Journal Article > CommentaryAbstract Only
Science. 2014 September 12; Volume 345 (Issue 6202); 1290-1292.; DOI:10.1126/science.1254164
Ager A, Burnham G, Checchi F, Gayer M, Grais RF, et al.
Science. 2014 September 12; Volume 345 (Issue 6202); 1290-1292.; DOI:10.1126/science.1254164
Given the growing scale and complexity of responses to humanitarian crises, it is important to develop a stronger evidence base for health interventions in such contexts. Humanitarian crises present unique challenges to rigorous and effective research, but there are substantial opportunities for scientific advance. Studies need to focus where the translation of evidence from noncrisis scenarios is not viable and on ethical ways of determining what happens in the absence of an intervention. Robust methodologies suited to crisis settings have to be developed and used to assess interventions with potential for delivery at scale. Strengthening research capacity in the low- to middle-income countries that are vulnerable to crises is also crucial.
Journal Article > Meta-AnalysisFull Text
J Infect Dis. 2011 July 1; Volume 204 (Issue suppl_1); DOI:10.1093/infdis/jir072
Cairns KL, Perry RT, Ryman TK, Nandy R, Grais RF
J Infect Dis. 2011 July 1; Volume 204 (Issue suppl_1); DOI:10.1093/infdis/jir072
Measles caused mortality in >164,000 children in 2008, with most deaths occurring during outbreaks. Nonetheless, the impact and desirability of conducting measles outbreak response immunization (ORI) in middle- and low-income countries has been controversial. World Health Organization guidelines published in 1999 recommended against ORI in such settings, although recently these guidelines have been reversed for countries with measles mortality reduction goals.
Journal Article > ResearchFull Text
Emerg Themes Epidemiol. 2010 July 19; Volume 7 (Issue 1); 4.; DOI:10.1186/1742-7622-7-4
Cairns KL, Nandy R, Grais RF
Emerg Themes Epidemiol. 2010 July 19; Volume 7 (Issue 1); 4.; DOI:10.1186/1742-7622-7-4
ABSTRACT
Measles, a highly infectious vaccine-preventable viral disease, is potentially fatal. Historically, measles case-fatality ratios (CFRs) have been reported to vary from 0.1% in the developed world to as high as 30% in emergency settings. Estimates of the global burden of mortality from measles, critical to prioritizing measles vaccination among other health interventions, are highly sensitive to the CFR estimates used in modeling; however, due to the lack of reliable, up-to-date data, considerable debate exists as to what CFR estimates are appropriate to use. To determine current measles CFRs in high-burden settings without vital registration we have conducted six retrospective measles mortality studies in such settings. This paper examines the methodological challenges of this work and our solutions to these challenges, including the integration of lessons from retrospective all-cause mortality studies into CFR studies, approaches to laboratory confirmation of outbreaks, and means of obtaining a representative sample of case-patients. Our experiences are relevant to those conducting retrospective CFR studies for measles or other diseases, and to those interested in all-cause mortality studies.
Measles, a highly infectious vaccine-preventable viral disease, is potentially fatal. Historically, measles case-fatality ratios (CFRs) have been reported to vary from 0.1% in the developed world to as high as 30% in emergency settings. Estimates of the global burden of mortality from measles, critical to prioritizing measles vaccination among other health interventions, are highly sensitive to the CFR estimates used in modeling; however, due to the lack of reliable, up-to-date data, considerable debate exists as to what CFR estimates are appropriate to use. To determine current measles CFRs in high-burden settings without vital registration we have conducted six retrospective measles mortality studies in such settings. This paper examines the methodological challenges of this work and our solutions to these challenges, including the integration of lessons from retrospective all-cause mortality studies into CFR studies, approaches to laboratory confirmation of outbreaks, and means of obtaining a representative sample of case-patients. Our experiences are relevant to those conducting retrospective CFR studies for measles or other diseases, and to those interested in all-cause mortality studies.
Journal Article > ReviewFull Text
Confl Health. 2011 September 26; Volume 5 (Issue 1); DOI:10.1186/1752-1505-5-21
Grais RF, Strebel PM, Mala P, Watson JA, Nandy R, et al.
Confl Health. 2011 September 26; Volume 5 (Issue 1); DOI:10.1186/1752-1505-5-21