1
|
Association of Diabetes with Meningitis Infection Risks: A Systematic Review and Meta-Analysis. Glob Health Epidemiol Genom 2022; 2022:3996711. [PMID: 36570413 PMCID: PMC9757945 DOI: 10.1155/2022/3996711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background The Global Burden of Disease Study in 2016 estimated that the global incident cases of meningitis have increased by 320,000 between 1990 and 2016. Current evidence suggests that diabetes may be a prime risk factor for meningitis among individuals, including older adults. However, findings of prior studies on this topic remain inconsistent, making a general conclusion relatively difficult. This study aimed to quantitatively synthesize the literature on the risk of meningitis associated with diabetes and compare the risk across different global regions. Method Literature search and study design protocol followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was conducted in PubMed, Web of Science, African Journal Online, and Google Scholar using relevant MESH terms. A random effect model was used to pull effect sizes. Results Initial search yielded 772 papers but 756 studies were excluded due to duplicity and not meeting inclusion criteria. In all, 16 papers involving 16847 cases were used. The pulled effect size (ES) of the association between diabetes and meningitis was 2.240 (OR = 2.240, 95% CI = 1.716-2.924). Regional-base analysis showed that diabetes increased the risk of developing meningitis in Europe (OR = 1.737, 95% CI = 1.299-2.323), Asia (OR = 2.192, 95% CI = 1.233-3.898), and North America (OR = 2.819, 95% CI = 1.159-6.855). These associations remained significant in the study design and etiological classe-based subgroup analyses. However, we surprisingly found no studies in Africa or South America. Conclusion Diabetes is a risk factor for developing meningitis. Given that no research on this topic came from Africa and South America, our findings should be contextually interpreted. We, however, encourage studies on diabetes-meningitis linkages from all parts of the world, particularly in Africa and South America, to confirm the findings of the present study.
Collapse
|
2
|
Chipeta MG, Kumaran EPA, Browne AJ, Hamadani BHK, Haines-Woodhouse G, Sartorius B, Reiner RC, Dolecek C, Hay SI, Moore CE. Mapping local variation in household overcrowding across Africa from 2000 to 2018: a modelling study. Lancet Planet Health 2022; 6:e670-e681. [PMID: 35932787 PMCID: PMC9364142 DOI: 10.1016/s2542-5196(22)00149-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 05/31/2022] [Accepted: 06/13/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Household overcrowding is a serious public health threat associated with high morbidity and mortality. Rapid population growth and urbanisation contribute to overcrowding and poor sanitation in low-income and middle- income countries, and are risk factors for the spread of infectious diseases, including COVID-19, and antimicrobial resistance. Many countries do not have adequate surveillance capacity to monitor household overcrowding. Geostatistical models are therefore useful tools for estimating household overcrowding. In this study, we aimed to estimate household overcrowding in Africa between 2000 and 2018 by combining available household survey data, population censuses, and other country-specific household surveys within a geostatistical framework. METHODS We used data from household surveys and population censuses to generate a Bayesian geostatistical model of household overcrowding in Africa for the 19-year period between 2000 and 2018. Additional sociodemographic and health-related covariates informed the model, which covered 54 African countries. FINDINGS We analysed 287 surveys and population censuses, covering 78 695 991 households. Spatial and temporal variability arose in household overcrowding estimates over time. In 2018, the highest overcrowding estimates were observed in the Horn of Africa region (median proportion 62% [IQR 57-63]); the lowest regional median proportion was estimated for the north of Africa region (16% [14-19]). Overall, 474·4 million (95% uncertainty interval [UI] 250·1 million-740·7 million) people were estimated to be living in overcrowded conditions in Africa in 2018, a 62·7% increase from the estimated 291·5 million (180·8 million-417·3 million) people who lived in overcrowded conditions in the year 2000. 48·5% (229·9 million) of people living in overcrowded conditions came from six African countries (Nigeria, Ethiopia, Democratic Republic of the Congo, Sudan, Uganda, and Kenya), with a combined population of 538·3 million people. INTERPRETATION This study incorporated survey and population censuses data and used geostatistical modelling to estimate continent-wide overcrowding over a 19-year period. Our analysis identified countries and areas with high numbers of people living in overcrowded conditions, thereby providing a benchmark for policy planning and the implementation of interventions such as in infectious disease control. FUNDING UK Department of Health and Social Care, Wellcome Trust, Bill & Melinda Gates Foundation.
Collapse
Affiliation(s)
- Michael G Chipeta
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK; African Institute for Development Policy, Lilongwe, Malawi
| | - Emmanuelle P A Kumaran
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Annie J Browne
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Bahar H Kashef Hamadani
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Georgina Haines-Woodhouse
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Benn Sartorius
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Robert C Reiner
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Christiane Dolecek
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK; Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA; Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Catrin E Moore
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK; Centre for Neonatal and Paediatric Infection, St George's, University of London, London, UK.
| |
Collapse
|
3
|
Musiime AK, Krezanoski PJ, Smith DL, Kilama M, Conrad MD, Otto G, Kyagamba P, Asiimwe J, Rek J, Nankabirwa JI, Arinaitwe E, Akol AM, Kamya MR, Staedke SG, Drakeley C, Bousema T, Lindsay SW, Dorsey G, Tusting LS. House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000063. [PMID: 36962263 PMCID: PMC10022195 DOI: 10.1371/journal.pgph.0000063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
House construction is rapidly modernizing across Africa but the potential benefits for human health are poorly understood. We hypothesised that improvements to housing would be associated with reductions in malaria, acute respiratory infection (ARI) and gastrointestinal illness in an area of low malaria endemicity in Uganda. Data were analysed from a cohort study of male and female child and adult residents (n = 531) of 80 randomly-selected households in Nagongera sub-county, followed for 24 months (October 4, 2017 to October 31, 2019). Houses were classified as modern (brick walls, metal roof and closed eaves) or traditional (all other homes). Light trap collections of mosquitoes were done every two weeks in all sleeping rooms. Every four weeks, we measured malaria infection (using microscopy and qPCR to detect malaria parasites), incidence of malaria, ARI and gastrointestinal illness. We collected 15,780 adult female Anopheles over 7,631 nights. We collected 13,277 blood samples of which 10.2% (1,347) were positive for malaria parasites. Over 958 person years we diagnosed 38 episodes of uncomplicated malaria (incidence 0.04 episodes per person-year at risk), 2,553 episodes of ARI (incidence 2.7 episodes per person-year) and 387 episodes of gastrointestinal illness (incidence 0.4 episodes per person-year). Modern houses were associated with a 53% lower human biting rate compared to traditional houses (adjusted incidence rate ratio [aIRR] 0.47, 95% confidence interval [CI] 0.32-0.67, p<0.001) and a 24% lower incidence of gastrointestinal illness (aIRR 0.76, 95% CI 0.59-0.98, p = 0.04) but no changes in malaria prevalence, malaria incidence nor ARI incidence. House improvements may reduce mosquito-biting rates and gastrointestinal illness among children and adults. For the health sector to leverage Africa's housing modernization, research is urgently needed to identify the healthiest house designs and to assess their effectiveness across a range of epidemiological settings in sub-Saharan Africa.
Collapse
Affiliation(s)
- Alex K Musiime
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Zoology, Entomology and Fisheries Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Paul J Krezanoski
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America
| | - David L Smith
- Department of Health Metrics Sciences, University of Washington, Seattle, United States of America
| | - Maxwell Kilama
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Melissa D Conrad
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America
| | - Geoffrey Otto
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | - John Rek
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Joaniter I Nankabirwa
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Anne M Akol
- Department of Zoology, Entomology and Fisheries Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Moses R Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sarah G Staedke
- Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Steve W Lindsay
- Department of Biosciences, Durham University, Durham, United Kingdom
| | - Grant Dorsey
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America
| | - Lucy S Tusting
- Faculty of Infectious and Tropical Diseases, Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
4
|
Davies-Barrett AM, Owens LS, Eeckhout PA. Paleopathology of the Ychsma: Evidence of respiratory disease during the Late Intermediate Period (AD 1000-1476) at the Central Coastal site of Pachacamac, Peru. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 34:63-75. [PMID: 34153817 DOI: 10.1016/j.ijpp.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate evidence for maxillary sinusitis and pulmonary inflammation in archaeological skeletons dating to the Late Intermediate Period (AD 1000-1476) at the site of Pachacamac, Peru. MATERIALS Thirty-nine individuals (male, female, and unknown sex; 16+ years age-at-death) were analyzed for inflammatory periosteal reaction (IPR) on the visceral (inner) surfaces of the ribs, and 16 individuals were analyzed for evidence of maxillary sinusitis. METHODS All individuals were macroscopically examined for bony changes in the maxillary sinuses and new bone formation on the ribs according to pre-established criteria. RESULTS Some 33.3% (13/39) of individuals had IPR on the ribs and 93.8% (15/16) had bony changes in the maxillary sinuses. CONCLUSIONS Respiratory disease was likely prevalent in people buried at Pachacamac during the Late Intermediate Period. A number of factors may have increased the risk of developing respiratory disease, including exposure to poor air quality and increased crowding and social mixing, resulting from pilgrimage to this important ritual center. SIGNIFICANCE This paper represents one of the first systematic analyses of evidence for respiratory disease in Peruvian and South American human skeletal remains, demonstrating the suitability of the region for further study. LIMITATIONS A limited sample was available for analysis. Additionally, the site's skeletal preservation was excellent, meaning the sample available for assessment of maxillary sinusitis was smaller, being limited to individuals with post-mortem breakage. FURTHER RESEARCH The results of this study should stimulate further much needed systematic investigation of evidence for respiratory disease in other Peruvian and South American populations.
Collapse
Affiliation(s)
- Anna M Davies-Barrett
- School of History, Archaeology and Religion, Cardiff University, John Percival Building, Colum Drive, Cardiff, CF10 3EU, United Kingdom.
| | - Lawrence S Owens
- University of Winchester. Sparkford Road, Winchester, SO22 4NR, United Kingdom; University of South Africa, Preller Street, Muckleneuk, Pretoria, 0002, South Africa
| | - Peter A Eeckhout
- Faculté de Philosophie et Sciences Sociales CP133/01, Université libre de Bruxelles, Av. F. Roosevelt 50, 1050, Brussels, Belgium
| |
Collapse
|
5
|
Kirolos A, Thindwa D, Khundi M, Burke RM, Henrion MYR, Nakamura I, Divala TH, Nliwasa M, Corbett EL, MacPherson P. Tuberculosis case notifications in Malawi have strong seasonal and weather-related trends. Sci Rep 2021; 11:4621. [PMID: 33633272 PMCID: PMC7907065 DOI: 10.1038/s41598-021-84124-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
Seasonal trends in tuberculosis (TB) notifications have been observed in several countries but are poorly understood. Explanatory factors may include weather, indoor crowding, seasonal respiratory infections and migration. Using enhanced citywide TB surveillance data collected over nine years in Blantyre, Malawi, we set out to investigate how weather and seasonality affect temporal trends in TB case notification rates (CNRs) across different demographic groups. We used data from prospective enhanced surveillance between April 2011 and December 2018, which systematically collected age, HIV status, sex and case notification dates for all registering TB cases in Blantyre. We retrieved temperature and rainfall data from the Global Surface Summary of the Day weather station database. We calculated weekly trends in TB CNRs, rainfall and temperature, and calculated 10-week moving averages. To investigate the associations between rainfall, temperature and TB CNRs, we fitted generalized linear models using a distributed lag nonlinear framework. The estimated Blantyre population increased from 1,068,151 in April 2011 to 1,264,304 in December 2018, with 15,908 TB cases recorded. Overall annual TB CNRs declined from 222 to 145 per 100,000 between 2012 and 2018, with the largest declines seen in HIV-positive people and adults aged over 20 years old. TB CNRs peaks occurred with increasing temperature in September and October before the onset of increased rainfall, and later in the rainy season during January-March, after sustained rainfall. When lag between a change in weather and TB case notifications was accounted for, higher average rainfall was associated with an equivalent six weeks of relatively lower TB notification rates, whereas there were no changes in TB CNR associated with change in average temperatures. TB CNRs in Blantyre have a seasonal pattern of two cyclical peaks per year, coinciding with the start and end of the rainy season. These trends may be explained by increased transmission at certain times of the year, by limited healthcare access, by patterns of seasonal respiratory infections precipitating cough and care-seeking, or by migratory patterns related to planting and harvesting during the rainy season.
Collapse
Affiliation(s)
- Amir Kirolos
- grid.10025.360000 0004 1936 8470Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Deus Thindwa
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - McEwen Khundi
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi
| | - Rachael M. Burke
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.8991.90000 0004 0425 469XClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Y. R. Henrion
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.48004.380000 0004 1936 9764Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Itaru Nakamura
- grid.412781.90000 0004 1775 2495Department of Infectious Diseases, Tokyo Medical University Hospital, Tokyo, Japan
| | - Titus H. Divala
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.10595.380000 0001 2113 2211Helse Nord TB Initiative, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Marriott Nliwasa
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.10595.380000 0001 2113 2211Helse Nord TB Initiative, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Elizabeth L. Corbett
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.8991.90000 0004 0425 469XClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter MacPherson
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi. .,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK. .,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
| |
Collapse
|
6
|
Villela DAM. Household crowding hampers mitigating the transmission of SARS-CoV-2. Rev Soc Bras Med Trop 2021; 54:e08212020. [PMID: 33605385 PMCID: PMC7891563 DOI: 10.1590/0037-8682-0821-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/21/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Household crowding deserves attention when evaluating the transmission intensity of SARS-CoV-2 in Brazil. We aimed to evaluate the association between household crowding and COVID-19 incidence. METHODS Linear and Poisson regression analyses were used to assess the associations between indices of household crowding (high, average, low) and COVID-19 incidence estimates. RESULTS Cities with a high index of household crowding were linked with a significantly higher COVID-19 incidence estimate (excess of 461 per 100,000; 95% confidence interval: 371-558 per 100,000). CONCLUSIONS Crowding typically promotes virus transmission. Considering urban and housing structures is essential in designing mitigation strategies during a pandemic.
Collapse
|
7
|
Nadimpalli ML, Marks SJ, Montealegre MC, Gilman RH, Pajuelo MJ, Saito M, Tsukayama P, Njenga SM, Kiiru J, Swarthout J, Islam MA, Julian TR, Pickering AJ. Urban informal settlements as hotspots of antimicrobial resistance and the need to curb environmental transmission. Nat Microbiol 2020; 5:787-795. [PMID: 32467623 DOI: 10.1038/s41564-020-0722-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/07/2020] [Indexed: 12/24/2022]
Abstract
Antimicrobial resistance (AMR) is a growing public health challenge that is expected to disproportionately burden lower- and middle-income countries (LMICs) in the coming decades. Although the contributions of human and veterinary antibiotic misuse to this crisis are well-recognized, environmental transmission (via water, soil or food contaminated with human and animal faeces) has been given less attention as a global driver of AMR, especially in urban informal settlements in LMICs-commonly known as 'shanty towns' or 'slums'. These settlements may be unique hotspots for environmental AMR transmission given: (1) the high density of humans, livestock and vermin living in close proximity; (2) frequent antibiotic misuse; and (3) insufficient drinking water, drainage and sanitation infrastructure. Here, we highlight the need for strategies to disrupt environmental AMR transmission in urban informal settlements. We propose that water and waste infrastructure improvements tailored to these settings should be evaluated for their effectiveness in limiting environmental AMR dissemination, lowering the community-level burden of antimicrobial-resistant infections and preventing antibiotic misuse. We also suggest that additional research is directed towards developing economic and legal incentives for evaluating and implementing water and waste infrastructure in these settings. Given that almost 90% of urban population growth will occur in regions predicted to be most burdened by the AMR crisis, there is an urgent need to build effective, evidence-based policies that could influence massive investments in the built urban environment in LMICs over the next few decades.
Collapse
Affiliation(s)
- Maya L Nadimpalli
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA.,Center for Integrated Management of Antimicrobial Resistance (CIMAR), Tufts University, Boston, MA, USA
| | - Sara J Marks
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | | | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA.,Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Monica J Pajuelo
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA.,Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mayuko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Pablo Tsukayama
- Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru.,Instituto de Medicina Tropical 'Alexander von Humboldt', Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - John Kiiru
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Jenna Swarthout
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA
| | - Mohammad Aminul Islam
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA.,International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Timothy R Julian
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Amy J Pickering
- Department of Civil and Environmental Engineering, Tufts University, Medford, MA, USA. .,Center for Integrated Management of Antimicrobial Resistance (CIMAR), Tufts University, Boston, MA, USA.
| |
Collapse
|
8
|
Tusting LS, Gething PW, Gibson HS, Greenwood B, Knudsen J, Lindsay SW, Bhatt S. Housing and child health in sub-Saharan Africa: A cross-sectional analysis. PLoS Med 2020; 17:e1003055. [PMID: 32203504 PMCID: PMC7089421 DOI: 10.1371/journal.pmed.1003055] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Housing is essential to human well-being but neglected in global health. Today, housing in Africa is rapidly improving alongside economic development, creating an urgent need to understand how these changes can benefit health. We hypothesised that improved housing is associated with better health in children living in sub-Saharan Africa (SSA). We conducted a cross-sectional analysis of housing conditions relative to a range of child health outcomes in SSA. METHODS AND FINDINGS Cross-sectional data were analysed for 824,694 children surveyed in 54 Demographic and Health Surveys, 21 Malaria Indicator Surveys, and two AIDS Indicator Surveys conducted in 33 countries between 2001 and 2017 that measured malaria infection by microscopy or rapid diagnostic test (RDT), diarrhoea, acute respiratory infections (ARIs), stunting, wasting, underweight, or anaemia in children aged 0-5 years. The mean age of children was 2.5 years, and 49.7% were female. Housing was categorised into a binary variable based on a United Nations definition comparing improved housing (with improved drinking water, improved sanitation, sufficient living area, and finished building materials) versus unimproved housing (all other houses). Associations between house type and child health outcomes were determined using conditional logistic regression within surveys, adjusting for prespecified covariables including age, sex, household wealth, insecticide-treated bed net use, and vaccination status. Individual survey odds ratios (ORs) were pooled using random-effects meta-analysis. Across surveys, improved housing was associated with 8%-18% lower odds of all outcomes except ARI (malaria infection by microscopy: adjusted OR [aOR] 0.88, 95% confidence intervals [CIs] 0.80-0.97, p = 0.01; malaria infection by RDT: aOR 0.82, 95% CI 0.77-0.88, p < 0.001; diarrhoea: aOR 0.92, 95% CI 0.88-0.97, p = 0.001; ARI: aOR 0.96, 95% CI 0.87-1.07, p = 0.49; stunting: aOR 0.83, 95% CI 0.77-0.88, p < 0.001; wasting: aOR 0.90, 95% CI 0.83-0.99, p = 0.03; underweight: aOR 0.85, 95% CI 0.80-0.90, p < 0.001; any anaemia: aOR 0.87, 95% CI 0.82-0.92, p < 0.001; severe anaemia: aOR 0.89, 95% CI 0.84-0.95, p < 0.001). In comparison, insecticide-treated net use was associated with 16%-17% lower odds of malaria infection (microscopy: aOR 0.83, 95% CI 0.78-0.88, p < 0.001; RDT: aOR 0.84, 95% CI 0.79-0.88, p < 0.001). Drinking water source and sanitation facility alone were not associated with diarrhoea. The main study limitations are the use of self-reported diarrhoea and ARI, as well as potential residual confounding by socioeconomic position, despite adjustments for household wealth and education. CONCLUSIONS In this study, we observed that poor housing, which includes inadequate drinking water and sanitation facility, is associated with health outcomes known to increase child mortality in SSA. Improvements to housing may be protective against a number of important childhood infectious diseases as well as poor growth outcomes, with major potential to improve children's health and survival across SSA.
Collapse
Affiliation(s)
- Lucy S. Tusting
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Peter W. Gething
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Harry S. Gibson
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jakob Knudsen
- The Royal Danish Academy of Fine Arts, Schools of Architecture, Design and Conservation, Copenhagen, Denmark
| | - Steve W. Lindsay
- Department of Biosciences, Durham University, Durham, United Kingdom
| | - Samir Bhatt
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| |
Collapse
|
9
|
Amidu N, Antuamwine BB, Addai-Mensah O, Abdul-Karim A, Stebleson A, Abubakari BB, Abenyeri J, Opoku AS, Nkukah JE, Najibullah AS. Diagnosis of bacterial meningitis in Ghana: Polymerase chain reaction versus latex agglutination methods. PLoS One 2019; 14:e0210812. [PMID: 30653582 PMCID: PMC6336253 DOI: 10.1371/journal.pone.0210812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 01/02/2019] [Indexed: 01/01/2023] Open
Abstract
Bacterial meningitis is a public health crisis in the northern part of Ghana, where it contributes to very high mortality and morbidity rates. Early detection of the causative organism will lead to better management and effective treatment. Our aim was to evaluate the diagnostic accuracy of Pastorex and Wellcogen latex agglutination tests for the detection of bacterial meningitis in a resource-limited setting. CSF samples from 330 suspected meningitis patients within the northern zone of Ghana were analysed for bacterial agents at the zonal Public Health Reference Laboratory in Tamale using polymerase chain reaction (PCR) and two latex agglutination test kits; Pastorex and Wellcogen. The overall positivity rate of samples tested for bacterial meningitis was 46.4%. Streptococcus pneumoniae was the most common cause of bacterial meningitis within the sub-region, with positivity rate of 25.2%, 28.2% and 28.8% when diagnosed using Wellcogen, Pastorex and PCR respectively. The Pastorex method was 97.4% sensitive while the Wellcogen technique was 87.6% sensitive. Both techniques however produced the same specificity of 99.4%. Our study revealed that the Pastorex method has a better diagnostic value for bacterial meningitis than the Wellcogen method and should be the method of choice in the absence of PCR.
Collapse
MESH Headings
- Adolescent
- Adult
- Bacterial Typing Techniques
- Child
- Child, Preschool
- Female
- Ghana
- Humans
- Latex Fixation Tests/methods
- Male
- Meningitis, Bacterial/cerebrospinal fluid
- Meningitis, Bacterial/diagnosis
- Meningitis, Bacterial/microbiology
- Meningitis, Haemophilus/cerebrospinal fluid
- Meningitis, Haemophilus/diagnosis
- Meningitis, Haemophilus/microbiology
- Meningitis, Meningococcal/cerebrospinal fluid
- Meningitis, Meningococcal/diagnosis
- Meningitis, Meningococcal/microbiology
- Meningitis, Pneumococcal/cerebrospinal fluid
- Meningitis, Pneumococcal/diagnosis
- Meningitis, Pneumococcal/microbiology
- Predictive Value of Tests
- ROC Curve
- Real-Time Polymerase Chain Reaction
- Reproducibility of Results
- Serotyping
- Streptococcal Infections/cerebrospinal fluid
- Streptococcal Infections/diagnosis
- Streptococcal Infections/microbiology
- Streptococcus agalactiae/genetics
- Streptococcus agalactiae/isolation & purification
- Young Adult
Collapse
Affiliation(s)
- Nafiu Amidu
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
- * E-mail:
| | - Benedict Boateng Antuamwine
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Otchere Addai-Mensah
- Department of Medical Laboratory Technology, School of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Azure Stebleson
- Public Health Reference Laboratory, Northern Region, Tamale, Ghana
| | | | - John Abenyeri
- Northern Regional Health Directorate, Ghana Health Service, Tamale, Ghana
| | - Afia Serwaa Opoku
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - John Eyulaku Nkukah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Ali Sidi Najibullah
- Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| |
Collapse
|
10
|
Omoleke SA, Alabi O, Shuaib F, Braka F, Tegegne SG, Umeh GC, Ticha JM, Onimisin A, Nsubuga P, Adamu U, Mohammed K, Onoka C, Alemu W. Environmental, economic and socio-cultural risk factors of recurrent seasonal epidemics of cerebrospinal meningitis in Kebbi state, northwestern Nigeria: a qualitative approach. BMC Public Health 2018; 18:1318. [PMID: 30541535 PMCID: PMC6292165 DOI: 10.1186/s12889-018-6196-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kebbi State remains the epicentre of the seasonal epidemic meningitis in northwestern Nigeria despite interventions. In this setting, no previous study has been conducted to understand the risk factors of the recurrent meningitis epidemics using qualitative approach. Consequently, this study intends to explore and better understand the environmental, economic and socio-cultural factors of recurrent seasonal epidemic meninigitis using a qualitative approach. METHODS We conducted in-depth interview (40 IDIs) and focus group discussions (6 FGDs) in two local government areas (LGAs) in Kebbi State, Northwestern Nigeria to understand the environmental, economic and socio-cultural factors of recurrent meningitis outbreaks. Routine surveillance data were used to guide the selection of settlements, wards and local government areas based on the frequency of re-occurrences and magnitude of the outbreaks. RESULTS The discussions revealed certain elements capable of potentiating the recurrence of seasonal meningitis epidemics. These are environmental issues, such as poorly-designed built environment, crowded sleeping and poorly ventilated rooms, dry and dusty weather condition. Other elements were economic challenges, such as poor household living conditions, neighbourhood deprivation, and socio-cultural elements, such as poor healthcare seeking behaviour, social mixing patterns, inadequate vaccination and vaccine hesitancy. CONCLUSION As suggested by participants, there are potential environmental, socio-cultural and economic factors in the study area that might have been driving recurrent epidemics of cerebrospinal meningitis. In a bid to addressing this perennial challenge, governments at various levels supported by health development partners such as the World Health Organisation (WHO), United Nation Habitat, and United National Development Programme can use the findings of this study to design policies and programmes targeting these factors towards complementing other preventive and control strategies.
Collapse
Affiliation(s)
- Semeeh A. Omoleke
- World Health Organisation, Country Representative Office, Abuja, Nigeria
- WHO Kebbi State Field Office, Brinin Kebbi, Kebbi State Nigeria
| | - Olatunji Alabi
- Department of Demography and Social Statistics, Federal University, Birnin Kebbi, Kebbi State Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Fiona Braka
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Sisay G. Tegegne
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Gregory C. Umeh
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Johnson M. Ticha
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | - Anthony Onimisin
- World Health Organisation, Country Representative Office, Abuja, Nigeria
| | | | - Usman Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Kabiru Mohammed
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Chima Onoka
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | |
Collapse
|
11
|
Le Polain De Waroux O, Edmunds WJ, Takahashi K, Ariyoshi K, Mulholland EK, Goldblatt D, Choi YH, Anh DD, Yoshida LM, Flasche S. Predicting the impact of pneumococcal conjugate vaccine programme options in Vietnam. Hum Vaccin Immunother 2018; 14:1939-1947. [PMID: 29781740 PMCID: PMC6149911 DOI: 10.1080/21645515.2018.1467201] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Although catch-up campaigns (CCs) at the introduction of pneumococcal conjugate vaccines (PCVs) may accelerate their impact, supply constraints may limit their benefit if the need for additional PCV doses results in introduction delay. We studied the impact of PCV13 introduction with and without CC in Nha Trang, Vietnam – a country that has not yet introduced PCV – through a dynamic transmission model. We modelled the impact on carriage and invasive pneumococcal disease (IPD) of routine vaccination (RV) only and that of RV with CCs targeting <1y olds (CC1), <2y olds (CC2) and <5y olds (CC5). The model was fitted to nasopharyngeal carriage data, and post-PCV predictions were based on best estimates of parameters governing post-PCV dynamics. With RV only, elimination in carriage of vaccine-type (VT) serotypes is predicted to occur across all age groups within 10 years after introduction, with near-complete replacement by non-VT. Most of the benefit of CCs is predicted to occur within the first 3 years with the highest impact at one year, when IPD incidence is predicted to be 11% (95%CrI 9 – 14%) lower than RV with CC1, 25% (21 – 30 %) lower with CC2 and 38% (32 – 46%) lower with CC5. However, CCs would only prevent more cases of IPD insofar as such campaigns do not delay introduction by more than about 6, 12 and 18 months for CC1, CC2 and CC5. Those findings are important to help guide vaccine introduction in countries that have not yet introduced PCV, particularly in Asia.
Collapse
Affiliation(s)
- Olivier Le Polain De Waroux
- a Centre for the mathematical modelling of infectious diseases, Department of Infectious Disease Epidemiology , London School of Hygiene and Tropical Medicine , London , UK
| | - W John Edmunds
- a Centre for the mathematical modelling of infectious diseases, Department of Infectious Disease Epidemiology , London School of Hygiene and Tropical Medicine , London , UK
| | - Kensuke Takahashi
- b Institute of Tropical Medicine, Nagasaki University , Nagasaki , Japan
| | - Koya Ariyoshi
- b Institute of Tropical Medicine, Nagasaki University , Nagasaki , Japan
| | - E Kim Mulholland
- a Centre for the mathematical modelling of infectious diseases, Department of Infectious Disease Epidemiology , London School of Hygiene and Tropical Medicine , London , UK.,c Menzies School of Health Research, Charles Darwin University , Darwin , Australia
| | - David Goldblatt
- d Institute of Child Health, University College London , London , UK
| | - Yoon Hong Choi
- e Immunisation, Hepatitis and Blood Safety Department , Public Health England , London , UK.,f Modelling and Economics Unit, Public Health England , London , UK
| | - Dang Duc Anh
- g National Institute of Hygiene and Epidemiology , Hanoi , Vietnam
| | - Lay Myint Yoshida
- b Institute of Tropical Medicine, Nagasaki University , Nagasaki , Japan
| | - Stefan Flasche
- a Centre for the mathematical modelling of infectious diseases, Department of Infectious Disease Epidemiology , London School of Hygiene and Tropical Medicine , London , UK
| |
Collapse
|
12
|
Social contact patterns of infants in deciding vaccination strategy: a prospective, cross-sectional, single-centre study. Epidemiol Infect 2018; 146:1157-1166. [DOI: 10.1017/s0950268818001048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AbstractSocial contact between individuals is believed to be a fundamental cause in the transmission of many respiratory tract infections. Because they have not yet been fully vaccinated, infants are at high risk for contracting whooping cough, influenza and their serious complications. Therefore, determining infant social contact patterns is an important step in protecting them from respiratory tract infection. This study included 1200 healthy infants (<12 months of age). Social contact diaries were used to estimate the frequency and nature of the infants’ social contacts. This survey also gathered information regarding the infants’ respiratory symptoms and their frequency of attendance at crowded places over a period of 1 week. The diary return rate was 83.8% (N = 1006), and there was a total of 4706 contacts reported for these infants. The median daily contact number per capita was 4 (range 1–18). The median number of contacts with adolescents was 0 (range 0–7). Of the infants, 50.3% had contact with non-household individuals. The mothers had the longest contacts with their babies. Contacts with school children, frequency of attendance at crowded places and age were determined to be significant effective factors for reporting respiratory symptoms. Results suggest that school-age siblings and the mothers should be primarily vaccinated, and parents should keep their babies away from crowded places for protecting their infants.
Collapse
|
13
|
Gianchecchi E, Piccini G, Torelli A, Rappuoli R, Montomoli E. An unwanted guest:Neisseria meningitidis– carriage, risk for invasive disease and the impact of vaccination with insight on Italy incidence. Expert Rev Anti Infect Ther 2017; 15:689-701. [DOI: 10.1080/14787210.2017.1333422] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Giulia Piccini
- VisMederi Srl, Siena, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | - Alessandro Torelli
- VisMederi Srl, Siena, Italy
- Department of Life Sciences, University of Siena, Siena, Italy
| | | | - Emanuele Montomoli
- VisMederi Srl, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| |
Collapse
|
14
|
Kwarteng A, Amuasi J, Annan A, Ahuno S, Opare D, Nagel M, Vinnemeier C, May J, Owusu-Dabo E. Current meningitis outbreak in Ghana: Historical perspectives and the importance of diagnostics. Acta Trop 2017; 169:51-56. [PMID: 28122199 DOI: 10.1016/j.actatropica.2017.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 01/14/2017] [Accepted: 01/16/2017] [Indexed: 01/07/2023]
Abstract
Bacterial meningitis continues to be one of the most dreaded infections in sub-Saharan Africa and other countries that fall in the "meningitis belt" due to recurrent nature of the infection and the sequel of deliberating effects among survivors even after treatment. Ghana has had recurrent epidemics in the past but has been free from high mortality levels. Whereas reasons for the low reported number of deaths in the past are unclear, we hypothesize that it may be due to increased vaccination from expanded program on immunization (EPI) and consequent herd immunity of the general population. As at the end of February, 2016, 100 individuals were reported to have died out of 500 recorded cases. The infection may cause severe brain damage and kills at least 1 out of 10 individuals if quick interventions are not provided. The Ghana Health Service (GHS) and the Ministry of Health (MoH), together with other local and international stakeholders are working intensely to control the spread of the infection in affected communities with treatment and other health management programmes. This review presents a quick overview of meningitis in Ghana with emphasis on S. pneumoniae (responsible for about 70% of cases in the recent epidemic) together with some recommendations aimed at ensuring a "meningitis-free Ghana".
Collapse
|
15
|
Manigart O, Trotter C, Findlow H, Assefa A, Mihret W, Moti Demisse T, Yeshitela B, Osei I, Hodgson A, Quaye SL, Sow S, Coulibaly M, Diallo K, Traore A, Collard JM, Moustapha Boukary R, Djermakoye O, Mahamane AE, Jusot JF, Sokhna C, Alavo S, Doucoure S, Ba EH, Dieng M, Diallo A, Daugla DM, Omotara B, Chandramohan D, Hassan-King M, Nascimento M, Woukeu A, Borrow R, Stuart JM, Greenwood B. A Seroepidemiological Study of Serogroup A Meningococcal Infection in the African Meningitis Belt. PLoS One 2016; 11:e0147928. [PMID: 26872255 PMCID: PMC4752490 DOI: 10.1371/journal.pone.0147928] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/11/2016] [Indexed: 12/31/2022] Open
Abstract
The pattern of epidemic meningococcal disease in the African meningitis belt may be influenced by the background level of population immunity but this has been measured infrequently. A standardised enzyme-linked immunosorbent assay (ELISA) for measuring meningococcal serogroup A IgG antibodies was established at five centres within the meningitis belt. Antibody concentrations were then measured in 3930 individuals stratified by age and residence from six countries. Seroprevalence by age was used in a catalytic model to determine the force of infection. Meningococcal serogroup A IgG antibody concentrations were high in each country but showed heterogeneity across the meningitis belt. The geometric mean concentration (GMC) was highest in Ghana (9.09 μg/mL [95% CI 8.29, 9.97]) and lowest in Ethiopia (1.43 μg/mL [95% CI 1.31, 1.57]) on the margins of the belt. The force of infection was lowest in Ethiopia (λ = 0.028). Variables associated with a concentration above the putative protective level of 2 μg/mL were age, urban residence and a history of recent vaccination with a meningococcal vaccine. Prior to vaccination with the serogroup A meningococcal conjugate vaccine, meningococcal serogroup A IgG antibody concentrations were high across the African meningitis belt and yet the region remained susceptible to epidemics.
Collapse
Affiliation(s)
- Olivier Manigart
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Medical Research Council Unit, Fajara, The Gambia
| | - Caroline Trotter
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Helen Findlow
- Public Health England Vaccine Evaluation Unit, Manchester, United Kingdom
| | - Abraham Assefa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Wude Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | | | - Isaac Osei
- Navrongo Health Research Centre, Navrongo, Ghana
| | | | | | - Samba Sow
- Centre pour les Vaccins en Développement, Bamako, Mali
| | | | - Kanny Diallo
- Centre pour les Vaccins en Développement, Bamako, Mali
| | - Awa Traore
- Centre pour les Vaccins en Développement, Bamako, Mali
| | | | | | | | | | | | - Cheikh Sokhna
- Institut de Recherche pour le Développement, Dakar, Senegal
| | - Serge Alavo
- Institut de Recherche pour le Développement, Dakar, Senegal
| | | | - El Hadj Ba
- Institut de Recherche pour le Développement, Dakar, Senegal
| | - Mariétou Dieng
- Institut de Recherche pour le Développement, Dakar, Senegal
| | | | | | - Babatunji Omotara
- Department of Community Medicine, University of Maiduguri, Maiduguri, Nigeria
| | - Daniel Chandramohan
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Musa Hassan-King
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Maria Nascimento
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Arouna Woukeu
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ray Borrow
- Public Health England Vaccine Evaluation Unit, Manchester, United Kingdom
| | - James M. Stuart
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Brian Greenwood
- Faculty of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| |
Collapse
|