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Steffen R, Hamer DH, Chen LH, Caumes E, Lau CL. Novel chikungunya and dengue vaccines-travel medicine applications. J Travel Med 2024:taae064. [PMID: 38637307 DOI: 10.1093/jtm/taae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Indexed: 04/20/2024]
Abstract
Recent epidemics of dengue and chikungunya have highlighted the urgent need for vaccines to reduce the risk of infection in travellers. Given challenges tracking chikungunya outbreaks in real-time and the widespread resurgence of dengue, broader indications for the use of the new chikungunya and dengue vaccines should be considered.
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Affiliation(s)
- Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, Department of Public and Global Health, Division of Infectious Diseases, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Switzerland
- Division of Epidemiology, Human Genetics & Environmental Sciences, University of Texas School of Public Health, Houston, TX, U.S.A
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health; Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine; and Center on Emerging Infectious Disease, Boston University, Boston, MA, USA
| | - Lin H Chen
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA
- Faculty of Medicine, Harvard Medical School, Boston, MA, USA
| | - Eric Caumes
- Infectious and Tropical Diseases. Hopital de l'Hotel-Dieu & Sorbonne University, Paris, France
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
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2
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Zhu Y, Restrepo AC, Wang HB, Mills DJ, Liang RR, Liu ZB, Lau CL, Furuya-Kanamori L. Malaria cases in China acquired through international travel, 2013-2022. J Travel Med 2024:taae056. [PMID: 38591791 DOI: 10.1093/jtm/taae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/27/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Despite the World Health Organisation certifying China malaria-free in 2021, the risk of local transmission caused by imported malaria cases remains a significant clinical and public health issue. It is necessary to present the changing trends of malaria in China and discuss the role of travel medicine services in consolidating malaria elimination. METHODS This study systematically reviewed articles and reports related to human malaria from 2013 to 2022 published in international and Chinese databases. Data on malaria (i.e. number of cases, Plasmodium spp., diagnostic method, country of acquisition, provinces with high risk of re-introduction and transmission) were collected and synthesised, then summarised using descriptive statistics. RESULTS Overall, 24 758 cases of malaria (>99.5% laboratory confirmed, > 99.2% imported, 0.5% fatal) were reported in China from 2013 to 2022, with a downward trend over the years (4128 cases in 2013 compared to 843 cases in 2022; χ2 trend p-value = 0.005). The last locally acquired case was reported in 2017. P. falciparum (65.5%) was the most common species identified, followed by P. vivax (20.9%) and P. ovale (10.0%). Two Pheidole knowlesi cases were also identified in 2014 and 2017 in returned travellers from Malaysia and Indonesia, respectively. The most common countries of malaria acquisition were Ghana, Angola, and Myanmar. P. vivax was mainly detected in returned travellers from Myanmar, while P. falciparum and P. ovale were detected in travellers from Sub-Saharan Africa. Imported cases were mainly reported in Yunnan, Jiangsu, Sichuan, Guangxi, Shandong, Zhejiang, and Henan provinces, where large numbers of Chinese people travel overseas for work. CONCLUSION Returned travellers from malaria-endemic countries pose a significant risk of malaria re-introduction to China. Travel medicine should be strengthened to improve the capacity and accessibility of both pre- and post-travel services, including malaria prophylaxis and prompt diagnosis of illness in returned travellers.
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Affiliation(s)
- Yan Zhu
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
- Zhuhai International Travel Healthcare Center of China Customs, Zhuhai, China
| | - Angela Cadavid Restrepo
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Hai-Bo Wang
- Zhuhai International Travel Healthcare Center of China Customs, Zhuhai, China
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Rong-Rong Liang
- Guangzhou International Travel Healthcare Center of China Customs, GuangZhou, China, and
| | - Zhi-Bin Liu
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD 4029, Australia
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Sohail A, Barry A, Auburn S, Cheng Q, Lau CL, Lee R, Price RN, Furuya-Kanamori L, Bareng P, McGuinness SL, Leder K. Imported malaria into Australia: surveillance insights and opportunities. J Travel Med 2024; 31:taad164. [PMID: 38127641 PMCID: PMC10998534 DOI: 10.1093/jtm/taad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Malaria continues to pose a significant burden in endemic countries, many of which lack access to molecular surveillance. Insights from malaria cases in travellers returning to non-endemic areas can provide valuable data to inform endemic country programmes. To evaluate the potential for novel global insights into malaria, we examined epidemiological and molecular data from imported malaria cases to Australia. METHODS We analysed malaria cases reported in Australia from 2012 to 2022 using National Notifiable Disease Surveillance System data. Molecular data on imported malaria cases were obtained from literature searches. RESULTS Between 2012 and 2022, 3204 malaria cases were reported in Australia. Most cases (69%) were male and 44% occurred in young adults aged 20-39 years. Incidence rates initially declined between 2012 and 2015, then increased until 2019. During 2012-2019, the incidence in travellers ranged from 1.34 to 7.71 per 100 000 trips. Cases were primarily acquired in Sub-Saharan Africa (n = 1433; 45%), Oceania (n = 569; 18%) and Southern and Central Asia (n = 367; 12%). The most common countries of acquisition were Papua New Guinea (n = 474) and India (n = 277). Plasmodium falciparum accounted for 58% (1871/3204) of cases and was predominantly acquired in Sub-Saharan Africa, and Plasmodium vivax accounted for 32% (1016/3204), predominantly from Oceania and Asia. Molecular studies of imported malaria cases to Australia identified genetic mutations and deletions associated with drug resistance and false-negative rapid diagnostic test results, and led to the establishment of reference genomes for P. vivax and Plasmodium malariae. CONCLUSIONS Our analysis highlights the continuing burden of imported malaria into Australia. Molecular studies have offered valuable insights into drug resistance and diagnostic limitations, and established reference genomes. Integrating molecular data into national surveillance systems could provide important infectious disease intelligence to optimize treatment guidelines for returning travellers and support endemic country surveillance programmes.
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Affiliation(s)
- Asma Sohail
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, Grampians Health, Ballarat 3350, Australia
| | - Alyssa Barry
- Institute for Physical and Mental Health and Clinical Translation (IMPACT) and School of Medicine, Deakin University, Geelong 3220, Australia
- Disease Elimination Program, Burnet Institute, Melbourne 3004, Australia
| | - Sarah Auburn
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0800, Australia
| | - Qin Cheng
- Drug Resistance and Diagnostics, Australian Defence Force Malaria and Infectious Disease Institute, Brisbane 4051, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Rogan Lee
- Parasitology Unit, Institute of Clinical Pathology and Medical Research, Sydney 2145, Australia
| | - Ric N Price
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin 0800, Australia
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX1 2JD, UK
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Paolo Bareng
- Institute for Physical and Mental Health and Clinical Translation (IMPACT) and School of Medicine, Deakin University, Geelong 3220, Australia
| | - Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, Alfred Health, Melbourne 3004, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Victorian Infectious Diseases Service, Melbourne Health, Melbourne 3052, Australia
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Zhu Y, Mills DJ, Mills C, Lau CL, Furuya-Kanamori L. Use of Dengvaxia® in Australian Travellers: a case series. J Travel Med 2024:taae052. [PMID: 38579018 DOI: 10.1093/jtm/taae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/07/2024]
Abstract
Dengvaxia is the only licensed dengue vaccine in Australia, but rarely used. We report the experience of using Dengvaxia in seven Australian travellers. Main reasons for opting for vaccination were travel to dengue-endemic regions and severe symptoms during the prior dengue infection. The vaccine was well tolerated by all travellers.
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Affiliation(s)
- Yan Zhu
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Zhuhai International Travel Healthcare Center of China Customs, Zhuhai, China
| | - Deborah J Mills
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Christine Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
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Kiani B, Sartorius B, Lau CL, Bergquist R. Mastering geographically weighted regression: key considerations for building a robust model. Geospat Health 2024; 19. [PMID: 38436363 DOI: 10.4081/gh.2024.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
Geographically weighted regression (GWR) takes a prominent role in spatial regression analysis, providing a nuanced perspective on the intricate interplay of variables within geographical landscapes (Brunsdon et al., 1998). However, it is essential to have a strong rationale for employing GWR, either as an addition to, or a complementary analysis alongside, non-spatial (global) regression models (Kiani, Mamiya et al., 2023). Moreover, the proper selection of bandwidth, weighting function or kernel types, and variable choices constitute the most critical configurations in GWR analysis (Wheeler, 2021). [...].
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Affiliation(s)
- Behzad Kiani
- UQ Centre for Clinical Research, The University of Queensland, Brisbane.
| | - Benn Sartorius
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Australia; Centre for Tropical Medicine and Global Health, Faculty of Medicine, University of Oxford, Oxford, UK; Department of Health Metric Sciences, Faculty of Medicine, University of Washington, Seattle.
| | - Colleen L Lau
- UQ Centre for Clinical Research, The University of Queensland, Brisbane.
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Warzywoda S, Fowler JA, Debattista J, Mills DJ, Furuya-Kanamori L, Durham J, Lau CL, Mullens AB, Istiko SN, Santaolaya C, Malhotra J, Dean JA. The provision of sexual and reproductive health information and services to travellers: an exploratory survey of Australian travel medicine clinicians. Sex Health 2024; 21:SH23098. [PMID: 38219736 DOI: 10.1071/sh23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND International travel can increase the risk of exposure to infectious diseases including sexually transmissible infections (STI). Pre-travel medical consultation provides an opportunity for travel-related health risk assessments and advice. This study explored how travel medicine clinicians integrate sexual and reproductive health (SRH) services into clinical practice. METHODS A convenience sample of travel medicine clinicians completed a cross-sectional survey online or via hard-copy disseminated at an annual national Australian travel medicine conference. RESULTS Of the 67 respondents, most (n , 51; 76.1%) had a postgraduate qualification relevant to travel medicine and 55.2% (n , 37) had worked in travel medicine for over 10years. Only 22.4% (n , 15) reported conducting a SRH history/STI risk assessment for all travel patients. STI testing pre-departure was conducted on patient request (48, 71.6%), if symptomatic (32, 47.8%) or based on risk history (28, 41.8%). SRH information pre-departure was most frequently provided if prompted by patient questions (n , 42; 62.7%), or based on the patient's history (n , 37; 55.2%). Over half the sample (n , 40; 59.7%) expressed interest in further training in SRH. CONCLUSION Providing and engaging with additional training may assist travel medicine clinicians to take a more proactive approach to SRH consultations and STI testing. Additional research is needed to explore models of care that will allow comprehensive SRH and STI services to be integrated into standard pre- and post-travel care.
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Affiliation(s)
- Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Joe Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Windsor, Qld, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Qld, Australia; and UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Jo Durham
- School of Public Health and Social Work, Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Faculty of Health Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Qld, Australia
| | - Satrio Nindyo Istiko
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Carlos Santaolaya
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Juhi Malhotra
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
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Furuya-Kanamori L, Mills DJ, Zhu Y, Lau CL. Can a single visit rabies pre-exposure prophylaxis eliminate the need for rabies immunoglobulin in last minute travellers? J Travel Med 2023; 30:taad139. [PMID: 37941445 DOI: 10.1093/jtm/taad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Yan Zhu
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
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McGuinness SL, Lau CL, Leder K. Co-circulation of Murray Valley encephalitis virus and Japanese encephalitis virus in south-eastern Australia. J Travel Med 2023; 30:taad059. [PMID: 37185780 PMCID: PMC10658655 DOI: 10.1093/jtm/taad059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023]
Affiliation(s)
- Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne 3004, Australia
| | - Colleen L Lau
- School of Public Health, The University of Queensland, Brisbane 4006, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne 3000, Australia
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Lau CL, Mills DJ, Mayfield H, Gyawali N, Johnson BJ, Lu H, Allel K, Britton PN, Ling W, Moghaddam T, Furuya-Kanamori L. A decision support tool for risk-benefit analysis of Japanese encephalitis vaccine in travellers. J Travel Med 2023; 30:taad113. [PMID: 37602668 DOI: 10.1093/jtm/taad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND During pre-travel consultations, clinicians and travellers face the challenge of weighing the risks verus benefits of Japanese encephalitis (JE) vaccination due to the high cost of the vaccine, low incidence in travellers (~1 in 1 million), but potentially severe consequences (~30% case-fatality rate). Personalised JE risk assessment based on the travellers' demographics and travel itinerary is challenging using standard risk matrices. We developed an interactive digital tool to estimate risks of JE infection and severe health outcomes under different scenarios to facilitate shared decision-making between clinicians and travellers. METHODS A Bayesian network (conditional probability) model risk-benefit analysis of JE vaccine in travellers was developed. The model considers travellers' characteristics (age, sex, co-morbidities), itinerary (destination, departure date, duration, setting of planned activities) and vaccination status to estimate the risks of JE infection, the development of symptomatic disease (meningitis, encephalitis), clinical outcomes (hospital admission, chronic neurological complications, death) and adverse events following immunization. RESULTS In low-risk travellers (e.g. to urban areas for <1 month), the risk of developing JE and dying is low (<1 per million) irrespective of the destination; thus, the potential impact of JE vaccination in reducing the risk of clinical outcomes is limited. In high-risk travellers (e.g. to rural areas in high JE incidence destinations for >2 months), the risk of developing symptomatic disease and mortality is estimated at 9.5 and 1.4 per million, respectively. JE vaccination in this group would significantly reduce the risk of symptomatic disease and mortality (by ~80%) to 1.9 and 0.3 per million, respectively. CONCLUSION The JE tool may assist decision-making by travellers and clinicians and could increase JE vaccine uptake. The tool will be updated as additional evidence becomes available. Future work needs to evaluate the usability of the tool. The interactive, scenario-based, personalised JE vaccine risk-benefit tool is freely available on www.VaxiCal.com.
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Affiliation(s)
- Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Helen Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Brian J Johnson
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Hongen Lu
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Kasim Allel
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
| | - Philip N Britton
- Department of Infectious Diseases and Microbiology, Children's Hospital Westmead, Westmead, NSW, Australia
- Child and Adolescent Health and Sydney ID, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Weiping Ling
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Tina Moghaddam
- School of Information Technology and Electrical Engineering, Faculty of Science, The University of Queensland, St Lucia, QLD, Australia
| | - Luis Furuya-Kanamori
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Mario Martin B, Cadavid Restrepo A, Mayfield HJ, Then Paulino C, De St Aubin M, Duke W, Jarolim P, Zielinski Gutiérrez E, Skewes Ramm R, Dumas D, Garnier S, Etienne MC, Peña F, Abdalla G, Lopez B, de la Cruz L, Henríquez B, Baldwin M, Sartorius B, Kucharski A, Nilles EJ, Lau CL. Using Regional Sero-Epidemiology SARS-CoV-2 Anti-S Antibodies in the Dominican Republic to Inform Targeted Public Health Response. Trop Med Infect Dis 2023; 8:493. [PMID: 37999612 PMCID: PMC10675152 DOI: 10.3390/tropicalmed8110493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Incidence of COVID-19 has been associated with sociodemographic factors. We investigated variations in SARS-CoV-2 seroprevalence at sub-national levels in the Dominican Republic and assessed potential factors influencing variation in regional-level seroprevalence. Data were collected in a three-stage cross-sectional national serosurvey from June to October 2021. Seroprevalence of antibodies against the SARS-CoV-2 spike protein (anti-S) was estimated and adjusted for selection probability, age, and sex. Multilevel logistic regression was used to estimate the effect of covariates on seropositivity for anti-S and correlates of 80% protection (PT80) against symptomatic infection for the ancestral and Delta strains. A total of 6683 participants from 134 clusters in all 10 regions were enrolled. Anti-S, PT80 for the ancestral and Delta strains odds ratio varied across regions, Enriquillo presented significant higher odds for all outcomes compared with Yuma. Compared to being unvaccinated, receiving ≥2 doses of COVID-19 vaccine was associated with a significantly higher odds of anti-S positivity (OR 85.94, [10.95-674.33]) and PT80 for the ancestral (OR 4.78, [2.15-10.62]) and Delta strains (OR 3.08, [1.57-9.65]) nationally and also for each region. Our results can help inform regional-level public health response, such as strategies to increase vaccination coverage in areas with low population immunity against currently circulating strains.
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Affiliation(s)
- Beatris Mario Martin
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (A.C.R.); (H.J.M.); (B.S.); (C.L.L.)
| | - Angela Cadavid Restrepo
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (A.C.R.); (H.J.M.); (B.S.); (C.L.L.)
| | - Helen J. Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (A.C.R.); (H.J.M.); (B.S.); (C.L.L.)
| | - Cecilia Then Paulino
- Ministry of Health and Social Assistance, Santo Domingo 10514, Dominican Republic (F.P.)
| | - Micheal De St Aubin
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA 02138, USA
| | - William Duke
- Faculty of Health Sciences, Pedro Henriquez Urena National University, Santo Domingo 10514, Dominican Republic;
| | - Petr Jarolim
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Harvard Medical School, Boston, MA 02115, USA
| | - Emily Zielinski Gutiérrez
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City 01015, Guatemala (B.L.)
| | - Ronald Skewes Ramm
- Ministry of Health and Social Assistance, Santo Domingo 10514, Dominican Republic (F.P.)
| | - Devan Dumas
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA 02138, USA
| | - Salome Garnier
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA 02138, USA
| | | | - Farah Peña
- Ministry of Health and Social Assistance, Santo Domingo 10514, Dominican Republic (F.P.)
| | - Gabriela Abdalla
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
| | - Beatriz Lopez
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City 01015, Guatemala (B.L.)
| | - Lucia de la Cruz
- Ministry of Health and Social Assistance, Santo Domingo 10514, Dominican Republic (F.P.)
| | - Bernarda Henríquez
- Ministry of Health and Social Assistance, Santo Domingo 10514, Dominican Republic (F.P.)
| | - Margaret Baldwin
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA 02138, USA
| | - Benn Sartorius
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (A.C.R.); (H.J.M.); (B.S.); (C.L.L.)
| | - Adam Kucharski
- Department of Infectious Disease Epidemiology and Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Eric James Nilles
- Brigham and Women’s Hospital, Boston, MA 02115, USA (G.A.); (E.J.N.)
- Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA 02138, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia; (A.C.R.); (H.J.M.); (B.S.); (C.L.L.)
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Foxlee ND, Taleo SA, Mathias A, Townell N, McIver L, Lau CL. The Impact of COVID-19 on Knowledge, Beliefs, and Practices of Ni-Vanuatu Health Workers Regarding Antibiotic Prescribing and Antibiotic Resistance, 2018 and 2022: A Mixed Methods Study. Trop Med Infect Dis 2023; 8:477. [PMID: 37888605 PMCID: PMC10611053 DOI: 10.3390/tropicalmed8100477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/02/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
Antimicrobial resistance (AMR) is included in the ten most urgent global public health threats. Global evidence suggests that antibiotics were over prescribed during the early waves of the COVID-19 pandemic, particularly in low- and middle-income countries. Inappropriate use of antibiotics drives the emergence and spread of antibiotic resistance. This study aimed to examine the impact of COVID-19 on Ni-Vanuatu health worker knowledge, beliefs, and practices (KBP) regarding antibiotic prescribing and awareness of antibacterial AMR. A mixed methods study was conducted using questionnaires and in-depth interviews in 2018 and 2022. A total of 49 respondents completed both baseline (2018) and follow-up (2022) questionnaires. Knowledge scores about prescribing improved between surveys, although health workers were less confident about some prescribing activities. Respondents identified barriers to optimal hand hygiene performance. More than three-quarters of respondents reported that COVID-19 influenced their prescribing practice and heightened their awareness of ABR: "more careful", "more aware", "stricter", and "need more community awareness". Recommendations include providing ongoing continuing professional development to improve knowledge, enhance skills, and maintain prescribing competency; formalising antibiotic stewardship and infection, prevention, and control (IPC) programmes to optimise prescribing and IPC practices; and raising community awareness about ABR to support more effective use of medications.
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Affiliation(s)
- Nicola D. Foxlee
- National Centre for Epidemiology and Public Health, Australian National University, Canberra, ACT 2600, Australia
| | - Siti Aishah Taleo
- Dispensary, Vila Central Hospital, Ministry of Health, Private Mail Bag, Port Vila 9009, Vanuatu
| | - Agnes Mathias
- Curative Services, Ministry of Health, Private Mail Bag, Port Vila 9009, Vanuatu
| | - Nicola Townell
- Pacific Region Infectious Diseases Association, Kenmore Hills, QLD 4069, Australia
| | | | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia;
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Rees EM, Lotto Batista M, Kama M, Kucharski AJ, Lau CL, Lowe R. Quantifying the relationship between climatic indicators and leptospirosis incidence in Fiji: A modelling study. PLOS Glob Public Health 2023; 3:e0002400. [PMID: 37819894 PMCID: PMC10566718 DOI: 10.1371/journal.pgph.0002400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
Leptospirosis, a global zoonotic disease, is prevalent in tropical and subtropical regions, including Fiji where it's endemic with year-round cases and sporadic outbreaks coinciding with heavy rainfall. However, the relationship between climate and leptospirosis has not yet been well characterised in the South Pacific. In this study, we quantify the effects of different climatic indicators on leptospirosis incidence in Fiji, using a time series of weekly case data between 2006 and 2017. We used a Bayesian hierarchical mixed-model framework to explore the impact of different precipitation, temperature, and El Niño Southern Oscillation (ENSO) indicators on leptospirosis cases over a 12-year period. We found that total precipitation from the previous six weeks (lagged by one week) was the best precipitation indicator, with increased total precipitation leading to increased leptospirosis incidence (0.24 [95% CrI 0.15-0.33]). Negative values of the Niño 3.4 index (indicative of La Niña conditions) lagged by four weeks were associated with increased leptospirosis risk (-0.2 [95% CrI -0.29 --0.11]). Finally, minimum temperature (lagged by one week) when included with the other variables was positively associated with leptospirosis risk (0.15 [95% CrI 0.01-0.30]). We found that the final model was better able to capture the outbreak peaks compared with the baseline model (which included seasonal and inter-annual random effects), particularly in the Western and Northern division, with climate indicators improving predictions 58.1% of the time. This study identified key climatic factors influencing leptospirosis risk in Fiji. Combining these results with demographic and spatial factors can support a precision public health framework allowing for more effective public health preparedness and response which targets interventions to the right population, place, and time. This study further highlights the need for enhanced surveillance data and is a necessary first step towards the development of a climate-based early warning system.
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Affiliation(s)
- Eleanor M. Rees
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Martín Lotto Batista
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Epidemiology Department, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Mike Kama
- Fiji Centre for Communicable Disease Control, The University of the South Pacific, Suva, Fiji
| | - Adam J. Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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13
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Guo Y, Mills DJ, Lau CL, Mills C, Furuya‐Kanamori L. Immune response after rabies pre-exposure prophylaxis and a booster dose in Australian bat carers. Zoonoses Public Health 2023; 70:465-472. [PMID: 37170441 PMCID: PMC10952468 DOI: 10.1111/zph.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/31/2023] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
Periodic vaccination against rabies is essential for individuals at continuing risk of rabies exposure. There is limited evidence on long-term immunogenicity after a 3-dose intramuscular (3IM) pre-exposure prophylaxis (PrEP) and single IM booster dose, thus current guideline recommendations differ in the interval for serology tests following PrEP and boosters. This study investigated post-PrEP and post-booster persistence of antibodies in Australian bat carers. Bat carers who received 3IM PrEP/booster doses and had post-PrEP/booster serology test results were included. The proportion of antibody-negative (<0.5 EU/mL) individuals after PrEP/booster dose were examined. Three hundred and five participants (65.6% females, median age at PrEP 43.1 years) were included. The proportion who were antibody-negative varied depending on the time between 3IM PrEP and the serology test: 8.0% <1 year, 29.8% 1-2 years, 21.2% 2-3 years and 7.7% >3 years. Ninety-one participants receiving booster doses were further assessed. Only one participant was antibody-negative at >3 years after receiving one IM booster dose. Our findings support that a serology test should be performed 1 year after 3IM PrEP, followed by first booster if required. Rabies antibodies persist for many years after receiving the booster doses. The interval between subsequent serology tests and the first booster dose should be no longer than 3 years. Future studies are required to provide more insight into the most appropriate timing of subsequent boosters.
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Affiliation(s)
- Yihan Guo
- School of Medicine, Faculty of MedicineThe University of QueenslandHerstonAustralia
| | - Deborah J. Mills
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
| | - Colleen L. Lau
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
- School of Public Health, Faculty of MedicineThe University of QueenslandHerstonAustralia
| | - Christine Mills
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
| | - Luis Furuya‐Kanamori
- School of Public Health, Faculty of MedicineThe University of QueenslandHerstonAustralia
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14
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McHugh L, Dyda A, Guglielmino C, Buckley C, Lau CL, Jennison AV, Regan DG, Wood J, Whiley D, Trembizki E. The changing epidemiology of Neisseria gonorrhoeae genogroups and antimicrobial resistance in Queensland, Australia, 2010-15: a case series analysis of unique Neisseria gonorrhoeae isolates. Sex Health 2023; 20:296-302. [PMID: 36972581 DOI: 10.1071/sh22118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Neisseria gonorrhoeae (NG) can lead to serious reproductive and sexual health outcomes, and the annual number of NG notifications in Australia increased steadily from 10329 in 2010 to 29549 by 2020. Australian populations most affected are urban men who have sex with men and First Nations peoples living in remote areas, and a resurgence in urban heterosexuals has been observed since 2012. METHODS A case series analysis of Queensland NG isolates (2010-15) exploring temporal trends and antimicrobial resistance by demographic and geographic distribution and genotype was performed. Proportions describe age, sex, strain, genogroup (NG multi-antigen sequence typing), region, swab site, antimicrobial sensitivity and isolate rates per 100000 population. Dominant genogroups were identified. RESULTS Among 3953 isolates, the median age was 25years (IQR 20-34years) and most (n =2871/3915, 73%) were men. Brisbane city (68.8) and Far North Queensland (54.1) excluding Cairns showed the highest rates. Forty-six genogroups were documented, seven (G2992, G6876, G1415, G4186, G5, G1407 and G6937) comprised half of all isolates. The predominant male genogroup was G2992 (16%), and G6876 (20%) for females; G5 was predominantly male from 2010 to 2011, but equal in both sexes from 2012 to 2015. CONCLUSION Considerable temporal, geographical and demographical diversity was observed in Queensland NG isolates, which has public health implications. Certain genogroups are more transient than others, and evidence suggests bridging from male-dominant networks to heterosexual networks. Molecular surveillance can enhance tracking the epidemiology and movement of NG in Australia, highlighting the necessity of genotyping to expose potentially prevalent strains circulating in undetected or underrepresented networks by current screening methods.
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Affiliation(s)
- Lisa McHugh
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia
| | - Amalie Dyda
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia
| | - Christine Guglielmino
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, Qld, Australia
| | - Cameron Buckley
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia
| | - Colleen L Lau
- University of Queensland, School of Public Health, Division of Medicine, Herston, Brisbane, Qld, Australia; and Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, Qld, Australia
| | - David G Regan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - James Wood
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - David Whiley
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia; and Pathology Queensland, Herston, Brisbane, Qld, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Health Research and Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, Brisbane, Qld, Australia
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15
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Willis GA, Kearns T, Mayfield HJ, Sheridan S, Thomsen R, Naseri T, David MC, Engelman D, Steer AC, Graves PM, Lau CL. Scabies prevalence after ivermectin-based mass drug administration for lymphatic filariasis, Samoa 2018-2019. PLoS Negl Trop Dis 2023; 17:e0011549. [PMID: 37607196 PMCID: PMC10497159 DOI: 10.1371/journal.pntd.0011549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 09/12/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Scabies is a common skin infestation caused by the Sarcoptes scabei mite. Ivermectin, one of three drugs used in mass drug administration (MDA) for lymphatic filariasis, is also effective for treating scabies. Ivermectin-based MDA was first conducted in Samoa in August 2018, with ivermectin being offered to those aged ≥5 years. Here, we report scabies prevalence in Samoa after MDA. METHODS We conducted household surveys 1.5-3.5 months (Survey 1) and 6-8 months (Survey 2) after the 2018 MDA in 35 primary sampling units. We conducted clinical examination for scabies-like rash and used International Alliance for the Control of Scabies classification criteria. We estimated scabies prevalence by age, gender and region. Multivariable logistic regression was used to assess factors associated with prevalence. RESULTS We surveyed 2868 people (499 households) and 2796 people (544 households) aged 0-75 years in Surveys 1 and 2, respectively. Scabies prevalence increased from 2.4% (95% CI 2.1-2.7%) to 4.4% (95% CI 4.0-4.9%) between surveys. Scabies was associated with younger age (0-4 years: aOR 3.5 [2.9-4.2]; 5-15 years: aOR 1.6 [1.4-1.8] compared to ≥16 years), female gender (aOR 1.2 [95% CI 1.1-1.4]; region (aOR range from 1.4 [1.1-1.7] to 2.5 [2.1-3.1] between regions), large households (aOR 2.6 [2.0-3.4] households ≥13), and not taking MDA in 2018 (aOR 1.3 [95% CI 1.1-1.6]). CONCLUSIONS We found moderate prevalence of scabies in two population-representative surveys conducted within 8 months of the 2018 MDA for lymphatic filariasis. Prevalence appeared to increase between the surveys, and ongoing surveillance is recommended, particularly in young children.
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Affiliation(s)
- Gabriela A. Willis
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Therese Kearns
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Helen J. Mayfield
- Research School of Population Health, Australian National University, Canberra, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Sarah Sheridan
- National Centre for Immunisation Research and Surveillance, Sydney, Australia
| | | | | | - Michael C. David
- School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Daniel Engelman
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Andrew C. Steer
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
| | - Colleen L. Lau
- Research School of Population Health, Australian National University, Canberra, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
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16
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Ng PYT, Lui CT, Lau CL, Fung HT, Lai CH, Lee LY. Characteristics of individuals who frequently use emergency departments in Hong Kong: a region-based cohort study. Hong Kong Med J 2023; 29:301-310. [PMID: 37599405 DOI: 10.12809/hkmj219460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Affiliation(s)
- P Y T Ng
- Accident and Emergency Department, Tin Shui Wai Hospital, Hong Kong SAR, China
| | - C T Lui
- Accident and Emergency Department, Tuen Mun Hospital, Hong Kong SAR, China
| | - C L Lau
- Accident and Emergency Department, Tuen Mun Hospital, Hong Kong SAR, China
| | - H T Fung
- Accident and Emergency Department, Tuen Mun Hospital, Hong Kong SAR, China
| | - C H Lai
- Accident and Emergency Department, Tin Shui Wai Hospital, Hong Kong SAR, China
| | - L Y Lee
- Accident and Emergency Department, Tin Shui Wai Hospital, Hong Kong SAR, China
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17
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Cadavid Restrepo AM, Martin BM, Fuimaono S, Clements ACA, Graves PM, Lau CL. Spatial predictive risk mapping of lymphatic filariasis residual hotspots in American Samoa using demographic and environmental factors. PLoS Negl Trop Dis 2023; 17:e0010840. [PMID: 37486947 PMCID: PMC10399813 DOI: 10.1371/journal.pntd.0010840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND American Samoa successfully completed seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006. The territory passed the school-based transmission assessment surveys in 2011 and 2015 but failed in 2016. One of the key challenges after the implementation of MDA is the identification of any residual hotspots of transmission. METHOD Based on data collected in a 2016 community survey in persons aged ≥8 years, Bayesian geostatistical models were developed for LF antigen (Ag), and Wb123, Bm14, Bm33 antibodies (Abs) to predict spatial variation in infection markers using demographic and environmental factors (including land cover, elevation, rainfall, distance to the coastline and distance to streams). RESULTS In the Ag model, females had a 26.8% (95% CrI: 11.0-39.8%) lower risk of being Ag-positive than males. There was a 2.4% (95% CrI: 1.8-3.0%) increase in the odds of Ag positivity for every year of age. Also, the odds of Ag-positivity increased by 0.4% (95% CrI: 0.1-0.7%) for each 1% increase in tree cover. The models for Wb123, Bm14 and Bm33 Abs showed similar significant associations as the Ag model for sex, age and tree coverage. After accounting for the effect of covariates, the radii of the clusters were larger for Bm14 and Bm33 Abs compared to Ag and Wb123 Ab. The predictive maps showed that Ab-positivity was more widespread across the territory, while Ag-positivity was more confined to villages in the north-west of the main island. CONCLUSION The findings may facilitate more specific targeting of post-MDA surveillance activities by prioritising those areas at higher risk of ongoing transmission.
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Affiliation(s)
- Angela M Cadavid Restrepo
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Beatris M Martin
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Archie C A Clements
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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18
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Shaw C, McLure A, Graves PM, Lau CL, Glass K. Lymphatic filariasis endgame strategies: Using GEOFIL to model mass drug administration and targeted surveillance and treatment strategies in American Samoa. PLoS Negl Trop Dis 2023; 17:e0011347. [PMID: 37200375 DOI: 10.1371/journal.pntd.0011347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 05/31/2023] [Accepted: 04/29/2023] [Indexed: 05/20/2023] Open
Abstract
American Samoa underwent seven rounds of mass drug administration (MDA) for lymphatic filariasis (LF) from 2000-2006, but subsequent surveys found evidence of ongoing transmission. American Samoa has since undergone further rounds of MDA in 2018, 2019, and 2021; however, recent surveys indicate that transmission is still ongoing. GEOFIL, a spatially-explicit agent-based LF model, was used to compare the effectiveness of territory-wide triple-drug MDA (3D-MDA) with targeted surveillance and treatment strategies. Both approaches relied on treatment with ivermectin, diethylcarbamazine, and albendazole. We simulated three levels of whole population coverage for 3D-MDA: 65%, 73%, and 85%, while the targeted strategies relied on surveillance in schools, workplaces, and households, followed by targeted treatment. In the household-based strategies, we simulated 1-5 teams travelling village-to-village and offering antigen (Ag) testing to randomly selected households in each village. If an Ag-positive person was identified, treatment was offered to members of all households within 100m-1km of the positive case. All simulated interventions were finished by 2027 and their effectiveness was judged by their 'control probability'-the proportion of simulations in which microfilariae prevalence decreased between 2030 and 2035. Without future intervention, we predict Ag prevalence will rebound. With 3D-MDA, a 90% control probability required an estimated ≥ 4 further rounds with 65% coverage, ≥ 3 rounds with 73% coverage, or ≥ 2 rounds with 85% coverage. While household-based strategies were substantially more testing-intensive than 3D-MDA, they could offer comparable control probabilities with substantially fewer treatments; e.g. three teams aiming to test 50% of households and offering treatment to a 500m radius had approximately the same control probability as three rounds of 73% 3D-MDA, but used < 40% the number of treatments. School- and workplace-based interventions proved ineffective. Regardless of strategy, reducing Ag prevalence below the 1% target threshold recommended by the World Health Organization was a poor indicator of the interruption of LF transmission, highlighting the need to review blanket elimination targets.
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Affiliation(s)
- Callum Shaw
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Angus McLure
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
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19
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McGuinness SL, Lau CL, Leder K. The evolving Japanese encephalitis situation in Australia and implications for travel medicine. J Travel Med 2023; 30:taad029. [PMID: 36869722 PMCID: PMC10075061 DOI: 10.1093/jtm/taad029] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
The recent emergence of Japanese encephalitis in south-eastern Australia highlights the changing epidemiology of this important disease and the need for integrated surveillance to inform risk-based discussions and vaccination advice for travellers and endemic populations.
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Affiliation(s)
- Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia
| | - Colleen L Lau
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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20
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Nilles EJ, de St Aubin M, Dumas D, Duke W, Etienne MC, Abdalla G, Jarolim P, Oasan T, Garnier S, Iihoshi N, Lopez B, de la Cruz L, Puello YC, Baldwin M, Roberts KW, Peña F, Durski K, Sanchez IM, Gunter SM, Kneubehl AR, Murray KO, Lino A, Strobel S, Baez AA, Lau CL, Kucharski A, Gutiérrez EZ, Skewes-Ramm R, Vasquez M, Paulino CT. Monitoring Temporal Changes in SARS-CoV-2 Spike Antibody Levels and Variant-Specific Risk for Infection, Dominican Republic, March 2021-August 2022. Emerg Infect Dis 2023; 29:723-733. [PMID: 36848869 PMCID: PMC10045678 DOI: 10.3201/eid2904.221628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
To assess changes in SARS-CoV-2 spike binding antibody prevalence in the Dominican Republic and implications for immunologic protection against variants of concern, we prospectively enrolled 2,300 patients with undifferentiated febrile illnesses in a study during March 2021-August 2022. We tested serum samples for spike antibodies and tested nasopharyngeal samples for acute SARS-CoV-2 infection using a reverse transcription PCR nucleic acid amplification test. Geometric mean spike antibody titers increased from 6.6 (95% CI 5.1-8.7) binding antibody units (BAU)/mL during March-June 2021 to 1,332 (95% CI 1,055-1,682) BAU/mL during May-August 2022. Multivariable binomial odds ratios for acute infection were 0.55 (95% CI 0.40-0.74), 0.38 (95% CI 0.27-0.55), and 0.27 (95% CI 0.18-0.40) for the second, third, and fourth versus the first anti-spike quartile; findings were similar by viral strain. Combining serologic and virologic screening might enable monitoring of discrete population immunologic markers and their implications for emergent variant transmission.
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21
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Assoum M, Lau CL, Thai PK, Ahmed W, Mueller JF, Thomas KV, Choi PM, Jackson G, Selvey LA. Wastewater Surveillance Can Function as an Early Warning System for COVID-19 in Low-Incidence Settings. Trop Med Infect Dis 2023; 8:tropicalmed8040211. [PMID: 37104337 PMCID: PMC10143724 DOI: 10.3390/tropicalmed8040211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/07/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction: During the first two years of the COVID-19 pandemic, Australia implemented a series of international and interstate border restrictions. The state of Queensland experienced limited COVID-19 transmission and relied on lockdowns to stem any emerging COVID-19 outbreaks. However, early detection of new outbreaks was difficult. In this paper, we describe the wastewater surveillance program for SARS-CoV-2 in Queensland, Australia, and report two case studies in which we aimed to assess the potential for this program to provide early warning of new community transmission of COVID-19. Both case studies involved clusters of localised transmission, one originating in a Brisbane suburb (Brisbane Inner West) in July–August 2021, and the other originating in Cairns, North Queensland in February–March 2021. Materials and Methods: Publicly available COVID-19 case data derived from the notifiable conditions (NoCs) registry from the Queensland Health data portal were cleaned and merged spatially with the wastewater surveillance data using statistical area 2 (SA2) codes. The positive predictive value and negative predictive value of wastewater detection for predicting the presence of COVID-19 reported cases were calculated for the two case study sites. Results: Early warnings for local transmission of SARS-CoV-2 through wastewater surveillance were noted in both the Brisbane Inner West cluster and the Cairns cluster. The positive predictive value of wastewater detection for the presence of notified cases of COVID-19 in Brisbane Inner West and Cairns were 71.4% and 50%, respectively. The negative predictive value for Brisbane Inner West and Cairns were 94.7% and 100%, respectively. Conclusions: Our findings highlight the utility of wastewater surveillance as an early warning tool in low COVID-19 transmission settings.
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Affiliation(s)
- Mohamad Assoum
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Phong K. Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Warish Ahmed
- CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102, Australia
| | - Jochen F. Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Kevin V. Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, Woolloongabba, QLD 4102, Australia
| | - Phil Min Choi
- Health Protection Branch, Queensland Health, Brisbane, QLD 4006, Australia
| | - Greg Jackson
- Health Protection Branch, Queensland Health, Brisbane, QLD 4006, Australia
| | - Linda A. Selvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4006, Australia
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22
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Nilles EJ, Paulino CT, de St Aubin M, Duke W, Jarolim P, Sanchez IM, Murray KO, Lau CL, Gutiérrez EZ, Ramm RS, Vasquez M, Kucharski A. Tracking immune correlates of protection for emerging SARS-CoV-2 variants. Lancet Infect Dis 2023; 23:153-154. [PMID: 36640795 PMCID: PMC9833833 DOI: 10.1016/s1473-3099(23)00001-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023]
Affiliation(s)
- Eric J Nilles
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Harvard Humanitarian Initiative, Cambridge, MA, USA.
| | | | - Michael de St Aubin
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Humanitarian Initiative, Cambridge, MA, USA
| | - William Duke
- Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic
| | - Petr Jarolim
- Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Kristy O Murray
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | | | - Emily Zielinski Gutiérrez
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala
| | - Ronald Skewes Ramm
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic
| | | | - Adam Kucharski
- London School of Hygiene & Tropical Medicine, London, UK
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23
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Nilles EJ, Paulino CT, de St Aubin M, Restrepo AC, Mayfield H, Dumas D, Finch E, Garnier S, Etienne MC, Iselin L, Duke W, Jarolim P, Oasan T, Yu J, Wan H, Peña F, Iihoshi N, Abdalla G, Lopez B, Cruz LDL, Henríquez B, Espinosa-Bode A, Puello YC, Durski K, Baldwin M, Baez AA, Merchant RC, Barouch DH, Skewes-Ramm R, Gutiérrez EZ, Kucharski A, Lau CL. SARS-CoV-2 seroprevalence, cumulative infections, and immunity to symptomatic infection - A multistage national household survey and modelling study, Dominican Republic, June-October 2021. Lancet Reg Health Am 2022; 16:100390. [PMID: 36408529 PMCID: PMC9642112 DOI: 10.1016/j.lana.2022.100390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022]
Abstract
Background Population-level SARS-CoV-2 immunological protection is poorly understood but can guide vaccination and non-pharmaceutical intervention priorities. Our objective was to characterise cumulative infections and immunological protection in the Dominican Republic. Methods Household members ≥5 years were enrolled in a three-stage national household cluster serosurvey in the Dominican Republic. We measured pan-immunoglobulin antibodies against the SARS-CoV-2 spike (anti-S) and nucleocapsid glycoproteins, and pseudovirus neutralising activity against the ancestral and B.1.617.2 (Delta) strains. Seroprevalence and cumulative prior infections were weighted and adjusted for assay performance and seroreversion. Binary classification machine learning methods and pseudovirus neutralising correlates of protection were used to estimate 50% and 80% protection against symptomatic infection. Findings Between 30 Jun and 12 Oct 2021 we enrolled 6683 individuals from 3832 households. We estimate that 85.0% (CI 82.1-88.0) of the ≥5 years population had been immunologically exposed and 77.5% (CI 71.3-83) had been previously infected. Protective immunity sufficient to provide at least 50% protection against symptomatic SARS-CoV-2 infection was estimated in 78.1% (CI 74.3-82) and 66.3% (CI 62.8-70) of the population for the ancestral and Delta strains respectively. Younger (5-14 years, OR 0.47 [CI 0.36-0.61]) and older (≥75-years, 0.40 [CI 0.28-0.56]) age, working outdoors (0.53 [0.39-0.73]), smoking (0.66 [0.52-0.84]), urban setting (1.30 [1.14-1.49]), and three vs no vaccine doses (18.41 [10.69-35.04]) were associated with 50% protection against the ancestral strain. Interpretation Cumulative infections substantially exceeded prior estimates and overall immunological exposure was high. After controlling for confounders, markedly lower immunological protection was observed to the ancestral and Delta strains across certain subgroups, findings that can guide public health interventions and may be generalisable to other settings and viral strains. Funding This study was funded by the US CDC.
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Affiliation(s)
- Eric J Nilles
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA
| | | | - Michael de St Aubin
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA
| | | | - Helen Mayfield
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Devan Dumas
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA
| | - Emilie Finch
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Salome Garnier
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA.,Harvard University, Cambridge, MA, USA
| | - Marie Caroline Etienne
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA
| | | | - William Duke
- Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic
| | - Petr Jarolim
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Timothy Oasan
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA
| | - Jingyou Yu
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Huahua Wan
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Farah Peña
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic
| | - Naomi Iihoshi
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA
| | - Gabriela Abdalla
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA
| | - Beatriz Lopez
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala
| | - Lucia de la Cruz
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic
| | - Bernarda Henríquez
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic
| | - Andres Espinosa-Bode
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala
| | | | - Kara Durski
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA
| | - Margaret Baldwin
- Division of Global Emergency Care and Humanitarian Studies, Brigham and Womens Hospital, Boston, MA, USA.,Infectious Diseases and Epidemics Program, Harvard Humanitarian Initiative, Cambridge, MA, USA
| | - Amado Alejandro Baez
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic.,Pedro Henríquez Ureña National University, Santo Domingo, Dominican Republic
| | - Roland C Merchant
- Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dan H Barouch
- Center for Virology and Vaccine Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Ronald Skewes-Ramm
- Ministry of Health and Social Assistance, Santo Domingo, Dominican Republic
| | - Emily Zielinski Gutiérrez
- Centers for Disease Control and Prevention, Central America Regional Office, Guatemala City, Guatemala
| | - Adam Kucharski
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Colleen L Lau
- School of Public Health, University of Queensland, Brisbane, Australia
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24
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Furuya-Kanamori L, Gyawali N, Mills Mbbs Mphtm DJ, Mills C, Hugo LE, Devine GJ, Lau CL. Immunogenicity of a single fractional intradermal dose of Japanese encephalitis live attenuated chimeric vaccine. J Travel Med 2022; 30:6779982. [PMID: 36308439 DOI: 10.1093/jtm/taac122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/09/2022] [Accepted: 10/14/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Japanese encephalitis (JE) is endemic in Asia and the western Pacific. Vaccination is recommended for travellers to endemic regions, but the high cost of the vaccine is a major barrier to uptake. METHODS A quasi-experimental, pre-post intervention clinical trial without a control group was conducted to assess the immunogenicity and safety of intradermal (ID) JE vaccine. Healthy adults (18-45 years) received one dose of 0.1 mL (20% of standard dose) ID Imojev® (JE live attenuated chimeric vaccine, Sanofi-Aventis). Adverse events following immunisation (AEFIs) were recorded 10 days post-vaccination. Blood samples were collected at baseline, 4, and 8 weeks post-vaccination. Neutralising antibodies were measured using 50% plaque reduction neutralisation test (PRNT50). Seroconversion was defined as PRNT50 titre ≥10. An in vitro study was also conducted to quantify the rate of decay of vaccine potency after reconstitution. RESULTS 51 participants (72.6% females, median age 31 years), all non-reactive to JE virus at baseline were enrolled. Mild and moderate AEFIs were reported by 19.6% of participants; none required medical attention or interfered with normal daily activities. All participants seroconverted at 4 weeks (GMT 249.3; 95%CI:192.8-322.5) and remained seropositive at 8-weeks (GMT 135.5; 95%CI:104.5-175.6). Vaccine potency declined at a rate of 0.14 log plaque-forming units/0.5 mL per hour. CONCLUSIONS In healthy adults, a single 0.1 mL ID dose of Imojev was safe and immunogenic, at least in the short-term. Reconstituted vials of Imojev vaccine may not retain their potency after 6 hours. Fractional JE ID vaccination could be a cheaper yet effective alternative for short-term travellers. Further studies need to investigate the immune response in a wider age range of individuals and the long-term immunogenicity of fractional JE ID vaccines. CLINICAL TRIALS REGISTRATION ACTRN12621000024842.
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Affiliation(s)
- Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Christine Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Leon E Hugo
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Gregor J Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Colleen L Lau
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
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25
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Williams O, Ross VR, Lau CL, Mayfield HJ. Epidemiology of cruciate ligament reconstruction in the Australian Defence Force and predictors of outcome. BMJ Mil Health 2022:e002150. [PMID: 36307144 DOI: 10.1136/military-2022-002150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning. This study describes the epidemiology of cruciate ligament reconstruction in the ADF and demonstrates the use of Bayesian networks (BN) to predict the likelihood of fitness for ongoing service under different scenarios. METHODS Members who had knee cruciate ligament reconstruction through ADF were identified from billing data and matched to electronic medical records to extract demographic and clinical data. Outcome measure was medical fitness for ADF service up to 24 months after reconstruction. BN models were used to compare outcomes between (1) age groups according to military service, and (2) sexes according to body mass index (BMI). RESULTS From November 2012 to June 2019, a total of 1199 individuals had knee cruciate ligament reconstruction (average 169 reconstructions/year). Following reconstruction and rehabilitation, 89 (7.4%) were medically unfit for service. Scenario analysis using a tree-augmented naïve BN model showed that, compared with Navy and Air Force, Army members had a higher probability of being unfit in those aged <35 years and a lower probability in those aged ≥35 years. In both sexes, those with obese BMI had the greatest probability of being unfit. CONCLUSION While most ADF members were fit for ongoing military service following cruciate ligament reconstruction, service type, age, sex and BMI influenced outcome. BNs provided an interactive and intuitive method to demonstrate the impact of different variables on the outcome.
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Affiliation(s)
- Olivia Williams
- Research School of Population Health, Australian National University College of Health and Medicine, Canberra, Australian Capital Territory, Australia
| | - V R Ross
- Health Policy, Programs and Assurance Branch, Joint Health Command, Canberra, Australian Capital Territory, Australia
| | - C L Lau
- Research School of Population Health, Australian National University College of Health and Medicine, Canberra, Australian Capital Territory, Australia
- School of Public Health, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - H J Mayfield
- School of Public Health, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
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26
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Jagals P, Kim I, Brereton C, Lau CL. Assessment of Environmental Impacts on Health: Examples from the Pacific Basin. Ann Glob Health 2022; 88:92. [PMID: 36348704 PMCID: PMC9585977 DOI: 10.5334/aogh.3671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/17/2022] [Indexed: 11/20/2022] Open
Abstract
Assessing environmental impacts on health in the Pacific Basin is challenged by significantly varying data types - quantities, qualities, and paucities - because of varying geographic sizes, environments, biodiversity, ecological assets, and human population densities, with highly varied and unequal socio-economic development and capacity to respond to environmental and health challenges. We discuss three case-based methodological examples from Pacific Basin environmental health impact assessments. These methods could be used to improve environmental health evidence at all country and regional levels across a spectrum of big data availability to no data. These methods are, 1) a risk assessment of airborne particulate matter in Korea based on the chemical composition of these particulates; 2) the use of system dynamics to appraise the influences of a range of environmental health determinants on child health outcomes in remote Solomon Islands; and 3) precision environmental public health methodologies based on comprehensive data collection, analyses, and modelling (including Bayesian belief networks and spatial epidemiology) increasing precision for good environmental health decision making to prevent and control a zoonotic disease in Fiji Islands. We show that while a common theme across the three examples is the value of high quality and quantity data to support stronger policy decisions and appropriate prioritizing of investment, it is also clear that for many countries in the Pacific Basin, sufficient data will remain a challenge to inform decision makers about environmental impact on health.
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Affiliation(s)
- Paul Jagals
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Injeong Kim
- Korea Institute of Industrial Technology, Seoul, South Korea
| | - Claire Brereton
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland, Australia
| | - Colleen L. Lau
- School of Public Health, The University of Queensland, Australia
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27
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Sinclair JE, Mayfield HJ, Short KR, Brown SJ, Puranik R, Mengersen K, Litt JCB, Lau CL. A Bayesian network analysis quantifying risks versus benefits of the Pfizer COVID-19 vaccine in Australia. NPJ Vaccines 2022; 7:93. [PMID: 35953502 PMCID: PMC9371378 DOI: 10.1038/s41541-022-00517-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
The Pfizer COVID-19 vaccine is associated with increased myocarditis incidence. Constantly evolving evidence regarding incidence and case fatality of COVID-19 and myocarditis related to infection or vaccination, creates challenges for risk-benefit analysis of vaccination. Challenges are complicated further by emerging evidence of waning vaccine effectiveness, and variable effectiveness against variants. Here, we build on previous work on the COVID-19 Risk Calculator (CoRiCal) by integrating Australian and international data to inform a Bayesian network that calculates probabilities of outcomes for the delta variant under different scenarios of Pfizer COVID-19 vaccine coverage, age groups (≥12 years), sex, community transmission intensity and vaccine effectiveness. The model estimates that in a population where 5% were unvaccinated, 5% had one dose, 60% had two doses and 30% had three doses, there was a substantially greater probability of developing (239–5847 times) and dying (1430–384,684 times) from COVID-19-related than vaccine-associated myocarditis (depending on age and sex). For one million people with this vaccine coverage, where transmission intensity was equivalent to 10% chance of infection over 2 months, 68,813 symptomatic COVID-19 cases and 981 deaths would be prevented, with 42 and 16 expected cases of vaccine-associated myocarditis in males and females, respectively. These results justify vaccination in all age groups as vaccine-associated myocarditis is generally mild in the young, and there is unequivocal evidence for reduced mortality from COVID-19 in older individuals. The model may be updated to include emerging best evidence, data pertinent to different countries or vaccines and other outcomes such as long COVID.
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Affiliation(s)
- Jane E Sinclair
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, QLD, Australia
| | - Helen J Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, QLD, Australia
| | - Samuel J Brown
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, QLD, Australia
| | - Rajesh Puranik
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Faculty of Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - John C B Litt
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.,Scientific Advisory Committee, Immunisation Coalition, Melbourne, VIC, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
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28
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Guglielmino CJD, Sandhu S, Lau CL, Buckely C, Trembizki E, Whiley DM, Jennison AV. Molecular characterisation of Neisseria gonorrhoeae associated with disseminated gonococcal infections in Queensland, Australia: a retrospective surveillance study. BMJ Open 2022; 12:e061040. [PMID: 35918119 PMCID: PMC9351343 DOI: 10.1136/bmjopen-2022-061040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Gonorrhoea caused by Neisseria gonorrhoeae is the second most notified sexually transmitted infection (STI) in Australia and the case numbers for this STI have been increasing globally. Progressive gonococcal infection may lead to disseminated gonococcal infection (DGI), which causes significant morbidity among patients. This study aims to examine the genetic diversity of N. gonorrhoeae isolates collected in Queensland from January 2010 to August 2015 and to determine factors associated with DGI in Queensland. DESIGN Retrospective surveillance study for epidemiological purposes. SETTING All gonorrhoeae isolates referred by private and public pathology laboratories to the state of Queensland, Australia Neisseria reference laboratory. METHODS Between January 2010 and August 2015, 3953 N. gonorrhoeae isolates from both metropolitan and regional Queensland infections were typed with NG-MAST (N. gonorrhoeae multiantigen sequence typing) to assess the genetic diversity between strains. Whole-genome sequencing (WGS) was used to investigate strain-related factors associated with DGI. RESULTS ST6876 was the most common NG-MAST type, detected in 7.6% of the isolates. DGI was significantly more likely in females <30 years (OR 13.02, p<0.0001) and in older males >30 years (OR 6.04, p<0.0001), with most cases originating from North Queensland (OR 8.5, p<0.0001). Strains harbouring PIA class of porB type were associated with DGI (OR 33.23, p<0.0001). CONCLUSION Genotyping techniques, such as NG-MAST and WGS, are proving instrumental in providing an insight into the population structure of N. gonorrhoeae, and genetic mechanisms of pathogenesis, such as for DGI.
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Affiliation(s)
- Christine J D Guglielmino
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
| | - Sumeet Sandhu
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
| | - Colleen L Lau
- Australian National University Research School of Population Health, Canberra, Australian Capital Territory, Australia
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Cameron Buckely
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Ella Trembizki
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland Central Laboratory, Queensland Health, Brisbane, Queensland, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Health, Archerfield, Queensland, Australia
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29
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Ang SH, Petrick P, Shamsul AS, Ramliza R, Kori N, Lau CL. The risk factors for complications and survival outcomes of Klebsiella pneumoniae Bacteraemia in Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia. Med J Malaysia 2022; 77:440-445. [PMID: 35902933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Mortality of Klebsiella pneumoniae (K. pneumoniae) bacteraemia was reported to be on the rise globally. The 30-day mortality rate of K. pneumoniae bacteraemia ranges from 16% to 55% in Beijing, Shanghai, and Taiwan. However, there is a lack of research on the survival outcomes of K. pneumoniae bacteraemia in Malaysia. The objectives of this study were to determine the poor prognostic factors and predictors of 14-day in-hospital mortality from K. pneumoniae bacteraemia. METHODS This was a retrospective cohort study of patients with K. pneumoniae bacteraemia in Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM). We included adult patients with blood cultures positive for K. pneumoniae between 1 January 2016 and 31 December 2019. Those with polymicrobial bacteraemia were excluded. Medical records were reviewed to obtain the sociodemographic data, gender, underlying comorbidities, invasive procedures at presentation, sources of bacteraemia, and whether appropriate empirical and definitive antibiotics was given on time. Data regarding complications of K. pneumoniae bacteraemia, including liver abscess, endopthalmitis, septic shock, Quick Pitt (qPitt) bacteraemia score defined as hypothermia, hypotension, respiratory failure, cardiac arrest, and altered mental status and stay in intensive care unit (ICU) were also recorded. The main outcome measure used was the survival in 14 days. Summary of statistical analysis was done. RESULTS A total of 260 patients with K. pneumoniae bacteraemia were included. All patients received appropriate empirical and definitive antibiotics within 24 h of the time that the sample for index blood cultures was obtained. Respiratory infection, septic shock, qPitt bacteraemia score ≥2, solid organ malignancy, stay in ICU, central venous line insertion at presentation, urinary catheterisation at presentation, and in-patient mechanical ventilation were identified as independent predictors of mortality in K. pneumoniae bacteraemia. The rate of complications such as liver abscess, endophthalmitis, ICU admission, and septic shock was not significantly different between survivors and non-survivors. The 14-day in-hospital mortality rate was 12.3%. The median length of hospitalisation was 11 days (IQR 6 - 19) . The predictors of poor prognosis for 14 days in-hospital mortality for K. pneumoniae bacteraemia were as follows: qPitt bacteraemia score ≥2, central venous line insertion, indwelling urinary catheter at presentation, and in-patient mechanical ventilation. Timing from K. pneumoniae bacteraemia event to death among those qPitt bacteraemia scores ≥2 was only for 9 days or less. CONCLUSIONS The 14-day in-hospital mortality of patients with K. pneumoniae bacteraemia in our setting was low. The qPitt bacteraemia score ≥2 was the strongest predictor of poor prognosis for 14-day in-hospital mortality in patients with K. pneumoniae bacteraemia. The qPitt bacteraemia score should be proposed to be used as a bedside screening tool for gram negative bacteraemia in our daily clinical practice, which is also useful for predicting mortality in critically ill patients.
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Affiliation(s)
- S H Ang
- Universiti Kebangsaan Malaysia Medical Centre, Department of Internal Medicine, Kuala Lumpur, Malaysia
| | - P Petrick
- Universiti Kebangsaan Malaysia Medical Centre, Department of Internal Medicine, Kuala Lumpur, Malaysia.
| | - A S Shamsul
- Universiti Kebangsaan Malaysia Medical Centre, Department of Community Health, Kuala Lumpur, Malaysia
| | - R Ramliza
- Universiti Kebangsaan Malaysia Medical Centre, Department of Medical Microbiology and Immunology, Kuala Lumpur, Malaysia
| | - N Kori
- Universiti Kebangsaan Malaysia Medical Centre, Department of Internal Medicine, Kuala Lumpur, Malaysia
| | - C L Lau
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pharmacy, Kuala Lumpur, Malaysia
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30
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Rees EM, Lau CL, Kama M, Reid S, Lowe R, Kucharski AJ. Estimating the duration of antibody positivity and likely time of Leptospira infection using data from a cross-sectional serological study in Fiji. PLoS Negl Trop Dis 2022; 16:e0010506. [PMID: 35696427 PMCID: PMC9232128 DOI: 10.1371/journal.pntd.0010506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/24/2022] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Leptospirosis is a zoonotic disease prevalent throughout the world, but with particularly high burden in Oceania (including the Pacific Island Countries and Territories). Leptospirosis is endemic in Fiji, with outbreaks often occurring following heavy rainfall and flooding. As a result of non-specific clinical manifestation and diagnostic challenges, cases are often misdiagnosed or under-ascertained. Furthermore, little is known about the duration of persistence of antibodies to leptospirosis, which has important clinical and epidemiological implications. Methodology and principal findings Using the results from a serosurvey conducted in Fiji in 2013, we fitted serocatalytic models to estimate the duration of antibody positivity and the force of infection (FOI, the rate at which susceptible individuals acquire infection or seroconversion), whilst accounting for seroreversion. Additionally, we estimated the most likely timing of infection. Using the reverse catalytic model, we estimated the duration of antibody persistence to be 8.33 years (4.76–12.50; assuming constant FOI) and 7.25 years (3.36–11.36; assuming time-varying FOI), which is longer than previous estimates. Using population age-structured seroprevalence data alone, we were not able to distinguish between these two models. However, by bringing in additional longitudinal data on antibody kinetics we were able to estimate the most likely time of infection, lending support to the time-varying FOI model. We found that most individuals who were antibody-positive in the 2013 serosurvey were likely to have been infected within the previous two years, and this finding is consistent with surveillance data showing high numbers of cases reported in 2012 and 2013. Conclusions This is the first study to use serocatalytic models to estimate the FOI and seroreversion rate for Leptospira infection. As well as providing an estimate for the duration of antibody positivity, we also present a novel method to estimate the most likely time of infection from seroprevalence data. These approaches can allow for richer, longitudinal information to be inferred from cross-sectional studies, and could be applied to other endemic diseases where antibody waning occurs. Leptospirosis is a bacterial zoonotic disease that occurs in almost all regions of the world, with a particularly high burden of disease in Oceania. It is widely considered to be a Neglected Zoonotic Disease, and it is often mis-diagnosed and under-ascertained. Very little information exists about the persistence of antibodies to leptospirosis, which is important for understanding how long individuals may have partial protection against reinfection. In this study, we show how data collected from a large population survey of leptospirosis antibodies can be used to estimate the duration of antibody persistence. Knowledge of the duration of antibody persistence enables an estimation of the duration of immunity to re-infection, which is most likely antibody-mediated. We also estimate the rate at which susceptible individuals acquire infection (force of infection), whilst accounting for antibody waning. This provides more accurate estimates of population-wide disease burden. Finally, we show how the results from a cross-sectional population survey can be used to estimate when infections may have occurred. This is particularly useful in areas with limited surveillance. This approach could be applied to other neglected diseases for which data are limited and where antibody waning occurs.
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Affiliation(s)
- Eleanor M. Rees
- Centre for Mathematical Modelling of Infectious Diseases, 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
- * E-mail:
| | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Mike Kama
- Fiji Centre for Communicable Disease Control, Suva, Fiji
- The University of the South Pacific, Suva, Fiji
| | - Simon Reid
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, 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
- Barcelona Supercomputing Center, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Adam J. Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Furuya-Kanamori L, Gyawali N, Mills DJ, Hugo LE, Devine GJ, Lau CL. The Emergence of Japanese Encephalitis in Australia and the Implications for a Vaccination Strategy. Trop Med Infect Dis 2022; 7:tropicalmed7060085. [PMID: 35736964 PMCID: PMC9229418 DOI: 10.3390/tropicalmed7060085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/16/2022] Open
Abstract
Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia. Until 2022, only six locally transmitted human JE cases had been reported in Australia; five in northern Queensland and one in the Northern Territory. Thus, JE was mainly considered to be a disease of travellers. On 4 March 2022, JE was declared a ‘Communicable Disease Incident of National Significance’ when a locally acquired human case was confirmed in southern Queensland. By 11 May 2022, 41 human JE cases had been notified in four states in Australia, in areas where JE has never been detected before. From this perspective, we discuss the potential reasons for the recent emergence of the JE virus in Australia in areas where JE has never been previously reported as well as the implications of and options for mass immunisation programs if the outbreak escalates in a JE virus-immunologically naïve population.
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Affiliation(s)
- Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston 4029, Australia
- Correspondence: (L.F.-K.); (C.L.L.)
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia; (N.G.); (L.E.H.); (G.J.D.)
| | - Deborah J. Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane 4000, Australia;
| | - Leon E. Hugo
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia; (N.G.); (L.E.H.); (G.J.D.)
| | - Gregor J. Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia; (N.G.); (L.E.H.); (G.J.D.)
| | - Colleen L. Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
- Correspondence: (L.F.-K.); (C.L.L.)
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Islam N, Xu C, Lau CL, Mills DJ, Clark J, Devine GJ, Hugo LE, Gyawali N, Thalib L, Furuya-Kanamori L. Persistence of antibodies, boostability, and interchangeability of Japanese encephalitis vaccines: A systematic review and dose-response meta-analysis. Vaccine 2022; 40:3546-3555. [PMID: 35568587 DOI: 10.1016/j.vaccine.2022.04.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The burden of Japanese encephalitis (JE) is substantial and is arguably one of the most serious viral encephalitic diseases with high case fatality and no specific treatment. JE vaccines are the only available mean to prevent the disease; however, the long-term persistence of antibodies, boostability, and interchangeability between different vaccine classes are not well understood. METHODS To summarise the evidence, PubMed, Embase, and Cochrane CENTRAL were systematically searched from their inception to March 2021. Dose-response meta-analysis was utilised to synthesise the proportion of individuals who were seropositive over time after a primary vaccination course and a booster dose. Proportion meta-analysis was conducted to estimate the proportion of individuals who were seropositive as well as those who reported adverse events following a booster dose with a different vaccine class. RESULTS Of 1053 publications retrieved, 27 studies with 4,558 participants were included. Of these, 11 studies assessed persistence of antibodies, 14 studies boostability, and 8 vaccine class interchangeability. The pooled seropositivity, 1-year after primary vaccination was 83.4% (95 %CI 78.2-89.5%) and remained stable for up to 5 years (82.7%; 95 %CI 76.1-89.4%). Rapid anamnestic response was observed 10 days post-booster dose, the proportion of individuals who were seropositive reached 96.9% (95 %CI 95.9-97.8%) and remained > 95% for up to 6 years. Inactivated mouse brain-derived vaccines followed by a booster dose of a different vaccine class was effective (i.e. seropositive 99%) and well tolerated. CONCLUSIONS A booster dose after the primary vaccination is effective and further booster doses may be needed after 7 years. Inactivated mouse brain-derived vaccine followed by a booster with a newer vaccine class is effective and safe; although, there is a paucity of data related to newer classes of vaccines interchangeability.
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Affiliation(s)
- Nazmul Islam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Chang Xu
- Ministry of Education, Key Laboratory for Population Health Across-Life Cycle, Anhui Medical University, Anhui, China
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia; Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia; Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Gregor J Devine
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Leon E Hugo
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Narayan Gyawali
- Mosquito Control Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Lukman Thalib
- Department of Biostatistics, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia.
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Curtis SJ, Langham FJ, Tang MJ, Vujovic O, Doyle JS, Lau CL, Stewardson AJ. Hospitalisation with injection-related infections: Validation of diagnostic codes to monitor admission trends at a tertiary care hospital in Melbourne, Australia. Drug Alcohol Rev 2022; 41:1053-1061. [PMID: 35411617 DOI: 10.1111/dar.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Injection-related infections (IRI) cause morbidity and mortality in people who inject drugs. Hospital administrative datasets can be used to describe hospitalisation trends, but there are no validated algorithms to identify injecting drug use and IRIs. We aimed to validate International Classification of Diseases (ICD) codes to identify admissions with IRIs and use these codes to describe IRIs within our hospital. METHODS We developed a candidate set of ICD codes to identify current injecting drug use and IRI and extracted admissions satisfying both criteria. We then used manual chart review data from 1 January 2017 to 30 April 2019 to evaluate the performance of these codes and refine our algorithm by selecting codes with a high-positive predictive value (PPV). We used the refined algorithm to describe trends and outcomes of people who inject drugs with an IRI at Alfred Hospital, Melbourne from 2008 to 2020. RESULTS Current injecting drug use was best predicted by opioid-related disorders (F11), 80% (95% confidence interval [CI] 74-85%), and other stimulant-related disorders (F15), 82% (95% CI 70-90%). All PPVs were ≥67% to identify specific IRIs, and ≥84% for identifying any IRI. Using these codes over 12 years, IRIs increased from 138 to 249 per 100 000 admissions, and skin and soft tissues infections (SSTI) were the most common (797/1751, 46%). DISCUSSION AND CONCLUSION Validated ICD-based algorithms can inform passive surveillance systems. Strategies to reduce hospitalisation with IRIs should be supported by early intervention and prevention, particularly for SSTIs which may represent delayed access to care.
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Affiliation(s)
- Stephanie J Curtis
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia.,Research School of Population Health, The Australian National University, Canberra, Australia
| | - Freya J Langham
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Mei Jie Tang
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Olga Vujovic
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Joseph S Doyle
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Andrew J Stewardson
- Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
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Mayfield HJ, Lau CL, Sinclair JE, Brown SJ, Baird A, Litt J, Vuorinen A, Short KR, Waller M, Mengersen K. Designing an evidence-based Bayesian network for estimating the risk versus benefits of AstraZeneca COVID-19 vaccine. Vaccine 2022; 40:3072-3084. [PMID: 35450781 PMCID: PMC8989774 DOI: 10.1016/j.vaccine.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 11/24/2022]
Abstract
Uncertainty surrounding the risk of developing and dying from Thrombosis and Thrombocytopenia Syndrome (TTS) associated with the AstraZeneca (AZ) COVID-19 vaccine may contribute to vaccine hesitancy. A model is urgently needed to combine and effectively communicate evidence on the risks versus benefits of the AZ vaccine. We developed a Bayesian network to consolidate evidence on risks and benefits of the AZ vaccine, and parameterised the model using data from a range of empirical studies, government reports, and expert advisory groups. Expert judgement was used to interpret the available evidence and determine the model structure, relevant variables, data for inclusion, and how these data were used to inform the model. The model can be used as a decision-support tool to generate scenarios based on age, sex, virus variant and community transmission rates, making it useful for individuals, clinicians, and researchers to assess the chances of different health outcomes. Model outputs include the risk of dying from TTS following the AZ COVID-19 vaccine, the risk of dying from COVID-19 or COVID-19-associated atypical severe blood clots under different scenarios. Although the model is focused on Australia, it can be adapted to international settings by re-parameterising it with local data. This paper provides detailed description of the model-building methodology, which can be used to expand the scope of the model to include other COVID-19 vaccines, booster doses, comorbidities and other health outcomes (e.g., long COVID) to ensure the model remains relevant in the face of constantly changing discussion on risks versus benefits of COVID-19 vaccination.
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Affiliation(s)
- Helen J Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jane E Sinclair
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Samuel J Brown
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Andrew Baird
- St Kilda Medical Group, St Kilda, Melbourne, Victoria, Australia
| | - John Litt
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Scientific Advisory Committee, Immunisation Coalition, Melbourne, Victoria, Australia
| | - Aapeli Vuorinen
- Data Science Institute, Columbia University, New York, NY, USA
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael Waller
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Wangdi K, Sheel M, Fuimaono S, Graves PM, Lau CL. Lymphatic filariasis in 2016 in American Samoa: Identifying clustering and hotspots using non-spatial and three spatial analytical methods. PLoS Negl Trop Dis 2022; 16:e0010262. [PMID: 35344542 PMCID: PMC8989349 DOI: 10.1371/journal.pntd.0010262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 04/07/2022] [Accepted: 02/15/2022] [Indexed: 02/04/2023] Open
Abstract
Background
American Samoa completed seven rounds of mass drug administration from 2000–2006 as part of the Global Programme to Eliminate Lymphatic Filariasis (LF). However, resurgence was confirmed in 2016 through WHO-recommended school-based transmission assessment survey and a community-based survey. This paper uses data from the 2016 community survey to compare different spatial and non-spatial methods to characterise clustering and hotspots of LF.
Method
Non-spatial clustering of infection markers (antigen [Ag], microfilaraemia [Mf], and antibodies (Ab [Wb123, Bm14, Bm33]) was assessed using intra-cluster correlation coefficients (ICC) at household and village levels. Spatial dependence, clustering and hotspots were examined using semivariograms, Kulldorf’s scan statistic and Getis-Ord Gi* statistics based on locations of surveyed households.
Results
The survey included 2671 persons (750 households, 730 unique locations in 30 villages). ICCs were higher at household (0.20–0.69) than village levels (0.10–0.30) for all infection markers. Semivariograms identified significant spatial dependency for all markers (range 207–562 metres). Using Kulldorff’s scan statistic, significant spatial clustering was observed in two previously known locations of ongoing transmission: for all markers in Fagali’i and all Abs in Vaitogi. Getis-Ord Gi* statistic identified hotspots of all markers in Fagali’i, Vaitogi, and Pago Pago-Anua areas. A hotspot of Ag and Wb123 Ab was identified around the villages of Nua-Seetaga-Asili. Bm14 and Bm33 Ab hotspots were seen in Maleimi and Vaitogi-Ili’ili-Tafuna.
Conclusion
Our study demonstrated the utility of different non-spatial and spatial methods for investigating clustering and hotspots, the benefits of using multiple infection markers, and the value of triangulating results between methods.
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Affiliation(s)
- Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
- * E-mail:
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
| | | | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences and Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Colleen L. Lau
- Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Acton, Canberra, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
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Mills DJ, Lau CL, Mills C, Furuya-Kanamori L. Long-term persistence of antibodies and boostability after rabies intradermal pre-exposure prophylaxis. J Travel Med 2022; 29:6454967. [PMID: 34875078 DOI: 10.1093/jtm/taab188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Currently, there is limited data on long-term persistence of antibodies and boostability of intradermal (ID) rabies pre-exposure prophylaxis (PrEP) schedules. This study investigated travellers who received a primary ID PrEP schedule at least 5 years previously to determine the persistence of antibodies and subsequent antibody response after one 0.1-ml ID booster dose. METHODS Adults (age ≥ 18 years) who had previously received ID PrEP at a specialist travel medicine clinic in Brisbane, Australia were included. At Day 0, blood was collected for serology and one dose of 0.1-ml ID rabies vaccine (Verorab®) was administered. At Day 7, serology was repeated. At Day 14, participants were given results and enquired if they experienced adverse events following immunization (AEFIs). Antibodies were measured using Platelia Rabies II ELISA; levels ≥0.5 EU/mL were considered antibody-positive. RESULTS 158 participants were included [64.6% female, median age at enrolment 56.4 years, interquartile range (IQR) 42.4-65.2 years], and median time since the primary ID PrEP was 8.5 years (IQR 6.9-11.7 years). The majority of participants (82.3%) were antibody-positive at Day 0. The proportion of participants who were antibody-positive at Day 0 was higher among those who were younger at primary vaccination (87.0% if aged<50 years, 75.8% of aged ≥50 years). The proportion of participants who were antibody-positive declined as median time since primary vaccination increased, though the trend was not statistically significant (p-trend = 0.187). All except one participant (99.4%) were antibody-positive after one ID booster dose. AEFIs were reported by 42.4% of participants and were mainly mild. CONCLUSIONS Rabies antibodies persist for many years after ID PrEP and can be rapidly boosted with a single ID dose. Future studies are needed to confirm that ID PrEP primes the immune system sufficiently so that boosters are not routinely needed, and only given in the event of a rabies-prone exposure.
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Affiliation(s)
- Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia.,Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Colleen L Lau
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia.,Research School of Population Health, Australian National University, Canberra, ACT, Australia.,School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Christine Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, QLD, Australia
| | - Luis Furuya-Kanamori
- Research School of Population Health, Australian National University, Canberra, ACT, Australia.,UQ Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia
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37
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Restrepo AMC, Gass K, Won KY, Sheel M, Robinson K, Graves PM, Fuimaono S, Lau CL. Potential use of antibodies to provide an earlier indication of lymphatic filariasis resurgence in post-mass drug administration surveillance, American Samoa. Int J Infect Dis 2022; 117:378-386. [PMID: 35150913 PMCID: PMC8948089 DOI: 10.1016/j.ijid.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/13/2022] [Accepted: 02/03/2022] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted seven rounds of mass drug administration between 2000 and 2006. The territory passed transmission assessment surveys (TAS) in 2011 (TAS-1) and 2015 (TAS-2). In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Ab) may have provided a timelier indication of LF resurgence in American Samoa. METHODS We examined school-level antigen (Ag) and Ab status (presence/absence of Ag- and Ab-positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, Bm33 Ags at each TAS. Pearson's chi-squared tests and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3. RESULTS Schools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% CI:1.2-512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33 or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0-24.5). CONCLUSION Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in post-mass drug administration (MDA) surveillance and decision making should be further investigated in other settings.
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Affiliation(s)
- Angela M Cadavid Restrepo
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
| | - Katherine Gass
- Neglected Tropical Diseases Support Center, Task Force for Global Heath, Decatur, Georgia, United States of America
| | - Kimberly Y Won
- Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, United States of America
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Keri Robinson
- Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Atlanta, Georgia, United States of America
| | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
| | - Saipale Fuimaono
- Department of Health, Pago Pago, American Samoa, United States of America
| | - Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia; Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
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Abstract
Rare neurological complications can occur after COVID-19 vaccination, but recent studies show that such complications are much more common after SARS-CoV-2 infection. Novel approaches to risk–benefit analysis such as Bayesian network models can integrate the latest global evidence with local factors to inform decision-making and support the global vaccination effort.
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Affiliation(s)
- Colleen L Lau
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
| | - Ian Galea
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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Furuya-Kanamori L, Mills DJ, Trembizki E, Robson JM, Jennison AV, Whiley DM, Lau CL. High rate of asymptomatic colonization with antimicrobial-resistant Escherichia coli in Australian returned travellers. J Travel Med 2022; 29:6365988. [PMID: 34494119 DOI: 10.1093/jtm/taab141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/27/2021] [Indexed: 11/12/2022]
Abstract
Global movement of people plays a key role in the spread of antimicrobial resistant (AMR) organisms. We found that 58% of Australian travellers returning from Asia were asymptomatic carriers of AMR Escherichia coli, including resistance to critically important antibiotics. Future studies are needed to identify interventions for travellers to reduce their risk of AMR acquisition.
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40
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Lau CL, Mayfield HJ, Sinclair JE, Brown SJ, Waller M, Enjeti AK, Baird A, Short KR, Mengersen K, Litt J. Risk-benefit analysis of the AstraZeneca COVID-19 vaccine in Australia using a Bayesian network modelling framework. Vaccine 2021; 39:7429-7440. [PMID: 34810000 PMCID: PMC8566665 DOI: 10.1016/j.vaccine.2021.10.079] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 10/27/2022]
Abstract
Thrombosis and Thrombocytopenia Syndrome (TTS) has been associated with the AstraZencea (AZ) COVID-19 vaccine (Vaxzevria). Australia has reported low TTS incidence of < 3/100,000 after the first dose, with case fatality rate (CFR) of 5-6%. Risk-benefit analysis of vaccination has been challenging because of rapidly evolving data, changing levels of transmission, and variation in rates of TTS, COVID-19, and CFR between age groups. We aim to optimise risk-benefit analysis by developing a model that enables inputs to be updated rapidly as evidence evolves. A Bayesian network was used to integrate local and international data, government reports, published literature and expert opinion. The model estimates probabilities of outcomes under different scenarios of age, sex, low/medium/high transmission (0.05%/0.45%/5.76% of population infected over 6 months), SARS-CoV-2 variant, vaccine doses, and vaccine effectiveness. We used the model to compare estimated deaths from AZ vaccine-associated TTS with i) COVID-19 deaths prevented under different scenarios, and ii) deaths from COVID-19 related atypical severe blood clots (cerebral venous sinus thrombosis & portal vein thrombosis). For a million people aged ≥ 70 years where 70% received first dose and 35% received two doses, our model estimated < 1 death from TTS, 25 deaths prevented under low transmission, and > 3000 deaths prevented under high transmission. Risks versus benefits varied significantly between age groups and transmission levels. Under high transmission, deaths prevented by AZ vaccine far exceed deaths from TTS (by 8 to > 4500 times depending on age). Probability of dying from COVID-related atypical severe blood clots was 58-126 times higher (depending on age and sex) than dying from TTS. To our knowledge, this is the first example of the use of Bayesian networks for risk-benefit analysis for a COVID-19 vaccine. The model can be rapidly updated to incorporate new data, adapted for other countries, extended to other outcomes (e.g., severe disease), or used for other vaccines.
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Affiliation(s)
- Colleen L Lau
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Helen J Mayfield
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jane E Sinclair
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Samuel J Brown
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael Waller
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Anoop K Enjeti
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia; Calvary Mater Newcastle Hospital, Waratah, NSW, Australia; NSW Health Pathology John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Andrew Baird
- St Kilda Medical Group, St Kilda, Victoria, Australia
| | - Kirsty R Short
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, Queensland, Australia
| | - Kerrie Mengersen
- School of Mathematical Sciences, Faculty of Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - John Litt
- Discipline of General Practice, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia; Scientific Advisory Committee, Immunisation Coalition, Melbourne, Victoria, Australia
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Field E, Dyda A, Hewett M, Weng H, Shi J, Curtis S, Law C, McHugh L, Sheel M, Moore J, Furuya-Kanamori L, Pillai P, Konings P, Purcell M, Stocks N, Williams G, Lau CL. Development of the COVID-19 Real-Time Information System for Preparedness and Epidemic Response (CRISPER), Australia. Front Public Health 2021; 9:753493. [PMID: 34858930 PMCID: PMC8631999 DOI: 10.3389/fpubh.2021.753493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Accurate and current information has been highlighted across the globe as a critical requirement for the COVID-19 pandemic response. To address this need, many interactive dashboards providing a range of different information about COVID-19 have been developed. A similar tool in Australia containing current information about COVID-19 could assist general practitioners and public health responders in their pandemic response efforts. The COVID-19 Real-time Information System for Preparedness and Epidemic Response (CRISPER) has been developed to provide accurate and spatially explicit real-time information for COVID-19 cases, deaths, testing and contact tracing locations in Australia. Developed based on feedback from key users and stakeholders, the system comprises three main components: (1) a data engine; (2) data visualization and interactive mapping tools; and (3) an automated alert system. This system provides integrated data from multiple sources in one platform which optimizes information sharing with public health responders, primary health care practitioners and the general public.
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Affiliation(s)
- Emma Field
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Amalie Dyda
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Michael Hewett
- The National Centre for Geographic Resources & Analysis in Primary Health Care (GRAPHC), Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Haotian Weng
- Software Innovation Institute, Australian National University, Canberra, ACT, Australia
| | - Jingjing Shi
- Software Innovation Institute, Australian National University, Canberra, ACT, Australia
| | - Stephanie Curtis
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Charlee Law
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Lisa McHugh
- School of Public Health, University of Queensland, Herston, QLD, Australia
| | - Meru Sheel
- National Centre for Epidemiology and Population Health, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Jess Moore
- School of Computing, Australian National University, Canberra, ACT, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, University of Queensland, Herston, QLD, Australia
| | | | - Paul Konings
- The National Centre for Geographic Resources & Analysis in Primary Health Care (GRAPHC), Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Michael Purcell
- Software Innovation Institute, Australian National University, Canberra, ACT, Australia
| | - Nigel Stocks
- Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia.,Australian Partnership for Preparedness Research on InfectiouS Disease Emergencies (APPRISE), The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Graham Williams
- Software Innovation Institute, Australian National University, Canberra, ACT, Australia
| | - Colleen L Lau
- School of Public Health, University of Queensland, Herston, QLD, Australia.,Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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Dyda A, Fahim M, Fraser J, Kirrane M, Wong I, McNeil K, Ruge M, Lau CL, Sullivan C. Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia. Appl Clin Inform 2021; 12:1135-1143. [PMID: 34852391 DOI: 10.1055/s-0041-1740190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. OBJECTIVE We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. METHODS Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. RESULTS Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital "depression." Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. CONCLUSION The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.
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Affiliation(s)
- Amalie Dyda
- School of Public Health, University of Queensland, Queensland, Australia
| | - Magid Fahim
- Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, Queensland, Australia.,Centre for Health Services Research, University of Queensland, Queensland, Australia
| | - Jon Fraser
- Digital Metro North, Metro North Hospital and Health Service, Brisbane, Australia
| | - Marianne Kirrane
- Digital Metro North, Metro North Hospital and Health Service, Brisbane, Australia.,Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Ides Wong
- Queensland Health, Brisbane, Queensland, Australia
| | - Keith McNeil
- Queensland Health, Brisbane, Queensland, Australia
| | - Maree Ruge
- Centre for Health Services Research, University of Queensland, Queensland, Australia.,Digital Metro North, Metro North Hospital and Health Service, Queensland, Australia
| | - Colleen L Lau
- School of Public Health, University of Queensland, Queensland, Australia.,Research School of Population Health, ANU College of Health and Medicine, Australian National University, Australian Capital Territory, Australia
| | - Clair Sullivan
- Centre for Health Services Research, University of Queensland, Queensland, Australia.,Digital Metro North, Metro North Hospital and Health Service, Brisbane, Australia
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Dyda A, Purcell M, Curtis S, Field E, Pillai P, Ricardo K, Weng H, Moore JC, Hewett M, Williams G, Lau CL. Differential privacy for public health data: An innovative tool to optimize information sharing while protecting data confidentiality. Patterns 2021; 2:100366. [PMID: 34909703 PMCID: PMC8662814 DOI: 10.1016/j.patter.2021.100366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has highlighted the need for the timely collection and sharing of public health data. It is important that data sharing is balanced with protecting confidentiality. Here we discuss an innovative mechanism to protect health data, called differential privacy. Differential privacy is a mathematically rigorous definition of privacy that aims to protect against all possible adversaries. In layperson's terms, statistical noise is applied to the data so that overall patterns can be described, but data on individuals are unlikely to be extracted. One of the first use cases for health data in Australia is the development of the COVID-19 Real-Time Information System for Preparedness and Epidemic Response (CRISPER), which provides proof of concept for the use of this technology in the health sector. If successful, this will benefit future sharing of public health data. Differential privacy is an innovative technique that can be applied to data to protect confidentiality. This has been used primarily to protect private sector data, but has significant implications for public health. We describe the methods of differential privacy in terms understandable to a non-computer-science audience. To our knowledge, this is the first article describing differential privacy in language and context appropriate for a health audience. The case study described shows the feasibility of the use of differential privacy for public health surveillance data to optimize information sharing while protecting data confidentiality. This method allows for data to be released in more granular detail in terms of time, place, and person without compromising privacy and confidentiality. Future research needs to consider other use cases, including a range of surveillance systems and applications in other types of health data.
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Graves PM, Joseph H, Coutts SP, Mayfield HJ, Maiava F, Ah Leong-Lui TA, Tupuimatagi Toelupe P, Toeaso Iosia V, Loau S, Pemita P, Naseri T, Thomsen R, Berg Soto A, Burkot TR, Wood P, Melrose W, Aratchige P, Capuano C, Kim SH, Ozaki M, Yajima A, Lammie PJ, Ottesen E, Hansell L, Baghirov R, Lau CL, Ichimori K. Control and elimination of lymphatic filariasis in Oceania: Prevalence, geographical distribution, mass drug administration, and surveillance in Samoa, 1998-2017. Adv Parasitol 2021; 114:27-73. [PMID: 34696844 DOI: 10.1016/bs.apar.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lymphatic filariasis (LF) is a major public health problem globally and in the Pacific Region. The Global Programme to Eliminate LF has made great progress but LF is persistent and resurgent in some Pacific countries and territories. Samoa remains endemic for LF despite elimination efforts through multiple two-drug mass drug administrations (MDA) since 1965, including renewed elimination efforts started in 1999 under the Pacific Programme for Elimination of LF (PacELF). Despite eight rounds of national and two rounds of subnational MDA under PacELF, Samoa failed transmission assessment surveys (TAS) in all three evaluation units in 2017. In 2018, Samoa was the first to distribute countrywide triple-drug MDA using ivermectin, diethylcarbamazine (DEC), and albendazole. This paper provides a review of MDAs and historical survey results from 1998 to 2017 in Samoa and highlights lessons learnt from LF elimination efforts, including challenges and potential ways to overcome them to successfully achieve elimination.
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Affiliation(s)
- Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia.
| | - Hayley Joseph
- Division of Population Health and Immunity, Walter and Eliza Hall Institute of Medical Research and Department of Medical Biology, The University of Melbourne, Melbourne, VIC, Australia
| | - Shaun P Coutts
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Helen J Mayfield
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | | | | | | | | | - Siatua Loau
- Ministry of Health and Health Services, Apia, Samoa
| | - Paulo Pemita
- Ministry of Health and Health Services, Apia, Samoa
| | - Take Naseri
- Ministry of Health and Health Services, Apia, Samoa
| | | | - Alvaro Berg Soto
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia
| | - Thomas R Burkot
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia
| | - Peter Wood
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia
| | - Wayne Melrose
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia
| | | | | | - Sung Hye Kim
- WHO Division of Pacific Technical Support, Suva, Fiji
| | - Masayo Ozaki
- WHO Division of Pacific Technical Support, Suva, Fiji
| | - Aya Yajima
- WHO Regional Office for the Western Pacific, Manila, Philippines
| | | | - Eric Ottesen
- Task Force for Global Health, Atlanta, GA, United States
| | | | | | - Colleen L Lau
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, ACT, Australia; School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Kazuyo Ichimori
- College of Public Health, Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, and JCU WHO Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Cairns and Townsville, QLD, Australia
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Foxlee ND, Townell N, Heney C, McIver L, Lau CL. Strategies Used for Implementing and Promoting Adherence to Antibiotic Guidelines in Low- and Lower-Middle-Income Countries: A Systematic Review. Trop Med Infect Dis 2021; 6:tropicalmed6030166. [PMID: 34564550 PMCID: PMC8482147 DOI: 10.3390/tropicalmed6030166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 01/09/2023] Open
Abstract
Containing antimicrobial resistance and reducing high levels of antibiotic consumption in low- and lower middle-income countries are a major challenge. Clinical guidelines targeting antibiotic prescribing can reduce consumption, however, the degrees to which clinical guidelines are adopted and adhered to are challenging for developers, policy makers and users. The aim of this study was to review the strategies used for implementing and promoting antibiotic guideline adherence in low- and lower middle-income countries. A review of published literature was conducted using PubMed, Cochrane Library, SCOPUS and the information systems of the World Health Organization and the Australian National University according to PRISMA guidelines and our PROSPERO protocol. The strategies were grouped into five broad categories based on the Cochrane Effective Practice and Organization of Care taxonomy. The 33 selected studies, representing 16 countries varied widely in design, setting, disease focus, methods, intervention components, outcomes and effects. The majority of interventions were multifaceted and resulted in a positive direction of effect. The nature of the interventions and study variability made it impossible to tease out which strategies had the greatest impact on improving CG compliance. Audit and feedback coupled with either workshops and/or focus group discussions were the most frequently used intervention components. All the reported strategies are established practices used in antimicrobial stewardship programs in high-income countries. We recommend interrupted time series studies be used as an alternative design to pre- and post-intervention studies, information about the clinical guidelines be made more transparent, and prescriber confidence be investigated.
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Affiliation(s)
- Nicola D. Foxlee
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2600, Australia;
- Correspondence: ; Tel.: +61-7-435-549-071
| | - Nicola Townell
- Infectious Disease Department, Sunshine Coast University Hospital, Birtinya, QLD 4575, Australia;
| | - Claire Heney
- Pathology Queensland, Central Microbiology, Brisbane, QLD 4006, Australia;
| | - Lachlan McIver
- Rocketship Pacific Ltd., Port Melbourne, Melbourne, VIC 3207, Australia;
| | - Colleen L. Lau
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT 2600, Australia;
- School of Public Health, University of Queensland, Herston, QLD 4006, Australia
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Wen SCH, Ezure Y, Rolley L, Spurling G, Lau CL, Riaz S, Paterson DL, Irwin AD. Gram-negative neonatal sepsis in low- and lower-middle-income countries and WHO empirical antibiotic recommendations: A systematic review and meta-analysis. PLoS Med 2021; 18:e1003787. [PMID: 34582466 PMCID: PMC8478175 DOI: 10.1371/journal.pmed.1003787] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Neonatal sepsis is a significant global health issue associated with marked regional disparities in mortality. Antimicrobial resistance (AMR) is a growing concern in Gram-negative organisms, which increasingly predominate in neonatal sepsis, and existing WHO empirical antibiotic recommendations may no longer be appropriate. Previous systematic reviews have been limited to specific low- and middle-income countries. We therefore completed a systematic review and meta-analysis of available data from all low- and lower-middle-income countries (LLMICs) since 2010, with a focus on regional differences in Gram-negative infections and AMR. METHODS AND FINDINGS All studies published from 1 January 2010 to 21 April 2021 about microbiologically confirmed bloodstream infections or meningitis in neonates and AMR in LLMICs were assessed for eligibility. Small case series, studies with a small number of Gram-negative isolates (<10), and studies with a majority of isolates prior to 2010 were excluded. Main outcomes were pooled proportions of Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, Acinetobacter and AMR. We included 88 studies (4 cohort studies, 3 randomised controlled studies, and 81 cross-sectional studies) comprising 10,458 Gram-negative isolates from 19 LLMICs. No studies were identified outside of Africa and Asia. The estimated pooled proportion of neonatal sepsis caused by Gram-negative organisms was 60% (95% CI 55% to 65%). Klebsiella spp. was the most common, with a pooled proportion of 38% of Gram-negative sepsis (95% CI 33% to 43%). Regional differences were observed, with higher proportions of Acinetobacter spp. in Asia and Klebsiella spp. in Africa. Resistance to aminoglycosides and third-generation cephalosporins ranged from 42% to 69% and from 59% to 84%, respectively. Study limitations include significant heterogeneity among included studies, exclusion of upper-middle-income countries, and potential sampling bias, with the majority of studies from tertiary hospital settings, which may overestimate the burden caused by Gram-negative bacteria. CONCLUSIONS Gram-negative bacteria are an important cause of neonatal sepsis in LLMICs and are associated with significant rates of resistance to WHO-recommended first- and second-line empirical antibiotics. AMR surveillance should underpin region-specific empirical treatment recommendations. Meanwhile, a significant global commitment to accessible and effective antimicrobials for neonates is required.
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Affiliation(s)
- Sophie C. H. Wen
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Infection Management Prevention Service, Queensland Children’s Hospital, Brisbane, Queensland, Australia
- * E-mail:
| | - Yukiko Ezure
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Lauren Rolley
- Infection Management Prevention Service, Queensland Children’s Hospital, Brisbane, Queensland, Australia
| | - Geoff Spurling
- Primary Care Clinical Unit, University of Queensland, Brisbane, Queensland, Australia
| | - Colleen L. Lau
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Saba Riaz
- Institute of Microbiology and Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - David L. Paterson
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia
| | - Adam D. Irwin
- Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
- Infection Management Prevention Service, Queensland Children’s Hospital, Brisbane, Queensland, Australia
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Cadavid Restrepo A, Furuya-Kanamori L, Mayfield H, Nilles E, Lau CL. Implications of a travel connectivity-based approach for infectious disease transmission risks in Oceania. BMJ Open 2021; 11:e046206. [PMID: 34385235 PMCID: PMC8361703 DOI: 10.1136/bmjopen-2020-046206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The increase in international travel brought about by globalisation has enabled the rapid spread of emerging pathogens with epidemic and pandemic potential. While travel connectivity-based assessments may help understand patterns of travel network-mediated epidemics, such approaches are rarely carried out in sufficient detail for Oceania where air travel is the dominant method of transportation between countries. DESIGN Travel data from the Australian Bureau of Statistics, Stats NZ and the United Nations World Tourism Organization websites were used to calculate travel volumes in 2018 within Oceania and between Oceania and the rest of the world. The Infectious Disease Vulnerability Index (IDVI) was incorporated into the analysis as an indicator of each country's capacity to contain an outbreak. Travel networks were developed to assess the spread of infectious diseases (1) into and from Oceania, (2) within Oceania and (3) between each of the Pacific Island Countries and Territories (PICTs) and their most connected countries. RESULTS Oceania was highly connected to countries in Asia, Europe and North America. Australia, New Zealand and several PICTs were highly connected to the USA and the UK (least vulnerable countries for outbreaks based on the IDVI), and to China (intermediate low vulnerable country). High variability was also observed between the PICTs in the geographical distribution of their international connections. The PICTs with the highest number of international connections were Fiji, French Polynesia, Guam and Papua New Guinea. CONCLUSION Travel connectivity assessments may help to accurately stratify the risk of infectious disease importation and outbreaks in countries depending on disease transmission in other parts of the world. This information is essential to track future requirements for scaling up and targeting outbreak surveillance and control strategies in Oceania.
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Affiliation(s)
- Angela Cadavid Restrepo
- School of Public Health, The University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Luis Furuya-Kanamori
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen Mayfield
- School of Public Health, The University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Eric Nilles
- Harvard Medical Shool, Harvard University, Cambridge, Massachusetts, USA
- Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, USA
| | - Colleen L Lau
- School of Public Health, The University of Queensland, Faculty of Medicine, Brisbane, Queensland, Australia
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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48
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Cleary E, Hetzel MW, Siba PM, Lau CL, Clements ACA. Correction to: Spatial prediction of malaria prevalence in Papua New Guinea: a comparison of Bayesian decision network and multivariate regression modelling approaches for improved accuracy in prevalence prediction. Malar J 2021; 20:318. [PMID: 34271929 PMCID: PMC8283970 DOI: 10.1186/s12936-021-03838-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Eimear Cleary
- Research School of Population Health, Australian National University, Canberra, Australia.
| | - Manuel W Hetzel
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Peter M Siba
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.,Centre for Health Research and Diagnostics, Divine Word University, Madang, Papua New Guinea
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australia.,School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Bentley, Australia.,Telethon Kids Institute, Nedlands, Australia
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Sheel M, Lau CL, Sheridan S, Fuimaono S, Graves PM. Comparison of Immunochromatographic Test (ICT) and Filariasis Test Strip (FTS) for Detecting Lymphatic Filariasis Antigen in American Samoa, 2016. Trop Med Infect Dis 2021; 6:tropicalmed6030132. [PMID: 34287387 PMCID: PMC8293346 DOI: 10.3390/tropicalmed6030132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/16/2022] Open
Abstract
Circulating filarial antigen (Ag) prevalence, measured using rapid point-of-care tests, is the standard indicator used for monitoring and surveillance in the Global Program to Eliminate Lymphatic Filariasis. In 2015, the immunochromatographic test (ICT) was replaced with the filariasis test strip (FTS), which has higher reported sensitivity. Despite differences in sensitivity, no changes in recommended surveillance targets were made when the FTS was introduced. In 2016, we conducted lymphatic filariasis surveys in American Samoa using FTS, which found higher Ag prevalence than previous surveys that used ICT. To determine whether the increase was real, we assessed the concordance between FTS and ICT results by paired testing of heparinised blood from 179 individuals (63% FTS-positive). ICT had 93.8% sensitivity and 100% specificity for identifying FTS-positive persons, and sensitivity was not associated with age, gender, or presence of microfilariae. Based on these findings, if ICT had been used in the 2016 surveys, the results and interpretation would have been similar to those reported using FTS. American Samoa would have failed Transmission Assessment Survey (TAS) of Grade 1 and 2 children with either test, and community prevalence would not have been significantly different (4.1%, 95% CI, 3.3-4.9% with FTS vs. predicted 3.8%, 95%, CI: 3.1-4.6% with ICT).
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Affiliation(s)
- Meru Sheel
- National Centre for Epidemiology and Health, Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton 2601, Australia
- Correspondence:
| | - Colleen L. Lau
- Faculty of Medicine, School of Public Health, University of Queensland, Brisbane 4006, Australia;
- Research School of Population Health, ANU College of Health and Medicine, The Australian National University, Acton 2601, Australia
| | - Sarah Sheridan
- National Centre for Immunisation Research and Surveillance, Westmead 2145, Australia;
| | | | - Patricia M. Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns 4870, Australia;
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Ling W, Doi SAR, Lau CL, Mills DJ, Kostoulas P, Furuya-Kanamori L. Diagnostic accuracy of ELISA kits for measurement of rabies antibodies. J Travel Med 2021; 28:6219918. [PMID: 33837777 DOI: 10.1093/jtm/taab060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Weiping Ling
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
| | - Colleen L Lau
- Research School of Population Health, Australian National University, Canberra, Australia.,Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Australia
| | - Deborah J Mills
- Research School of Population Health, Australian National University, Canberra, Australia.,Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Australia
| | - Polychronis Kostoulas
- Faculty of Public Health, School of Health Sciences, University of Thessaly, Karditsa, Greece
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Australia.,Research School of Population Health, Australian National University, Canberra, Australia
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