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Minter A, Medley GF, Hollingsworth TD. Using Passive Surveillance to Maintain Elimination as a Public Health Problem for Neglected Tropical Diseases: A Model-Based Exploration. Clin Infect Dis 2024; 78:S169-S174. [PMID: 38662695 PMCID: PMC11088853 DOI: 10.1093/cid/ciae097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Great progress is being made toward the goal of elimination as a public health problem for neglected tropical diseases such as leprosy, human African trypanosomiasis, Buruli ulcer, and visceral leishmaniasis, which relies on intensified disease management and case finding. However, strategies for maintaining this goal are still under discussion. Passive surveillance is a core pillar of a long-term, sustainable surveillance program. METHODS We use a generic model of disease transmission with slow epidemic growth rates and cases detected through severe symptoms and passive detection to evaluate under what circumstances passive detection alone can keep transmission under control. RESULTS Reducing the period of infectiousness due to decreasing time to treatment has a small effect on reducing transmission. Therefore, to prevent resurgence, passive surveillance needs to be very efficient. For some diseases, the treatment time and level of passive detection needed to prevent resurgence is unlikely to be obtainable. CONCLUSIONS The success of a passive surveillance program crucially depends on what proportion of cases are detected, how much of their infectious period is reduced, and the underlying reproduction number of the disease. Modeling suggests that relying on passive detection alone is unlikely to be enough to maintain elimination goals.
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Affiliation(s)
- Amanda Minter
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford
| | - Graham F Medley
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford
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2
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Simpson H, Mengiste A, Mbonigaba JB, Kollie K, Nganda M, Dean L, Argaw D, Davey G, Semrau M. Research priorities to support the development of integrated national strategies to control skin-neglected tropical diseases. Trans R Soc Trop Med Hyg 2023; 117:132-138. [PMID: 36130404 PMCID: PMC9890312 DOI: 10.1093/trstmh/trac086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/04/2022] [Accepted: 08/25/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Skin-presenting neglected tropical diseases (skin-NTDs) impose large burdens on affected people, families and communities. The NTD Roadmap 2021-2030 presents a strategic plan to guide collaborative, multisectoral action to overcome these burdens, defining targets to control, eliminate and/or eradicate skin-NTDs by 2030. One of its targets is for 40 countries to adopt integrated skin-NTD strategies. Despite this high-level support for integration, only four countries were implementing integrated skin-NTD strategies in 2020. METHODS We hosted workshops at the 2021 annual meeting of the Coalition for Operational Research on NTDs, to discuss the operationalisation of Roadmap goals into national strategies and interventions for skin-NTD control. Speakers included NTD Programme Managers from NTD-endemic countries, technical experts and researchers of different aspects of skin-NTDs. RESULTS Challenges include community perceptions of interventions, demonstrating the cost-effectiveness of integrated care, availability and accessibility of community-based and primary healthcare services, the quality of data on skin-NTD morbidity and changes to operational structures required for integration. Research priorities included the identification of optimal case detection platforms, evaluation of integrated care, understanding the impacts of integration on community members and community health staff and development of point-of-care diagnostics. CONCLUSIONS The operational research priorities are intended to support the scale-up of integrated skin-NTDs programmes.
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Affiliation(s)
- Hope Simpson
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton BN1 9PX, UK.,Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Asrat Mengiste
- College of Health Sciences, Addis Ababa University, 2Q92+P2W, Addis Ababa, Ethiopia
| | - Jean Bosco Mbonigaba
- Rwanda Neglected Tropical Diseases Programme, Rwanda Biomedical Centre, Ministry of Health 23VV+3MM, Kigali, Rwanda
| | - Karsor Kollie
- Non Communicable and Neglected Tropical Disease Program in the Ministry of Health and Social Welfare, 8643+F7C, Monrovia, Liberia
| | - Motto Nganda
- Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Laura Dean
- Capacity Research Unit, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
| | - Daniel Argaw
- Department of Control of Neglected Tropical Diseases, World Health Organization, 1211 Geneva, Switzerland
| | - Gail Davey
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Maya Semrau
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
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3
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Mathematical modelling Treponema infection in free-ranging Olive baboons (Papio anubis) in Tanzania. Epidemics 2022; 41:100638. [PMID: 36283270 DOI: 10.1016/j.epidem.2022.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/24/2022] [Accepted: 10/03/2022] [Indexed: 12/29/2022] Open
Abstract
Yaws is a chronic infection caused by the bacterium Treponema pallidum susp. pertenue (TPE) that was thought to be an exclusive human pathogen but was recently found and confirmed in nonhuman primates. In this paper, we develop the first compartmental ODE model for TPE infection with treatment of wild olive baboons. We solve for disease-free and endemic equilibria and give conditions on local and global stability of the disease-free equilibrium. We calibrate the model based on the data from Lake Manyara National Park in Tanzania. We use the model to help the park managers devise an effective strategy for treatment. We show that an increasing treatment rate yields a decrease in disease prevalence. This indicates that TPE can be eliminated through intense management in closed population. Specifically, we show that if the whole population is treated at least once every 5-6 years, a disease-free equilibrium can be reached. Furthermore, we demonstrate that to see a substantial decrease of TPE infection to near-elimination levels within 15 years, the whole population needs to be treated every 2-3 years.
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4
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Kimball P, Levenson J, Moore A, Rychtar J, Taylor D. An ODE model of yaws elimination in Lihir Island, Papua New Guinea. PeerJ 2022; 10:e13018. [PMID: 35317072 PMCID: PMC8934533 DOI: 10.7717/peerj.13018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/06/2022] [Indexed: 01/11/2023] Open
Abstract
Yaws is a chronic infection that affects mainly the skin, bone and cartilage and spreads mostly between children. The new approval of a medication as treatment in 2012 has revived eradication efforts and now only few known localized foci of infection remain. The World Health Organization strategy mandates an initial round of total community treatment (TCT) with single-dose azithromycin followed either by further TCT or by total targeted treatment (TTT), an active case-finding and treatment of cases and their contacts. We develop the compartmental ODE model of yaws transmission and treatment for these scenarios. We solve for disease-free and endemic equilibria and also perform the stability analysis. We calibrate the model and validate its predictions on the data from Lihir Island in Papua New Guinea. We demonstrate that TTT strategy is efficient in preventing outbreaks but, due to the presence of asymptomatic latent cases, TTT will not eliminate yaws within a reasonable time frame. To achieve the 2030 eradication target, TCT should be applied instead.
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Affiliation(s)
- Presley Kimball
- Department of Mathematics, Creighton University, Omaha, NE, United States of America
| | - Jacob Levenson
- Department of Mathematics, Washington and Lee University, Lexington, VA, United States of America
| | - Amy Moore
- Department of Mathematics and Statistics, Elon University, Elon, NC, United States of America
| | - Jan Rychtar
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Dewey Taylor
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA, United States of America
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5
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Kouroumalis E, Voumvouraki A. Hepatitis C virus: A critical approach to who really needs treatment. World J Hepatol 2022; 14:1-44. [PMID: 35126838 PMCID: PMC8790391 DOI: 10.4254/wjh.v14.i1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/14/2021] [Accepted: 12/31/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction of effective drugs in the treatment of hepatitis C virus (HCV) infection has prompted the World Health Organization to declare a global eradication target by 2030. Propositions have been made to screen the general population and treat all HCV carriers irrespective of the disease status. A year ago the new severe acute respiratory syndrome coronavirus 2 virus appeared causing a worldwide pandemic of coronavirus disease 2019 disease. Huge financial resources were redirected, and the pandemic became the first priority in every country. In this review, we examined the feasibility of the World Health Organization elimination program and the actual natural course of HCV infection. We also identified and analyzed certain comorbidity factors that may aggravate the progress of HCV and some marginalized subpopulations with characteristics favoring HCV dissemination. Alcohol consumption, HIV coinfection and the presence of components of metabolic syndrome including obesity, hyperuricemia and overt diabetes were comorbidities mostly responsible for increased liver-related morbidity and mortality of HCV. We also examined the significance of special subpopulations like people who inject drugs and males having sex with males. Finally, we proposed a different micro-elimination screening and treatment program that can be implemented in all countries irrespective of income. We suggest that screening and treatment of HCV carriers should be limited only in these particular groups.
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Affiliation(s)
- Elias Kouroumalis
- Department of Gastroenterology, University of Crete Medical School, Heraklion 71500, Crete, Greece
| | - Argyro Voumvouraki
- First Department of Internal Medicine, AHEPA University Hospital, Thessaloniki 54621, Greece
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6
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Mabey D, Agler E, Amuasi JH, Hernandez L, Hollingsworth TD, Hotez PJ, Lammie PJ, Malecela MN, Matendechero SH, Ottesen E, Phillips RO, Reeder JC, Szwarcwald CL, Shott JP, Solomon AW, Steer A, Swaminathan S. Towards a comprehensive research and development plan to support the control, elimination and eradication of neglected tropical diseases. Trans R Soc Trop Med Hyg 2021; 115:196-199. [PMID: 33179054 PMCID: PMC7842110 DOI: 10.1093/trstmh/traa114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
To maximise the likelihood of success, global health programmes need repeated, honest appraisal of their own weaknesses, with research undertaken to address any identified gaps. There is still much to be learned to optimise work against neglected tropical diseases. To facilitate that learning, a comprehensive research and development plan is required. Here, we discuss how such a plan might be developed.
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Affiliation(s)
- David Mabey
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | | | - John H Amuasi
- African Research Network for Neglected Tropical Diseases, Kumasi AK-039-5028, Ghana
| | - Leda Hernandez
- Department of Health, Infectious Disease Office, National Center for Disease Prevention and Control, Manila 1003, Philippines
| | - T Déirdre Hollingsworth
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
| | - Peter J Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX 77030s, USA.,Hagler Institute for Advanced Study at Texas A & M University, College Station, TX 77843, USA.,Department of Biology, Baylor University, Waco, TX 76706, USA.,James A. Baker III Institute of Public Policy, Rice University, Houston, TX 77005, USA.,Scowcroft Institute of International Affairs, Bush School of Government and Public Service, Texas A & M University, College Station, TX 77845, USA
| | - Patrick J Lammie
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Mwelecele N Malecela
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Eric Ottesen
- Neglected Tropical Diseases Support Center, Task Force for Global Health, Decatur, GA 30030, USA
| | - Richard O Phillips
- Kumasi Center for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi AK-039-5028, Ghana
| | - John C Reeder
- UNICEF, UNDP, World Bank, WHO Special Programme for Research and Training in Tropical Disease (TDR), 1211 Geneva 21040-900, Switzerland
| | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Joseph P Shott
- Division of Neglected Tropical Diseases, Office of Infectious Diseases, Bureau for Global Health, USAID, Washington, DC 20004, USA
| | - Anthony W Solomon
- Department of Control of Neglected Tropical Diseases, WHO 1211, Geneva, Switzerland
| | - Andrew Steer
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3010, Australia.,Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
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7
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Cooley GM, Feldstein LR, Bennett SD, Estivariz CF, Weil L, Bohara R, Vandenent M, Mainul Hasan A, Akhtar MS, Uzzaman MS, Billah MM, Conklin L, Ehlman DC, Asiedu K, Solomon AW, Alamgir A, Flora MS, Martin DL. No Serological Evidence of Trachoma or Yaws Among Residents of Registered Camps and Makeshift Settlements in Cox's Bazar, Bangladesh. Am J Trop Med Hyg 2021; 104:2031-2037. [PMID: 33939630 PMCID: PMC8176462 DOI: 10.4269/ajtmh.21-0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/16/2021] [Indexed: 12/03/2022] Open
Abstract
Successful achievement of global targets for elimination of trachoma as a public health problem and eradication of yaws will require control efforts to reach marginalized populations, including refugees. Testing for serologic evidence of transmission of trachoma and yaws in residents of registered camps and a Makeshift Settlement in Cox’s Bazar District, Bangladesh, was added to a serosurvey for vaccine-preventable diseases (VPDs) conducted April–May 2018. The survey was primarily designed to estimate remaining immunity gaps for VPDs, including diphtheria, measles, rubella, and polio. Blood specimens from 1- to 14-year-olds from selected households were collected and tested for antibody responses against antigens from Treponema pallidum and Chlamydia trachomatis using a multiplex bead assay to evaluate for serologic evidence of the neglected tropical diseases (NTDs) yaws and trachoma, respectively. The prevalence of antibodies against two C. trachomatis antigens in children ranged from 1.4% to 1.5% for Pgp3 and 2.8% to 7.0% for CT694. The prevalence of antibody responses against both of two treponemal antigens (recombinant protein17 and treponemal membrane protein A) tested was 0% to 0.15% in two camps. The data are suggestive of very low or no transmission of trachoma and yaws, currently or previously, in children resident in these communities. This study illustrates how integrated serologic testing can provide needed data to help NTD programs prioritize limited resources.
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Affiliation(s)
- Gretchen M Cooley
- 1Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leora R Feldstein
- 2Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,3Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sarah D Bennett
- 3Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Concepcion F Estivariz
- 3Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lauren Weil
- 4National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | | | - M Salim Uzzaman
- 8Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | | | - Laura Conklin
- 3Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Daniel C Ehlman
- 3Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Asm Alamgir
- 8Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh
| | | | - Diana L Martin
- 1Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
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8
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Antibody Responses to Two Recombinant Treponemal Antigens (rp17 and TmpA) before and after Azithromycin Treatment for Yaws in Ghana and Papua New Guinea. J Clin Microbiol 2021; 59:JCM.02509-20. [PMID: 33568467 DOI: 10.1128/jcm.02509-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/03/2021] [Indexed: 11/20/2022] Open
Abstract
WHO and its partners aim to interrupt yaws transmission in countries of endemicity and to certify others as being yaws-free. Transmission can be assessed using rapid plasma reagin (RPR) tests, reflecting current or recent infection, but RPR is operationally impractical. We evaluated changes in antibody levels against two recombinant treponemal antigens, rp17 (also known as Tp17) and TmpA, after antibiotic treatment given as part of a randomized controlled trial for yaws in Ghana and Papua New Guinea. Paired serum samples from children aged 6 to 15 years with confirmed yaws, collected before and after treatment, were tested for antibodies to rp17 and TmpA using a semiquantitative bead-based immunoassay. Of 344 baseline samples, 342 tested positive for anti-rp17 antibodies and 337 tested positive for anti-TmpA antibodies. Six months after treatment, the median decrease in anti-rp17 signal was 3.2%, whereas the median decrease in anti-TmpA was 53.8%. The magnitude of change in the anti-TmpA response increased with increasing RPR titer fold change. These data demonstrate that responses to TmpA decrease markedly within 6 months of treatment whereas (as expected) those to rp17 do not. Incorporating responses to TmpA as a marker of recent infection within an integrated sero-surveillance platform could provide a way to prioritize areas for yaws mapping.
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9
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Timothy JWS, Beale MA, Rogers E, Zaizay Z, Halliday KE, Mulbah T, Giddings RK, Walker SL, Thomson NR, Kollie KK, Pullan RL, Marks M. Epidemiologic and Genomic Reidentification of Yaws, Liberia. Emerg Infect Dis 2021; 27:1123-1132. [PMID: 33754988 PMCID: PMC8007311 DOI: 10.3201/eid2704.204442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We confirmed endemicity and autochthonous transmission of yaws in Liberia after a population-based, community-led burden estimation (56,825 participants). Serologically confirmed yaws was rare and focal at population level (24 cases; 2.6 [95% CI 1.4-3.9] cases/10,000 population) with similar clinical epidemiology to other endemic countries in West Africa. Unsupervised classification of spatially referenced case finding data indicated that yaws was more likely to occur in hard-to-reach communities; healthcare-seeking was low among communities, and clinical awareness of yaws was low among healthcare workers. We recovered whole bacterial genomes from 12 cases and describe a monophyletic clade of Treponema pallidum subspecies pertenue, phylogenetically distinct from known TPE lineages, including those affecting neighboring nonhuman primate populations (Taï Forest, Côte d'Ivoire). Yaws is endemic in Liberia but exhibits low focal population prevalence with evidence of a historical genetic bottleneck and subsequent local expansion. Reporting gaps appear attributable to challenging epidemiology and low disease awareness.
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10
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Streptococcus pyogenes Is Associated with Idiopathic Cutaneous Ulcers in Children on a Yaws-Endemic Island. mBio 2021; 12:mBio.03162-20. [PMID: 33436440 PMCID: PMC7844543 DOI: 10.1128/mbio.03162-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Exudative cutaneous ulcers (CU) in yaws-endemic areas are associated with Treponema pallidum subsp. pertenue (TP) and Haemophilus ducreyi (HD), but one-third of CU cases are idiopathic (IU). Using mass drug administration (MDA) of azithromycin, a yaws eradication campaign on Lihir Island in Papua New Guinea reduced but failed to eradicate yaws; IU rates remained constant throughout the campaign. To identify potential etiologies of IU, we obtained swabs of CU lesions (n = 279) and of the skin of asymptomatic controls (AC; n = 233) from the Lihir Island cohort and characterized their microbiomes using a metagenomics approach. CU bacterial communities were less diverse than those of the AC. Using real-time multiplex PCR with pathogen-specific primers, we separated CU specimens into HD-positive (HD+), TP+, HD+TP+, and IU groups. Each CU subgroup formed a distinct bacterial community, defined by the species detected and/or the relative abundances of species within each group. Streptococcus pyogenes was the most abundant organism in IU (22.65%) and was enriched in IU compared to other ulcer groups. Follow-up samples (n = 31) were obtained from nonhealed ulcers; the average relative abundance of S. pyogenes was 30.11% in not improved ulcers and 0.88% in improved ulcers, suggesting that S. pyogenes in the not improved ulcers may be azithromycin resistant. Catonella morbi was enriched in IU that lacked S. pyogenes As some S. pyogenes and TP strains are macrolide resistant, penicillin may be the drug of choice for CU azithromycin treatment failures. Our study will aid in the design of diagnostic tests and selective therapies for CU.IMPORTANCE Cutaneous ulcers (CU) affect approximately 100,000 children in the tropics each year. While two-thirds of CU are caused by Treponema pallidum subspecies pertenue and Haemophilus ducreyi, the cause(s) of the remaining one-third is unknown. Given the failure of mass drug administration of azithromycin to eradicate CU, the World Health Organization recently proposed an integrated disease management strategy to control CU. Success of this strategy requires determining the unknown cause(s) of CU. By using 16S rRNA gene sequencing of swabs obtained from CU and the skin of asymptomatic children, we identified another possible cause of skin ulcers, Streptococcus pyogenes Although S. pyogenes is known to cause impetigo and cellulitis, this is the first report implicating the organism as a causal agent of CU. Inclusion of S. pyogenes into the integrated disease management plan will improve diagnostic testing and treatment of this painful and debilitating disease of children and strengthen elimination efforts.
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11
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Roingeard P, Beaumont E. Hepatitis C Vaccine: 10 Good Reasons for Continuing. Hepatology 2020; 71:1845-1850. [PMID: 32060946 DOI: 10.1002/hep.31182] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/11/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Philippe Roingeard
- Faculté de Médecine, INSERM U1259, Université de Tours and CHRU de Tours, Tours, France
| | - Elodie Beaumont
- Faculté de Médecine, INSERM U1259, Université de Tours and CHRU de Tours, Tours, France
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12
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Dyson L, Mooring EQ, Holmes A, Tildesley MJ, Marks M. Insights from quantitative and mathematical modelling on the proposed 2030 goals for Yaws. Gates Open Res 2019; 3:1576. [PMID: 31886455 PMCID: PMC6913063 DOI: 10.12688/gatesopenres.13078.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 11/20/2022] Open
Abstract
The World Health Organization is currently developing 2030 goals for neglected tropical diseases (NTDs). In these, yaws has been targeted for eradication by 2030, with 50% of member states certified free of yaws transmission by 2023. Here we summarise the yaws modelling literature and discuss the proposed goal and strategy. The current Morges strategy involves rounds of Total Community Treatment (TCT), in which all members of the community are treated, and Total Targeted Treatment (TTT), treating active cases and their contacts. However, modelling and empirical work suggest that latent infections are often not found in the same household as active cases, reducing the utility of household-based contact tracing for a TTT strategy. Economic modelling has also discovered uncertainty in the cost of eradication, requiring further data to give greater information. We also note the need for improved active surveillance in previously endemic countries, in order to plan future intervention efforts and ensure global eradication.
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Affiliation(s)
- Louise Dyson
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK.,School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Eric Q Mooring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alex Holmes
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK
| | - Michael J Tildesley
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK.,School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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