, such as the expedition of Ebola vaccine production. However, as vaccine production lags in the subcontinent, among other challenges, the risk of another ebola outbreak is likely and feared by public health authorities in the region. This review describes the inequality of vaccine production in Africa and the resurgence of EVD, emphasizing the significance of health equality.
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Affiliation(s)
- Toufik Abdul-Rahman
- Medical Institute, Sumy State University, Sumy, Ukraine
- ICORMed Collaborative, Sumy, Ukraine
| | - Lukman Lawal
- Faculty of Clinical Sciences, University of Ilorin, Ilorin, Nigeria
| | - Emily Meale
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Soyemi Toluwalashe
- Lagos State University of College of Medicine, Faculty of Clinical Sciences, Ikeja, Nigeria
| | - Uthman Hassan Alao
- Department of Biomedical Laboratory Science, Faculty of Basic Medical Sciences, University of Ibadan, Ibadan, Nigeria
| | - Shankhaneel Ghosh
- Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan, Bhubaneswar, India
| | - Neil Garg
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | | | - Andrew Awuah Wireko
- Medical Institute, Sumy State University, Sumy, Ukraine
- ICORMed Collaborative, Sumy, Ukraine
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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29
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Schreiner CL, Basinski AJ, Remien CH, Nuismer SL. Optimizing the delivery of self-disseminating vaccines in fluctuating wildlife populations. PLoS Negl Trop Dis 2023; 17:e0011018. [PMID: 37594985 PMCID: PMC10468088 DOI: 10.1371/journal.pntd.0011018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 08/30/2023] [Accepted: 07/30/2023] [Indexed: 08/20/2023] Open
Abstract
Zoonotic pathogens spread by wildlife continue to spill into human populations and threaten human lives. A potential way to reduce this threat is by vaccinating wildlife species that harbor pathogens that are infectious to humans. Unfortunately, even in cases where vaccines can be distributed en masse as edible baits, achieving levels of vaccine coverage sufficient for pathogen elimination is rare. Developing vaccines that self-disseminate may help solve this problem by magnifying the impact of limited direct vaccination. Although models exist that quantify how well these self-disseminating vaccines will work when introduced into temporally stable wildlife populations, how well they will perform when introduced into populations with pronounced seasonal population dynamics remains unknown. Here we develop and analyze mathematical models of fluctuating wildlife populations that allow us to study how reservoir ecology, vaccine design, and vaccine delivery interact to influence vaccine coverage and opportunities for pathogen elimination. Our results demonstrate that the timing of vaccine delivery can make or break the success of vaccination programs. As a general rule, the effectiveness of self-disseminating vaccines is optimized by introducing after the peak of seasonal reproduction when the number of susceptible animals is near its maximum.
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Affiliation(s)
- Courtney L. Schreiner
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Andrew J. Basinski
- Institute for Interdisciplinary Data Sciences, University of Idaho, Moscow, Idaho, United States of America
| | - Christopher H. Remien
- Department of Mathematics and Statistical Sciences, University of Idaho, Moscow, Idaho, United States of America
| | - Scott L. Nuismer
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, United States of America
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30
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Mudalegundi S, Ross RD, Larbelee J, Amegashie F, Dolo RF, Prakalapakorn GS, Ray V, Gargu C, Sosu Y, Sackor J, Cooper PZ, Wallace A, Nyain R, Burkholder B, Van Ryn C, Davis B, Fallah MP, Reilly C, Bishop RJ, Eghrari AO. Long-Term Decrease in Intraocular Pressure in Survivors of Ebola Virus Disease in the Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL) III Study. OPHTHALMOLOGY SCIENCE 2023; 3:100238. [PMID: 36582215 PMCID: PMC9792389 DOI: 10.1016/j.xops.2022.100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Objective Survivors of Ebola virus disease (EVD) experience decreased intraocular pressure (IOP) relative to unaffected close contacts during the first year of convalescence. Whether this effect persists over time and its relationship to intraocular pathology are unclear. We sought to determine whether IOP remained lower in survivors of EVD over 4 years of follow-up and to identify associated risk factors. Design Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL) III is a 5-year, longitudinal cohort study of survivors of EVD and their close contacts and is a collaboration between the Liberian Ministry of Health and the United States National Institutes of Health. Participants Participants who enrolled in PREVAIL III at John F. Kennedy Medical Center in Liberia, West Africa from June 2015 to March 2016 who underwent comprehensive ophthalmic evaluation annually for 5 consecutive visits. Methods Intraocular pressure was measured at each visit by a handheld rebound tonometer using sterile tips. Comparisons are made between antibody-positive survivors and antibody-negative close contacts. Main Outcome Measures Intraocular pressure, measured in mmHg, at each study visit. Results Of 565 antibody-positive survivors and 644 antibody-negative close contacts enrolled in the study at baseline, the majority of participants returned annually, with 383 (67.8%) and 407 (63.2%) participants, respectively, presenting for the final study visit at a median of 60 months after symptom onset. A sustained, relative decrease in IOP was observed in survivors relative to close contacts, with mean difference of -0.72 mmHg (95% confidence interval [CI] -1.18 to -0.27) at the final study visit. This difference remained constant throughout the study period (P = 0.4 for interaction over time). Among survivors, physical examination findings of vitreous cell and OCT findings of vitreous opacities both demonstrated a significant association with decreased IOP at baseline (P < 0.05 for both). After adjusting for such factors, the difference throughout the follow-up (-0.93 mmHg, 95% CI, -1.23 to -0.63) remained significant. Conclusions Survivors of EVD experienced a sustained decrease in IOP relative to close contacts over a 5-year period after EVD. The results highlight the importance of considering long-term sequelae of emerging infectious diseases within a population. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
| | | | | | - Fred Amegashie
- Liberia Noncommunicable Disease Alliance, Monrovia, Liberia
| | | | | | - Vincent Ray
- Department of Ophthalmology, California Pacific Medical Center, San Francisco
| | - Catherine Gargu
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Yassah Sosu
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Jennie Sackor
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Precious Z. Cooper
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Augustine Wallace
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | - Ruth Nyain
- Partnership for Research on Vaccines and Infectious Diseases in Liberia, Monrovia, Liberia
| | | | - Collin Van Ryn
- Division of Biostatistics, University of Minnesota, Minneapolis
| | - Bionca Davis
- Division of Biostatistics, University of Minnesota, Minneapolis
| | | | - Cavan Reilly
- Division of Biostatistics, University of Minnesota, Minneapolis
| | - Rachel J. Bishop
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
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Keita M, Polonsky JA, Ahuka-Mundeke S, Ilumbulumbu MK, Dakissaga A, Boiro H, Anoko JN, Diassy L, Ngwama JK, Bah H, Tosalisana MK, Kitenge Omasumbu R, Chérif IS, Boland ST, Delamou A, Yam A, Flahault A, Dagron S, Gueye AS, Keiser O, Fall IS. A community-based contact isolation strategy to reduce the spread of Ebola virus disease: an analysis of the 2018-2020 outbreak in the Democratic Republic of the Congo. BMJ Glob Health 2023; 8:e011907. [PMID: 37263672 PMCID: PMC10254818 DOI: 10.1136/bmjgh-2023-011907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/06/2023] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Despite tremendous progress in the development of diagnostics, vaccines and therapeutics for Ebola virus disease (EVD), challenges remain in the implementation of holistic strategies to rapidly curtail outbreaks. We investigated the effectiveness of a community-based contact isolation strategy to limit the spread of the disease in the Democratic Republic of Congo (DRC). METHODS We did a quasi-experimental comparison study. Eligible participants were EVD contacts registered from 12 June 2019 to 18 May 2020 in Beni and Mabalako Health Zones. Intervention group participants were isolated to specific community sites for the duration of their follow-up. Comparison group participants underwent contact tracing without isolation. The primary outcome was measured as the reproduction number (R) in the two groups. Secondary outcomes were the delay from symptom onset to isolation and case management, case fatality rate (CFR) and vaccination uptake. RESULTS 27 324 EVD contacts were included in the study; 585 in the intervention group and 26 739 in the comparison group. The intervention group generated 32 confirmed cases (5.5%) in the first generation, while the comparison group generated 87 (0.3%). However, the 32 confirmed cases arising from the intervention contacts did not generate any additional transmission (R=0.00), whereas the 87 confirmed cases arising from the comparison group generated 99 secondary cases (R=1.14). The average delay between symptom onset and case isolation was shorter (1.3 vs 4.8 days; p<0.0001), CFR lower (12.5% vs 48.4%; p=0.0001) and postexposure vaccination uptake higher (86.0% vs 56.8%; p<0.0001) in the intervention group compared with the comparison group. A significant difference was also found between intervention and comparison groups in survival rate at the discharge of hospitalised confirmed patients (87.9% vs 47.7%, respectively; p=0.0004). CONCLUSION The community-based contact isolation strategy used in DRC shows promise as a potentially effective approach for the rapid cessation of EVD transmission, highlighting the importance of rapidly implemented, community-oriented and trust-building control strategies.
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Affiliation(s)
- Mory Keita
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jonathan A Polonsky
- Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Adama Dakissaga
- Direction Régionale de la Santé du Plateau Central, Ministère de la Santé et de l'Hygiène Publique, Ziniaré, Burkina Faso
| | - Hamadou Boiro
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Julienne Ngoundoung Anoko
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Lamine Diassy
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - John Kombe Ngwama
- Direction Générale de la Lutte contre la Maladie, Ministère de la Santé, Kinshasa, Democratic Republic of Congo
| | - Houssainatou Bah
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Richard Kitenge Omasumbu
- Equipe Médicale d'Urgence, Ministère de la Santé Publique, Kinshasa, Congo (the Democratic Republic of the)
| | | | | | - Alexandre Delamou
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Abdoulaye Yam
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphanie Dagron
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Abdou Salam Gueye
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Olivia Keiser
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ibrahima Socé Fall
- Global Neglected Tropical Diseases programme, World Health Organization, Geneva, Switzerland
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Zwick H, Asobee MS, Mitton IK, Headley J, Eagle DE. Burial workers' perceptions of community resistance and support systems during an Ebola outbreak in the Eastern Democratic Republic of the Congo: a qualitative study. Confl Health 2023; 17:25. [PMID: 37231435 DOI: 10.1186/s13031-023-00521-0] [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] [Received: 03/16/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Community Health Workers (CHWs) provide vital services during disease outbreaks. Appropriate burials of those who died from an infectious disease outbreak is a critical CHW function to prevent infection and disease spread. During the 2018 Ebola Virus Disease (EVD) outbreak in Beni Town, North Kivu, Democratic Republic of the Congo, we sought to understand the levels of understanding, trust, and cooperation of the community in response to the outbreak, the barriers burial workers faced in their health work and its impact on local burial workers and other CHWs. METHODS 12 EVD burial CHWs in Beni Town completed an hour-long qualitative in-depth interview on their experiences. They were recruited from a local counseling center. Interviews were recorded, transcribed and translated into English. A team of 3 researchers identified structural and emergent themes using applied thematic analysis. RESULTS Workers reported major misconceptions in the community surrounding the initiation of the outbreak. Community misconceptions were based on widespread governmental mistrust as well as a belief system that intertwines traditional and scientific understandings of the world. EVD burial workers identified violence directed at them and community misinformation as the two largest barriers to effectively carrying out their work. They named several important support systems including family and friends, personal relaxation techniques, and a local counseling center. CONCLUSIONS As with other disease outbreaks globally, we found that government mistrust and religious beliefs strongly impacted community perceptions of the EVD outbreak. Previous studies have demonstrated clinic-based medical personnel are often the targets of violence. Our research shows that burial workers were also targeted and exposed to extreme levels of violence in their work. Along with their ability to effectively respond to the outbreak, violence has a negative impact on their own mental wellbeing. Burial workers found group counseling sessions to be an effective tool for managing the stress associated with their work. Further developing and testing of group-based interventions for this group is a priority for future research.
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Affiliation(s)
- Hana Zwick
- Section of Infectious Diseases, Boston Medical Center, Boston, MA, USA
| | - Marc Salama Asobee
- Christian Bilingual University of the Congo, Beni Town, Democratic Republic of Congo
| | | | - Jennifer Headley
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC, 27710, USA
| | - David E Eagle
- Duke Global Health Institute, Duke University, 310 Trent Dr, Durham, NC, 27710, USA.
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Al Mashud MA, Kumer A, Mukerjee N, Chandro A, Maitra S, Chakma U, Dey A, Akash S, Alexiou A, Khan AA, Alanazi AM, Ghosh A, Chen KT, Sharma R. Mechanistic inhibition of Monkeypox and Marburg virus infection by O-rhamnosides and Kaempferol-o-rhamnosides derivatives: a new-fangled computational approach. Front Cell Infect Microbiol 2023; 13:1188763. [PMID: 37293201 PMCID: PMC10245557 DOI: 10.3389/fcimb.2023.1188763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
Abstract
The increasing incidence of Monkeypox virus (Mpox) and Marburg virus (MARV) infections worldwide presents a significant challenge to global health, as limited treatment options are currently available. This study investigates the potential of several O-rhamnosides and Kaempferol-O-rhamnosides as Mpox and MARV inhibitors using molecular modeling methods, including ADMET, molecular docking, and molecular dynamics/MD simulation. The effectiveness of these compounds against the viruses was assessed using the Prediction of Activity Spectra for Substances (PASS) prediction. The study's primary focus is molecular docking prediction, which demonstrated that ligands (L07, L08, and L09) bind to Mpox (PDB ID: 4QWO) and MARV (PDB ID: 4OR8) with binding affinities ranging from -8.00 kcal/mol to -9.5 kcal/mol. HOMO-LUMO based quantum calculations were employed to determine the HOMO-LUMO gap of frontier molecular orbitals (FMOs) and to estimate chemical potential, electronegativity, hardness, and softness. Drug similarity and ADMET prediction assessments of pharmacokinetic properties revealed that the compounds were likely non-carcinogenic, non-hepatotoxic, and rapidly soluble. Molecular dynamic (MD) modeling was used to identify the most favorable docked complexes involving bioactive chemicals. MD simulations indicate that varying types of kaempferol-O-rhamnoside are necessary for successful docking validation and maintaining the stability of the docked complex. These findings could facilitate the discovery of novel therapeutic agents for treating illnesses caused by the Mpox and MARV viruses.
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Affiliation(s)
- Md. Abdullah Al Mashud
- Biophysics and Biomedicine Research Lab, Department of Electrical & Electronic Engineering, Islamic University, Kushtia, Bangladesh
| | - Ajoy Kumer
- Laboratory of Computational Research for Drug Design and Material Science, Department of Chemistry, European University of Bangladesh, Dhaka, Bangladesh
| | - Nobendu Mukerjee
- Department of Microbiology, West Bengal State University, West Bengal, Kolkata, India
- Department of Health Sciences, Novel Global Community Educational Foundation, Habersham, NSW, Australia
| | - Akhel Chandro
- Department of Poultry Science, Faculty of Animal Science & Veterinary Medicine, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
| | - Swastika Maitra
- Department of Microbiology, Adamas University, West Bengal, Kolkata, India
| | - Unesco Chakma
- Laboratory of Computational Research for Drug Design and Material Science, Department of Chemistry, European University of Bangladesh, Dhaka, Bangladesh
- School of Electronic Science and Engineering, Southeast University, Nanjing, China
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, West Bengal, India
| | - Shopnil Akash
- Department of Pharmacy, Daffodil International University, Sukrabad, Dhaka, Bangladesh
| | - Athanasiosis Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Habersham, NSW, Australia
- Department of Neuroscience, AFNP Med, Wien, Austria
| | - Azmat Ali Khan
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Amer M. Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Arabinda Ghosh
- Microbiology Division, Department of Botany, Gauhati University, Assam, India
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Azari R, Borisch B. What is public health? a scoping review. Arch Public Health 2023; 81:86. [PMID: 37165370 PMCID: PMC10170773 DOI: 10.1186/s13690-023-01091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/15/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND during the last hundred years, several major public health issues have already afflicted humanity. Most frequently cited definitions of public health have stemmed from long-standing definitions, which raises several concerns including whether these definitions can respond to today's public health challenges. The present study aimed to identify and review available public health definitions in the first place. METHODS in this scoping review, we undertook an electronic search in four databases (PubMed, Web of Science, Embase, and EBSCOhost) from inception until June 06, 2022, and a grey literature search in Google Scholar. Moreover, reference lists of publications included in the scoping review were screened manually for additional relevant publications. All types of scientific publications, in English, that focused on the definition of public health and provided an original definition were included. Year, type, disciplinary fields of publications, objectives of publications, and public health definitions were extracted. RESULTS 5651 publications were identified through the scoping search, of which five were subjected to full-text review. Of these publications, two were included. An additional nine publications were identified through the manual screening. A total 11 of publications were included in the scoping review. Of the 11 definitions included in this review, the latest original definitions date back to about two decades ago. CONCLUSIONS there is a noticeable lack of updated definitions of public health. Considering our findings and the ever-changing nature of public health issues, there is an urgent need for re-assessing and updating public health definitions.
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Affiliation(s)
- Razieh Azari
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, 1202, Switzerland.
| | - Bettina Borisch
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, 1202, Switzerland
- World Federation of Public Health Associations, WFPHA, Geneva, Switzerland
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Chavez S, Koyfman A, Gottlieb M, Brady WJ, Carius BM, Liang SY, Long B. Ebola virus disease: A review for the emergency medicine clinician. Am J Emerg Med 2023; 70:30-40. [PMID: 37196593 DOI: 10.1016/j.ajem.2023.04.037] [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] [Received: 02/13/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Ebolavirus, the causative agent of Ebola virus disease (EVD) has been responsible for sporadic outbreaks mainly in sub-Saharan Africa since 1976. EVD is associated with high risk of transmission, especially to healthcare workers during patient care. OBJECTIVE The purpose of this review is to provide a concise review of EVD presentation, diagnosis, and management for emergency clinicians. DISCUSSION EVD is spread through direct contact, including blood, bodily fluids or contact with a contaminated object. Patients may present with non-specific symptoms such as fevers, myalgias, vomiting, or diarrhea that overlap with other viral illnesses, but rash, bruising, and bleeding may also occur. Laboratory analysis may reveal transaminitis, coagulopathy, and disseminated intravascular coagulation. The average clinical course is approximately 8-10 days with an average case fatality rate of 50%. The mainstay of treatment is supportive care, with two U.S. Food and Drug Administration-approved monoclonal antibody treatments (Ebanga and Inmazeb). Survivors of the disease may have a complicated recovery, marked by long-term symptoms. CONCLUSION EVD is a potentially deadly condition that can present with a wide range of signs and symptoms. Emergency clinicians must be aware of the presentation, evaluation, and management to optimize the care of these patients.
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Affiliation(s)
- Summer Chavez
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, United States of America.
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas 75390, TX, United States of America
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, United States of America
| | - William J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States of America.
| | | | - Stephen Y Liang
- Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis 63110, MO, United States of America.
| | - Brit Long
- SAUSHEC, Emergency Medicine, Brooke Army Medical Center, United States of America
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36
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Cross RW, Prasad AN, Woolsey CB, Agans KN, Borisevich V, Dobias NS, Comer JE, Deer DJ, Geisbert JB, Rasmussen AL, Lipkin WI, Fenton KA, Geisbert TW. Natural history of nonhuman primates after conjunctival exposure to Ebola virus. Sci Rep 2023; 13:4175. [PMID: 36914721 PMCID: PMC10011569 DOI: 10.1038/s41598-023-31027-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
Transmission of Ebola virus (EBOV) primarily occurs via contact exposure of mucosal surfaces with infected body fluids. Historically, nonhuman primate (NHP) challenge studies have employed intramuscular (i.m.) or small particle aerosol exposure, which are largely lethal routes of infection, but mimic worst-case scenarios such as a needlestick or intentional release, respectively. When exposed by more likely routes of natural infection, limited NHP studies have shown delayed onset of disease and reduced mortality. Here, we performed a series of systematic natural history studies in cynomolgus macaques with a range of conjunctival exposure doses. Challenge with 10,000 plaque forming units (PFU) of EBOV was uniformly lethal, whereas 5/6 subjects survived lower dose challenges (100 or 500 PFU). Conjunctival challenge resulted in a protracted time-to death compared to i.m. Asymptomatic infection was observed in survivors with limited detection of EBOV replication. Inconsistent seropositivity in survivors may suggest physical or natural immunological barriers are sufficient to prevent widespread viral dissemination.
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Affiliation(s)
- Robert W Cross
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Abhishek N Prasad
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Courtney B Woolsey
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Krystle N Agans
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Viktoriya Borisevich
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Natalie S Dobias
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Jason E Comer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Daniel J Deer
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Joan B Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Angela L Rasmussen
- Center for Infection and Immunity, Columbia Mailman School of Public Health, New York, NY, 10032, USA
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, SK, Canada
| | - Walter Ian Lipkin
- Center for Infection and Immunity, Columbia Mailman School of Public Health, New York, NY, 10032, USA
| | - Karla A Fenton
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA
| | - Thomas W Geisbert
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, 77550, USA.
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, 77550, USA.
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Onyekuru N, Ihemezie E, Ezea C, Apeh C, Onyekuru B. Impacts of Ebola disease outbreak in West Africa: Implications for government and public health preparedness and lessons from COVID-19. SCIENTIFIC AFRICAN 2023; 19:e01513. [PMID: 36570591 PMCID: PMC9759305 DOI: 10.1016/j.sciaf.2022.e01513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/26/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
There has been an increase in the outbreak of communicable diseases in recent times; the most recent ones are Ebola Virus Disease (EVD) and COVID-19. These diseases have had different impacts on society and the ecosystem. However, underlying these impacts are the levels of preparedness of governments and public health institutions to mitigate and control these diseases. Therefore, this paper aims to explore these impacts, government and institutional interventions and their nexus towards the effective management of such crises. A critical review of empirical literature was adopted for the methodological approach and narrative synthesis used for analysis. Results show that EVD had diverse impacts on West Africa; economically through the loss of income from economic activities due to widespread sickness among workers and movement restrictions. EVD also had significant social impacts, such as reduced community cohesion, school and business closures, job losses, food insecurity, and high morbidity and mortality. Though some good efforts have been made by different countries in collaboration with international organisations like the World Health Organization to control disease outbreaks more effectively, the recent COVID-19 pandemic has however exposed major weaknesses in the capacity of most African countries to cope. Poor capacity for testing and treatment, inadequate health facilities, poor incentives for health care workers, poor governance systems, poor border control, and awareness and research capacities impacted negatively on the capacity to control disease outbreaks. There is, therefore, a need to strengthen health systems across Africa through improved resource mobilisation, staff training, and coordination of investment strategies to sustain health system preparedness to manage future emerging or re-emerging outbreaks.
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Affiliation(s)
- N.A. Onyekuru
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom
| | - E.J. Ihemezie
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,Corresponding author:
| | - C.P. Ezea
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,School of Life Science, University of Warwick, Coventry, United Kingdom
| | - C.C. Apeh
- Resource and Environmental Policy Research Centre, Department of Agricultural Economics, University of Nigeria, Nsukka,Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom
| | - B.O. Onyekuru
- Sustainability Research Institute, School of Earth and Environment, University of Leeds, United Kingdom,Centre for Distant and E-learning, University of Nigeria, Nsukka
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Traore T, Shanks S, Haider N, Ahmed K, Jain V, Rüegg SR, Razavi A, Kock R, Erondu N, Rahman-Shepherd A, Yavlinsky A, Mboera L, Asogun D, McHugh TD, Elton L, Oyebanji O, Okunromade O, Ansumana R, Djingarey MH, Ali Ahmed Y, Diallo AB, Balde T, Talisuna A, Ntoumi F, Zumla A, Heymann D, Socé Fall I, Dar O. How prepared is the world? Identifying weaknesses in existing assessment frameworks for global health security through a One Health approach. Lancet 2023; 401:673-687. [PMID: 36682374 DOI: 10.1016/s0140-6736(22)01589-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic has exposed faults in the way we assess preparedness and response capacities for public health emergencies. Existing frameworks are limited in scope, and do not sufficiently consider complex social, economic, political, regulatory, and ecological factors. One Health, through its focus on the links among humans, animals, and ecosystems, is a valuable approach through which existing assessment frameworks can be analysed and new ways forward proposed. Although in the past few years advances have been made in assessment tools such as the International Health Regulations Joint External Evaluation, a rapid and radical increase in ambition is required. To sufficiently account for the range of complex systems in which health emergencies occur, assessments should consider how problems are defined across stakeholders and the wider sociopolitical environments in which structures and institutions operate. Current frameworks do little to consider anthropogenic factors in disease emergence or address the full array of health security hazards across the social-ecological system. A complex and interdependent set of challenges threaten human, animal, and ecosystem health, and we cannot afford to overlook important contextual factors, or the determinants of these shared threats. Health security assessment frameworks should therefore ensure that the process undertaken to prioritise and build capacity adheres to core One Health principles and that interventions and outcomes are assessed in terms of added value, trade-offs, and cobenefits across human, animal, and environmental health systems.
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Affiliation(s)
- Tieble Traore
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal.
| | - Sarah Shanks
- Institute of Zoology, Zoological Society of London, London, UK
| | - Najmul Haider
- Royal Veterinary College, University of London, London, UK; School of Life Sciences, Keele University, Keele, UK
| | - Kanza Ahmed
- Global Operations, UK Health Security Agency, London, UK
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Simon R Rüegg
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmed Razavi
- Global Operations, UK Health Security Agency, London, UK
| | - Richard Kock
- Royal Veterinary College, University of London, London, UK
| | - Ngozi Erondu
- O'Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC, USA
| | | | - Alexei Yavlinsky
- Infectious Disease Informatics, Institute of Health Informatics, University College London, London, UK
| | - Leonard Mboera
- Southern African Centre for Infectious Disease Surveillance Foundation for One Health, Morogoro, Tanzania
| | - Danny Asogun
- Ekpoma and Irrua Specialist Teaching Hospital, Ambrose Alli University, Irrua, Nigeria
| | - Timothy D McHugh
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Linzy Elton
- Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, UK
| | - Oyeronke Oyebanji
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rashid Ansumana
- School of Community Health Sciences, Niala University, Bo Campus, Bo, Sierra Leone
| | - Mamoudou Harouna Djingarey
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Yahaya Ali Ahmed
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Amadou Bailo Diallo
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Dakar Hub, Dakar, Senegal
| | - Thierno Balde
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Ambrose Talisuna
- WHO Emergency Preparedness and Response Cluster, WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Department of Infection, Division of Infection and Immunity, University College London, London, UK; National Institute for Health and Care Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - David Heymann
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Osman Dar
- Global Operations, UK Health Security Agency, London, UK; Global Health Programme, Royal Institute of International Affairs, London, UK
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Gorle S, V.N. CS, L. VR, K. RR, Akula R. Glucose as an eco-friendly reducing agent for a one-pot multicomponent synthesis of quinoxalines. SYNTHETIC COMMUN 2023. [DOI: 10.1080/00397911.2023.2176237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Simhachalam Gorle
- Technology Development Centre, APSL, Dr. Reddy’s Laboratories Ltd, Hyderabad, India
- Department of Chemistry, GIS, GITAM (Deemed to be University), Visakhapatnam, India
| | - Chandra Sekhar V.N.
- Technology Development Centre, APSL, Dr. Reddy’s Laboratories Ltd, Hyderabad, India
- Department of Chemistry, GIS, GITAM (Deemed to be University), Visakhapatnam, India
| | - Vaikunta Rao L.
- Department of Chemistry, GIS, GITAM (Deemed to be University), Visakhapatnam, India
| | - Raghavendra Rao K.
- Technology Development Centre, APSL, Dr. Reddy’s Laboratories Ltd, Hyderabad, India
| | - Raghunadh Akula
- Technology Development Centre, APSL, Dr. Reddy’s Laboratories Ltd, Hyderabad, India
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Idowu AO, Omosun YO, Igietseme JU, Azenabor AA. The COVID-19 pandemic in sub-Saharan Africa: The significance of presumed immune sufficiency. Afr J Lab Med 2023; 12:1964. [PMID: 36756213 PMCID: PMC9900247 DOI: 10.4102/ajlm.v12i1.1964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/24/2022] [Indexed: 02/04/2023] Open
Abstract
A novel coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China in 2019 and later ignited a global pandemic. Contrary to expectations, the effect of the pandemic was not as devastating to Africa and its young population compared to the rest of the world. To provide insight into the possible reasons for the presumed immune sufficiency to coronavirus disease 2019 (COVID-19) in Africa, this review critically examines literature published from 2020 onwards on the dynamics of COVID-19 infection and immunity and how other prevalent infectious diseases in Africa might have influenced the outcome of COVID-19. Studies characterising the immune response in patients with COVID-19 show that the correlates of protection in infected individuals are T-cell responses against the SARS-CoV-2 spike protein and neutralising titres of immunoglobin G and immunoglobin A antibodies. In some other studies, substantial pre-existing T-cell reactivity to SARS-CoV-2 was detected in many people from diverse geographical locations without a history of exposure. Certain studies also suggest that innate immune memory, which offers protection against reinfection with the same or another pathogen, might influence the severity of COVID-19. In addition, an initial analysis of epidemiological data showed that COVID‑19 cases were not severe in some countries that implemented universal Bacillus Calmette-Guerin (BCG) vaccination policies, thus supporting the potential of BCG vaccination to boost innate immunity. The high burden of infectious diseases and the extensive vaccination campaigns previously conducted in Africa could have induced specific and non-specific protective immunity to infectious pathogens in Africans.
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Affiliation(s)
- Abel O Idowu
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Yusuf O Omosun
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
| | - Joseph U Igietseme
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia, United States
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States
| | - Anthony A Azenabor
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, College of Medicine, University of Lagos, Lagos, Nigeria
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Keita M, Talisuna A, Chamla D, Burmen B, Cherif MS, Polonsky JA, Boland S, Barry B, Mesfin S, Traoré FA, Traoré J, Kimenyi JP, Diallo AB, Godjedo TP, Traore T, Delamou A, Ki-Zerbo GA, Dagron S, Keiser O, Gueye AS. Investing in preparedness for rapid detection and control of epidemics: analysis of health system reforms and their effect on 2021 Ebola virus disease epidemic response in Guinea. BMJ Glob Health 2023; 8:bmjgh-2022-010984. [PMID: 36599498 DOI: 10.1136/bmjgh-2022-010984] [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] [Received: 10/16/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023] Open
Abstract
The 2014-2016 West Africa Ebola Virus Disease (EVD) Epidemic devastated Guinea's health system and constituted a public health emergency of international concern. Following the crisis, Guinea invested in the establishment of basic health system reforms and crucial legal instruments for strengthening national health security in line with the WHO's recommendations for ensuring better preparedness for (and, therefore, a response to) health emergencies. The investments included the scaling up of Integrated Disease Surveillance and Response; Joint External Evaluation of International Health Regulation capacities; National Action Plan for Health Security; Simulation Exercises; One Health platforms; creation of decentralised structures such as regional and prefectural Emergency Operation Centres; Risk assessment and hazard identification; Expanding human resources capacity; Early Warning Alert System and community preparedness. These investments were tested in the subsequent 2021 EVD outbreak and other epidemics. In this case, there was a timely declaration and response to the 2021 EVD epidemic, a lower-case burden and mortality rate, a shorter duration of the epidemic and a significant reduction in the cost of the response. Similarly, there was timely detection, response and containment of other epidemics including Lassa fever and Marburg virus disease. Findings suggest the utility of the preparedness activities for the early detection and efficient containment of outbreaks, which, therefore, underlines the need for all countries at risk of infectious disease epidemics to invest in similar reforms. Doing so promises to be not only cost-effective but also lifesaving.
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Affiliation(s)
- Mory Keita
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo .,Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ambrose Talisuna
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Dick Chamla
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Barbara Burmen
- Health Security Preparedness, World Health Organization, Geneva, Switzerland
| | - Mahamoud Sama Cherif
- Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Jonathan A Polonsky
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Emergency Response, World Health Organization, Geneva, Switzerland
| | - Samuel Boland
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Boubacar Barry
- Emergency Response, World Health Organization, Geneva, Switzerland
| | - Samuel Mesfin
- Emergency Response, World Health Organization, Geneva, Switzerland
| | - Fodé Amara Traoré
- National Agency for Health Security, Ministry of Health, Conakry, Guinea
| | - Jean Traoré
- National Agency for Health Security, Ministry of Health, Conakry, Guinea
| | - Jean Paul Kimenyi
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Amadou Bailo Diallo
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Togbemabou Primous Godjedo
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Tieble Traore
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Alexandre Delamou
- African Centre of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Georges Alfred Ki-Zerbo
- Office at the African Union (AU) and Un Economic Commission for Africa (UNECA), World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Stephanie Dagron
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Olivia Keiser
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Abdou Salam Gueye
- Emergency Preparedness and Response, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Frimpong SO, Paintsil E. Community engagement in Ebola outbreaks in sub-Saharan Africa and implications for COVID-19 control: A scoping review. Int J Infect Dis 2023; 126:182-192. [PMID: 36462575 DOI: 10.1016/j.ijid.2022.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES There is a paucity of scoping data on the specific roles community engagement played in preventing and managing the Ebola virus disease (EVD) outbreak in sub-Saharan Africa. We assessed the role, benefits, and mechanisms of community engagement to understand its effect on EVD case detection, survival, and mortality in sub-Saharan Africa. The implications for COVID-19 prevention and control were also highlighted. METHODS We searched for articles between 2010 and 2020 in the MEDLINE and Embase databases. The study types included were randomized trials, quasiexperimental studies, observational studies, case series, and reports. RESULTS A total of 903 records were identified for screening. A total of 216 articles met the review criteria, 103 were initially selected, and 44 were included in the final review. Our findings show that effective community involvement during the EVD outbreak depended on the survival rates, testimonials of survivors, risk perception, and the inclusion of community leaders. Community-based interventions improved knowledge and attitudes, case findings, isolation efforts, and treatment uptake. CONCLUSION Although the studies included in this review were of highly variable quality, findings from this review may provide lessons for the role of community engagement in the COVID-19 pandemic's prevention and control in sub-Saharan Africa.
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Affiliation(s)
- Shadrack Osei Frimpong
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA.
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA; Department of Pharmacology, Yale School of Medicine, New Haven, USA; School of Management, Yale University, New Haven, USA
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Tshomba AO, Mukadi-Bamuleka DR, De Weggheleire A, Tshiani OM, Kitenge RO, Kayembe CT, Jacobs BKM, Lynen L, Mbala-Kingebeni P, Muyembe-Tamfum JJ, Ahuka-Mundeke S, Mumba DN, Tshala-Katumbay DD, Mulangu S. Development of Ebola virus disease prediction scores: Screening tools for Ebola suspects at the triage-point during an outbreak. PLoS One 2022; 17:e0278678. [PMID: 36525443 PMCID: PMC9757576 DOI: 10.1371/journal.pone.0278678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The control of Ebola virus disease (EVD) outbreaks relies on rapid diagnosis and prompt action, a daunting task in limited-resource contexts. This study develops prediction scores that can help healthcare workers improve their decision-making at the triage-point of EVD suspect-cases during EVD outbreaks. METHODS We computed accuracy measurements of EVD predictors to assess their diagnosing ability compared with the reference standard GeneXpert® results, during the eastern DRC EVD outbreak. We developed predictive scores using the Spiegelhalter-Knill-Jones approach and constructed a clinical prediction score (CPS) and an extended clinical prediction score (ECPS). We plotted the receiver operating characteristic curves (ROCs), estimated the area under the ROC (AUROC) to assess the performance of scores, and computed net benefits (NB) to assess the clinical utility (decision-making ability) of the scores at a given cut-off. We performed decision curve analysis (DCA) to compare, at a range of threshold probabilities, prediction scores' decision-making ability and to quantify the number of unnecessary isolation. RESULTS The analysis was done on data from 10432 subjects, including 651 EVD cases. The EVD prevalence was 6.2% in the whole dataset, 14.8% in the subgroup of suspects who fitted the WHO Ebola case definition, and 3.2% for the set of suspects who did not fit this case definition. The WHO clinical definition yielded 61.6% sensitivity and 76.4% specificity. Fatigue, difficulty in swallowing, red eyes, gingival bleeding, hematemesis, confusion, hemoptysis, and a history of contact with an EVD case were predictors of EVD. The AUROC for ECPS was 0.88 (95%CI: 0.86-0.89), significantly greater than this for CPS, 0.71 (95%CI: 0.69-0.73) (p < 0.0001). At -1 point of score, the CPS yielded a sensitivity of 85.4% and specificity of 42.3%, and the ECPS yielded sensitivity of 78.8% and specificity of 81.4%. The diagnostic performance of the scores varied in the three disease contexts (the whole, fitting or not fitting the WHO case definition data sets). At 10% of threshold probability, e.g. in disease-adverse context, ECPS gave an NB of 0.033 and a net reduction of unnecessary isolation of 67.1%. Using ECPS as a joint approach to isolate EVD suspects reduces the number of unnecessary isolations by 65.7%. CONCLUSION The scores developed in our study showed a good performance as EVD case predictors since their use improved the net benefit, i.e., their clinical utility. These rapid and low-cost tools can help in decision-making to isolate EVD-suspicious cases at the triage point during an outbreak. However, these tools still require external validation and cost-effectiveness evaluation before being used on a large scale.
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Affiliation(s)
- Antoine Oloma Tshomba
- Department of Public Health, University of Kisangani, Kisangani, Democratic Republic of Congo
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- * E-mail:
| | - Daniel-Ricky Mukadi-Bamuleka
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Anja De Weggheleire
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Olivier M. Tshiani
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Richard O. Kitenge
- National Emergency Program, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Charles T. Kayembe
- Department of Internal Medicine, University of Kisangani, Kisangani, Democratic Republic of the Congo
| | - Bart K. M. Jacobs
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lutgarde Lynen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Placide Mbala-Kingebeni
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe-Tamfum
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Dieudonné N. Mumba
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Désiré D. Tshala-Katumbay
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Neurology and School of Public Health, Oregon Health & Science University, Portland, Oregon, United States of America
- Department of Neurology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Sabue Mulangu
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
- Department of Medical Biology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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Kumar M, Akbarialiabad H, Kouhanjani MF, Kiburi S, Shidhaye P, Taghrir MH, Shidhaye R. Association of Major Disease Outbreaks With Adolescent and Youth Mental Health in Low- and Middle-Income Countries: A Systematic Scoping Review. JAMA Psychiatry 2022; 79:1232-1240. [PMID: 36223094 DOI: 10.1001/jamapsychiatry.2022.3109] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
IMPORTANCE Adolescents and young people have been historically understudied populations, and previous studies indicate that during epidemics, these populations, especially in low- and middle-income countries (LMICs), are at high risk of developing mental disturbances. OBJECTIVE To identify the existing evidence regarding the association of mental health with outbreaks of the influenza A (H1N1), Zika, Ebola, and SARS-CoV-2 virus in exposed youth and adolescents in LMICs. EVIDENCE REVIEW Across 6 databases (Embase, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science), the mental health outcomes of adolescents and youth (aged 10-24 years) associated with 4 major pandemic outbreaks from January 2009 to January 2021 in LMICs were reviewed. A group of 3 authors at each stage carried out the screening, selection, and quality assessment using Joanna Briggs Institute checklists. The social determinants of adolescent well-being framework was used as a guide to organizing the review. FINDINGS A total of 57 studies fulfilled the search criteria, 55 related to the SARS-CoV-2 (COVID-19) pandemic and 2 covered the H1N1 influenza epidemics. There were no studies associated with Zika or Ebola outbreaks that met screening criteria. The studies reported high rates of anxiety and depressive symptoms among adolescents, including posttraumatic stress disorder, general stress, and health-related anxiety. Potential risk factors associated with poor mental health outcomes included female sex; home residence in areas with strict lockdown limitations on social and physical movement; reduced physical activity; poor parental, family, or social support; previous exposure to COVID-19 infection; or being part of an already vulnerable group (eg, previous psychiatric conditions, childhood trauma, or HIV infection). CONCLUSIONS AND RELEVANCE Results of this systematic scoping review suggest that the COVID-19 pandemic and H1N1 epidemic were associated with adverse mental health among adolescents and youth from LMICs. Vulnerable youth and adolescents may be at higher risk of developing mental health-related complications, requiring more responsive interventions and further research. Geographically localized disease outbreaks such as Ebola, Zika, and H1N1 influenza are highly understudied and warrant future investigation.
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Affiliation(s)
- Manasi Kumar
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya.,Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Hossein Akbarialiabad
- Trauma Research Center, Rajaee Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Farjoud Kouhanjani
- Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Namazi Hospital, Shiraz, Iran
| | | | | | - Mohammad Hossein Taghrir
- Trauma Research Center, Rajaee Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rahul Shidhaye
- Psychiatry, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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45
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Furuyama W, Sakaguchi M, Yamada K, Nanbo A. Development of an imaging system for visualization of Ebola virus glycoprotein throughout the viral lifecycle. Front Microbiol 2022; 13:1026644. [PMID: 36406413 PMCID: PMC9669576 DOI: 10.3389/fmicb.2022.1026644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/16/2022] [Indexed: 11/06/2022] Open
Abstract
Ebola virus (EBOV) causes severe EBOV disease (EVD) in humans and non-human primates. Currently, limited countermeasures are available, and the virus must be studied in biosafety level-4 (BSL-4) laboratories. EBOV glycoprotein (GP) is a single transmembrane protein responsible for entry into host cells and is the target of multiple approved drugs. However, the molecular mechanisms underlying the intracellular dynamics of GP during EBOV lifecycle are poorly understood. In this study, we developed a novel GP monitoring system using transcription- and replication-competent virus-like particles (trVLPs) that enables the modeling of the EBOV lifecycle under BSL-2 conditions. We constructed plasmids to generate trVLPs containing the coding sequence of EBOV GP, in which the mucin-like domain (MLD) was replaced with fluorescent proteins. The generated trVLP efficiently replicated over multiple generations was similar to the wild type trVLP. Furthermore, we confirmed that the novel trVLP system enabled real-time visualization of GP throughout the trVLP replication cycle and exhibited intracellular localization similar to that of wild type GP. In summary, this novel monitoring system for GP will enable the characterization of the molecular mechanism of the EBOV lifecycle and can be applied for the development of therapeutics against EVD.
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Affiliation(s)
- Wakako Furuyama
- Department of Virus Infection Dynamics, National Research Center for the Control and Prevention of Infectious Diseases, Nagasaki University, Nagasaki, Japan
| | - Miako Sakaguchi
- Central Laboratory, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Kento Yamada
- Department of Virus Infection Dynamics, National Research Center for the Control and Prevention of Infectious Diseases, Nagasaki University, Nagasaki, Japan
| | - Asuka Nanbo
- Department of Virus Infection Dynamics, National Research Center for the Control and Prevention of Infectious Diseases, Nagasaki University, Nagasaki, Japan
- *Correspondence: Asuka Nanbo,
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Santangelo OE, Gianfredi V, Provenzano S. Wikipedia searches and the epidemiology of infectious diseases: A systematic review. DATA KNOWL ENG 2022. [DOI: 10.1016/j.datak.2022.102093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hazel A, Davidson MC, Rogers A, Barrie MB, Freeman A, Mbayoh M, Kamara M, Blumberg S, Lietman TM, Rutherford GW, Jones JH, Porco TC, Richardson ET, Kelly JD. Social Network Analysis of Ebola Virus Disease During the 2014 Outbreak in Sukudu, Sierra Leone. Open Forum Infect Dis 2022; 9:ofac593. [PMID: 36467298 PMCID: PMC9709704 DOI: 10.1093/ofid/ofac593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/01/2022] [Indexed: 08/02/2023] Open
Abstract
Background Transmission by unreported cases has been proposed as a reason for the 2013-2016 Ebola virus (EBOV) epidemic decline in West Africa, but studies that test this hypothesis are lacking. We examined a transmission chain within social networks in Sukudu village to assess spread and transmission burnout. Methods Network data were collected in 2 phases: (1) serological and contact information from Ebola cases (n = 48, including unreported); and (2) interviews (n = 148), including Ebola survivors (n = 13), to identify key social interactions. Social links to the transmission chain were used to calculate cumulative incidence proportion as the number of EBOV-infected people in the network divided by total network size. Results The sample included 148 participants and 1522 contacts, comprising 10 social networks: 3 had strong links (>50% of cases) to the transmission chain: household sharing (largely kinship), leisure time, and talking about important things (both largely non-kin). Overall cumulative incidence for these networks was 37 of 311 (12%). Unreported cases did not have higher network centrality than reported cases. Conclusions Although this study did not find evidence that explained epidemic decline in Sukudu, it excluded potential reasons (eg, unreported cases, herd immunity) and identified 3 social interactions in EBOV transmission.
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Affiliation(s)
- Ashley Hazel
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
| | - Michelle C Davidson
- School of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Abu Rogers
- School of Medicine, Stanford University, Stanford, California, USA
| | - M Bailor Barrie
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Partners in Health, Freetown, Sierra Leone
| | | | | | | | - Seth Blumberg
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
| | - George W Rutherford
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - James Holland Jones
- Division of Social Sciences, Doerr School of Sustainability and the Environment, Stanford University, Stanford, California, USA
| | - Travis C Porco
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Eugene T Richardson
- Partners in Health, Freetown, Sierra Leone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - J Daniel Kelly
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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48
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Tusabe F, Tahir IM, Akpa CI, Mtaki V, Baryamujura J, Kamau B, Lidoroh S, Kobugabe PL, Maaga NO, Bongomin F. Lessons Learned from the Ebola Virus Disease and COVID-19 Preparedness to Respond to the Human Monkeypox Virus Outbreak in Low- and Middle-Income Countries. Infect Drug Resist 2022; 15:6279-6286. [PMID: 36329989 PMCID: PMC9624151 DOI: 10.2147/idr.s384348] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Recently, the World Health Organization (WHO) declared the human monkeypox virus disease an international health emergency. In the past decades, infectious disease epidemics have significantly impacted low- and middle-income countries (LMICs), with coronavirus disease-2019 (COVID-19) being the most recent. LMICs, particularly in Africa and Asia, responded reasonably well by strengthening health systems, including infection prevention and control strategies, laboratory systems, risk communication, and training of essential healthcare workers for surge capacity in preparation for and response to COVID-19. With the possibility of other epidemics, such as the current epidemic of human Monkeypox, a consolidated global response is required. This article discusses lessons learned from previous Ebola and COVID-19 outbreaks and also provides recommendations on how these lessons can be useful to strengthen monkeypox disease outbreak preparedness and response in LMIC.
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Affiliation(s)
- Fred Tusabe
- Global Health Security Department, Infectious Diseases Institute, Makerere University, Kampala, Uganda,Correspondence: Fred Tusabe, Tel +256 777317065, Email
| | - Imtiaz Mahmood Tahir
- College of Allied Health Professionals, Faculty of Medical Sciences, Government College University, Faisalabad, Pakistan
| | - Chijioke Igwe Akpa
- Surveillance and Epidemiology Department, Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Victor Mtaki
- Medical Laboratory Department, Baylor College of Medicine Children’s Foundation, Mwanza, Tanzania
| | - Jovan Baryamujura
- Global Health Security Department, Baylor College of Medicine Children’s Foundation, Kampala, Uganda
| | - Beatrice Kamau
- Health Services Department, Nairobi County, Nairobi, Kenya
| | - Sharon Lidoroh
- Public Health Department, Africa Centers for Disease Control and Prevention (Africa CDC), Addis Ababa, Kenya
| | - Penlope Lillian Kobugabe
- Counselling Department, Makerere University-John Hopkins Research Collaboration, Kampala, Uganda
| | - Nathan Okemwa Maaga
- Department of Diagnostics, Ministry of Health, Kisii County Government, Nairobi, Kenya
| | - Felix Bongomin
- Department of Medical Microbiology & Immunology, Gulu University, Gulu, Uganda
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After action review of the response to an outbreak of Lassa fever in Sierra Leone, 2019: Best practices and lessons learnt. PLoS Negl Trop Dis 2022; 16:e0010755. [PMID: 36197925 PMCID: PMC9534430 DOI: 10.1371/journal.pntd.0010755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two that were exported to the Netherlands. The outbreak tested multiple technical capacities in the International Health Regulations (2005) in a real-life setting. As such, an after action review (AAR) was undertaken as recommended by World Health Organization. We report on the findings of the AAR including best practices and lessons learnt. Methods A two stage review process was employed. The first stage involved national pillar level reviews for each technical pillar and one review of the district level response. The second stage brought together all pillars, including participants from the national and sub-national level as well as health sector partners. National guidelines were used as references during the deliberations. A standardized template was used to report on the key findings on what happened, what was supposed to happen, what went well and lessons learnt. Results This was a hospital associated outbreak that likely occurred due to a breach in infection prevention and control (IPC) practices resulting in three health workers being infected during a surgical operation. There was a delay in detecting the outbreak on time due to low index of suspicion among clinicians. Once detected, the outbreak response contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Notable gaps included delays in accessing local emergency funding and late distribution of IPC and laboratory supplies. Conclusions The incident management system worked optimally to contain this outbreak. The core technical gaps identified in surveillance, IPC and delay in deployment of resources should be addressed through systemic changes that can mitigate future outbreaks. The International Health Regulations (IHR) Monitoring and Evaluation Framework was developed by the World Health Organization to provide strategies to monitor and assess how countries are building their core public health capacities under IHR (2005). The framework has four components: annual reporting on IHR capacities (mandatory), Joint External Evaluation, simulation exercises and After Action Review (AAR). In November 2019, an outbreak of Lassa Fever occurred among health workers in a non-endemic district in Sierra Leone. The outbreak resulted in five cases, including two deaths and two exported cases to the Netherlands. The outbreak tested multiple technical capacities in the IHR (2005) in a real-life setting. We therefore conducted an AAR to assess how well the country responded to the outbreak. This hospital associated outbreak likely occurred due to a breach in infection prevention and control (IPC) practices. The response launched after detection of the outbreak successfully contained the outbreak within one incubation period. Areas that worked well included coordination, contact tracing, active case search and ring IPC. Areas that needed improvement were clinicians’ knowledge on Lassa Fever, delays in accessing local emergency funding and late distribution of IPC and laboratory supplies.
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Dada S, De Brún A, Banda EN, Bhattacharya S, Mutunga Z, Gilmore B. A realist review protocol on communications for community engagement in maternal and newborn health programmes in low- and middle-income countries. Syst Rev 2022; 11:201. [PMID: 36096841 PMCID: PMC9465973 DOI: 10.1186/s13643-022-02061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community engagement (CE) has been increasingly implemented across health interventions, including for maternal and newborn health (MNH). This may take various forms, from participatory women's groups and community health committees to public advocacy days. While research suggests a positive influence of CE on MNH outcomes, such as mortality or care-seeking behaviour, there is a need for further evidence on the processes of CE in different settings in order to inform the future development and implementation of CE across programmes. Communication is an integral component of CE serving as a link between the programme and community. The aim of the realist review described in this protocol is to understand how, why, to what extent, and for whom CE contributes to intended and unintended outcomes in MNH programming, focusing on the communication components of CE. METHODS Realist review methodology will be used to provide a causal understanding of what communication for CE interventions in MNH programming work, for whom, to what extent, why, and how. This will be done by developing and refining programme theories on communications for CE in MNH through a systematic review of the literature and engaging key experts for input and feedback. By extrapolating context-mechanism-outcome configurations, this review seeks to understand how certain contexts trigger or inhibit specific mechanisms and what outcomes this interaction generates when communication in CE interventions is used in MNH programming. DISCUSSION A realist philosophy is well-suited to address the aims of this study because of the complex nature of CE. The review findings will be used to inform a realist evaluation case study of CE for an MNH programme in order to ascertain transferable findings that can inform and guide engagement activities in various settings. Findings will also be shared with stakeholders and experts involved in the consultative processes of the review (through workshops or policy briefs) in order to ensure the relevance of these findings to policy and practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022293564.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland. .,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
| | - Aoife De Brún
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Esther Namwaba Banda
- Zambia Ministry of Health, Lusaka, Zambia.,Midwives Association of Zambia, Lusaka, Zambia
| | | | | | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland.,School of Nursing Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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