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1. Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial

Author

Mahamar, Almahamoudou, Sanogo, Koualy, Sidibe, Youssoufa, Diarra, Kalifa, Samassekou, Mamoudou, Attaher, Oumar, Tapily, Amadou, Diallo, Makonon, Dicko, Oumar Mohamed, Kaya, Mahamadou, Maguiraga, Seydina Oumar, Sankare, Yaya, Yalcouye, Hama, Diarra, Soumaila, Niambele, Sidi Mohamed, Thera, Ismaila, Sagara, Issaka, Sylla, Mala, Dolo, Amagana, Misidai, Nsajigwa, Simando, Sylvester, Msami, Hania, Juma, Omary, Gutapaka, Nicolaus, Paul, Rose, Mswata, Sarah, Sasamalo, Ibrahim, Johaness, Kasmir, Sultan, Mwantumu, Alexander, Annastazia, Kimaro, Isaac, Lwanga, Kauye, Mtungwe, Mwajuma, Khamis, Kassim, Rugarabam, Lighton, Kalinga, Wilmina, Mohammed, Mohammed, Kamange, Janeth, Msangi, Jubilate, Mwaijande, Batuli, Mtaka, Ivanny, Mhapa, Matilda, Mlaganile, Tarsis, Mbaga, Thabit, Yerbanga, Rakiswende Serge, Samtouma, Wendkouni, Sienou, Abdoul Aziz, Kabre, Zachari, Ouedraogo, Wendinpui Jedida Muriel, Yarbanga, G Armel Bienvenu, Zongo, Issaka, Savadogo, Hamade, Sanon, Joseph, Compaore, Judicael, Kere, Idrissa, Yoni, Ferdinand Lionel, Sanre, Tewende Martine, Ouattara, Seydou Bienvenu, Provstgaard-Morys, Samuel, Woods, Danielle, Snow, Robert W., Amek, Nyaguara, Ngetsa, Caroline J., Ochola-Oyier, Lynette Isabella, Musyoki, Jennifer, Munene, Marianne, Mumba, Noni, Adetifa, Uche Jane, Muiruri, Charles Mwangi, Mwawaka, Jimmy Shangala, Mwaganyuma, Mwatasa Hussein, Ndichu, Martha Njeri, Weya, Joseph Ochieng, Njogu, Kelvin, Grant, Jane, Webster, Jayne, Lakhkar, Anand, Ido, N. Félix André, Traore, Ousmane, Tahita, Marc Christian, Bonko, Massa dit Achille, Rouamba, Toussaint, Ouedraogo, D. Florence, Soma, Rachidatou, Millogo, Aida, Ouedraogo, Edouard, Sorgho, Faizatou, Konate, Fabé, Valea, Innocent, Datoo, Mehreen S, Dicko, Alassane, Tinto, Halidou, Ouédraogo, Jean-Bosco, Hamaluba, Mainga, Olotu, Ally, Beaumont, Emma, Ramos Lopez, Fernando, Natama, Hamtandi Magloire, Weston, Sophie, Chemba, Mwajuma, Compaore, Yves Daniel, Issiaka, Djibrilla, Salou, Diallo, Some, Athanase M, Omenda, Sharon, Lawrie, Alison, Bejon, Philip, Rao, Harish, Chandramohan, Daniel, Roberts, Rachel, Bharati, Sandesh, Stockdale, Lisa, Gairola, Sunil, Greenwood, Brian M, Ewer, Katie J, Bradley, John, Kulkarni, Prasad S, Shaligram, Umesh, and Hill, Adrian V S

Published
2024
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2. Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance

Author

Mackenzie, Grant A, Hill, Philip C, Jeffries, David J, Ndiaye, Malick, Sahito, Shah M, Hossain, Ilias, Uchendu, Uchendu, Ameh, David, Adeyemi, Oyedeji, Pathirana, Jayani, Olatunji, Yekini, Abatan, Baderinwa, Muhammad, Bilquees S, Ahameefula, Ebirim, Fombah, Augustin E, Adeshola, Banjo, Lobga, Babila G, Saha, Debasish, Mackenzie, Roslyn, Odutola, Aderonke, Plumb, Ian D, Akano, Aliu, Ebruke, Bernard E, Ideh, Readon C, Kuti, Bankole, Githua, Peter, Olutunde, Emmanuel, Ofordile, Ogochukwu, Green, Edward, Usuf, Effua, Badji, Henry, Ikumapayi, Usman NA, Manjang, Ahmed, Salaudeen, Rasheed, Nsekpong, E David, Jarju, Sheikh, Antonio, Martin, Sambou, Sana, Ceesay, Lamin, Lowe-Jallow, Yamundow, Fofana, Sidat, Jasseh, Momodou, Mulholland, Kim, Knoll, Maria, Levine, Orin S, Howie, Stephen R, Adegbola, Richard A, Greenwood, Brian M, and Corrah, Tumani

Published
2021
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3. Absence of Putative Artemisinin Resistance Mutations Among Plasmodium falciparum in Sub-Saharan Africa: A Molecular Epidemiologic Study

Author

Taylor, Steve M, Parobek, Christian M, DeConti, Derrick K, Kayentao, Kassoum, Coulibaly, Sheick Oumar, Greenwood, Brian M, Tagbor, Harry, Williams, John, Bojang, Kalifa, Njie, Fanta, Desai, Meghna, Kariuki, Simon, Gutman, Julie, Mathanga, Don P, Mårtensson, Andreas, Ngasala, Billy, Conrad, Melissa D, Rosenthal, Philip J, Tshefu, Antoinette K, Moormann, Ann M, Vulule, John M, Doumbo, Ogobara K, Kuile, Feiko O ter, Meshnick, Steven R, Bailey, Jeffrey A, and Juliano, Jonathan J

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Prevention, Vector-Borne Diseases, Rare Diseases, Antimicrobial Resistance, Genetics, Infectious Diseases, Biodefense, Vaccine Related, Malaria, Aetiology, 2.1 Biological and endogenous factors, 2.2 Factors relating to the physical environment, Infection, Good Health and Well Being, Adult, Africa South of the Sahara, Antimalarials, Artemisinins, Child, Child, Preschool, Female, Gene Frequency, Genotype, High-Throughput Nucleotide Sequencing, Humans, Malaria, Falciparum, Male, Molecular Epidemiology, Mutation, Plasmodium falciparum, Polymorphism, Genetic, Pregnancy, Prevalence, falciparum malaria, artemisinin resistance, drug resistance, molecular epidemiology, Biological Sciences, Medical and Health Sciences, Microbiology, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

Plasmodium falciparum parasites that are resistant to artemisinins have been detected in Southeast Asia. Resistance is associated with several polymorphisms in the parasite's K13-propeller gene. The molecular epidemiology of these artemisinin resistance genotypes in African parasite populations is unknown. We developed an assay to quantify rare polymorphisms in parasite populations that uses a pooled deep-sequencing approach to score allele frequencies, validated it by evaluating mixtures of laboratory parasite strains, and then used it to screen P. falciparum parasites from >1100 African infections collected since 2002 from 14 sites across sub-Saharan Africa. We found no mutations in African parasite populations that are associated with artemisinin resistance in Southeast Asian parasites. However, we observed 15 coding mutations, including 12 novel mutations, and limited allele sharing between parasite populations, consistent with a large reservoir of naturally occurring K13-propeller variation. Although polymorphisms associated with artemisinin resistance in P. falciparum in Southeast Asia are not prevalent in sub-Saharan Africa, numerous K13-propeller coding polymorphisms circulate in Africa. Although their distributions do not support a widespread selective sweep for an artemisinin-resistant phenotype, the impact of these mutations on artemisinin susceptibility is unknown and will require further characterization. Rapid, scalable molecular surveillance offers a useful adjunct in tracking and containing artemisinin resistance.

Published
2015

4. Staphylococcus aureus Bacteremia in Children of Rural Areas of The Gambia, 2008-2015

Author

Odutola, Aderonke, Bottomley, Christian, Zaman, Syed A., Lindsay, Jodi, Shah, Muhammed, Hossain, Ilias, Ndiaye, Malick, Osuorah, Chidebere D.I., Olatunji, Yekini, Badji, Henry, Ikumapayi, Usman N.A., Manjang, Ahmad, Salaudeen, Rasheed, Ceesay, Lamin, Jasseh, Momodou, Adegbola, Richard A., Corrah, Tumani, Hill, Philip C., Greenwood, Brian M., and Mackenzie, Grant A.

Subjects
Staphylococcus aureus infections, Bacteremia, Pediatric diseases, Staphylococcus aureus, Blood tests, Meningitis, Pneumonia, Medical research, Epidemiology, Developing countries, Death, Rural areas, Intelligence gathering, Newborn infants, Infection, Children, Health
Abstract

In 2016, invasive bacterial diseases accounted for one quarter of the 5.6 million childhood deaths worldwide (1). Most invasive bacterial diseases occur in sub-Saharan Africa and other low- and middle-income [...]

Published
2019
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6. Treatment of Chronic Asymptomatic Plasmodium falciparum Infection Does Not Increase the Risk of Clinical Malaria Upon Reinfection

Author

Portugal, Silvia, Tran, Tuan M., Ongoiba, Aissata, Bathily, Aboudramane, Li, Shanping, Doumbo, Safiatou, Skinner, Jeff, Doumtabe, Didier, Kone, Younoussou, Sangala, Jules, Jain, Aarti, Davies, D. Huw, Hung, Christopher, Liang, Li, Ricklefs, Stacy, Homann, Manijeh Vafa, Felgner, Philip L., Porcella, Stephen F., Färnert, Anna, Doumbo, Ogobara K., Kayentao, Kassoum, Greenwood, Brian M., Traore, Boubacar, and Crompton, Peter D.

Published
2017

7. Invasive bacterial disease in young infants in rural Gambia: Population-based surveillance

Author

Olatunji, Yekini A, primary, Banjo, Adeshola A, additional, Jarde, Alexander, additional, Salaudeen, Rasheed, additional, Ndiaye, Malick, additional, Galega, Lobga B, additional, Odutola, Aderonke, additional, Hossain, Ilias M, additional, Osuorah, Chidiebere, additional, Sahito, Muhammad S, additional, Muhammad, Bilquees Shah, additional, Ikumapayi, Nurudeen U, additional, Drammeh, Momodou M, additional, Manjang, Ahmad, additional, Adegbola, Richard A, additional, Greenwood, Brian M, additional, Hill, Philip C, additional, and Grant, Mackenzie A, additional

Published
2023
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8. Impact of the introduction of pneumococcal conjugate vaccination on pneumonia in The Gambia: population-based surveillance and case-control studies

Author

Mackenzie, Grant A, Hill, Philip C, Sahito, Shah M, Jeffries, David J, Hossain, Ilias, Bottomley, Christian, Uchendu, Uchendu, Ameh, David, Ndiaye, Malick, Osuorah, Chidebereh D, Adeyemi, Oyedeji, Pathirana, Jayani, Olatunji, Yekini, Abatan, Bade, Ahameefula, Ebirim, Muhammad, Bilquees S, Fombah, Augustin E, Saha, Debasish, Mackenzie, Roslyn, Plumb, Ian, Akano, Aliu, Ebruke, Bernard, Ideh, Readon C, Kuti, Bankole, Githua, Peter, Olutunde, Emmanuel, Ofordile, Ogochukwu, Green, Edward, Usuf, Effua, Badji, Henry, Ikumapayi, Usman N A, Manjang, Ahmad, Salaudeen, Rasheed, Nsekpong, E David, Jarju, Sheikh, Antonio, Martin, Sambou, Sana, Ceesay, Lamin, Lowe-Jallow, Yamundow, Sowe, Dawda, Jasseh, Momodou, Mulholland, Kim, Knoll, Maria, Levine, Orin S, Howie, Stephen R, Adegbola, Richard A, Greenwood, Brian M, and Corrah, Tumani

Published
2017
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11. Household transmission of Neisseria meningitidis in the African meningitis belt: a longitudinal cohort study

Author

Ali, Oumer, Aseffa, Abraham, Omer, Ahmed Bedru, Lema, Tsehaynesh, Demissie, Tesfaye Moti, Tekletsion, Yenenesh, Worku, Alemayehu, Xabher, Haimanot Guebre, Yamuah, Lawrence, Boukary, Rahamatou Moustapha, Collard, Jean-Marc, Dan Dano, Ibrahim, Habiboulaye, Ibrahim, Issaka, Bassira, Jusot, Jean-François, Ousmane, Sani, Rabe, Issoufa, Dauglaz, Doumagoum Moto, Gami, Jean Pierre, Gamougam, Kadidja, Mbainadji, Lodoum, Naibei, Nathan, Narbé, Maxime, Toralta, Jacques, Berthe, Abdoulaye, Diallo, Kanny, Keita, Mahamadou, Coulibaly, Adama, Onwuchekwa, Uma, Sow, Samba O, Tamboura, Boubou, Traore, Awa, Toure, Aliou, Clark, Tom, Mayer, Leonard, Amodu, Mary, Beida, Omeiza, Gadzama, Galadima, Omotara, Babatunji, Zailani, Sambo, Yahya, Shuaibu, Chandramohan, Daniel, Greenwood, Brian M, Hassan-King, Musa, Manigart, Olivier, Nascimento, Maria, M Stuart, James, Woukeu, Arouna, Basta, Nicole E, Bai, Xilian, Borrow, Ray, Findlow, Helen, Alavo, Serge, Bassene, Hubert, Diallo, Aldiouma, Dieng, Marietou, Doucouré, Souleymane, Gomis, Jules François, Ndiaye, Assane, Sokhna, Cheikh, Trape, Jean François, Bugri, Akalifa, Forgor, Abudulai, Hodgson, Abraham, Osei, Isaac, Quaye, Stephen L, Williams, John, Wontuo, Peter, Irving, Thomas, Trotter, Caroline L, Karachaliou, Andromachi, Bennett, Julia, Hill, Dorothea, Harrison, Odile, Maiden, Martin C, Rebbetts, Lisa, and Watkins, Eleanor

Published
2016
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12. Effect of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease in The Gambia: a population-based surveillance study

Author

Mackenzie, Grant A, Hill, Philip C, Jeffries, David J, Hossain, Ilias, Uchendu, Uchendu, Ameh, David, Ndiaye, Malick, Adeyemi, Oyedeji, Pathirana, Jayani, Olatunji, Yekini, Abatan, Bade, Muhammad, Bilquees S, Fombah, Augustin E, Saha, Debasish, Plumb, Ian, Akano, Aliu, Ebruke, Bernard, Ideh, Readon C, Kuti, Bankole, Githua, Peter, Olutunde, Emmanuel, Ofordile, Ogochukwu, Green, Edward, Usuf, Effua, Badji, Henry, Ikumapayi, Usman N A, Manjang, Ahmad, Salaudeen, Rasheed, Nsekpong, E David, Jarju, Sheikh, Antonio, Martin, Sambou, Sana, Ceesay, Lamin, Lowe-Jallow, Yamundow, Jasseh, Momodou, Mulholland, Kim, Knoll, Maria, Levine, Orin S, Howie, Stephen R, Adegbola, Richard A, Greenwood, Brian M, and Corrah, Tumani

Published
2016
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13. Pharyngeal carriage of Neisseria species in the African meningitis belt

Author

Diallo, Kanny, Trotter, Caroline, Timbine, Youssouf, Tamboura, Boubou, Sow, Samba O., Issaka, Bassira, Dano, Ibrahim D., Collard, Jean-Marc, Dieng, Marietou, Diallo, Aldiouma, Mihret, Adane, Ali, Oumer A., Aseffa, Abraham, Quaye, Stephen L., Bugri, Akalifa, Osei, Isaac, Gamougam, Kadidja, Mbainadji, Lodoum, Daugla, Doumagoum M., Gadzama, Galadima, Sambo, Zailani B., Omotara, Babatunji A., Bennett, Julia S., Rebbetts, Lisa S., Watkins, Eleanor R., Nascimento, Maria, Woukeu, Arouna, Manigart, Olivier, Borrow, Ray, Stuart, James M., Greenwood, Brian M., and Maiden, Martin C.J.

Published
2016
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14. Safety and efficacy of malaria vaccine candidate R21/Matrix-M in African children: a multicentre, double-blind, randomised, phase 3 trial

Author

Datoo, Mehreen S, Dicko, Alassane, Tinto, Halidou, Ouédraogo, Jean-Bosco, Hamaluba, Mainga, Olotu, Ally, Beaumont, Emma, Ramos Lopez, Fernando, Natama, Hamtandi Magloire, Weston, Sophie, Chemba, Mwajuma, Compaore, Yves Daniel, Issiaka, Djibrilla, Salou, Diallo, Some, Athanase M, Omenda, Sharon, Lawrie, Alison, Bejon, Philip, Rao, Harish, Chandramohan, Daniel, Roberts, Rachel, Bharati, Sandesh, Stockdale, Lisa, Gairola, Sunil, Greenwood, Brian M, Ewer, Katie J, Bradley, John, Kulkarni, Prasad S, Shaligram, Umesh, Hill, Adrian V S, Mahamar, Almahamoudou, Sanogo, Koualy, Sidibe, Youssoufa, Diarra, Kalifa, Samassekou, Mamoudou, Attaher, Oumar, Tapily, Amadou, Diallo, Makonon, Dicko, Oumar Mohamed, Kaya, Mahamadou, Maguiraga, Seydina Oumar, Sankare, Yaya, Yalcouye, Hama, Diarra, Soumaila, Niambele, Sidi Mohamed, Thera, Ismaila, Sagara, Issaka, Sylla, Mala, Dolo, Amagana, Misidai, Nsajigwa, Simando, Sylvester, Msami, Hania, Juma, Omary, Gutapaka, Nicolaus, Paul, Rose, Mswata, Sarah, Sasamalo, Ibrahim, Johaness, Kasmir, Sultan, Mwantumu, Alexander, Annastazia, Kimaro, Isaac, Lwanga, Kauye, Mtungwe, Mwajuma, Khamis, Kassim, Rugarabam, Lighton, Kalinga, Wilmina, Mohammed, Mohammed, Kamange, Janeth, Msangi, Jubilate, Mwaijande, Batuli, Mtaka, Ivanny, Mhapa, Matilda, Mlaganile, Tarsis, Mbaga, Thabit, Yerbanga, Rakiswende Serge, Samtouma, Wendkouni, Sienou, Abdoul Aziz, Kabre, Zachari, Ouedraogo, Wendinpui Jedida Muriel, Yarbanga, G Armel Bienvenu, Zongo, Issaka, Savadogo, Hamade, Sanon, Joseph, Compaore, Judicael, Kere, Idrissa, Yoni, Ferdinand Lionel, Sanre, Tewende Martine, Ouattara, Seydou Bienvenu, Provstgaard-Morys, Samuel, Woods, Danielle, Snow, Robert W., Amek, Nyaguara, Ngetsa, Caroline J., Ochola-Oyier, Lynette Isabella, Musyoki, Jennifer, Munene, Marianne, Mumba, Noni, Adetifa, Uche Jane, Muiruri, Charles Mwangi, Mwawaka, Jimmy Shangala, Mwaganyuma, Mwatasa Hussein, Ndichu, Martha Njeri, Weya, Joseph Ochieng, Njogu, Kelvin, Grant, Jane, Webster, Jayne, Lakhkar, Anand, Ido, N. Félix André, Traore, Ousmane, Tahita, Marc Christian, Bonko, Massa dit Achille, Rouamba, Toussaint, Ouedraogo, D. Florence, Soma, Rachidatou, Millogo, Aida, Ouedraogo, Edouard, Sorgho, Faizatou, Konate, Fabé, and Valea, Innocent

Abstract

Recently, we found that a new malaria vaccine, R21/Matrix-M, had over 75% efficacy against clinical malaria with seasonal administration in a phase 2b trial in Burkina Faso. Here, we report on safety and efficacy of the vaccine in a phase 3 trial enrolling over 4800 children across four countries followed for up to 18 months at seasonal sites and 12 months at standard sites.

Published
2024
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15. Genomic characterization of novel Neisseria species

Author

Diallo, Kanny, MacLennan, Jenny, Harrison, Odile B., Msefula, Chisomo, Sow, Samba O., Daugla, Doumagoum M., Johnson, Errin, Trotter, Caroline, MacLennan, Calman A., Parkhill, Julian, Borrow, Ray, Greenwood, Brian M., and Maiden, Martin C. J.

Published
2019
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17. Childhood meningitis in rural Gambia: 10 years of population-based surveillance

Author

Ikumapayi, Usman N., primary, Hill, Philip C., additional, Hossain, Ilias, additional, Olatunji, Yekini, additional, Ndiaye, Malick, additional, Badji, Henry, additional, Manjang, Ahmed, additional, Salaudeen, Rasheed, additional, Ceesay, Lamin, additional, Adegbola, Richard A., additional, Greenwood, Brian M., additional, and Mackenzie, Grant A., additional

Published
2022
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18. Continuing effectiveness of serogroup a meningococcal conjugate vaccine, Chad, 2013

Author

Gamougam, Kadidja, Daugla, Doumagoum M., Toralta, Jacques, Ngadoua, Cyriaque, Fermon, Florence, Page, Anne-Laure, Djingarey, Mamoudou H., Caugant, Dominique A., Manigart, Olivier, Trotter, Caroline L., Stuart, James M., and Greenwood, Brian M.

Subjects
Meningitis -- Prevention, Conjugate vaccines -- Patient outcomes, Epidemics -- Prevention -- Chad, Health
Abstract

For >100 years, countries in the meningitis belt of Africa have experienced intermittent epidemics of meningococcal meningitis, caused mainly by the serogroup A meningococcus (1). After development and prequalification of [...]

Published
2015
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24. Childhood meningitis in rural Gambia: 10 years of population-based surveillance

Author

Hill, Philip C, primary, Ikumapayi, Usman Nurudeen, additional, Hossain, Ilias Mohammad, additional, Olatunji, Yekini, additional, Ndiaye, Malick, additional, Badjie, Henry, additional, Manjang, Ahmed, additional, Salaudeen, Rasheed, additional, Ceesay, Lamin, additional, Adegbola, Richard Adebayo, additional, Greenwood, Brian M, additional, and Mackenzie, Grant A, additional

Published
2022
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29. Impact of the introduction of pneumococcal conjugate vaccination on invasive pneumococcal disease and pneumonia in The Gambia: 10 years of population-based surveillance

Author

Gambia Pneumococcal Surveillance Group, Mackenzie, Grant A, Hill, Philip C, Jeffries, David J, Ndiaye, Malick, Sahito, Shah M, Hossain, Ilias, Uchendu, Uchendu, Ameh, David, Adeyemi, Oyedeji, Pathirana, Jayani, Olatunji, Yekini, Abatan, Baderinwa, Muhammad, Bilquees S, Ahameefula, Ebirim, Fombah, Augustin E, Adeshola, Banjo, Lobga, Babila G, Saha, Debasish, Mackenzie, Roslyn, Odutola, Aderonke, Plumb, Ian D, Akano, Aliu, Ebruke, Bernard E, Ideh, Readon C, Kuti, Bankole, Githua, Peter, Olutunde, Emmanuel, Ofordile, Ogochukwu, Green, Edward, Usuf, Effua, Badji, Henry, Ikumapayi, Usman Na, Manjang, Ahmed, Salaudeen, Rasheed, Nsekpong, E David, Jarju, Sheikh, Antonio, Martin, Sambou, Sana, Ceesay, Lamin, Lowe-Jallow, Yamundow, Fofana, Sidat, Jasseh, Momodou, Mulholland, Kim, Knoll, Maria, Levine, Orin S, Howie, Stephen R, Adegbola, Richard A, Greenwood, Brian M, and Corrah, Tumani

Abstract

BACKGROUND: The Gambia introduced seven-valent pneumococcal conjugate vaccine (PCV7) in August 2009, followed by PCV13 in May, 2011, using a schedule of three primary doses without a booster dose or catch-up immunisation. We aimed to assess the long-term impact of PCV on disease incidence. METHODS: We did 10 years of population-based surveillance for invasive pneumococcal disease (IPD) and WHO defined radiological pneumonia with consolidation in rural Gambia. The surveillance population included all Basse Health and Demographic Surveillance System residents aged 2 months or older. Nurses screened all outpatients and inpatients at all health facilities using standardised criteria for referral. Clinicians then applied criteria for patient investigation. We defined IPD as a compatible illness with isolation of Streptococcus pneumoniae from a normally sterile site (cerebrospinal fluid, blood, or pleural fluid). We compared disease incidence between baseline (May 12, 2008-May 11, 2010) and post-vaccine years (2016-2017), in children aged 2 months to 14 years, adjusting for changes in case ascertainment over time. FINDINGS: We identified 22 728 patients for investigation and detected 342 cases of IPD and 2623 cases of radiological pneumonia. Among children aged 2-59 months, IPD incidence declined from 184 cases per 100 000 person-years to 38 cases per 100 000 person-years, an 80% reduction (95% CI 69-87). Non-pneumococcal bacteraemia incidence did not change significantly over time (incidence rate ratio 0·88; 95% CI, 0·64-1·21). We detected zero cases of vaccine-type IPD in the 2-11 month age group in 2016-17. Incidence of radiological pneumonia decreased by 33% (95% CI 24-40), from 10·5 to 7·0 per 1000 person-years in the 2-59 month age group, while pneumonia hospitalisations declined by 27% (95% CI 22-31). In the 5-14 year age group, IPD incidence declined by 69% (95% CI -28 to 91) and radiological pneumonia by 27% (95% CI -5 to 49). INTERPRETATION: Routine introduction of PCV13 substantially reduced the incidence of childhood IPD and pneumonia in rural Gambia, including elimination of vaccine-type IPD in infants. Other low-income countries can expect substantial impact from the introduction of PCV13 using a schedule of three primary doses. FUNDING: Gavi, The Vaccine Alliance; Bill & Melinda Gates Foundation; UK Medical Research Council; Pfizer Ltd.

Published
2021

30. An epidemiological study of RSV infection in the Gambia

Author

Weber Martin W., Milligan Paul, Sanneh Mariama, Awemoyi Agnes, Dakour Raduwan, Schneider Gisela, Palmer Ayo, Jallow Mariatou, Oparaogu Anslem, Whittle Hilton, Mulholland E. Kim, and Greenwood Brian M.

Subjects
Respiratory syncytial virus, Human/pathogenicity, Respiratory syncytial virus infections/epidemiology, Respiratory tract infections/etiology, Anoxemia, Patient admission, Hospitals, Measles, Epidemiologic factors, Health services accessibility, Households, Epidemiologic studies, Gambia, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVE: To describe the epidemiology of respiratory syncytial virus (RSV) infection in a developing country. METHODS: The work was carried out in three hospitals for primary cases and in the community for secondary cases in the western region of the Gambia, West Africa. RSV infection was diagnosed by immunofluorescence of nasopharyngeal aspirate samples in children younger than two years admitted to hospital with acute lower respiratory infection (ALRI). Routine records of all children with ALRI were analysed, and the incidence rates of ALRI, severe RSV-associated respiratory illness and hypoxaemic RSV infections were compared. A community-based study was undertaken to identify secondary cases and to obtain information about spread of the virus. FINDINGS: 4799 children with ALRI who were younger than two years and lived in the study area were admitted to the study hospitals: 421 had severe RSV-associated respiratory illness; 55 of these were hypoxaemic. Between 1994 and 1996, the observed incidence rate for ALRI in 100 children younger than one year living close to hospital was 9.6 cases per year; for severe RSV-associated respiratory illness 0.83; and for hypoxaemic RSV-associated respiratory illness 0.089. The proportion of all ALRI admissions due to RSV was 19%. Overall, 41% of children younger than five years in compounds in which cases lived and 42% in control compounds had evidence of RSV infection during the surveillance period. CONCLUSION: RSV is an important cause of ALRI leading to hospital admission in the Gambia. Morbidity is considerable and efforts at prevention are worthwhile.

Published
2002

40. Effect of removing direct payment for health care on utilisation and health outcomes in Ghanaian children: a randomised controlled trial

Author

Ansah, Evelyn Korkor, Narh-Bana, Solomon, Asiamah, Sabina, Dzordzordzi, Vivian, Biantey, Kingsley, Dickson, Kakra, Gyapong, John Owusu, Koram, Kwadwo Ansah, Greenwood, Brian M., Mills, Anne, and Whitty, Christopher J.M.

Subjects
Company business management, Medical care, Cost of -- Influence, Malaria -- Care and treatment, Malaria -- Prognosis, Children -- Health aspects, Children -- Management
Abstract

Background Delays in accessing care for malaria and other diseases can lead to disease progression, and user fees are a known barrier to accessing health care. Governments are introducing free health care to improve health outcomes. Free health care affects treatment seeking, and it is therefore assumed to lead to improved health outcomes, but there is no direct trial evidence of the impact of removing out-of-pocket payments on health outcomes in developing countries. This trial was designed to test the impact of free health care on health outcomes directly. Methods and Findings 2,194 households containing 2,592 Ghanaian children under 5 y old were randomised into a prepayment scheme allowing free primary care including drugs, or to a control group whose families paid user fees for health care (normal practice); 165 children whose families had previously paid to enrol in the prepayment scheme formed an observational arm. The primary outcome was moderate anaemia (haemoglobin [Hb] < 8 g/dl); major secondary outcomes were health care utilisation, severe anaemia, and mortality. At baseline the randomised groups were similar. Introducing free primary health care altered the health care seeking behaviour of households; those randomised to the intervention arm used formal health care more and nonformal care less than the control group. Introducing free primary health care did not lead to any measurable difference in any health outcome. The primary outcome of moderate anaemia was detected in 37 (3.1%) children in the control and 36 children (3.2%) in the intervention arm (adjusted odds ratio 1.05, 95% confidence interval 0.66-1.67). There were four deaths in the control and five in the intervention group. Mean Hb concentration, severe anaemia, parasite prevalence, and anthropometric measurements were similar in each group. Families who previously self-enrolled in the prepayment scheme were significantly less poor, had better health measures, and used services more frequently than those in the randomised group. Conclusions In the study setting, removing out-of-pocket payments for health care had an impact on health care-seeking behaviour but not on the health outcomes measured. Trial registration: ClinicalTrials.gov (#NCT00146692)., Introduction Levels of mortality in African children are unacceptably high. Access to medical care is a key determinant of health and one that can be addressed [1,2]. Malaria is a [...]

Published
2009

42. Malaria: progress, perils, and prospects for eradication

Author

Greenwood, Brian M., Fidock, David A., Kyle, Dennis E., Kappe, Stefan H.I., Alonso, Pedro L., Collins, Frank H., and Duffy, Patrick E.

Subjects
Company business management, Malaria -- Drug therapy, Malaria -- Prevention, DDT (Insecticide) -- Dosage and administration, Chloroquine -- Dosage and administration, Public health -- Management
Abstract

There are still approximately 500 million cases of malaria and 1 million deaths from malaria each year. Yet recently, malaria incidence has been dramatically reduced in some parts of Africa by increasing deployment of anti-mosquito measures and new artemisinin-containing treatments, prompting renewed calls for global eradication. However, treatment and mosquito control currently depend on too few compounds and thus are vulnerable to the emergence of compound-resistant parasites and mosquitoes. As discussed in this Review, new drugs, vaccines, and insecticides, as well as improved surveillance methods, are research priorities. Insights into parasite biology, human immunity, and vector behavior will guide efforts to translate parasite and mosquito genome sequences into novel interventions., Introduction More than 2 billion people are at risk of malaria (1), which primarily affects poor populations in tropical and subtropical areas, where the temperature and rainfall are most suitable [...]

Published
2008

44. Narrative review of methods and findings of recent studies on the carriage of meningococci and other Neisseria species in the African Meningitis Belt

Author

Greenwood, Brian M, Aseffa, Abraham, Caugant, Dominique A, Diallo, Kanny, Kristiansen, Paul A, Maiden, Martin CJ, Stuart, James M, and Trotter, Caroline L

Subjects
portage du méningocoque, Reviews, Meningococcal Vaccines, Review, Neisseria meningitidis, Meningitis, Meningococcal, Mass Vaccination, African meningitis belt, ceinture africaine de la méningite, meningococcal carriage, Neisseria meningitidis, Serogroup A, Africa, Carrier State, Humans
Abstract

Objective To review the findings of studies of pharyngeal carriage of Neisseria meningitidis and related species conducted in the African meningitis belt since a previous review published in 2007. Methods PubMed and Web of Science were searched in July 2018 using the terms ‘meningococcal OR Neisseria meningitidis OR lactamica AND carriage AND Africa’, with the search limited to papers published on or after 1st January 2007. We conducted a narrative review of these publications. Results One hundred and thirteen papers were identified using the search terms described above, 20 of which reported new data from surveys conducted in an African meningitis belt country. These papers described 40 surveys conducted before the introduction of the group A meningococcal conjugate vaccine (MenAfriVacR) during which 66 707 pharyngeal swabs were obtained. Carriage prevalence of N. meningitidis varied substantially by time and place, ranging from

Published
2018

45. Nasopharyngeal carriage of streptococcus pneumoniae in Gambian villagers

Author

Hill, Philip C., Akisanya, Abiodun, Sankareh, Kawsu, Cheung, Yin Bun, Saaka, Mark, Lahai, George, Greenwood, Brian M., and Adegbola, Richard A.

Subjects
Streptococcus pneumoniae -- Research, Streptococcus pneumoniae -- Care and treatment, Streptococcus pneumoniae -- Demographic aspects, Bacterial vaccines -- Usage, Bacterial vaccines -- Research, Nasopharynx -- Diseases, Nasopharynx -- Physiological aspects, Health, Health care industry
Published
2006

46. Manslaughter by fake artesunate in Asia--will Africa be next?

Author

Newton, Paul N., McGready, Rose, Fernandez, Facundo, Green, Michael D., Sunjio, Manuela, Bruneton, Carinne, Phanouvong, Souly, Millet, Pascal, Whitty, Christopher J.M., Talisuna, Ambrose O., Proux, Stephane, Christophel, Eva Maria, Malenga, Grace, Singhasivanon, Pratap, Bojang, Kalifa, Kaur, Harparkash, Palmer, Kevin, Day, Nicholas P.J., Greenwood, Brian M., Nosten, Francois, and White, Nicholas J.

Subjects
Artemisia, Drug resistance, Malaria, Manslaughter
Abstract

Falciparum malaria kills, and it particularly kills the rural poor. Artemisinin derivatives, such as artesunate, are a vital component of Plasmodium falciparum malaria treatment and control in the face of [...]

Published
2006

47. Amodiaquine alone, amodiaquine + sulfadoxine-pyrimethamine, amodiaquine + artesunate, and artemether-lumefantrine for outpatient treatment of malaria in Tanzanian children: a four-arm randomised effectiveness trial

Author

Mutabingwa, Theonest K., Anthony, Devota, Heller, Archie, Hallett, Rachel, Ahmed, Jalal, Drakeley, Chris, Greenwood, Brian M., and Whitty, Christopher J.M.

Subjects
Children -- Health aspects, Drug therapy, Combination -- Usage, Plasmodium falciparum -- Care and treatment, Plasmodium falciparum -- Drug therapy, Malaria -- Care and treatment, Malaria -- Drug therapy, Malaria -- Patient outcomes
Published
2005

48. Malaria

Author

Greenwood, Brian M., Bojang, Kalifa, Whitty, Christopher JM, and Targett, Geoffrey AT

Published
2005

49. A CD4+ T-cell immune response to a conserved epitope in the circumsporozoite protein correlates with protection from natural Plasmodium falciparum infection and disease

Author

Reece, William H H, Pinder, Margaret, Gothard, Philip K, Milligan, Paul, Bojang, Kalifa, Doherty, Tom, Plebanski, Magdalena, Akinwunmi, Peter, Everaere, Simone, Watkins, Katherine R, Voss, Gerald, Tornieporth, Nadia, Alloueche, Ali, Greenwood, Brian M, Kester, Kent E, McAdam, Keith P W J, Cohen, Joe, and Hill, Adrian V S

Abstract

Author(s): William H H Reece [1]; Margaret Pinder [2]; Philip K Gothard [1]; Paul Milligan [2]; Kalifa Bojang [2]; Tom Doherty [2]; Magdalena Plebanski [1]; Peter Akinwunmi [2]; Simone Everaere [...]

Published
2004
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50. Malaria vaccines and their potential role in the elimination of malaria

Author

Greenwood Brian M and Targett Geoffrey A

Subjects
Arctic medicine. Tropical medicine, RC955-962, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination, now being considered seriously in some epidemiological situations, requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. The feature of the life-cycles of human malarias that presents the greatest challenge to an elimination programme is the persistence of parasites as asymptomatic infections. These are an important source from which transmission to mosquitoes can occur. Consequently, an elimination strategy requires a community-based approach covering all individuals and not just those who are susceptible to clinical malaria. The progress that has been made in development of candidate malaria vaccines is reviewed. It is unlikely that many of these will have the efficacy required for complete elimination of parasites, though they may have an important role to play as part of future integrated control programmes. Vaccines for elimination must have a high level of efficacy in order to stop transmission to mosquitoes. This might be achieved with some pre-erythrocytic stage candidate vaccines or by targeting the sexual stages directly with transmission-blocking vaccines. An expanded malaria vaccine programme with such objectives is now a priority.

Published
2008
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