BACKGROUND
Nipah virus (NiV), a highly lethal virus in humans, circulates in Pteropus bats throughout South and Southeast Asia. Difficulty in obtaining viral genomes from bats means we have a poor understanding of NiV diversity.
METHODS
We develop phylogenetic approaches applied to the most comprehensive collection of genomes to date (N = 257, 175 from bats, 73 from humans) from 6 countries over 22 years (1999–2020). We divide the 4 major NiV sublineages into 15 genetic clusters. Using Approximate Bayesian Computation fit to a spatial signature of viral diversity, we estimate the presence and the average size of genetic clusters per area.
RESULTS
We find that, within any bat roost, there are an average of 2.4 co-circulating genetic clusters, rising to 5.5 clusters at areas of 1500–2000 km2. We estimate that each genetic cluster occupies an average area of 1.3 million km2 (95% confidence interval [CI], .6–2.3 million km2), with 14 clusters in an area of 100 000 km2 (95% CI, 6–24 km2). In the few sites in Bangladesh and Cambodia where genomic surveillance has been concentrated, we estimate that most clusters have been identified, but only approximately 15% of overall NiV diversity has been uncovered.
CONCLUSIONS
Our findings are consistent with entrenched co-circulation of distinct lineages, even within roosts, coupled with slow migration over larger spatial scales.
From our practitioners’ viewpoint, we reflect on the deployment of the ‘MSF Listen’ platform in our programmes and how it evolved from a purely misinformation-focused digital tool to a broader workflow and approach to understanding community needs in crises through accountable management of community feedback.
Among refugees residing in countries of first asylum, such as Malaysia, high rates of psychological distress call for creative intervention responses.
AIMS
This study examines implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model promoting emotional well-being and access to services.
METHOD
The one-session intervention was implemented in community settings by refugee facilitators during 2017 to 2020. 140 Participants including Afghan ( n = 43), Rohingya ( n = 41), and Somali ( n = 56) refugees were randomized to receive either the intervention at baseline, or to a waitlist control group. At 30 days post-intervention, all participants completed a post-assessment. Additionally, after completing the intervention, participants provided feedback on SBIRT content and process.
RESULTS
Findings indicate the intervention was feasible to implement. Among the full sample, Refugee Health Screening-15 emotional distress scores reduced significantly among participants in the intervention group when compared to those in the waitlist control group. Examining findings by nationality, only Afghan and Rohingya participants in the intervention condition experienced significant reductions in distress scores compared to their counterparts in the control condition. Examining intervention effects on service access outcomes, only Somali participants in the intervention condition experienced significant increases in service access compared to the control condition.
CONCLUSIONS
Findings indicate the potential value of this SBIRT intervention, warranting further research.
Both rural, urban, camp, open and conflict settings will be included. Recognising that different locations may have been exposed to COVID-19 in its early phase, it will continue to explore within each setting throughout the outbreak period. So far, the following sites are to be included:
• Nigeria: Anka and Benue IDP camps (Pilot)
• Jordan: Syrian refugee Zaatari camp
• Iraq: Syrian and Iraqi refugee camp(s)
• Sierra Leone: Tonkolili project (Pilot)
• Malaysia: Penang Rohingya refugees : Myanmar Pauktaw camp, Rakhine state
• Bangladesh:Cox Bazaar camps and Kamrangirchar peri-urban slum
• Ethiopia Gambella camp
• Democratic Republic of Congo: South Kivu (Fizi and Kimbi-Lulenge health zones)
Further sites may be submitted to ERB during the outbreak.