Journal Article > CommentaryFull Text
Lancet Global Health. 2014 June 1; Volume 2 (Issue 6); DOI:10.1016/S2214-109X(14)70218-9
Quaglio GL, Ramsay AR, Harries AD, Karapiperis T, Putoto G, et al.
Lancet Global Health. 2014 June 1; Volume 2 (Issue 6); DOI:10.1016/S2214-109X(14)70218-9
Journal Article > ResearchAbstract Only
Am J Trop Med Hyg. 1996 August 1; Volume 55 (Issue 2); 131-137.; DOI:10.4269/ajtmh.1996.55.131
Bouma MJ, Dye C, van der Kaay HJ
Am J Trop Med Hyg. 1996 August 1; Volume 55 (Issue 2); 131-137.; DOI:10.4269/ajtmh.1996.55.131
Following a striking increase in the severity of autumnal outbreaks of Plasmodium falciparum during the last decade in the Northwest Frontier Province (NWFP) of Pakistan, the role of climatologic variables was investigated. A multivariate analysis showed that during the transmission season of P. falciparum, the amount of rainfall in September and October, the temperature in November and December, and the humidity in December were all correlated (r2 = 0.82) with two measures of P. falciparum, the falciparum rate (percent of slides examined positive for P. falciparum) since 1981 and the annual P. falciparum proportion (percent of all malaria infections diagnosed as P. falciparum) since 1978. Climatologic records since 1876 show an increase in mean November and December temperatures by 2 degrees C and 1.5 degrees C, respectively, and in October rainfall. Mean humidity in December has also been increasing since 1950. These climatologic changes in the area appear to have made conditions for transmission of P. falciparum more favorable, and may account for the increase in incidence observed in the NWFP in recent years.
Journal Article > ResearchFull Text
Int J Tuberc Lung Dis. 2014 August 1; Volume 18 (Issue 8); 899-904.; DOI:10.5588/ijtld.14.0007
Hill P, Dye C, Viney K, Tabutoa K, Kienene T, et al.
Int J Tuberc Lung Dis. 2014 August 1; Volume 18 (Issue 8); 899-904.; DOI:10.5588/ijtld.14.0007
SETTING
The global target of tuberculosis (TB) elimination by 2050 requires new approaches. Active case finding plus mass prophylactic treatment has been disappointing. We consider mass full anti-tuberculosis treatment as an approach to TB elimination in Kiribati, a Pacific Island nation, with a persistent epidemic of high TB incidence.
OBJECTIVE
To construct a mathematical model to predict whether mass treatment with a full course of anti-tuberculosis drugs might eliminate TB from the defined population of the Republic of Kiribati.
METHODS
We constructed a seven-state compartmental model of the life cycle of Mycobacterium tuberculosis in which active TB disease arises from the progression of infection, reinfection, reactivation and relapse, while distinguishing infectious from non-infectious disease. We evaluated the effects of 5-yearly mass treatment using a range of parameter values to generate outcomes in uncertainty analysis.
RESULTS
Assuming population-wide treatment effectiveness for latent tuberculous infection and active TB of ⩾90%, annual TB incidence is expected to fall sharply at each 5-yearly round of treatment, approaching elimination in two decades. The model showed that the incidence rate is sensitive to the relapse rate after successful treatment of TB.
CONCLUSION
Mass treatment may help to eliminate TB, at least for discrete or geographically isolated populations.
The global target of tuberculosis (TB) elimination by 2050 requires new approaches. Active case finding plus mass prophylactic treatment has been disappointing. We consider mass full anti-tuberculosis treatment as an approach to TB elimination in Kiribati, a Pacific Island nation, with a persistent epidemic of high TB incidence.
OBJECTIVE
To construct a mathematical model to predict whether mass treatment with a full course of anti-tuberculosis drugs might eliminate TB from the defined population of the Republic of Kiribati.
METHODS
We constructed a seven-state compartmental model of the life cycle of Mycobacterium tuberculosis in which active TB disease arises from the progression of infection, reinfection, reactivation and relapse, while distinguishing infectious from non-infectious disease. We evaluated the effects of 5-yearly mass treatment using a range of parameter values to generate outcomes in uncertainty analysis.
RESULTS
Assuming population-wide treatment effectiveness for latent tuberculous infection and active TB of ⩾90%, annual TB incidence is expected to fall sharply at each 5-yearly round of treatment, approaching elimination in two decades. The model showed that the incidence rate is sensitive to the relapse rate after successful treatment of TB.
CONCLUSION
Mass treatment may help to eliminate TB, at least for discrete or geographically isolated populations.
Journal Article > CommentaryFull Text
Lancet. 2017 November 11; Volume 390 (Issue 10108); 2211-2214.; DOI:10.1016/S0140-6736(17)31224-2
Perkins MD, Dye C, Balasegaram M, Brechot C, Mombouli JV, et al.
Lancet. 2017 November 11; Volume 390 (Issue 10108); 2211-2214.; DOI:10.1016/S0140-6736(17)31224-2
Diagnostics are crucial in mitigating the effect of disease outbreaks. Because diagnostic development and validation are time consuming, they should be carried out in anticipation of epidemics rather than in response to them. The diagnostic response to the 2014-15 Ebola epidemic, although ultimately effective, was slow and expensive. If a focused mechanism had existed with the technical and financial resources to drive its development ahead of the outbreak, point-of-care Ebola tests supporting a less costly and more mobile response could have been available early on in the diagnosis process. A new partnering model could drive rapid development of tests and surveillance strategies for novel pathogens that emerge in future outbreaks. We look at lessons learned from the Ebola outbreak and propose specific solutions to improve the speed of new assay development and ensure their effective deployment.