The validity of test-negative design for assessment of typhoid conjugate vaccine protection: comparison of estimates by different study designs using data from a cluster-randomised controlled trial

Our findings suggests that the TND provides reliable estimates of TCV effectiveness, whereas the cohort design can bias vaccine effectiveness estimates, possibly due to unmeasured confounding effects,...

thelancet.com

Aetiologies, neuroradiological features, and risk factors for mortality and long-term neurosequelae of febrile coma in Malawian children: a prospective cohort study

Despite malaria control efforts, cerebral malaria remains the most common cause of febrile coma in Malawi. However, non-malarial coma causes a greater disease burden (death and disability), and a high...

thelancet.com

Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries

AbstractIntroductionAntimicrobial resistance (AMR) presents a major global health threat, driven in part by the inappropriate use of antibiotics including in low- and middle-income countries (LMICs). Improving the quality of antibiotic use is a key rationale for the development of the WHO’s AWaRe (Access, Watch and Reserve) system. There is a need to review the uptake of the AWaRe system since its launch to guide future practice.MethodsA literature search was conducted between 2017, the launch of AWaRe, and 2024. Inclusion criteria were studies that reported on antibiotic use in LMICs using the AWaRe system.ResultsEighty-five studies were included in the review, of which 56.4% focused on antibiotic use trends, with 28.2% reporting on prescribing patterns; 51.7% of the studies included inpatients. Only 14.1% of studies reported meeting the 2024 United Nations General Assembly (UNGA) AMR recommended target of at least 70% of human antibiotic use being Access antibiotics, with a concerning trend of overuse of Watch antibiotics (68.2% of studies). Dispensing practices revealed significant dispensing of antibiotics without prescriptions especially in Pakistan and Bangladesh. Watch antibiotics were more available but also more expensive than Access antibiotics.ConclusionsEncouragingly, many LMICs are now reporting antibiotic use via the AWaRe system, including in antimicrobial stewardship programmes (ASPs). Wide variation exists in the proportion of AWaRe antibiotics used across LMICs, with overuse of Watch antibiotics. There is an urgent need for targeted AWaRe-based ASPs in LMICs to meet recent UNGA recommendations. Improving the use, availability and affordability of Access antibiotics is essential to combat AMR.

academic.oup.com

‘Devastating’: Malawi left in dire straits by Trump’s decision to freeze aid

African nation relies on US and other foreign donors to help fund healthcare projects and schools

theguardian.com

A systematised review and evidence synthesis on the broader societal impact of vaccines against Salmonella - npj Vaccines

npj Vaccines - A systematised review and evidence synthesis on the broader societal impact of vaccines against Salmonella

nature.com

A framework for managing infectious diseases in rural areas in low- and middle-income countries in the face of climate change—East Africa as a case study

Climate change is having unprecedented impacts on human health, including increasing infectious disease risk. Despite this, health systems across the world are currently not prepared for novel disease...

journals.plos.org

Disseminated mpox in an immunocompromised patient in DR Congo: a call for a shift from disease-focused to person-centred outbreak response

This Correspondence examines a complex case of an immunocompromised patient at an mpox treatment centre in South Kivu, DR Congo, highlighting the shortcomings of outbreak-focused care models and their...

thelancet.com

Typhinder: Rapid, low-cost colorimetric detection of Salmonella Typhi bacteriophages for environmental surveillance

medrxiv.org

Water, sanitation, handwashing, and nutritional interventions can reduce child antibiotic use: evidence from Bangladesh and Kenya - Nature Communications

In this work, authors show that randomized water, sanitation, hygiene and nutrition interventions reduced child antibiotic use in Bangladesh (in parallel with high intervention uptake and reduced infe...

nature.com

verixiv.org

Early-Life Infections and Subsequent Risk and Antibiotics Use in Childhood

This cohort study examines whether early-life infection burden is associated with a later risk of infection and systemic antibiotic treatment episodes in childhood.

jamanetwork.com

System vaccinology analysis of predictors and mechanisms of antibody response durability to multiple vaccines in humans - Nature Immunology

Pulendran and colleagues define a molecular signature that can be used to predict the durability of antibody responses to vaccination and reveal important insights into the mechanisms by which vaccine...

nature.com

Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization

Since 1974 substantial gains in childhood survival have occurred in every global region. We estimate that EPI has provided the single greatest contribution to improved infant survival over the past 50 years. In the context of strengthening primary health care, our results show that equitable universal access to immunisation remains crucial to sustain health gains and continue to save future lives from preventable infectious mortality.

thelancet.com

Seroprevalence and risk factors for Crimean-Congo hemorrhagic fever virus exposure among febrile patients in northern Tanzania - PubMed

We show serologic evidence of prior exposure to Crimean-Congo hemorrhagic fever virus among humans in northern Tanzania. Similar to other settings, our results suggest that exposure is closely linked ...

pubmed.ncbi.nlm.nih.gov

E coli found in water supply of properties of south-east London

Residents of properties in Brockley advised to boil water until results of tests by Thames Water are returned

theguardian.com

9 countries said goodbye to a devastating disease in 2024

Nine countries eliminated a disease in 2024. Here's how Pakistan pulled it off — fulfilling a young boy's dream of eliminating blindness caused by bacterial infections.

npr.org

Health associated quality of life impairment in People who inject drugs (PWID) after blood stream infection.

People who inject drugs (PWID) have high rates of blood stream infections (BSI) with Staphylococcus aureus (SA) and group A streptococcus (GAS). Little is known about health related quality of life outcomes after BSI.

journalofinfection.com

Sepsis in northern Tanzania: a prospective observational study of clinical characteristics, management, and outcomes for adolescents and adults with sepsis

AbstractBackground. Despite a high burden of sepsis in sub-Saharan Africa, clinical data for adolescent and adult sepsis in this setting are limited. We so

academic.oup.com

Inequalities in uptake of childhood vaccination in England, 2019-23: longitudinal study

Objective To quantify changes in inequalities in uptake of childhood vaccination during a period of steadily declining overall childhood vaccination rates in England. Design Longitudinal study. Sett...

bmj.com

The fight to rid Pakistan’s coal pits of diseases that plagued British miners a century ago

Ultra-portable, AI driven x-rays have been used to find undiagnosed TB, as miners inhaling soot in Victorian-era conditions are at high risk

telegraph.co.uk

doi.org

PNAS

Proceedings of the National Academy of Sciences (PNAS), a peer reviewed journal of the National Academy of Sciences (NAS) - an authoritative source of high-impact, original research that broadly spans...

pnas.org

The association between rickettsial infection and hyperinflammation, diagnostic and management challenges.

We read with interest the excellent review on the characteristics of imported rickettsial infections to the United Kingdom, published in JOI on 15/03/2023.1 The authors made many valuable insights, including the finding that whilst most cases of spotted fever in this retrospective cohort were treated as outpatients, patients from the typhus group were deemed to be the “sickest” group of rickettsial patients, with a higher rate of inpatient admission (59%), ITU admission (21%) and at least one reported death (accepting outcomes were not routinely documented in the Rare and Imported Pathogen Laboratory (RIPL)).

journalofinfection.com

Interplay Between the Gut Microbiome and Typhoid Fever: Insights from Endemic Countries and a Controlled Human Infection Model

Typhoid fever is a systemic infection caused by Salmonella enterica serovar Typhi ( S. Typhi) invasion from the gut lumen. Transmission between people occurs through ingestion of contaminated food and...

medrxiv.org

Conference report of the 2024 Antimicrobial Resistance Meeting - npj Antimicrobials and Resistance

The Antimicrobial Resistance - Genomes, Big Data and Emerging Technologies Conference explored key topics including measuring the burden of AMR, global public health pathogen genomics infrastructure a...

nature.com

Cost of the typhoid conjugate vaccine introduction through an integrated campaign and follow-on routine immunization in Malawi

Malawi introduced typhoid conjugate vaccine (TCV) in 2023 through an integrated campaign delivering TCV alongside other vaccines and interventions (me…

sciencedirect.com

Unknown disease kills 143 in southwest Congo, local authorities say

An unknown disease killed 143 people in Democratic Republic of the Congo's southwestern province in November, local authorities told Reuters.

reuters.com