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1. Impact of a national tsetse control programme to eliminate Gambian sleeping sickness in Uganda: a spatiotemporal modelling study

Author

Sophie Dunkley, Andrew Hope, Joshua Longbottom, Johan Esterhuizen, Michael J Lehane, TN Clement Mangwiro, Albert Mugenyi, Richard Selby, Inaki Tirados, Steve J Torr, and Michelle C Stanton

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

Introduction Tsetse flies (Glossina) transmit Trypanosoma brucei gambiense, which causes gambiense human African trypanosomiasis (gHAT). As part of national efforts to eliminate gHAT as a public health problem, Uganda implemented a large-scale programme of deploying Tiny Targets, which comprise panels of insecticide-treated material which attract and kill tsetse. At its peak, the programme was the largest tsetse control operation in Africa. Here, we quantify the impact of Tiny Targets and environmental changes on the spatial and temporal patterns of tsetse abundance across North-Western Uganda.Methods We leverage a 100-month longitudinal dataset detailing Glossina fuscipes fuscipes catches from monitoring traps between October 2010 and December 2019 within seven districts in North-Western Uganda. We fitted a boosted regression tree (BRT) model assessing environmental suitability, which was used alongside Tiny Target data to fit a spatiotemporal geostatistical model predicting tsetse abundance across our study area (~16 000 km2). We used the spatiotemporal model to quantify the impact of Tiny Targets and environmental changes on the distribution of tsetse, alongside metrics of uncertainty.Results Environmental suitability across the study area remained relatively constant over time, with suitability being driven largely by elevation and distance to rivers. By performing a counterfactual analysis using the fitted spatiotemporal geostatistical model, we show that deployment of Tiny Targets across an area of 4000 km2 reduced the overall abundance of tsetse to low levels (median daily catch=1.1 tsetse/trap, IQR=0.85–1.28). No spatial–temporal locations had high (>10 tsetse/trap/day) numbers of tsetse compared with 18% of locations for the counterfactual.Conclusions In Uganda, Tiny Targets reduced the abundance of G. f. fuscipes and maintained tsetse populations at low levels. Our model represents the first spatiotemporal geostatistical model investigating the effects of a national tsetse control programme. The outputs provide important data for informing next steps for vector control and surveillance.

Published
2024
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2. Estimating the impact of Tiny Targets in reducing the incidence of Gambian sleeping sickness in the North-west Uganda focus

Author

Paul R. Bessell, Johan Esterhuizen, Michael J. Lehane, Joshua Longbottom, Albert Mugenyi, Richard Selby, Inaki Tirados, Steve J. Torr, Charles Waiswa, Charles Wamboga, and Andrew Hope

Subjects
Human African trypanosomiasis, Tsetse control, Tiny Targets, Uganda, Disease control, Elimination, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Riverine species of tsetse (Glossina) transmit Trypanosoma brucei gambiense, which causes Gambian human African trypanosomiasis (gHAT), a neglected tropical disease. Uganda aims to eliminate gHAT as a public health problem through detection and treatment of human cases and vector control. The latter is being achieved through the deployment of ‘Tiny Targets’, insecticide-impregnated panels of material which attract and kill tsetse. We analysed the spatial and temporal distribution of cases of gHAT in Uganda during the period 2010–2019 to assess whether Tiny Targets have had an impact on disease incidence. Methods To quantify the deployment of Tiny Targets, we mapped the rivers and their associated watersheds in the intervention area. We then categorised each of these on a scale of 0–3 according to whether Tiny Targets were absent (0), present only in neighbouring watersheds (1), present in the watersheds but not all neighbours (2), or present in the watershed and all neighbours (3). We overlaid all cases that were diagnosed between 2000 and 2020 and assessed whether the probability of finding cases in a watershed changed following the deployment of targets. We also estimated the number of cases averted through tsetse control. Results We found that following the deployment of Tiny Targets in a watershed, there were fewer cases of HAT, with a sampled error probability of 0.007. We estimate that during the intervention period 2012–2019 we should have expected 48 cases (95% confidence intervals = 40–57) compared to the 36 cases observed. The results are robust to a range of sensitivity analyses. Conclusions Tiny Targets have reduced the incidence of gHAT by 25% in north-western Uganda. Graphical abstract

Published
2021
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3. Scaling up of tsetse control to eliminate Gambian sleeping sickness in northern Uganda.

Author

Andrew Hope, Albert Mugenyi, Johan Esterhuizen, Inaki Tirados, Lucas Cunningham, Gala Garrod, Mike J Lehane, Joshua Longbottom, Tn Clement Mangwiro, Mercy Opiyo, Michelle Stanton, Steve J Torr, Glyn A Vale, Charles Waiswa, and Richard Selby

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

BackgroundTsetse flies (Glossina) transmit Trypanosoma brucei gambiense which causes Gambian human African trypanosomiasis (gHAT) in Central and West Africa. Several countries use Tiny Targets, comprising insecticide-treated panels of material which attract and kill tsetse, as part of their national programmes to eliminate gHAT. We studied how the scale and arrangement of target deployment affected the efficacy of control.Methodology and principal findingsBetween 2012 and 2016, Tiny Targets were deployed biannually along the larger rivers of Arua, Maracha, Koboko and Yumbe districts in North West Uganda with the aim of reducing the abundance of tsetse to interrupt transmission. The extent of these deployments increased from ~250 km2 in 2012 to ~1600 km2 in 2015. The impact of Tiny Targets on tsetse populations was assessed by analysing catches of tsetse from a network of monitoring traps; sub-samples of captured tsetse were dissected to estimate their age and infection status. In addition, the condition of 780 targets (~195/district) was assessed for up to six months after deployment. In each district, mean daily catches of tsetse (G. fuscipes fuscipes) from monitoring traps declined significantly by >80% following the deployment of targets. The reduction was apparent for several kilometres on adjacent lengths of the same river but not in other rivers a kilometre or so away. Expansion of the operational area did not always produce higher levels of suppression or detectable change in the age structure or infection rates of the population, perhaps due to the failure to treat the smaller streams and/or invasion from adjacent untreated areas. The median effective life of a Tiny Target was 61 (41.8-80.2, 95% CI) days.ConclusionsScaling-up of tsetse control reduced the population of tsetse by >80% across the intervention area. Even better control might be achievable by tackling invasion of flies from infested areas within and outside the current intervention area. This might involve deploying more targets, especially along smaller rivers, and extending the effective life of Tiny Targets.

Published
2022
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4. Modelling the impact of climate change on the distribution and abundance of tsetse in Northern Zimbabwe

Author

Joshua Longbottom, Cyril Caminade, Harry S. Gibson, Daniel J. Weiss, Steve Torr, and Jennifer S. Lord

Subjects
Tsetse, Northern zimbabwe, Spatial model, Abundance estimates, Sleeping sickness, r-HAT, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Climate change is predicted to impact the transmission dynamics of vector-borne diseases. Tsetse flies (Glossina) transmit species of Trypanosoma that cause human and animal African trypanosomiasis. A previous modelling study showed that temperature increases between 1990 and 2017 can explain the observed decline in abundance of tsetse at a single site in the Mana Pools National Park of Zimbabwe. Here, we apply a mechanistic model of tsetse population dynamics to predict how increases in temperature may have changed the distribution and relative abundance of Glossina pallidipes across northern Zimbabwe. Methods Local weather station temperature measurements were previously used to fit the mechanistic model to longitudinal G. pallidipes catch data. To extend the use of the model, we converted MODIS land surface temperature to air temperature, compared the converted temperatures with available weather station data to confirm they aligned, and then re-fitted the mechanistic model using G. pallidipes catch data and air temperature estimates. We projected this fitted model across northern Zimbabwe, using simulations at a 1 km × 1 km spatial resolution, between 2000 to 2016. Results We produced estimates of relative changes in G. pallidipes mortality, larviposition, emergence rates and abundance, for northern Zimbabwe. Our model predicts decreasing tsetse populations within low elevation areas in response to increasing temperature trends during 2000–2016. Conversely, we show that high elevation areas (> 1000 m above sea level), previously considered too cold to sustain tsetse, may now be climatically suitable. Conclusions To our knowledge, the results of this research represent the first regional-scale assessment of temperature related tsetse population dynamics, and the first high spatial-resolution estimates of this metric for northern Zimbabwe. Our results suggest that tsetse abundance may have declined across much of the Zambezi Valley in response to changing climatic conditions during the study period. Future research including empirical studies is planned to improve model accuracy and validate predictions for other field sites in Zimbabwe.

Published
2020
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5. Addressing the global snakebite crisis with geo-spatial analyses – Recent advances and future direction

Author

Anna F.V. Pintor, Nicolas Ray, Joshua Longbottom, Carlos A. Bravo-Vega, Masoud Yousefi, Kris A. Murray, Dileepa S. Ediriweera, and Peter J. Diggle

Subjects
Snakebite incidence, Envenomings, Neglected tropical diseases, Spatio-temporal epidemiology, Medically relevant snakes, Species distribution models, Toxicology. Poisons, RA1190-1270
Abstract

Venomous snakebite is a neglected tropical disease that annually leads to hundreds of thousands of deaths or long-term physical and mental ailments across the developing world. Insufficient data on spatial variation in snakebite risk, incidence, human vulnerability, and accessibility of medical treatment contribute substantially to ineffective on-ground management. There is an urgent need to collect data, fill knowledge gaps and address on-ground management problems. The use of novel, and transdisciplinary approaches that take advantage of recent advances in spatio-temporal models, ‘big data’, high performance computing, and fine-scale spatial information can add value to snakebite management by strategically improving our understanding and mitigation capacity of snakebite. We review the background and recent advances on the topic of snakebite related geospatial analyses and suggest avenues for priority research that will have practical on-ground applications for snakebite management and mitigation. These include streamlined, targeted data collection on snake distributions, snakebites, envenomings, venom composition, health infrastructure, and antivenom accessibility along with fine-scale models of spatio-temporal variation in snakebite risk and incidence, intraspecific venom variation, and environmental change modifying human exposure. These measures could improve and ‘future-proof’ antivenom production methods, antivenom distribution and stockpiling systems, and human-wildlife conflict management practices, while simultaneously feeding into research on venom evolution, snake taxonomy, ecology, biogeography, and conservation.

Published
2021
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6. Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis

Author

Annie J. Browne, Bahar H. Kashef Hamadani, Emmanuelle A. P. Kumaran, Puja Rao, Joshua Longbottom, Eli Harriss, Catrin E. Moore, Susanna Dunachie, Buddha Basnyat, Stephen Baker, Alan D. Lopez, Nicholas P. J. Day, Simon I. Hay, and Christiane Dolecek

Subjects
Enteric fever, Typhoid fever, Paratyphoid fever, Salmonella Typhi, Salmonella Paratyphi A, Antimicrobial drug resistance, Medicine
Abstract

Abstract Background Antimicrobial resistance (AMR) is an increasing threat to global health. There are > 14 million cases of enteric fever every year and > 135,000 deaths. The disease is primarily controlled by antimicrobial treatment, but this is becoming increasingly difficult due to AMR. Our objectives were to assess the prevalence and geographic distribution of AMR in Salmonella enterica serovars Typhi and Paratyphi A infections globally, to evaluate the extent of the problem, and to facilitate the creation of geospatial maps of AMR prevalence to help targeted public health intervention. Methods We performed a systematic review of the literature by searching seven databases for studies published between 1990 and 2018. We recategorised isolates to allow the analysis of fluoroquinolone resistance trends over the study period. The prevalence of multidrug resistance (MDR) and fluoroquinolone non-susceptibility (FQNS) in individual studies was illustrated by forest plots, and a random effects meta-analysis was performed, stratified by Global Burden of Disease (GBD) region and 5-year time period. Heterogeneity was assessed using the I 2 statistics. We present a descriptive analysis of ceftriaxone and azithromycin resistance. Findings We identified 4557 articles, of which 384, comprising 124,347 isolates (94,616 S. Typhi and 29,731 S. Paratyphi A) met the pre-specified inclusion criteria. The majority (276/384; 72%) of studies were from South Asia; 40 (10%) articles were identified from Sub-Saharan Africa. With the exception of MDR S. Typhi in South Asia, which declined between 1990 and 2018, and MDR S. Paratyphi A, which remained at low levels, resistance trends worsened for all antimicrobials in all regions. We identified several data gaps in Africa and the Middle East. Incomplete reporting of antimicrobial susceptibility testing (AST) and lack of quality assurance were identified. Interpretation Drug-resistant enteric fever is widespread in low- and middle-income countries, and the situation is worsening. It is essential that public health and clinical measures, which include improvements in water quality and sanitation, the deployment of S. Typhi vaccination, and an informed choice of treatment are implemented. However, there is no licenced vaccine for S. Paratyphi A. The standardised reporting of AST data and rollout of external quality control assessment are urgently needed to facilitate evidence-based policy and practice. Trial registration PROSPERO CRD42018029432.

Published
2020
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7. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning.

Author

Elizabeth A Cromwell, Joshua C P Osborne, Thomas R Unnasch, Maria-Gloria Basáñez, Katherine M Gass, Kira A Barbre, Elex Hill, Kimberly B Johnson, Katie M Donkers, Shreya Shirude, Chris A Schmidt, Victor Adekanmbi, Olatunji O Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J Brady, Nicola Luigi Bragazzi, Zahid A Butt, Felix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M A Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zaki, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L Feigin, Eduarda Fernandes, Nataliya A Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj-Mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa de Hidru, Tarig B Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D Ilic, Irena M Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J Krohn, Dian Kusuma, Carlo La Vecchia, Van Charles Lansingh, Paul H Lee, Kate E LeGrand, Shanshan Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah A Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian-Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O Olagunju, Andrew T Olagunju, Ahmed Omar Bali, Obinna E Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S Mohammad Sajadi, Abdallah M Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F Schipp, Amira A Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, Aziz Sheikh, B Suresh Kumar Shetty, Jae Il Shin, K M Shivakumar, Biagio Simonetti, Jasvinder A Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L Thompson, Alan J Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A Uthman, Natalie V S Vinkeles Melchers, Francesco S Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi-Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat-Allah Salah A Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi-Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I Hay, and David M Pigott

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.

Published
2021
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8. Optimising passive surveillance of a neglected tropical disease in the era of elimination: A modelling study.

Author

Joshua Longbottom, Charles Wamboga, Paul R Bessell, Steve J Torr, and Michelle C Stanton

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

BackgroundSurveillance is an essential component of global programs to eliminate infectious diseases and avert epidemics of (re-)emerging diseases. As the numbers of cases decline, costs of treatment and control diminish but those for surveillance remain high even after the 'last' case. Reducing surveillance may risk missing persistent or (re-)emerging foci of disease. Here, we use a simulation-based approach to determine the minimal number of passive surveillance sites required to ensure maximum coverage of a population at-risk (PAR) of an infectious disease.Methodology and principal findingsFor this study, we use Gambian human African trypanosomiasis (g-HAT) in north-western Uganda, a neglected tropical disease (NTD) which has been reduced to historically low levels (95% of a total PAR of ~3million individuals living ≤1h from a diagnostic centre, and we demonstrate an approach to best place these facilities, informing a minimal impact scale back.ConclusionsOur results highlight that surveillance of g-HAT in north-western Uganda can be scaled back without substantially reducing coverage of the PAR. The methodology described can contribute to cost-effective and equable strategies for the surveillance of NTDs and other infectious diseases approaching elimination or (re-)emergence.

Published
2021
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9. Trypa-NO! contributes to the elimination of gambiense human African trypanosomiasis by combining tsetse control with 'screen, diagnose and treat' using innovative tools and strategies.

Author

Joseph Mathu Ndung'u, Alain Boulangé, Albert Picado, Albert Mugenyi, Allan Mortensen, Andrew Hope, Brahim Guihini Mollo, Bruno Bucheton, Charles Wamboga, Charles Waiswa, Dramane Kaba, Enock Matovu, Fabrice Courtin, Gala Garrod, Geoffrey Gimonneau, Georgina V Bingham, Hassane Mahamat Hassane, Inaki Tirados, Isabel Saldanha, Jacques Kabore, Jean-Baptiste Rayaisse, Jean-Mathieu Bart, Jessica Lingley, Johan Esterhuizen, Joshua Longbottom, Justin Pulford, Lingue Kouakou, Lassina Sanogo, Lucas Cunningham, Mamadou Camara, Mathurin Koffi, Michelle Stanton, Mike Lehane, Moise Saa Kagbadouno, Oumou Camara, Paul Bessell, Peka Mallaye, Philippe Solano, Richard Selby, Sophie Dunkley, Steve Torr, Sylvain Biéler, Veerle Lejon, Vincent Jamonneau, Wilfried Yoni, and Zachary Katz

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Published
2020
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10. Mapping geographical inequalities in oral rehydration therapy coverage in low-income and middle-income countries, 2000–17

Author

Kirsten E Wiens, Paulina A Lindstedt, Brigette F Blacker, Kimberly B Johnson, Mathew M Baumann, Lauren E Schaeffer, Hedayat Abbastabar, Sr, Foad Abd-Allah, Ahmed Abdelalim, Ibrahim Abdollahpour, Kedir Hussein Abegaz, Ayenew Negesse Abejie, Lucas Guimarães Abreu, Michael R M Abrigo, Ahmed Abualhasan, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Maryam Adabi, Abdu A Adamu, Oladimeji M Adebayo, Rufus Adesoji Adedoyin, Sr, Victor Adekanmbi, Olatunji O Adetokunboh, Sr, Beyene Meressa Adhena, Mohsen Afarideh, Sohail Ahmad, Keivan Ahmadi, Anwar E Ahmed, Muktar Beshir Ahmed, Rushdia Ahmed, Temesgen Yihunie Akalu, Fares Alahdab, Ziyad Al-Aly, Noore Alam, Sr, Samiah Alam, Genet Melak Alamene, Turki M Alanzi, Jacqueline Elizabeth Alcalde-Rabanal, Beriwan Abdulqadir Ali, Mehran Alijanzadeh, Vahid Alipour, Syed Mohamed Aljunid, Ali Almasi, Sr, Amir Almasi-Hashiani, Hesham M Al-Mekhlafi, Khalid A Altirkawi, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Sr, Arianna Maever L Amit, Sr, Catalina Liliana Andrei, Sr, Mina Anjomshoa, Amir Anoushiravani, Sr, Fereshteh Ansari, Carl Abelardo T Antonio, Benny Antony, Ernoiz Antriyandarti, Jalal Arabloo, Hany Mohamed Amin Aref, Sr, Olatunde Aremu, Bahram Armoon, Amit Arora, Sr, Krishna K Aryal, Afsaneh Arzani, Mehran Asadi-Aliabadi, Hagos Tasew Atalay, Seyyed Shamsadin Athari, Sr, Seyyede Masoume Athari, Sachin R Atre, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Getinet Ayano, Martin Amogre Ayanore, Sr, Yared Asmare Aynalem IV, Samad Azari, Peter S Azzopardi, Ebrahim Babaee, Tesleem Kayode Babalola, Alaa Badawi, Sr, Mohan Bairwa, Shankar M Bakkannavar, Senthilkumar Balakrishnan, Ayele Geleto Bali, Maciej Banach, Sr, Joseph Adel Mattar Banoub, Sr, Aleksandra Barac, Till Winfried Bärnighausen, Huda Basaleem, Sanjay Basu, Vo Dinh Bay, Mohsen Bayati, Estifanos Baye, Neeraj Bedi, Mahya Mahya Beheshti Beheshti, Masoud Behzadifar, Meysam Behzadifar, Bayu Begashaw Bekele, Yaschilal Muche Belayneh, Michellr L Bell, Sr, Derrick A Bennett, Sr, Dessalegn Ajema Berbada, Robert S Bernstein, Anusha Ganapati Bhat, Sr, Krittika Bhattacharyya, Sr, Suraj Bhattarai, Soumyadeep Bhaumik, Zulfiqar A Bhutta, Ali Bijani, Boris Bikbov, Binyam Minuye Birihane IV, Raaj Kishore Biswas, Somayeh Bohlouli, Hunduma Amensisa Amensisa Bojia I, Soufiane Boufous, Oliver J Brady, Nicola Luigi Bragazzi, Andrey Nikolaevich Briko, Nikolay Ivanovich Briko, Gabrielle B Britton, Sharath Burugina Nagaraja, Sr, Reinhard Busse, Sr, Zahid A Butt, Luis LA Alberto Cámera, Sr, Ismael R Campos-Nonato, Sr, Jorge Cano, Josip Car, Rosario Cárdenas, Felix Carvalho, Sr, Carlos A Castañeda-Orjuela, Sr, Franz Castro, Wagaye Fentahun Chanie, Sr, Pranab Chatterjee, Vijay Kumar Chattu, Tesfaye Yitna Yitna Chichiabellu, Jr, Ken Lee Chin, Sr, Devasahayam J Christopher, Dinh-Toi Chu, Natalie Maria Cormier, Vera Marisa Costa, Carlos Culquichicon, Matiwos Soboka Daba, Giovanni Damiani, Sr, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Sr, Jai K Das, Rajat Das Gupta, Aditya Prasad Dash, Gail Davey, Claudio Alberto Dávila-Cervantes, Adrian C Davis, Sr, Dragos Virgil Davitoiu, Fernando Pio De la Hoz, Asmamaw Bizuneh Demis, Dereje Bayissa Demissie, Getu Debalkie Demissie, Gebre Teklemariam Demoz, Sr, Edgar Denova-Gutiérrez, Sr, Kebede Deribe, Sr, Assefa Desalew, Aniruddha Deshpande, Samath Dhamminda Dharmaratne, Preeti Dhillon, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Sr, Isaac Oluwafemi Dipeolu, Shirin Djalalinia, Kerrie E Doyle, Eleonora Dubljanin, Bereket Duko, Andre Rodrigues Duraes, Mohammad Ebrahimi Kalan, Hisham Atan Edinur, Sr, Andem Effiong, Sr, Aziz Eftekhari, Nevine El Nahas, Iman El Sayed, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema I, Hala Rashad Elhabashy, Sr, Shaimaa I El-Jaafary, Hajer Elkout, Aisha Elsharkawy, Iqbal RF Elyazar, Aklilu Endalamaw, Daniel Adane Endalew, Sr, Sharareh Eskandarieh, Alireza Esteghamati, Sadaf Esteghamati, Sr, Arash Etemadi, Oluchi Ezekannagha, Mohammad Fareed, Roghiyeh Faridnia, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Sr, Seyed-Mohammad Fereshtehnejad, Eduarda Fernandes, Irina Filip, Florian Fischer, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Sr, Masoud Foroutan, Richard Charles Franklin, Takeshi Fukumoto, Mohamed M Gad, Reta Tsegaye Gayesa, Teshome Gebre, Sr, Ketema Bizuwork Gebremedhin, Gebreamlak Gebremedhn Gebremeskel, Sr, Hailay Abrha Gesesew, Kebede Embaye Gezae, Keyghobad Ghadiri, Sr, Ahmad Ghashghaee, Pramesh Raj Ghimire, Sr, Paramjit Singh Gill, Sr, Tiffany K Gill, Themba G G Ginindza, Nelson G M Gomes, Sameer Vali Gopalani, Alessandra C Goulart, Bárbara Niegia Garcia Goulart, Ayman Grada, Mohammed Ibrahim Mohialdeen Gubari, Harish Chander Gugnani, Sr, Davide Guido, Rafael Alves Guimarães, Yuming Guo, Sr, Rajeev Gupta, Nima Hafezi-Nejad, Dessalegn H Haile, Sr, Gessessew Bugssa Hailu, Arvin Haj-Mirzaian, Arya Haj-Mirzaian, Randah R Hamadeh, Samer Hamidi, Demelash Woldeyohannes Handiso, Hamidreza Haririan, Sr, Ninuk Hariyani, Ahmed I Hasaballah, Md Mehedi Hasan, Edris Hasanpoor, Amir Hasanzadeh, Hadi Hassankhani, Hamid Yimam Hassen, Mohamed I Hegazy, Behzad Heibati, Behnam Heidari, Delia Hendrie, Sr, Nathaniel J Henry, Claudiu Herteliu, Fatemeh Heydarpour, Hagos Degefa de Hidru I, Thomas R Hird, Chi Linh Hoang, Enayatollah Homaie Rad, Praveen Hoogar, Mohammad Hoseini, Naznin Hossain, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Sr, Guoqing Hu, Mohammedaman Mama Hussen, Segun Emmanuel Ibitoye, Ehimario U Igumbor, Sr, Olayinka Stephen Ilesanmi, Milena D Ilic, Mohammad Hasan Imani-Nasab, Usman Iqbal, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Chinwe Juliana Iwu, Neda Izadi, Sr, Anelisa Jaca, Nader Jahanmehr, Mihajlo Jakovljevic, Amir Jalali, Achala Upendra Jayatilleke, Ravi Prakash Jha, Vivekanand Jha, John S Ji, Sr, Jost B Jonas, Jacek Jerzy Jozwiak, Ali Kabir, Zubair Kabir, Sr, Amaha Kahsay, Hamed Kalani, Tanuj Kanchan, Behzad Karami Matin, André Karch, Mohd Anisul Karim, Hamidreza Karimi-Sari, Surendra Karki, Amir Kasaeian, Gebremicheal Gebreslassie Kasahun, Yawukal chane Kasahun, Habtamu Kebebe Kasaye, Gebrehiwot G Kassa, Getachew Mullu Kassa, Gbenga A Kayode, Ali Kazemi Karyani, Mihiretu M Kebede, Peter Njenga Keiyoro, Abraham Getachew Kelbore, Sr, Andre Pascal Kengne, Sr, Daniel Bekele Ketema, Yousef Saleh Khader, Morteza Abdullatif Khafaie, Nauman Khalid, Rovshan Khalilov, Ejaz Ahmad Khan, Sr, Junaid Khan, Md Nuruzzaman Khan I, Muhammad Shahzeb Khan, Khaled Khatab, Sr, Amir M Khater, Mona M Khater, Maryam Khayamzadeh, Mohammad Khazaei, Salman Khazaei, Mohammad Hossein Khosravi, Jagdish Khubchandani, Ali Kiadaliri, Yun Jin Kim, Ruth W Kimokoti, Adnan Kisa, Sezer Kisa, Niranjan Kissoon, Sr, Shivakumar KM Marulasiddaiah M KMShivakumar, Sr, Sonali Kochhar, Tufa Kolola, Sr, Hamidreza Komaki, Soewarta Kosen, Parvaiz A Koul, Ai Koyanagi, Moritz U G Kraemer, Kewal Krishan, Nuworza Kugbey, G Anil Kumar, Manasi Kumar, Sr, Pushpendra Kumar, Vivek Kumar, Dian Kusuma, Carlo La Vecchia, Ben Lacey, Sheetal D Lad, Dharmesh Kumar Lal, Felix Lam, Faris Hasan Lami, Sr, Prabhat Lamichhane, Van Charles Lansingh, Savita Lasrado, Avula Laxmaiah, Paul H Lee, Sr, Kate E LeGrand, Mostafa Leili, Tsegaye Lolaso Lenjebo, Cheru Tesema Leshargie, Sr, Aubrey J Levine, Shanshan Li, Sr, Shai Linn, Shiwei Liu, Simin Liu, Rakesh Lodha, Joshua Longbottom, Jaifred Christian F Lopez, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, D R Mahadeshwara Prasad, Phetole Walter Mahasha, Sr, Narayan B Mahotra, Azeem Majeed, Reza Malekzadeh, Sr, Deborah Carvalho Malta, Abdullah A Mamun, Sr, Navid Manafi, Sr, Ana Laura Manda, Narendar Dawani Dawanu Manohar, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Joemer C Maravilla, Gabriel Martinez, Sr, Santi Martini, Francisco Rogerlândio Martins-Melo, Anthony Masaka, Benjamin Ballard Massenburg, Manu Raj Mathur, Benjamin K Mayala, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Man Mohan Mehndiratta, Sr, Kala M Mehta, Tefera C Chane Mekonnen, Gebrekiros Gebremichael Meles, Peter T N Memiah, Ziad A Memish, Sr, Walter Mendoza, Ritesh G Menezes, Seid Tiku Mereta, Tuomo J Meretoja, Sr, Tomislav Mestrovic, Bartosz Miazgowski, Kebadnew Mulatu Mihretie, Sr, Ted R Miller, GK Mini, Erkin M Mirrakhimov, Babak Moazen, Bahram Mohajer, Amjad Mohamadi-Bolbanabad, Dara K Mohammad, Karzan Abdulmuhsin Mohammad, Yousef Mohammad, Naser Mohammad Gholi Mezerji, Roghayeh Mohammadibakhsh, Noushin Mohammadifard, Jemal Abdu Mohammed, Sr, Shafiu Mohammed, Farnam Mohebi, Ali H Mokdad, Mariam Molokhia, Lorenzo Monasta, Yoshan Moodley, Sr, Catrin E Moore, Sr, Ghobad Moradi, Masoud Moradi, Mohammad Moradi-Joo, Maziar Moradi-Lakeh, Paula Moraga, Linda Morales, Ilais Moreno Velásquez, Abbas Mosapour, Simin Mouodi, Seyyed Meysam Mousavi, Miliva Mozaffor I, Kindie Fentahun Muchie, Sr, Getahun Fentaw Mulaw, Sr, Sandra B Munro, Moses K Muriithi, Christopher J L Murray, GVS Murthy, Kamarul Imran Musa, Ghulam Mustafa, Sr, Saravanan Muthupandian, Sr, Ashraf F Nabhan, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Kovin S Naidoo, Gurudatta Naik, Farid Najafi, Vinay Nangia, Sr, Jobert Richie Nansseu, Bruno Ramos Nascimento, Sr, Javad Nazari, Duduzile Edith Ndwandwe, Sr, Ionut Negoi, Sr, Henok Biresaw Netsere Netsere, Sr, Josephine W Ngunjiri, Sr, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Dabere Nigatu, Solomon Gedlu Nigatu, Dina Nur Anggraini Ningrum, Chukwudi A Nnaji, Marzieh Nojomi, Vuong Minh Nong, Ole F Norheim, Sr, Jean Jacques Noubiap, Soraya Nouraei Motlagh, Bogdan Oancea, Okechukwu Samuel Ogah, Felix Akpojene Ogbo, In-Hwan Oh, Andrew T Olagunju, Tinuke O Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Sr, Eyal Oren, Doris V V Ortega-Altamirano, Sr, Osayomwanbo Osarenotor, Frank B Osei, Sr, Mayowa O Owolabi, Mahesh P A, Sr, Jagadish Rao Padubidri, Smita Pakhale, Sangram Kishor Patel, Angel J Paternina-Caicedo, Sr, Ashish Pathak, Sr, George C Patton, Deepak Paudel, Sr, Kebreab Paulos, Sr, Veincent Christian Filipino Pepito, Alexandre Pereira, Norberto Perico, Aslam Pervaiz, Julia Moreira Pescarini, Bakhtiar Piroozi, Meghdad Pirsaheb, Maarten J Postma, Hadi Pourjafar, Farshad Pourmalek, Sr, Akram Pourshams, Hossein Poustchi, Sergio I Prada, Sr, Narayan Prasad, Liliana Preotescu, Hedley Quintana, Navid Rabiee, Amir Radfar, Alireza Rafiei, Fakher Rahim, Afarin Rahimi-Movaghar, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Muhammad Aziz Rahman, SHAFIUR Rahman, Fatemeh Rajati, Sr, Saleem Muhammad Rana, Sr, Chhabi Lal Ranabhat, Davide Rasella, David Laith Rawaf, Salman Rawaf, Sr, Lal Rawal, Wasiq Faraz Rawasia, Vishnu Renjith, Andre M N Renzaho, Sr, Serge Resnikoff, Sr, Melese Abate Reta, Negar Rezaei, Mohammad sadegh Rezai, Seyed Mohammad Riahi, Ana Isabel Ribeiro, Jennifer Rickard, Sr, Maria Rios-Blancas, Leonardo Roever, Luca Ronfani, Elias Merdassa Roro, Sr, Jennifer M Ross, Enrico Rubagotti, Salvatore Rubino, Anas M Saad, Yogesh Damodar Sabde, Siamak Sabour, Ehsan Sadeghi, Sr, Yahya Safari, Roya Safari-Faramani, Rajesh Sagar, Amirhossein Sahebkar, Mohammad Ali Sahraian, S Mohammad Sajadi, Mohammad Reza Salahshoor, Nasir Salam, Sr, Payman Salamati, Hosni Salem, Marwa R Rashad Salem I, Yahya Salimi, Hamideh Salimzadeh, Abdallah M Samy, Juan Sanabria, Sr, Milena M Santric-Milicevic, Bruno Piassi Sao Jose, Sivan Yegnanarayana Iyer Saraswathy, Kaushik Sarkar, Sr, Abdur Razzaque Sarker, Nizal Sarrafzadegan I, Benn Sartorius, Brijesh Sathian, Thirunavukkarasu Sathish, Monika Sawhney, Sonia Saxena, Sr, David C Schwebel, Sr, Anbissa Muleta Senbeta IV, Subramanian Senthilkumaran, Sadaf G Sepanlou, Edson Serván-Mori, Sr, Hosein Shabaninejad, Azadeh Shafieesabet, Sr, Masood Ali Shaikh, Ali S Shalash, Sr, Seifadin Ahmed Shallo, Mehran Shams-Beyranvand, MohammadBagher Shamsi, Morteza Shamsizadeh, Mohammed Shannawaz, Kiomars Sharafi, Hamid Sharifi, Hatem Samir Shehata, Sr, Aziz Sheikh, B Suresh Kumar Shetty, Sr, Kenji Shibuya, Sr, Wondimeneh Shibabaw Shiferaw, Sr, Desalegn Markos Shifti, Mika Shigematsu, Jae Il Shin, Rahman Shiri, Sr, Reza Shirkoohi, Soraya Siabani, Tariq Jamal Siddiqi, Diego Augusto Santos Silva, Ambrish Singh, Jasvinder A Singh, Narinder Pal Singh, Virendra Singh, Malede Mequanent Sisay, Eirini Skiadaresi, Mohammad Reza Sobhiyeh, Sr, Anton Sokhan, Shahin Soltani, Ranjani Somayaji, Moslem Soofi, Muluken Bekele Sorrie, Sr, Ireneous N Soyiri, Chandrashekhar T Sreeramareddy, Agus Sudaryanto, Mu'awiyyah Babale Sufiyan, Sr, Hafiz Ansar Rasul Suleria, Marufa Sultana, Bruno Fokas Sunguya, Bryan L Sykes, Rafael Tabarés-Seisdedos, Takahiro Tabuchi, Degena Bahrey Tadesse, Jr, Ingan Ukur Tarigan, Aberash Abay Tasew, Yonatal Mesfin Tefera, Sr, Merhawi Gebremedhin Tekle, Mohamad-Hani Temsah, Berhe Etsay Tesfay I, Fisaha Haile Haile Tesfay, Belay Tessema, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Nihal Thomas, Alemayehu Toma Toma, Sr, Roman Topor-Madry, Marcos Roberto Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Khanh Bao Tran, Irfan Ullah, Bhaskaran Unnikrishnan, Muhammad Shariq Usman, Sr, Benjamin S Chudi Uzochukwu, Sr, Pascual R Valdez, Santosh Varughese, Sr, Francesco S Violante, Sr, Sebastian Vollmer, Sr, Feleke Gebremeskel W/hawariat, Sr, Yasir Waheed, Mitchell Taylor Wallin, Yafeng Wang, Yuan-Pang Wang, Marcia Weaver, Bedilu Girma Weji, Girmay Teklay Weldesamuel, Catherine A Welgan, Andrea Werdecker, Ronny Westerman, Sr, Taweewat Wiangkham, Charles Shey Wiysonge, Sr, Haileab Fekadu Wolde, Sr, Dawit Zewdu Wondafrash, Tewodros Eshete Wonde, Sr, Getasew Taddesse Worku, Sr, Ai-Min Wu, Gelin Xu, Ali Yadollahpour, Seyed Hossein Yahyazadeh Jabbari, Tomohide Yamada, Sr, Hiroshi Yatsuya, Alex Yeshaneh, Christopher Sabo Yilgwan, Mekdes Tigistu Yilma, Paul Yip, Sr, Engida Yisma, Naohiro Yonemoto, Sr, Seok-Jun Yoon, Mustafa Z Younis, Mahmoud Yousefifard, Hebat-Allah Salah A Yousof, Chuanhua Yu, Hasan Yusefzadeh, Siddhesh Zadey, Zoubida Zaidi, Sojib Bin Zaman, Mohammad Zamani, Hamed Zandian, Nejimu Biza Zepro, Taddese Alemu Zerfu, Yunquan Zhang, Xiu-Ju George Zhao, Arash Ziapour, Sanjay Zodpey, Sr, Yves Miel H Zuniga, Simon I Hay, and Robert C Reiner, Jr

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Oral rehydration solution (ORS) is a form of oral rehydration therapy (ORT) for diarrhoea that has the potential to drastically reduce child mortality; yet, according to UNICEF estimates, less than half of children younger than 5 years with diarrhoea in low-income and middle-income countries (LMICs) received ORS in 2016. A variety of recommended home fluids (RHF) exist as alternative forms of ORT; however, it is unclear whether RHF prevent child mortality. Previous studies have shown considerable variation between countries in ORS and RHF use, but subnational variation is unknown. This study aims to produce high-resolution geospatial estimates of relative and absolute coverage of ORS, RHF, and ORT (use of either ORS or RHF) in LMICs. Methods: We used a Bayesian geostatistical model including 15 spatial covariates and data from 385 household surveys across 94 LMICs to estimate annual proportions of children younger than 5 years of age with diarrhoea who received ORS or RHF (or both) on continuous continent-wide surfaces in 2000–17, and aggregated results to policy-relevant administrative units. Additionally, we analysed geographical inequality in coverage across administrative units and estimated the number of diarrhoeal deaths averted by increased coverage over the study period. Uncertainty in the mean coverage estimates was calculated by taking 250 draws from the posterior joint distribution of the model and creating uncertainty intervals (UIs) with the 2·5th and 97·5th percentiles of those 250 draws. Findings: While ORS use among children with diarrhoea increased in some countries from 2000 to 2017, coverage remained below 50% in the majority (62·6%; 12 417 of 19 823) of second administrative-level units and an estimated 6 519 000 children (95% UI 5 254 000–7 733 000) with diarrhoea were not treated with any form of ORT in 2017. Increases in ORS use corresponded with declines in RHF in many locations, resulting in relatively constant overall ORT coverage from 2000 to 2017. Although ORS was uniformly distributed subnationally in some countries, within-country geographical inequalities persisted in others; 11 countries had at least a 50% difference in one of their units compared with the country mean. Increases in ORS use over time were correlated with declines in RHF use and in diarrhoeal mortality in many locations, and an estimated 52 230 diarrhoeal deaths (36 910–68 860) were averted by scaling up of ORS coverage between 2000 and 2017. Finally, we identified key subnational areas in Colombia, Nigeria, and Sudan as examples of where diarrhoeal mortality remains higher than average, while ORS coverage remains lower than average. Interpretation: To our knowledge, this study is the first to produce and map subnational estimates of ORS, RHF, and ORT coverage and attributable child diarrhoeal deaths across LMICs from 2000 to 2017, allowing for tracking progress over time. Our novel results, combined with detailed subnational estimates of diarrhoeal morbidity and mortality, can support subnational needs assessments aimed at furthering policy makers' understanding of within-country disparities. Over 50 years after the discovery that led to this simple, cheap, and life-saving therapy, large gains in reducing mortality could still be made by reducing geographical inequalities in ORS coverage. Funding: Bill & Melinda Gates Foundation.

Published
2020
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11. Quantifying geographic accessibility to improve efficiency of entomological monitoring.

Author

Joshua Longbottom, Ana Krause, Stephen J Torr, and Michelle C Stanton

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

BackgroundVector-borne diseases are important causes of mortality and morbidity in humans and livestock, particularly for poorer communities and countries in the tropics. Large-scale programs against these diseases, for example malaria, dengue and African trypanosomiasis, include vector control, and assessing the impact of this intervention requires frequent and extensive monitoring of disease vector abundance. Such monitoring can be expensive, especially in the later stages of a successful program where numbers of vectors and cases are low.Methodology/principal findingsWe developed a system that allows the identification of monitoring sites where pre-intervention densities of vectors are predicted to be high, and travel cost to sites is low, highlighting the most efficient locations for longitudinal monitoring. Using remotely sensed imagery and an image classification algorithm, we mapped landscape resistance associated with on- and off-road travel for every gridded location (3m and 0.5m grid cells) within Koboko district, Uganda. We combine the accessibility surface with pre-existing estimates of tsetse abundance and propose a stratified sampling approach to determine the most efficient locations for longitudinal data collection. Our modelled predictions were validated against empirical measurements of travel-time and existing maps of road networks. We applied this approach in northern Uganda where a large-scale vector control program is being implemented to control human African trypanosomiasis, a neglected tropical disease (NTD) caused by trypanosomes transmitted by tsetse flies. Our accessibility surfaces indicate a high performance when compared to empirical data, with remote sensing identifying a further ~70% of roads than existing networks.Conclusions/significanceBy integrating such estimates with predictions of tsetse abundance, we propose a methodology to determine the optimal placement of sentinel monitoring sites for evaluating control programme efficacy, moving from a nuanced, ad-hoc approach incorporating intuition, knowledge of vector ecology and local knowledge of geographic accessibility, to a reproducible, quantifiable one.

Published
2020
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12. Malaria Data by District: An open-source web application for increasing access to malaria information [version 2; peer review: 2 approved]

Author

Sean Tomlinson, Andy South, and Joshua Longbottom

Subjects
Medicine, Science
Abstract

Preventable diseases still cause huge mortality in low- and middle-income countries. Research in spatial epidemiology and earth observation is helping academics to understand and prioritise how mortality could be reduced and generates spatial data that are used at a global and national level, to inform disease control policy. These data could also inform operational decision making at a more local level, for example to help officials target efforts at a local/regional level. To be usable for local decision-making, data needs to be presented in a way that is relevant to and understandable by local decision makers. We demonstrate an approach and prototype web application to make spatial outputs from disease modelling more useful for local decision making. Key to our approach is: (1) we focus on a handful of important data layers to maintain simplicity; (2) data are summarised at scales relevant to decision making (administrative units); (3) the application has the ability to rank and compare administrative units; (4) open-source code that can be modified and re-used by others, to target specific user-needs. Our prototype application allows visualisation of a handful of key layers from the Malaria Atlas Project. Data can be summarised by administrative unit for any malaria endemic African country, ranked and compared; e.g. to answer questions such as, ‘does the district with the highest malaria prevalence also have the lowest coverage of insecticide treated nets?’. The application is developed in R and the code is open-source. It would be relatively easy for others to change the source code to incorporate different data layers, administrative boundaries or other data visualisations. We suggest such open-source web application development can facilitate the use of data for public health decision making in low resource settings.

Published
2019
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13. Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

Author

Freya M Shearer, BSc, Joshua Longbottom, MSc, Annie J Browne, MPH, David M Pigott, DPhil, Oliver J Brady, DPhil, Moritz U G Kraemer, DPhil, Fatima Marinho, PhD, Sergio Yactayo, MD, Valdelaine E M de Araújo, PhD, Aglaêr A da Nóbrega, PhD, Nancy Fullman, MPH, Sarah E Ray, BS, Jonathan F Mosser, MD, Jeffrey D Stanaway, PhD, Stephen S Lim, ProfPhD, Robert C Reiner, Jr, PhD, Catherine L Moyes, PhD, Simon I Hay, ProfFMedSci, and Nick Golding, DPhil

Subjects
Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. Methods: We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa). We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Findings: Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the Congo, and South Sudan, where vaccination coverage in 2016 was estimated to be substantially less than the recommended threshold to prevent outbreaks. Overall, we estimated that vaccination coverage levels achieved by 2016 avert between 94 336 and 118 500 cases of yellow fever annually within risk zones, on the basis of conservative and optimistic vaccination scenarios. The areas outside at-risk regions with predicted high receptivity to yellow fever transmission (eg, parts of Malaysia, Indonesia, and Thailand) were less extensive than the distribution of the main urban vector, A aegypti, with low receptivity to yellow fever transmission in southern China, where A aegypti is known to occur. Interpretation: Our results provide the evidence base for targeting vaccination campaigns within risk zones, as well as emphasising their high effectiveness. Our study highlights areas where public health authorities should be most vigilant for potential spread or importation events. Funding: Bill & Melinda Gates Foundation.

Published
2018
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14. Plasmodium vivax Transmission in Africa.

Author

Rosalind E Howes, Robert C Reiner, Katherine E Battle, Joshua Longbottom, Bonnie Mappin, Dariya Ordanovich, Andrew J Tatem, Chris Drakeley, Peter W Gething, Peter A Zimmerman, David L Smith, and Simon I Hay

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Malaria in sub-Saharan Africa has historically been almost exclusively attributed to Plasmodium falciparum (Pf). Current diagnostic and surveillance systems in much of sub-Saharan Africa are not designed to identify or report non-Pf human malaria infections accurately, resulting in a dearth of routine epidemiological data about their significance. The high prevalence of Duffy negativity provided a rationale for excluding the possibility of Plasmodium vivax (Pv) transmission. However, review of varied evidence sources including traveller infections, community prevalence surveys, local clinical case reports, entomological and serological studies contradicts this viewpoint. Here, these data reports are weighted in a unified framework to reflect the strength of evidence of indigenous Pv transmission in terms of diagnostic specificity, size of individual reports and corroboration between evidence sources. Direct evidence was reported from 21 of the 47 malaria-endemic countries studied, while 42 countries were attributed with infections of visiting travellers. Overall, moderate to conclusive evidence of transmission was available from 18 countries, distributed across all parts of the continent. Approximately 86.6 million Duffy positive hosts were at risk of infection in Africa in 2015. Analysis of the mechanisms sustaining Pv transmission across this continent of low frequency of susceptible hosts found that reports of Pv prevalence were consistent with transmission being potentially limited to Duffy positive populations. Finally, reports of apparent Duffy-independent transmission are discussed. While Pv is evidently not a major malaria parasite across most of sub-Saharan Africa, the evidence presented here highlights its widespread low-level endemicity. An increased awareness of Pv as a potential malaria parasite, coupled with policy shifts towards species-specific diagnostics and reporting, will allow a robust assessment of the public health significance of Pv, as well as the other neglected non-Pf parasites, which are currently invisible to most public health authorities in Africa, but which can cause severe clinical illness and require specific control interventions.

Published
2015
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16. Mapping local variation in educational attainment across Africa.

Author

Nicholas Graetz, Joseph Friedman, Aaron Osgood-Zimmerman, Roy Burstein, Molly H. Biehl, Chloe Shields, Jonathan F. Mosser, Daniel C. Casey, Aniruddha Deshpande, Lucas Earl, Robert C. Reiner, Sarah E. Ray, Nancy Fullman, Aubrey J. Levine, Rebecca W. Stubbs, Benjamin K. Mayala, Joshua Longbottom, Annie J. Browne, Samir Bhatt, Daniel J. Weiss, Peter W. Gething, Ali H. Mokdad, Stephen S. Lim, Christopher J. L. Murray, Emmanuela Gakidou, and Simon I. Hay

Published
2018
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17. Estimating the impact of Tiny Targets in reducing the incidence of Gambian sleeping sickness in the North-west Uganda focus

Author

Charles Wamboga, Paul R. Bessell, Michael J. Lehane, Inaki Tirados, Johan Esterhuizen, Joshua Longbottom, Steve J. Torr, Richard Selby, Albert Mugenyi, Andrew Hope, and Charles Waiswa

Subjects
Insecticides, Watershed, Gambian sleeping sickness, Tsetse Flies, Range (biology), Elimination, Trypanosoma brucei gambiense, wa_395, Infectious and parasitic diseases, RC109-216, Biology, Insect Control, wa_110, Tiny Targets, Disease control, wc_705, parasitic diseases, medicine, Animals, Humans, African trypanosomiasis, Uganda, qx_505, Socioeconomics, Tsetse control, qx_4, Incidence (epidemiology), Research, Incidence, Human African trypanosomiasis, Tropical disease, medicine.disease, Insect Vectors, Infectious Diseases, Trypanosomiasis, African, North west, Parasitology, Gambia, Public Health
Abstract

Background Riverine species of tsetse (Glossina) transmit Trypanosoma brucei gambiense, which causes Gambian human African trypanosomiasis (gHAT), a neglected tropical disease. Uganda aims to eliminate gHAT as a public health problem through detection and treatment of human cases and vector control. The latter is being achieved through the deployment of ‘Tiny Targets’, insecticide-impregnated panels of material which attract and kill tsetse. We analysed the spatial and temporal distribution of cases of gHAT in Uganda during the period 2010–2019 to assess whether Tiny Targets have had an impact on disease incidence. Methods To quantify the deployment of Tiny Targets, we mapped the rivers and their associated watersheds in the intervention area. We then categorised each of these on a scale of 0–3 according to whether Tiny Targets were absent (0), present only in neighbouring watersheds (1), present in the watersheds but not all neighbours (2), or present in the watershed and all neighbours (3). We overlaid all cases that were diagnosed between 2000 and 2020 and assessed whether the probability of finding cases in a watershed changed following the deployment of targets. We also estimated the number of cases averted through tsetse control. Results We found that following the deployment of Tiny Targets in a watershed, there were fewer cases of HAT, with a sampled error probability of 0.007. We estimate that during the intervention period 2012–2019 we should have expected 48 cases (95% confidence intervals = 40–57) compared to the 36 cases observed. The results are robust to a range of sensitivity analyses. Conclusions Tiny Targets have reduced the incidence of gHAT by 25% in north-western Uganda. Graphical abstract

Published
2021

18. Estimating the impact of Tiny Targets in reducing the incidence of gambiense sleeping sickness in the North West Uganda focus

Author

Paul Bessell, Johan Esterhuizen, Mike Lehane, Joshua Longbottom, Albert Mugenyi, Richard Selby, Inaki Tirados, Steve J Torr, Charles Waiswa, Charles Wamboga, and Andrew Hope

Abstract

Background Riverine species of tsetse (Glossina) transmit Trypanosoma brucei gambiense which causes Gambian human African trypanosomiasis (gHAT), a neglected tropical disease. Uganda aims to eliminate gHAT as a public health problem through detection and treatment of human cases and vector control. The latter is being achieved through the deployment of ‘Tiny Targets’, insecticide-impregnated panels of material which attract and kill tsetse. We analysed the spatial and temporal distribution of cases of gHAT in Uganda during the period 2010-2019 to assess whether Tiny Targets have had an impact on disease incidence.Methods To quantify the deployment of Tiny Targets, we mapped the rivers and their associated watersheds in the intervention area. We then categorised each of these on a 0-3 scale according to whether Tiny Targets were absent (0), present only in neighbouring watersheds (1), present in the watersheds but not all neighbours (2) or present in the watershed and all neighbours (3). We overlaid all cases that were diagnosed between 2000 and 2020 and assessed whether the probability of finding cases in a watershed changed following the deployment of targets. We also estimated the number of cases averted by tsetse control.Results We found that following the deployment of Tiny Targets in a watershed there are fewer cases of HAT (p=0.007). We estimate that during the intervention period 2012-2019 we should have expected 48 cases (95% confidence intervals = 40-57) compared to the 36 cases observed. The results are robust to a range of sensitivity analyses.Conclusions Tiny Targets have reduced the incidence of gHAT by 25% in North Western Uganda.

Published
2021
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19. Optimising passive surveillance of a neglected tropical disease in the era of elimination: A modelling study

Author

Michelle C. Stanton, Joshua Longbottom, Paul R. Bessell, Charles Wamboga, and Steve J. Torr

Subjects
Epidemiology, RC955-962, Disease, Health Services Accessibility, Geographical Locations, Medical Conditions, wc_705, Arctic medicine. Tropical medicine, Zoonoses, Medicine and Health Sciences, African trypanosomiasis, Uganda, qx_505, wa_105, education.field_of_study, Disease surveillance, Population Health, Neglected Diseases, Primary Prevention, Infectious Diseases, Scale (social sciences), Neglected tropical diseases, Public aspects of medicine, RA1-1270, Research Article, Neglected Tropical Diseases, wc_680, Infectious Disease Control, Population, Disease Surveillance, Trypanosomiasis, Environmental health, Tropical Medicine, medicine, Parasitic Diseases, education, Population Density, Protozoan Infections, business.industry, Public Health, Environmental and Occupational Health, Tropical disease, medicine.disease, Tropical Diseases, Health Care, Trypanosomiasis, African, Infectious disease (medical specialty), Health Care Facilities, Infectious Disease Surveillance, Medical Risk Factors, People and Places, Africa, business
Abstract

Background Surveillance is an essential component of global programs to eliminate infectious diseases and avert epidemics of (re-)emerging diseases. As the numbers of cases decline, costs of treatment and control diminish but those for surveillance remain high even after the ‘last’ case. Reducing surveillance may risk missing persistent or (re-)emerging foci of disease. Here, we use a simulation-based approach to determine the minimal number of passive surveillance sites required to ensure maximum coverage of a population at-risk (PAR) of an infectious disease. Methodology and principal findings For this study, we use Gambian human African trypanosomiasis (g-HAT) in north-western Uganda, a neglected tropical disease (NTD) which has been reduced to historically low levels (95% of a total PAR of ~3million individuals living ≤1h from a diagnostic centre, and we demonstrate an approach to best place these facilities, informing a minimal impact scale back. Conclusions Our results highlight that surveillance of g-HAT in north-western Uganda can be scaled back without substantially reducing coverage of the PAR. The methodology described can contribute to cost-effective and equable strategies for the surveillance of NTDs and other infectious diseases approaching elimination or (re-)emergence., Author summary Disease surveillance systems are an essential component of public health practice and are often considered the first line in averting epidemics for (re-)emerging diseases. Regular evaluation of surveillance systems ensures that they remain operating at maximum efficiency; systems that survey diseases of low incidence, such as those within elimination settings, should be simplified to reduce the reporting burden. A lack of guidance on how to optimise disease surveillance in an elimination setting may result in added expense, and/or the underreporting of disease. Here, we propose a framework methodology to determine systematically the optimal number and placement of surveillance sites for the surveillance of infectious diseases approaching elimination. By utilising estimates of geographic accessibility, through the construction of a resistance surface and a simulation approach, we identify that the number of operational diagnostic facilities for Gambian human African trypanosomiasis in north-western Uganda can be reduced by 70% with a minimal reduction in existing coverage, and identify the minimum number of facilities required to meet coverage targets. Our analysis can be used to inform the number and positioning of surveillance sites for diseases within an elimination setting. Passive surveillance becomes increasingly important as cases decline and active surveillance becomes less cost-effective; methods to evaluate how best to engage this passive surveillance capacity given facility capacity and geographic distribution are pertinent for several NTDs where diagnosis is complex. Not only is this a complicated research area for diseases approaching elimination, a well-designed surveillance system is essential for the detection of emerging diseases, with this work being topical in a climate where emerging pathogens are becoming more commonplace.

Published
2021

20. Addressing the global snakebite crisis with geo-spatial analyses – Recent advances and future direction

Author

Kris A. Murray, Joshua Longbottom, Masoud Yousefi, Peter J. Diggle, Dileepa Senajith Ediriweera, Carlos A. Bravo-Vega, Nicolas Ray, and Anna F.V. Pintor

Subjects
Geospatial analysis, Envenoming, Ecology (disciplines), Antivenom, Big data, Spatio-temporal epidemiology, Medically relevant snakes, Article from A trans-disciplinary view of snakebite envenoming, Edited by: Dr. Rafael Ruiz de Castañeda, Dr. Isabelle Bolon and Dr. Jose Maria Gutiérrez, Toxicology, computer.software_genre, Geo spatial, RA1190-1270, medicine, Species distribution models, Environmental planning, Neglected tropical diseases, ddc:613, ddc:333.7-333.9, business.industry, wa_900, Tropical disease, Snakebite incidence, medicine.disease, GIS, wa_100, Envenomings, Geography, Toxicology. Poisons, Conflict management, business, computer, wd_410
Abstract

Venomous snakebite is a neglected tropical disease that annually leads to hundreds of thousands of deaths or long-term physical and mental ailments across the developing world. Insufficient data on spatial variation in snakebite risk, incidence, human vulnerability, and accessibility of medical treatment contribute substantially to ineffective on-ground management. There is an urgent need to collect data, fill knowledge gaps and address on-ground management problems. The use of novel, and transdisciplinary approaches that take advantage of recent advances in spatio-temporal models, ‘big data’, high performance computing, and fine-scale spatial information can add value to snakebite management by strategically improving our understanding and mitigation capacity of snakebite. We review the background and recent advances on the topic of snakebite related geospatial analyses and suggest avenues for priority research that will have practical on-ground applications for snakebite management and mitigation. These include streamlined, targeted data collection on snake distributions, snakebites, envenomings, venom composition, health infrastructure, and antivenom accessibility along with fine-scale models of spatio-temporal variation in snakebite risk and incidence, intraspecific venom variation, and environmental change modifying human exposure. These measures could improve and ‘future-proof’ antivenom production methods, antivenom distribution and stockpiling systems, and human-wildlife conflict management practices, while simultaneously feeding into research on venom evolution, snake taxonomy, ecology, biogeography, and conservation., Highlights • Many knowledge gaps remain on snake distributions and spatial snakebite variation. • Targeted data collection and high resolution spatial models are needed. • Maps of snake distributions, bite incidence, and vulnerable populations are needed. • Area-specific antivenom delivery requires studies on spatial venom variation. • Human welfare and snake conservation require spatial management of conflict.

Published
2021

21. Modelling the impact of climate change on the distribution and abundance of tsetse in Northern Zimbabwe

Author

Harry S. Gibson, Cyril Caminade, Daniel J. Weiss, Joshua Longbottom, Jennifer S. Lord, and Stephen J. Torr

Subjects
Zimbabwe, 010504 meteorology & atmospheric sciences, Tsetse Flies, Climate Change, Trypanosoma brucei gambiense, 030231 tropical medicine, Population, Population Dynamics, Climate change, Vector Borne Diseases, wa_395, Biology, 01 natural sciences, Weather station, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, 0302 clinical medicine, Abundance (ecology), wc_705, medicine, Animals, Humans, African trypanosomiasis, lcsh:RC109-216, Tsetse, education, Relative species abundance, Abundance estimates, Weather, Sea level, 0105 earth and related environmental sciences, education.field_of_study, qx_4, National park, Research, Elevation, Temperature, Sleeping sickness, medicine.disease, Insect Vectors, Spatial model, Infectious Diseases, Trypanosomiasis, African, Northern zimbabwe, Environmental science, Parasitology, Female, Physical geography, r-HAT
Abstract

Background Climate change is predicted to impact the transmission dynamics of vector-borne diseases. Tsetse flies (Glossina) transmit species of Trypanosoma that cause human and animal African trypanosomiasis. A previous modelling study showed that temperature increases between 1990 and 2017 can explain the observed decline in abundance of tsetse at a single site in the Mana Pools National Park of Zimbabwe. Here, we apply a mechanistic model of tsetse population dynamics to predict how increases in temperature may have changed the distribution and relative abundance of Glossina pallidipes across northern Zimbabwe. Methods Local weather station temperature measurements were previously used to fit the mechanistic model to longitudinal G. pallidipes catch data. To extend the use of the model, we converted MODIS land surface temperature to air temperature, compared the converted temperatures with available weather station data to confirm they aligned, and then re-fitted the mechanistic model using G. pallidipes catch data and air temperature estimates. We projected this fitted model across northern Zimbabwe, using simulations at a 1 km × 1 km spatial resolution, between 2000 to 2016. Results We produced estimates of relative changes in G. pallidipes mortality, larviposition, emergence rates and abundance, for northern Zimbabwe. Our model predicts decreasing tsetse populations within low elevation areas in response to increasing temperature trends during 2000–2016. Conversely, we show that high elevation areas (> 1000 m above sea level), previously considered too cold to sustain tsetse, may now be climatically suitable. Conclusions To our knowledge, the results of this research represent the first regional-scale assessment of temperature related tsetse population dynamics, and the first high spatial-resolution estimates of this metric for northern Zimbabwe. Our results suggest that tsetse abundance may have declined across much of the Zambezi Valley in response to changing climatic conditions during the study period. Future research including empirical studies is planned to improve model accuracy and validate predictions for other field sites in Zimbabwe.

Published
2020

22. A new malaria vector in Africa: predicting the expansion range of Anopheles stephensi and identifying the urban populations at risk

Author

Joshua Longbottom, Catherine L. Moyes, Janet Hemingway, Katherine J. Willis, Samuel Pironon, Neil Massey, and Marianne E. Sinka

Subjects
Male, Plasmodium, Urban Population, Range (biology), wa_395, Mosquito Vectors, Invasive species, invasive species, stomatognathic system, Peninsula, Anopheles, parasitic diseases, Animals, Humans, Socioeconomics, Anopheles stephensi, Ecosystem, qx_4, Multidisciplinary, geography.geographical_feature_category, biology, species distribution model, fungi, Outbreak, Biological Sciences, biology.organism_classification, wc_750, Malaria, Urban malaria, Geography, Habitat, Vector (epidemiology), Africa, qx_515, urban malaria, vector, ensemble modeling, Animal Distribution, Environmental Sciences
Abstract

Significance In 2012, an unusual outbreak of malaria occurred in Djibouti City followed by increasingly severe annual outbreaks. Investigations revealed the presence of an Asian mosquito species; Anopheles stephensi, which thrives in urban environments. An. stephensi has since been identified in Ethiopia and Sudan. By combining data for An. stephensi across its full range (Asia, Arabian Peninsula, Horn of Africa) with spatial models that identify the species’ preferred habitat, we provide evidence-based maps predicting the possible African locations where An. stephensi could establish if allowed to spread. Our results suggest over 126 million people in cities across Africa could be at risk. This supports the WHO’s call for targeted An. stephensi control and prioritized surveillance., In 2012, an unusual outbreak of urban malaria was reported from Djibouti City in the Horn of Africa and increasingly severe outbreaks have been reported annually ever since. Subsequent investigations discovered the presence of an Asian mosquito species; Anopheles stephensi, a species known to thrive in urban environments. Since that first report, An. stephensi has been identified in Ethiopia and Sudan, and this worrying development has prompted the World Health Organization (WHO) to publish a vector alert calling for active mosquito surveillance in the region. Using an up-to-date database of published locational records for An. stephensi across its full range (Asia, Arabian Peninsula, Horn of Africa) and a set of spatial models that identify the environmental conditions that characterize a species’ preferred habitat, we provide evidence-based maps predicting the possible locations across Africa where An. stephensi could establish if allowed to spread unchecked. Unsurprisingly, due to this species’ close association with man-made habitats, our maps predict a high probability of presence within many urban cities across Africa where our estimates suggest that over 126 million people reside. Our results strongly support the WHO’s call for surveillance and targeted vector control and provide a basis for the prioritization of surveillance.

Published
2020

23. Optimising passive surveillance of a neglected tropical disease in the era of elimination: A modelling study

Author

Michelle C. Stanton, Steve J. Torr, Paul R. Bessell, Joshua Longbottom, and Charles Wamboga

Subjects
education.field_of_study, business.industry, Infectious disease (medical specialty), Environmental health, Population, Epidemiological surveillance, Medicine, Tropical disease, African trypanosomiasis, Disease, business, medicine.disease, education
Abstract

BackgroundSurveillance is an essential component of global programs to eliminate infectious diseases and avert epidemics of (re-)emerging diseases. As the numbers of cases decline, costs of treatment and control diminish but those for surveillance remain high even after the ‘last’ case. Reducing surveillance may risk missing persistent or (re-)emerging foci of disease. Here, we use a simulation-based approach to determine the minimal number of passive surveillance sites required to ensure maximum coverage of a population at-risk (PAR) of an infectious disease.Methodology and Principal FindingsFor this study, we use Gambian human African trypanosomiasis (g-HAT) in north-western Uganda, a neglected tropical disease (NTD) which has been reduced to historically low levels (95% of a total PAR of ~3million individuals living ≤1h from a diagnostic centre, and we demonstrate an approach to best place these facilities, informing a minimal impact scale back.ConclusionsOur results highlight that surveillance of g-HAT in north-western Uganda can be scaled back without substantially reducing coverage of the PAR. The methodology described can contribute to cost-effective and equable strategies for the surveillance of NTDs and other infectious diseases approaching elimination or (re-)emergence.Author SummaryDisease surveillance systems are an essential component of public health practice and are often considered the first line in averting epidemics for (re-)emerging diseases. Regular evaluation of surveillance systems ensures that they remain operating at maximum efficiency; systems that survey diseases of low incidence, such as those within elimination settings, should be simplified to reduce the reporting burden. A lack of guidance on how to optimise disease surveillance in an elimination setting may result in added expense, and/or the underreporting of disease. Here, we propose a framework methodology to determine systematically the optimal number and placement of surveillance sites for the surveillance of infectious diseases approaching elimination. By utilising estimates of geographic accessibility, through the construction of a resistance surface and a simulation approach, we identify that the number of operational diagnostic facilities for Gambian human African trypanosomiasis in north-western Uganda can be reduced by 70% with a minimal reduction in existing coverage, and identify the minimum number of facilities required to meet coverage targets. Our analysis can be used to inform the number and positioning of surveillance sites for diseases within an elimination setting. Passive surveillance becomes increasingly important as cases decline and active surveillance becomes less cost-effective; methods to evaluate how best to engage this passive surveillance capacity given facility capacity and geographic distribution are pertinent for several NTDs where diagnosis is complex. Not only is this a complicated research area for diseases approaching elimination, a well-designed surveillance system is essential for the detection of emerging diseases, with this work being topical in a climate where emerging pathogens are becoming more commonplace.

Published
2020
Full Text
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24. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000-17: analysis for the Global Burden of Disease Study 2017

Author

Manisha Dubey, Fatemeh Rajati, Mehran Shams-Beyranvand, Amir Khater, Reza Shirkoohi, Segun Emmanuel Ibitoye, David C. Schwebel, Milena Ilic, Kebede Embaye Gezae, Ali Akbar Fazaeli, Ronny Westerman, Taye Abuhay Zewale, Ravi Mehrotra, Sezer Kisa, Junaid Khan, Jost B. Jonas, Dian Kusuma, Marcel Ausloos, Getnet Gedefaw, Hamed Zandian, Edward J Mills, Aparna Lal, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Jacqueline Elizabeth Alcalde Rabanal, Yousef Veisani, Sharath Burugina Nagaraja, Christopher Troeger, Ismael R. Campos-Nonato, Kidane Tadesse Gebremariam, Maysaa El Sayed Zaki, Oliver J. Brady, David Laith Rawaf, Tamer H. Farag, Simin Mouodi, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Soumyadeep Bhaumik, Samad Azari, Getinet Ayano, Faris Lami, Raaj Kishore Biswas, Maryam Adabi, Alaa Badawi, Saravanan Muthupandian, Amir Hasanzadeh, Martin Amogre Ayanore, Maziar Moradi-Lakeh, Mohamad-Hani Temsah, Kavumpurathu Raman Thankappan, Bineyam Taye, Nader Jafari Balalami, Hamid Yimam Hassen, Karzan Abdulmuhsin Mohammad, Paul H. Lee, Emerito Jose A. Faraon, Kewal Krishan, Muhammad Ali, Ehsan Sadeghi, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Lal B. Rawal, Alyssa N. Sbarra, Behnam Heidari, Dietrich Rothenbacher, Hagos Tasew Atalay, Eric L. Ding, Noushin Mohammadifard, Nihal Thomas, Man Mohan Mehndiratta, Sanghamitra Pati, Addisu Melese, Niranjan Kissoon, Farzad Manafi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Mohammad Reza Sobhiyeh, Frank B. Osei, Koku Sisay Tamirat, Yahya Salimi, Pranab Chatterjee, Gebreamlak Gebremedhn Gebremeskel, Olatunji O. Adetokunboh, Benjamin K. Mayala, Bhaskaran Unnikrishnan, Zahid A Butt, Olufemi Ajumobi, Fiseha Wadilo Wada, Shafiu Mohammed, Charles Shey Shey Wiysonge, Félix Carvalho, Masresha Tessema Anegago, Yun Jin Kim, Ai-Min Wu, Ketema Bizuwork Gebremedhin, Paulina A. Lindstedt, Ana-Laura Manda, Aziz Eftekhari, Rakhi Dandona, Mehdi Fazlzadeh, Nicole Davis Weaver, Muluken Bekele Sorrie, Marwa Rashad Salem, Kassawmar Angaw Bogale, Dongyu Zhang, Saeed Safari, Vivekanand Jha, Keivan Ahmadi, Turki Alanzi, Amir Jalali, Hamidreza Haririan, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Lucas Guimarães Abreu, Gessessew Bugssa Hailu, Surendra Karki, Kirsten E. Wiens, Boikhutso Tlou, Soraya Siabani, Muluken Azage Yenesew, Asnakew Achaw Ayele, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Susanna Dunachie, Marcos Roberto Tovani-Palone, Daniel Bekele Ketema, Tissa Wijeratne, Dessalegn Ajema Berbada, André Karch, Ebrahim Babaee, Akram Pourshams, Seyyed Meysam Mousavi, Bal Govind Chauhan, Giuseppe Remuzzi, Vera Marisa Costa, Mehdi Yaseri, Tahereh Pashaei, Benn Sartorius, Helen Derara Diro, Anelisa Jaca, Mostafa Hosseini, Nikolay Ivanovich Briko, Franz Castro, Cuong Tat Nguyen, Chalachew Genet Akal, Natalie Maria Cormier, Ghulam Mustafa, Sonia Lewycka, Achala Upendra Jayatilleke, David L. Smith, Ibrahim A Khalil, Genet Melak Alamene, George C Patton, Andem Effiong, Gebrekiros Gebremichael Meles, Collins Chansa, Tsegaye Lolaso Lenjebo, Van C. Lansingh, Chabila C Mapoma, Olayinka Stephen Ilesanmi, Aso Mohammad Darwesh, Aubrey J. Levine, Miliva Mozaffor, Till Bärnighausen, Ali Rostami, André Faro, Rushdia Ahmed, Colm McAlinden, Duduzile Ndwandwe, Neeraj Bedi, Irfan Ullah, Winfried März, Rajeev Gupta, Masood Ali Shaikh, Catalina Liliana Andrei, Ali Kazemi Karyani, Shaimaa I. El-Jaafary, Abbas Mosapour, Javad Nazari, Obinna Onwujekwe, Narinder Pal Singh, Dabere Nigatu, Tanuj Kanchan, Jagdish Khubchandani, Aklilu Endalamfaw, Hajer Elkout, Michelle L. Bell, Beyene Meressa Adhena, Evanson Z. Sambala, Nelson Alvis-Guzman, Nefsu Awoke, Mohammad Ali Sahraian, Muki Shey, Christiane Dolecek, Kedir Hussein Abegaz, Syed Ather Hussain, Birhan Tamene Alemnew, Arash Etemadi, Anwar E. Ahmed, Vinay Nangia, Sachin R Atre, Roghiyeh Faridnia, Robert C. Reiner, Rajat Das Gupta, Aniruddha Deshpande, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Muktar Beshir Ahmed, Kiana Ramezanzadeh, Jacek Jerzy Jozwiak, Chi Linh Hoang, Bahram Armoon, Manfred Accrombessi, Christopher J L Murray, Ebrahim M Yimer, Rashmi Gupta, Ahmed Omar Bali, Dadi Marami, Arash Tehrani-Banihashemi, Getnet Mengistu, Govinda Prasad Dhungana, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Ali S. Akanda, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Irina Filip, Mohammad Fareed, Hagos Degefa Hidru, Morteza Shamsizadeh, Mojtaba Hoseini-Ghahfarokhi, Yared A Asmare Aynalem, Gelin Xu, Zubair Kabir, Khalid A Altirkawi, Beatriz Paulina Ayala Quintanilla, Kenean Getaneh Tlaye, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Mika Shigematsu, Bryan L. Sykes, Quique Bassat, Jemal Abdu Mohammed, Seyed Mostafa Mir, Moslem Soofi, Nuruzzaman Khan, Ensiyeh Jenabi, Seyed-Mohammad Fereshtehnejad, Alireza Esteghamati, Paramjit Gill, Nathaniel J Henry, Meghnath Dhimal, Hosein Shabaninejad, Trang Huyen Nguyen, Amjad Mohamadi-Bolbanabad, Eugenio Traini, Mohammad Zamani, Arianna Maever L. Amit, Mehran Alijanzadeh, Florian Fischer, Rafael Moreira Claro, Pushpendra Kumar, Shai Linn, Lucas Earl, Haileab Fekadu Wolde, Getenet Dessie, Doris D. V. Ortega-Altamirano, John S. Ji, Moritz U. G. Kraemer, Saeed Amini, Ziad A. Memish, Aisha Elsharkawy, Ken Lee Chin, Mustafa Z. Younis, Daniel Diaz, Hebat Allah Salah A. Yousof, Seifadin Ahmed Shallo, Tomohide Yamada, Adrian Pana, Salman Rawaf, Amir Almasi-Hashiani, Platon D. Lopukhov, Alireza Rafiei, Dragos Virgil Davitoiu, Hossein Poustchi, Ayele Geleto Bali, Francesco Saverio Violante, Leonardo Roever, Giovanni Damiani, Maha El Tantawi, Nuworza Kugbey, Hadi Pourjafar, Michael R.M. Abrigo, Dinh-Toi Chu, Farkhonde Salehi, Phetole Walter Mahasha, Farnam Mohebi, Sathish Thirunavukkarasu, Dharmesh Kumar Lal, Senbagam Duraisamy, Demelash Woldeyohannes Handiso, Eleonora Dubljanin, Takeshi Fukumoto, Biruck Desalegn Yirsaw, Fakher Rahim, Jasvinder A. Singh, Jai K Das, Savita Lasrado, Ana Isabel Ribeiro, Santosh Varughese, Adnan Kisa, Laurie B. Marczak, Amira Shaheen, Peter Njenga Keiyoro, Nader Jahanmehr, Yuming Guo, Arash Ziapour, Alex Yeshaneh, Ninuk Hariyani, Seyed Sina Naghibi Irvani, Sameer Vali Gopalani, Joel M. Francis, Asmamaw Demis, Ahamarshan Jayaraman Nagarajan, Praveen Hoogar, Nicola Luigi Bragazzi, Yunquan Zhang, Yousef Mohammad, Iman El Sayed, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Marzieh Nojomi, Tewodros Eshete Wonde, Sameh Magdeldin, Anton Sokhan, Nauman Khalid, Nima Hafezi-Nejad, Ben Lacey, Luca Ronfani, James Albright, Senthilkumar Balakrishnan, Ejaz Ahmad Khan, Khanh Bao Tran, Guoqing Hu, Yousef Khader, Parvaneh Mirabi, Boris Bikbov, Feleke Mekonnen Demeke, Assefa Desalew, Yasir Waheed, Berhe Etsay Tesfay, Julio Cesar Campuzano Rincon, Ernoiz Antriyandarti, Brian J. Hall, James A Platts-Mills, Gbenga A. Kayode, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Navid Manafi, Ravi Prakash Jha, Yilma Chisha Dea Geramo, Hamideh Salimzadeh, Fisaha Haile Tesfay, Abdullah Al Mamun, Ali Bijani, Hedley Quintana, Shanshan Li, Kebreab Paulos, Joan B. Soriano, Victor Adekanmbi, Oladimeji Adebayo, David Teye Doku, Brijesh Sathian, Bakhtiar Piroozi, MohammadBagher Shamsi, Netsanet Fentahun, Shymaa Enany, Ayman Grada, Salvatore Rubino, Kenji Shibuya, Norberto Perico, Sergio I. Prada, Andrea Farioli, Gebremicheal Gebreslassie Kasahun, Mohsen Afarideh, Maciej Banach, Andrey Nikolaevich Briko, Mohsen Asadi-Lari, Rakesh Lodha, David M. Pigott, Bárbara Niegia Garcia de Goulart, Hadi Hassankhani, Daniel Adane Endalew, Siamak Sabour, Yoshan Moodley, Preeti Dhillon, Dilaram Acharya, Anas M. Saad, Ibrahim Abdelmageed Ginawi, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Hasan Yusefzadeh, Mohammad Rabiee, Ajay Patle, Rahman Shiri, Girmay Teklay Weldesamuel, Sivan Yegnanarayana Iyer Saraswathy, Mekdes Tigistu Yilma, Davide Guido, Chuanhua Yu, Abdallah M. Samy, Ali Talha Khalil, Ashish Awasthi, Pascual R. Valdez, Nelson G.M. Gomes, Nejimu Biza Zepro, Taweewat Wiangkham, Anthony Masaka, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Krittika Bhattacharyya, Maryam Khayamzadeh, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Farah Daoud, QuynhAnh P Nguyen, Suleman Atique, Sheikh Mohammed Shariful Islam, Indang Trihandini, Mario Poljak, Bartosz Miazgowski, Huda Basaleem, Rafael Alves Guimares, Mina Anjomshoa, Peng Jia, Yafeng Wang, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, Itamar S. Santos, Alireza Khatony, Desalegn Tadese Mengistu, Samath D Dharmaratne, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Shankar M Bakkannavar, Konrad Pesudovs, Tina Beyranvand, Liliana Preotescu, Leticia Avila-Burgos, Enrico Rubagotti, Amira Hamed Darwish, Mahdi Safdarian, Ali Yadollahpour, Vijay Kumar Chattu, Moses K. Muriithi, Azmeraw T. Amare, Si Si, Joshua Longbottom, Somayeh Bohlouli, Khaled Khatab, Masoud Behzadifar, Anusha Ganapati Bhat, G Anil Kumar, Margaret Kosek, Mona M. Khater, Reta Tsegaye Gayesa, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Jalal Arabloo, Kimberly B. Johnson, Andrew T Olagunju, Mowafa Househ, In-Hwan Oh, Arya Haj-Mirzaian, Desta Haftu Hayelom, Jae Il Shin, Ahmed Abdelalim, Catherine A. Welgan, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Rosario Cárdenas, Mohammad Khazaei, Sebastian Vollmer, Xiu-Ju Zhao, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Davide Rasella, Melese Abate Reta, Hedayat Abbastabar, Manu Raj Mathur, Aliasghar Ahmad Kiadaliri, Ritesh G. Menezes, Molly K. Miller-Petrie, Beriwan Abdulqadir Ali, Ahmed I. Hasaballah, Joseph Frostad, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Deborah Carvalho Malta, Brigette F. Blacker, Carlo La Vecchia, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Zewdie Aderaw Alemu, Foad Abd-Allah, Elias Merdassa Roro, Agus Sudaryanto, Fariba Ghassemi, Behzad Karami Matin, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Maheswar Satpathy, Mahesh P A, Carlos Miguel Rios González, Pallab K. Maulik, Amir Kasaeian, Ali H. Mokdad, Alemayehu Toma Mena, Tamirat Tesfaye Dasa, Abdur Razzaque Sarker, Andre M. N. Renzaho, Muhammad Aziz Rahman, Ali Kabir, Josephine W. Ngunjiri, Aberash Abay Tassew, Kala M. Mehta, Ionut Negoi, Hosni Salem, Hesham M. Al-Mekhlafi, Sharareh Eskandarieh, Rufus A. Adedoyin, Saleem M Rana, Engida Yisma, Sahel Valadan Tahbaz, Hossein Farzam, Krishna K. Aryal, Lalit Dandona, Masoud Moradi, Juan Sanabria, Gebre Teklemariam Demoz, Naser Mohammad Gholi Mezerji, Shirin Djalalinia, Suraj Bhattarai, Ammas Siraj Mohammed, Claudiu Herteliu, Dawit Zewdu Wondafrash, Mohsen Bayati, Arvin Haj-Mirzaian, Gulfaraz Khan, Mostafa Leili, Nasir Salam, Ehsan Khodamoradi, Jean Jacques Noubiap, Vahid Alipour, Mohammad Ali Mansournia, Rajesh Sagar, Jagadish Rao Padubidri, Manasi Kumar, Mehdi Sharif, Fatemeh Heydarpour, Navid Rabiee, Gvs Murthy, Hamed Kalani, Mayowa O. Owolabi, Claudio Alberto Davila, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Mathew M. Baumann, Bereket Duko Adema, Lorenzo Monasta, Paul S. F. Yip, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Ibrahim Abdollahpour, Dhirendra N Sinha, Farid Najafi, Kebede Deribe, Paula Moraga, Mehedi Hasan, Mohammad Moradi-Joo, Melkamu Merid Mengesha, Temesgen Yihunie Akalu, Vishnu Renjith, Syed Mohamed Aljunid, Zemenu Tadesse Tessema, Amir Radfar, Nuno Taveira, Masoud Foroutan, Demelash Abewa Elemineh, Chinwe Juliana Iwu, Kamarul Imran Musa, Getaneh Alemu Abebe, Farshad Pourmalek, Olatunde Aremu, Mohammad Reza Salahshoor, Derrick A Bennett, Ahmad Daryani, Alebachew Fasil Ashagre, Apurba Shil, Narayan Bahadur Mahotra, Nelson J. Alvis-Zakzuk, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Naderi, Mehdi Hosseinzadeh, Rovshan Khalilov, Ai Koyanagi, Salman Khazaei, Jennifer Rickard, Ali Almasi, Sandra B. Munro, Carlos Zambrana-Torrelio, Naohiro Yonemoto, Ahmad Ghashghaee, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Diarrhoea, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, GeoHealth, Reiner, Robert C, Wiens, Kirsten E, Deshpande, Aniruddha, Baumann, Mathew M, Adema, Bereket Duko, Yirsaw, Biruck Desalegn, Yisma, Engida, Hay, Simon I, Local Burden of Disease Diarrhoea Collaborators, Tampere University, Health Sciences, University of Helsinki, Institute for Molecular Medicine Finland, Clinicum, HUS Comprehensive Cancer Center, Local Burden of Disease Diarrhoea Collaborator, and Violante FS

Subjects
Low income countries, medicine.medical_treatment, 030204 cardiovascular system & hematology, Global Health, THERAPY, Global Burden of Disease, 0302 clinical medicine, Prevalence, Global health, Medicine, WATER, 030212 general & internal medicine, Children, 11 Medical and Health Sciences, Incidence, Mortality rate, Incidence (epidemiology), 1. No poverty, General Medicine, 3142 Public health care science, environmental and occupational health, Diarrhoea, 3. Good health, Child, Preschool, Middle income countries, A990 Medicine and Dentistry not elsewhere classified, TERRITORIES, Life Sciences & Biomedicine, Infants, Diarrhea, AFRICA, medicine.medical_specialty, Childhood deaths, RJ, sanitation, Developing country, Childhood diarrhoeal morbidity, ITC-HYBRID, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Environmental health, SYSTEMATIC ANALYSIS, Life Science, Humans, Healthcare Disparities, Oral rehydration therapy, Risk factor, hand washing, Developing Countries, Disease burden, Global Nutrition, Wereldvoeding, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, CHOLERA, Public health, Bayes Theorem, diarrheal disease, Local Burden of Disease Diarrhoea Collaborators, ITC-ISI-JOURNAL-ARTICLE, NA, Human medicine, Diarrea, business
Abstract

Background: Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood diarrhoea. Methods: We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor estimates. Findings: The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy coverage. Interpretation: By co-analysing geospatial trends in diarrhoeal burden and its key risk factors, we could assess candidate drivers of subnational death reduction. Further, by doing a counterfactual analysis of the remaining disease burden using key risk factors, we identified potential intervention strategies for vulnerable populations. In view of the demands for limited resources in LMICs, accurately quantifying the burden of diarrhoea and its drivers is important for precision public health. This work was primarily supported by a grant from the Bill & Melinda Gates Foundation (OPP1132415). S Aljunid reports additional funding from the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project outside of the study. A Awasthi is supported by the Department of Science and Technology, Government of India, New Delhi, through the INSPIRE Faculty Program outside of the study. A Badawi reports additional funding from the Public Health Agency of Canada outside of the study. A Barac reports additional funding from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (no III45005) outside of the study. T Bärnighausen reports additional funding by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research outside of the study. F Carvalho and E Fernandez report additional funding from the Portuguese national funds (UID/MULTI/04378/2019 and UID/QUI/50006/2019) outside of the study. V M Costa reports additional funding from Fundação da Ciência e Tecnologia (FCT) for her grant (SFRH/BPD/110001/2015), which was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia, IP, under the Norma Transitória – DL57/2016/CP1334/CT0006 outside of the study. J De Neve reports additional funding from the Alexander von Humboldt Foundation outside of the study. K Deribe reports additional funding from the Wellcome Trust (grant number 201900) as part of his International Intermediate Fellowship outside of the study. D Endalew and M Moradi report additional funding from Wolkite University. M Ausloos, C Herteliu, and A Pana report additional funding from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI (project number PN-III-P4-ID-PCCF-2016-0084) outside of the study. C Herteliu reports additional funding from the European Fund for Regional Development through Operational Program for Competitiveness (Project ID P_40_382) and the European Fund for Regional Development, through InterReg Romania-Hungary (project code EMS ROHU 217) outside of the study. P Hoogar reports additional funding from the Centre for Holistic Development and Research (CHDR), Kalaghatagi and The Department of Studies in Anthropology, Karnatak University, D S Islam reports additional funding from the National Heart Foundation of Australia and the Institute for Physical Activity and Nutrition, Deakin University outside of the study. A Khatony reports additional funding from the Clinical Research Development Center of Imam Reza Hospital in Kermanshah outside of the study. J Khubchandani reports additional funding from Merck Research Laboratories outside of the study. K Krishan reports additional funding from the UGC Center of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India outside of the study. M Kumar reports additional funding from the Fogarty Foundation/NIH through a K43 award (TW010716-01A1) outside of the study. B Lacey reports additional funding from the National Institute for Health Research Oxford Biomedical Research Centre and the British Heart Foundation Centre of Research Excellence (Oxford, UK) outside of the study. A M Samy reports additional funding from the Egyptian Fulbright Mission Program (EFMP) outside of the study. S Seyedmousavi reports additional funding from the Intramural Program of National Institute of Health Clinical Center, Bethesda, MD, USA outside of the study. M Shey reports additional funding from the Wellcome Trust Kenji Shibuya reports additional funding from Japan's Ministry of Health, Labour and Welfare and Japan's Ministry of Education, Culture, Sport, Science and Technology outside of the study. M Sobhiyeh reports additional funding from the Clinical Research Development Center of Imam Reza Hospital, Kermanshah University of Medical Sciences outside of the study. J Soriano reports additional funding from Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain outside of the study. N Taveira reports additional funding from the LIFE study (RIA2016MC-1615) of the European and Developing Countries Clinical Trials Partnership (EDCTP) program supported by the European Union outside of the study. B Unnikrishnan reports additional funding from the Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India outside of the study. T Wijeratne reports additional funding from the Department of Medicine, Faculty of Medicine, University of Rajarata, Saliyapura, Sri Lanka outside of the study. C S Wiysonge reports additional funding from the South African Medical Research Council and the National Research Foundation of South Africa outside of the study.

Published
2020

25. Quantifying geographic accessibility to improve efficiency of entomological monitoring

Author

Ana Krause, Joshua Longbottom, Stephen J. Torr, and Michelle C. Stanton

Subjects
0301 basic medicine, Geographic information system, Computer science, Cost effectiveness, RC955-962, Transportation, Disease Vectors, Dengue fever, Geographical Locations, Mathematical and Statistical Techniques, 0302 clinical medicine, Arctic medicine. Tropical medicine, Zoonoses, Medicine and Health Sciences, Uganda, African trypanosomiasis, 2. Zero hunger, 0303 health sciences, Vector control, Contextual image classification, Statistics, Transportation Infrastructure, Empirical measure, Stratified sampling, 3. Good health, Infectious Diseases, Geography, Physical Sciences, qu_26.5, Costs and Cost Analysis, Neglected tropical diseases, Engineering and Technology, Regression Analysis, Public aspects of medicine, RA1-1270, Cartography, Environmental Monitoring, Research Article, Neglected Tropical Diseases, Trypanosoma, Livestock, Tsetse Flies, Infectious Disease Control, 030231 tropical medicine, Vector Borne Diseases, wa_670, Linear Regression Analysis, Research and Analysis Methods, Models, Biological, Civil Engineering, African Trypanosomiasis, 03 medical and health sciences, Trypanosomiasis, Parasitic Diseases, medicine, Animals, Humans, Statistical Methods, 030304 developmental biology, Models, Statistical, Protozoan Infections, business.industry, Public Health, Environmental and Occupational Health, Biology and Life Sciences, Tropical disease, Tropical Diseases, medicine.disease, Insect Vectors, Roads, Vector-Borne Diseases, Species Interactions, Trypanosomiasis, African, 030104 developmental biology, qx_650, Vector (epidemiology), Remote Sensing Technology, People and Places, Africa, Geographic Information Systems, Pest Control, business, Entomology, Mathematics, Malaria
Abstract

Background Vector-borne diseases are important causes of mortality and morbidity in humans and livestock, particularly for poorer communities and countries in the tropics. Large-scale programs against these diseases, for example malaria, dengue and African trypanosomiasis, include vector control, and assessing the impact of this intervention requires frequent and extensive monitoring of disease vector abundance. Such monitoring can be expensive, especially in the later stages of a successful program where numbers of vectors and cases are low. Methodology/Principal findings We developed a system that allows the identification of monitoring sites where pre-intervention densities of vectors are predicted to be high, and travel cost to sites is low, highlighting the most efficient locations for longitudinal monitoring. Using remotely sensed imagery and an image classification algorithm, we mapped landscape resistance associated with on- and off-road travel for every gridded location (3m and 0.5m grid cells) within Koboko district, Uganda. We combine the accessibility surface with pre-existing estimates of tsetse abundance and propose a stratified sampling approach to determine the most efficient locations for longitudinal data collection. Our modelled predictions were validated against empirical measurements of travel-time and existing maps of road networks. We applied this approach in northern Uganda where a large-scale vector control program is being implemented to control human African trypanosomiasis, a neglected tropical disease (NTD) caused by trypanosomes transmitted by tsetse flies. Our accessibility surfaces indicate a high performance when compared to empirical data, with remote sensing identifying a further ~70% of roads than existing networks. Conclusions/Significance By integrating such estimates with predictions of tsetse abundance, we propose a methodology to determine the optimal placement of sentinel monitoring sites for evaluating control programme efficacy, moving from a nuanced, ad-hoc approach incorporating intuition, knowledge of vector ecology and local knowledge of geographic accessibility, to a reproducible, quantifiable one., Author summary Assessing the impact of vector control programmes requires longitudinal measurements of the abundance of insect vectors within intervention areas. Such monitoring can be expensive, especially in the later stages of a successful program where numbers of vectors and cases of disease are low. Efficient monitoring involves a prior selection of monitoring sites that are easy to reach and produce rich information on vector abundance. Here, we used image classification and cost-distance algorithms to produce estimates of accessibility within Koboko district, Uganda, where vector control is contributing to the elimination of sleeping sickness, a neglected tropical disease (NTD). We combine an accessibility surface with pre-existing estimates of tsetse abundance and propose a stratified sampling approach to determine locations which are associated with low cost (lowest travel time) and potential for longitudinal data collection (high pre-intervention abundance). Our method could be adapted for use in the planning and monitoring of tsetse- and other vector-control programmes. By providing methods to ensure that vector control programmes operate at maximum efficiency, we can ensure that the limited funding associated with some of these NTDs has the largest impact.

Published
2020

26. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Author

Elizabeth A. Cromwell, Joshua C.P. Osborne, Thomas R. Unnasch, María Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Shreya Shirude, Chris A. Schmidt, Victor Adekanmbi, Olatunji O. Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M. Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F. Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A. Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J. Brady, Nicola Luigi Bragazzi, Zahid A. Butt, Félix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M.A. Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zak, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L. Feigin, Eduarda Fernandes, Nataliya A. Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj‐mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa De Hidru, Tarig B. Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D. Ilic, Irena M. Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R. Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A. Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M. Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J. Krohn, Dian Kusuma, Carlo La Vecchia, Charles Lansingh Van, Paul H. Lee, Kate E. Legrand, S. (Shanshan) Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R. Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F. Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O. Olagunju, Andrew T. Olagunju, Ahmed Omar Bali, Obinna E. Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S. Mohammad Sajadi, Abdallah M. Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F. Schipp, Amira A. Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, A (Aziz) Sheikh, B. Suresh Kumar Shetty, Jae Il Shin, K. M. Shivakumar, Biagio Simonetti, Jasvinder A. Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L. Thompson, Alan J. Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A. Uthman, Natalie V.S.Vinkeles Melchers, Francesco S. Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat Allah Salah A. Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I. Hay, David M. Pigott, Elizabeth A. Cromwell, Joshua C.P. Osborne, Thomas R. Unnasch, María Gloria Basáñez, Katherine M. Gass, Kira A. Barbre, Elex Hill, Kimberly B. Johnson, Katie M. Donkers, Shreya Shirude, Chris A. Schmidt, Victor Adekanmbi, Olatunji O. Adetokunboh, Mohsen Afarideh, Ehsan Ahmadpour, Muktar Beshir Ahmed, Temesgen Yihunie Akalu, Ziyad Al-Aly, Fahad Mashhour Alanezi, Turki M. Alanzi, Vahid Alipour, Catalina Liliana Andrei, Fereshteh Ansari, Mustafa Geleto Ansha, Davood Anvari, Seth Christopher Yaw Appiah, Jalal Arabloo, Benjamin F. Arnold, Marcel Ausloos, Martin Amogre Ayanore, Atif Amin Baig, Maciej Banach, Aleksandra Barac, Till Winfried Bärnighausen, Mohsen Bayati, Krittika Bhattacharyya, Zulfiqar A. Bhutta, Sadia Bibi, Ali Bijani, Somayeh Bohlouli, Mahdi Bohluli, Oliver J. Brady, Nicola Luigi Bragazzi, Zahid A. Butt, Félix Carvalho, Souranshu Chatterjee, Vijay Kumar Chattu, Soosanna Kumary Chattu, Natalie Maria Cormier, Saad M.A. Dahlawi, Giovanni Damiani, Farah Daoud, Aso Mohammad Darwesh, Ahmad Daryani, Kebede Deribe, Samath Dhamminda Dharmaratne, Daniel Diaz, Hoa Thi Do, Maysaa El Sayed Zak, Maha El Tantawi, Demelash Abewa Elemineh, Anwar Faraj, Majid Fasihi Harandi, Yousef Fatahi, Valery L. Feigin, Eduarda Fernandes, Nataliya A. Foigt, Masoud Foroutan, Richard Charles Franklin, Mohammed Ibrahim Mohialdeen Gubari, Davide Guido, Yuming Guo, Arvin Haj‐mirzaian, Kanaan Hamagharib Abdullah, Samer Hamidi, Claudiu Herteliu, Hagos Degefa De Hidru, Tarig B. Higazi, Naznin Hossain, Mehdi Hosseinzadeh, Mowafa Househ, Olayinka Stephen Ilesanmi, Milena D. Ilic, Irena M. Ilic, Usman Iqbal, Seyed Sina Naghibi Irvani, Ravi Prakash Jha, Farahnaz Joukar, Jacek Jerzy Jozwiak, Zubair Kabir, Leila R. Kalankesh, Rohollah Kalhor, Behzad Karami Matin, Salah Eddin Karimi, Amir Kasaeian, Taras Kavetskyy, Gbenga A. Kayode, Ali Kazemi Karyani, Abraham Getachew Kelbore, Maryam Keramati, Rovshan Khalilov, Ejaz Ahmad Khan, Md Nuruzzaman Nuruzzaman Khan, Khaled Khatab, Mona M. Khater, Neda Kianipour, Kelemu Tilahun Kibret, Yun Jin Kim, Soewarta Kosen, Kris J. Krohn, Dian Kusuma, Carlo La Vecchia, Charles Lansingh Van, Paul H. Lee, Kate E. Legrand, S. (Shanshan) Li, Joshua Longbottom, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Afshin Maleki, Abdullah Mamun, Ali Manafi, Navid Manafi, Mohammad Ali Mansournia, Francisco Rogerlândio Martins-Melo, Mohsen Mazidi, Colm McAlinden, Birhanu Geta Meharie, Walter Mendoza, Endalkachew Worku Mengesha, Desalegn Tadese Mengistu, Seid Tiku Mereta, Tomislav Mestrovic, Ted R. Miller, Mohammad Miri, Masoud Moghadaszadeh, Abdollah Mohammadian Hafshejani, Reza Mohammadpourhodki, Shafiu Mohammed, Salahuddin Mohammed, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F. Mosser, Mehdi Naderi, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Ionut Negoi, Cuong Tat Nguyen, Huong Lan Thi Nguyen, Trang Huyen Nguyen, Rajan Nikbakhsh, Bogdan Oancea, Tinuke O. Olagunju, Andrew T. Olagunju, Ahmed Omar Bali, Obinna E. Onwujekwe, Adrian Pana, Hadi Pourjafar, Fakher Rahim, Mohammad Hifz Ur Rahman, Priya Rathi, Salman Rawaf, David Laith Rawaf, Reza Rawassizadeh, Serge Resnikoff, Melese Abate Reta, Aziz Rezapour, Enrico Rubagotti, Salvatore Rubino, Ehsan Sadeghi, Abedin Saghafipour, S. Mohammad Sajadi, Abdallah M. Samy, Rodrigo Sarmiento-Suárez, Monika Sawhney, Megan F. Schipp, Amira A. Shaheen, Masood Ali Shaikh, Morteza Shamsizadeh, Kiomars Sharafi, A (Aziz) Sheikh, B. Suresh Kumar Shetty, Jae Il Shin, K. M. Shivakumar, Biagio Simonetti, Jasvinder A. Singh, Eirini Skiadaresi, Amin Soheili, Shahin Soltani, Emma Elizabeth Spurlock, Mu'awiyyah Babale Sufiyan, Takahiro Tabuchi, Leili Tapak, Robert L. Thompson, Alan J. Thomson, Eugenio Traini, Bach Xuan Tran, Irfan Ullah, Saif Ullah, Chigozie Jesse Uneke, Bhaskaran Unnikrishnan, Olalekan A. Uthman, Natalie V.S.Vinkeles Melchers, Francesco S. Violante, Haileab Fekadu Wolde, Tewodros Eshete Wonde, Tomohide Yamada, Sanni Yaya, Vahid Yazdi Feyzabadi, Paul Yip, Naohiro Yonemoto, Hebat Allah Salah A. Yousof, Chuanhua Yu, Yong Yu, Hasan Yusefzadeh, Leila Zaki, Sojib Bin Zaman, Maryam Zamanian, Zhi Jiang Zhang, Yunquan Zhang, Arash Ziapour, Simon I. Hay, and David M. Pigott

Abstract

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0.71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50.2% exceed this threshold for suitability in at least one 5×5-km location. The for

Published
2021
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27. Trypa-NO! contributes to the elimination of gambiense human African trypanosomiasis by combining tsetse control with 'screen, diagnose and treat' using innovative tools and strategies

Author

Paul R. Bessell, Charles Waiswa, Jessica K. Lingley, Joshua Longbottom, Gala Garrod, Zachary Katz, Fabrice Courtin, Allan Mortensen, Hassane Mahamat Hassane, Dramane Kaba, Peka Mallaye, Inaki Tirados, Mathurin Koffi, Philippe Solano, Albert Picado, Moise Kagbadouno, Vincent Jamonneau, Andrew Hope, Wilfried Yoni, Geoffrey Gimonneau, Oumou Camara, Alain Boulangé, Bruno Bucheton, Sylvain Biéler, Enock Matovu, Lassina Sanogo, Michelle C. Stanton, Steve J. Torr, Sophie Dunkley, Jean-Baptiste Rayaissé, Georgina V. Bingham, Isabel Saldanha, Mamadou Camara, Michael J. Lehane, Charles Wamboga, Veerle Lejon, Brahim Guihini Mollo, Johan Esterhuizen, Albert Mugenyi, Justin Pulford, Richard Selby, Lingué Kouakou, Joseph Mathu Ndung'u, Jean-Mathieu Bart, Lucas J. Cunningham, Jacques Kaboré, Interactions hôtes-vecteurs-parasites-environnement dans les maladies tropicales négligées dues aux trypanosomatides (UMR INTERTRYP), Université de Bordeaux (UB)-Institut de Recherche pour le Développement (IRD)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad), Département Systèmes Biologiques (Cirad-BIOS), and Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)

Subjects
Trypanosoma brucei rhodesiense, 0301 basic medicine, Insecticides, Epidemiology, International Cooperation, Trypanosoma brucei gambiense, RC955-962, Antibodies, Protozoan, Disease Vectors, L73 - Maladies des animaux, Geographical Locations, Medical Conditions, 0302 clinical medicine, Glossina palpalis, OUGANDA, Arctic medicine. Tropical medicine, Zoonoses, wc_705, Medicine and Health Sciences, Mass Screening, Uganda, African trypanosomiasis, Trypanosoma brucei, qx_505, Refugees, biology, Transmission (medicine), Trypanosoma gambiense, Contrôle de maladies, Trypanosomose africaine, Integrated approach, 3. Good health, Vecteur de maladie, Infectious Diseases, S50 - Santé humaine, Public aspects of medicine, RA1-1270, L72 - Organismes nuisibles des animaux, Neglected Tropical Diseases, Tsetse control, Chad, Tsetse Flies, Infectious Disease Control, 030231 tropical medicine, wa_395, Insect Control, wa_110, African Trypanosomiasis, 03 medical and health sciences, Trypanosomiasis, parasitic diseases, Parasitic Diseases, medicine, Animals, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, TCHAD, Demography, Protozoan Infections, Éradication des maladies, Policy Platform, Public Health, Environmental and Occupational Health, Tsetse fly, Central africa, Tropical Diseases, biology.organism_classification, medicine.disease, Virology, Cote d'Ivoire, Trypanosomiasis, African, 030104 developmental biology, GUINEE, People and Places, Africa, Guinea, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Gambiense human African trypanosomiasis (g-HAT) is the chronic form of sleeping sickness caused by Trypanosoma brucei gambiense in West and Central Africa, while Trypanosoma brucei rhodesiense causes an acute form in eastern Africa. g-HAT is targeted for elimination as a public health problem by 2020 and 0 transmission by 2030 [1,2]. Control of g-HAT is largely based on identification and treatment of infected individuals, supplemented by control of the tsetse fly vectors [3]. There has been growing evidence that when both tsetse control and case identification activities are carried out simultaneously in the same geographies, elimination of the disease is accelerated [4–6]. Here, we describe how the Trypa-NO! Partnership is using novel and classical tools to drive g-HAT elimination in an integrated approach, progress made, lessons learnt, and future directions.

Published
2020
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28. Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Author

Mohsen Bayati, Arvin Haj-Mirzaian, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Nasir Salam, Mohamad-Hani Temsah, Fatemeh Heydarpour, Davide Rasella, Kavumpurathu Raman Thankappan, Ghulam Mustafa, Sergey Konstantinovitch Vladimirov, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Leonardo Roever, Oghenowede Eyawo, Koustuv Dalal, Ana-Laura Manda, Ritesh G. Menezes, Molly K. Miller-Petrie, Javad Yoosefi Lebni, Gebreamlak Gebremedhn Gebremeskel, Aziz Eftekhari, Oleguer Plana-Ripoll, Jon Wakefield, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Edris Hasanpoor, Brijesh Sathian, Kala M. Mehta, Moritz U. G. Kraemer, Saeed Amini, Hesham M. Al-Mekhlafi, Abbas Yadegar, João Pedro Silva, Desmond Kuupiel, Anvar Asadi, Hamid Sharifi, Ebrahim Babaee, Dessalegn Ajema Berbada, Taddese Alemu Zerfu, Ian Davis, Mostafa Qorbani, Fatemeh Rajati, Samer Hamidi, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Syed Mohamed Aljunid, Elias Merdassa Roro, Mihaela Hostiuc, Robert S. Bernstein, Vahid Yazdi-Feyzabadi, Gebre Teklemariam Demoz, Irina Filip, Mu'awiyyah Babale Sufiyan, Amir Khater, Lidia Morawska, Sangram Kishor Patel, Robert C. Reiner, Joshua O. Akinyemi, Telma Zahirian Moghadam, Ali Akbar Fazaeli, Reza Malekzadeh, Olatunde Aremu, Mohammad Reza Salahshoor, Irfan Ullah, Gabrielle B. Britton, Gelin Xu, Nathaniel J Henry, Thomas R. Hird, Ronny Westerman, Vera Marisa Costa, Reza Assadi, Tiffany K. Gill, Chhabi Lal Ranabhat, Meysam Olfatifar, Sezer Kisa, Grant Rodgers Kemp, Mahmoud Yousefifard, Aleksandra Barac, Simon I. Hay, Walter Mendoza, Mohammad Zamani, Nader Jafari Balalami, Mahdi Safdarian, Manfred S. Green, Mahesh P A, Nahid Neamati, Pallab K. Maulik, Ali H. Mokdad, Joshua Longbottom, Somayeh Bohlouli, Ahmad Daryani, Ibrahim Abdollahpour, Mostafa Hosseini, Deborah Carvalho Malta, Nick Golding, Sheikh Mohammed Shariful Islam, Shirin Nosratnejad, Haidong Wang, Shadi Rahimzadeh, Pushpendra Kumar, Mehdi Noroozi, Andre M. N. Renzaho, Brent Bell, Huong Lan Thi Nguyen, Khaled Khatab, Meghdad Pirsaheb, Yousef Veisani, Katie R Nielsen, Ionut Negoi, Seyyed Meysam Mousavi, Amir Ashraf-Ganjouei, Mohammad Hassan Emamian, Joseph L Ward, Sharath Burugina Nagaraja, Songhomitra Panda-Jonas, Ettore Beghi, Azeem Majeed, Ivy Shiue, Delia Hendrie, Roghiyeh Faridnia, Seyed Mostafa Mir, Moslem Soofi, Ghobad Moradi, Mahsa Ghajarzadeh, Chandrashekhar T Sreeramareddy, Milad Hasankhani, Mohamed I Hegazy, Mika Shigematsu, Bryan L. Sykes, Vahid Alipour, Ruth W Kimokoti, Afshin Maleki, Nafiseh Baheiraei, Noore Alam, Jalal Arabloo, Mariam Molokhia, Kimberly B. Johnson, Amber Sligar, Nicole Davis Weaver, Kerem Shuval, Malede Mequanent Sisay, Paul H. Lee, Reza Ghadimi, Mahbobeh Faramarzi, Natalia V. Bhattacharjee, Ehsan Sadeghi, Brandon V. Pickering, Animika Pandey, Ana Isabel Ribeiro, Felix Greaves, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Yun Jin Kim, Agus Sudaryanto, Hebat Allah Salah A. Yousof, Hadi Pourjafar, Tomohide Yamada, Alireza Rafiei, Rosario Cárdenas, Mohammad Khazaei, Hasan Yusefzadeh, Rahman Shiri, Girmay Teklay Weldesamuel, Zahra Jorjoran Shushtari, Michael Collison, Stanislav S. Otstavnov, Narayanaswamy Venketasubramanian, Yahya Salimi, Naohiro Yonemoto, Ahmad Ghashghaee, Soewarta Kosen, Al Artaman, Surendra Karki, Tariq Jamal Siddiqi, Lorenzo Monasta, Amit Arora, Christopher S Yilgwan, Ahamarshan Jayaraman Nagarajan, Adnan Kisa, Gholamreza Roshandel, Vahid Rashedi, Daniel Diaz, Amir Vahedian-Azimi, Erkin M. Mirrakhimov, Nuworza Kugbey, Zohreh Arefi, Benjamin B. Massenburg, Robert G. Weintraub, Lauren E. Schaeffer, Alexandre C. Pereira, Mehdi Hosseinzadeh, Milena M Santric Milicevic, Ai Koyanagi, Mehran Shams-Beyranvand, Salman Khazaei, Olalekan A. Uthman, Mohamed Hsairi, Nuno Taveira, Masoud Foroutan, Jayendra Sharma, Hanna Demelash Desyibelew, Max Roser, Keivan Ahmadi, Yousef Khader, Hamideh Salimzadeh, Ali Bijani, Shanshan Li, Mehran Alijanzadeh, Florian Fischer, Aziz Sheikh, Eun-Kee Park, Stefan Listl, Smita Pakhale, Brian J. Hall, Alireza Zangeneh, Ravi Mehrotra, Kidu Gidey Weldegwergs, Mahdi Afshari, Son Hoang Nguyen, Francisco Rogerlândio Martins-Melo, Rupak Desai, Aziz Rezapour, Hassan Magdy Abd El Razek, Gillian I. Hollerich, Reza Saeedi, Iman El Sayed, Olayinka Stephen Ilesanmi, Ben Lacey, Soheil Ebrahimpour, Laura Dwyer-Lindgren, Roya Ebrahimi, Bolajoko O. Olusanya, Tommi Vasankari, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Job F M van Boven, Nataliya Foigt, Mojtaba Hoseini-Ghahfarokhi, Saleh Salehi Zahabi, Mehdi Fazlzadeh, Neeraj Bedi, Hamed Mirjalali, Payman Salamati, P N Sylaja, Ted R. Miller, George J. Milne, Alaa Badawi, Muhammad Usman, Amir Hasanzadeh, Michelle L. Bell, Giang Thu Vu, Masoud Behzadifar, Manasi Kumar, Mona M. Khater, Josip Car, Nafis Sadat, Mostafa Leili, Mehdi Sharif, Hadi Hassankhani, Mowafa Househ, Joshua A. Salomon, Morteza Mansourian, G Anil Kumar, João C. Fernandes, Tufa Kolola, Arya Haj-Mirzaian, Masood Ali Shaikh, Keyghobad Ghadiri, Andrew T Olagunju, Bahram Armoon, Beatriz Paulina Ayala Quintanilla, Samantha Perkins, Mohsen Mazidi, Stefan Lorkowski, Sagnik Dey, Edward J Mills, Ali Kabir, Maryam Khazaei-Pool, Mohammad Rabiee, Arianna Maever L. Amit, John S. Ji, Sivan Yegnanarayana Iyer Saraswathy, Fares Alahdab, Vafa Rahimi-Movaghar, Martin McKee, Hadi Parsian, Ejaz Ahmad Khan, Amirhossein Sahebkar, Paramjit Gill, Dara K. Mohammad, Naznin Hossain, Karen M. Tabb, Annie J. Browne, Abdallah M. Samy, Elham Ehsani-Chimeh, Nelson G.M. Gomes, Destallem Gebremedhin Gebre, Fakher Rahim, Sheetal D. Lad, Rajat Das Gupta, Yash Jobanputra, Rajesh Sharma, Davoud Adham, Richard Ofori-Asenso, Farah Daoud, Aso Mohammad Darwesh, Meghnath Dhimal, Pranab Chatterjee, Javad Javidnia, Shafiu Mohammed, Amir Abdoli, Josep Maria Haro, Stefanie Watson, Behnam Nabavizadeh, Masoumeh Abbasi, Kefyalew Addis Alene, Marzieh Nojomi, G. K. Mini, Abbas Mosapour, Cyrus Cooper, Yirga Legesse Nirayo, Jagdish Khubchandani, Muhammed Magdy Abd El Razek, Faramarz Shaahmadi, Satar Rezaei, Mahdi Sharif-Alhoseini, Francesco Saverio Violante, Eyal Oren, Erfan Zabeh, Atte Meretoja, Nicholas Graetz, Kris J. Krohn, Anthony Masaka, Oladimeji Adebayo, Mikk Jürisson, Faris Lami, Marcos Roberto Tovani-Palone, Chloe Shields, Yahya Safari, Yasir Waheed, Dilaram Acharya, Seyed Mohammad Riahi, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Alberto Ortiz, Samad Azari, Shymaa Enany, Maha Ezalarab, Salvatore Rubino, Enayatollah Homaie Rad, Roghayeh Khabiri, Seyed-Mohammad Fereshtehnejad, Yuming Guo, Sonia Saxena, Nicholas J K Breitborde, Takeshi Fukumoto, Hamid Yimam Hassen, Thomas Pilgrim, Yasser Vasseghian, Dragos Virgil Davitoiu, Farid Najafi, Sathish Thirunavukkarasu, Ali Rostami, Efat Mohamadi, Sameh Magdeldin, Hedley Quintana, Cyrus Alinia, Rodrigo Sarmiento-Suarez, Roya Safari-Faramani, Leila Doshmangir, Kewal Krishan, Karen Sliwa, Nazrul Islam, Neal Marquez, Genet Melak Alamene, Andem Effiong, Khanh Bao Tran, Amir Kasaeian, Adeladza Kofi Amegah, Hamidreza Haririan, Maha El Tantawi, Anders Larsson, André Faro, Rushdia Ahmed, Amir Shamshirian, Josephine W. Ngunjiri, Yousef Moradi, Sharareh Eskandarieh, Evanson Z. Sambala, Nelson Alvis-Guzman, Mehdi Moradinazar, Lauren Woyczynski, Parul Puri, Yunquan Zhang, Navid Manafi, Vinay Nangia, Joan B. Soriano, Victor Adekanmbi, Sofia Androudi, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Netsanet Fentahun, Achala Upendra Jayatilleke, David L. Smith, Solomon Sisay, Giuseppe Gorini, Meysam Behzadifar, Charles Shey Wiysonge, Bach Xuan Tran, Lal B. Rawal, Arefeh Babazadeh, Damaris K. Kinyoki, Morteza Shamsizadeh, Ziad El-Khatib, Zohreh Anbari, Abdol Sattar Pagheh, Ranjani Somayaji, Frank B. Osei, Nancy Fullman, Zahid A Butt, Ai-Min Wu, Tahereh Pashaei, Benn Sartorius, Aaron Osgood-Zimmerman, Sachin R Atre, Mehdi Ahmadi, Chalachew Genet Akal, Aubrey J. Levine, Mohammad Fareed, Quique Bassat, Khalid A Altirkawi, Ensiyeh Jenabi, Daem Roshani, Mina Anjomshoa, Jasvinder A. Singh, Yafeng Wang, Samath D Dharmaratne, Enrico Rubagotti, Ruxandra Irina Negoi, Reinhard Busse, Abdullah Al Mamun, Yoshan Moodley, Mohammed Almalki, Peter W. Gething, Alireza Khatony, Usman Iqbal, Soraya Nouraei Motlagh, Roy Burstein, Hamed Zandian, Rakhi Dandona, Mojtaba Bagherzadeh, Majid Pirestani, Jaifred Christian F. Lopez, Chuanhua Yu, Arash Ziapour, Seyed Sina Naghibi Irvani, Bárbara Niegia Garcia Goulart, Pascual R. Valdez, Amir Jalali, Chukwudi A Nnaji, Kelechi Elizabeth Oladimeji, Tomislav Mestrovic, Isidora S. Vujcic, Osayomwanbo Osarenotor, Azin Nahvijou, Chi Linh Hoang, Christopher J L Murray, Mustafa Z. Younis, Veincent Christian Filipino Pepito, Andre Rodrigues Duraes, Yuan-Pang Wang, Felix Akpojene Ogbo, Aniruddha Deshpande, Nicholas J Kassebaum, Jacek Jerzy Jozwiak, Soghra Bagheri, Paul S. F. Yip, Sree Bhushan Raju, Sadaf G. Sepanlou, Kebede Deribe, Junaid Khan, Mohammad Aghaali, Lalit Dandona, Masoud Moradi, Molly R Nixon, Bruno Piassi Sao Jose, Atalay Goshu Muluneh, Mohammad Hasan Imani-Nasab, Naser Mohammad Gholi Mezerji, Abdullah Sulieman Terkawi, Sojib Bin Zaman, Muhammad Shahzeb Khan, Maysaa El Sayed Zaki, Gebrekiros Gebremichael Meles, Suraj Bhattarai, Yared Belete Belay, Ammas Siraj Mohammed, Dawit Zewdu Wondafrash, Abbas Balouchi, Silvano Gallus, Mohammad Abdollahi, Long Hoang Nguyen, Zulfiqar A Bhutta, Jean Jacques Noubiap, Mehdi Naderi, Bernhard T. Baune, Lucas Earl, Doris D. V. Ortega-Altamirano, Michael R.M. Abrigo, Farkhonde Salehi, Hamed Kalani, Mayowa O. Owolabi, Feleke Mekonnen Demeke, Lee Ling Lim, Ulrich O Mueller, Laurie B. Marczak, Peter Njenga Keiyoro, Ehsan Ahmadpour, Navid Rabiee, Dinh-Toi Chu, Vasily Vlassov, Bradford D Gessner, Tsegaye Tewelde Gebrehiwot, Sorin Hostiuc, Bakhtiar Piroozi, Mahdieh Abbasalizad-Farhangi, Takahiro Tabuchi, Philimon Gona, Bahar Ataeinia, Azra Ramezankhani, Duduzile Ndwandwe, Obinna Onwujekwe, Zohreh Rahimi, Seyedmojtaba Seyedmousavi, Wagaye Fentahun Chanie, Neda Kianipour, Rizwan Suliankatchi Abdulkader, Dhirendra N Sinha, Young-Ho Khang, Paula Moraga, Manoochehr Karami, Solomon Olum, Rafael Tabarés-Seisdedos, Zemenu Tadesse Tessema, Amir Radfar, Kiomars Sharafi, Rohollah Kalhor, Benjamin K. Mayala, Mahmood Moosazadeh, David C. Schwebel, Jost B. Jonas, Quyen G. To, Ester Cerin, Martin Amogre Ayanore, Value, Affordability and Sustainability (VALUE), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Groningen Research Institute for Asthma and COPD (GRIAC), Veritati - Repositório Institucional da Universidade Católica Portuguesa, Department of Earth Observation Science, Faculty of Geo-Information Science and Earth Observation, UT-I-ITC-ACQUAL, GeoHealth, HUS Neurocenter, Department of Neurosciences, Neurologian yksikkö, Clinicum, HUS Comprehensive Cancer Center, Staff Services, Department of Surgery, University of Helsinki, Islam, Nazrul [0000-0003-3982-4325], Apollo - University of Cambridge Repository, Burstein R., Henry N.J., Collison M.L., Marczak L.B., Sligar A., Watson S., Marquez N., Abbasalizad-Farhangi M., Abbasi M., Abd-Allah F., Abdoli A., Abdollahi M., Abdollahpour I., Abdulkader R.S., Abrigo M.R.M., Acharya D., Adebayo O.M., Adekanmbi V., Adham D., Afshari M., Aghaali M., Ahmadi K., Ahmadi M., 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Koyanagi A., Kraemer M.U.G., Krishan K., Krohn K.J., Kugbey N., Kumar G.A., Kumar M., Kumar P., Kuupiel D., Lacey B., Lad S.D., Lami F.H., Larsson A.O., Lee P.H., Leili M., Levine A.J., Li S., Lim L.-L., Listl S., Longbottom J., Lopez J.C.F., Lorkowski S., Magdeldin S., Abd El Razek H.M., Abd El Razek M.M., Majeed A., Maleki A., Malekzadeh R., Malta D.C., Mamun A.A., Manafi N., Manda A.-L., Mansourian M., Martins-Melo F.R., Masaka A., Massenburg B.B., Maulik P.K., Mayala B.K., Mazidi M., McKee M., Mehrotra R., Mehta K.M., Meles G.G., Mendoza W., Menezes R.G., Meretoja A., Meretoja T.J., Mestrovic T., Miller T.R., Miller-Petrie M.K., Mills E.J., Milne G.J., Mini G.K., Mir S.M., Mirjalali H., Mirrakhimov E.M., Mohamadi E., Mohammad D.K., Darwesh A.M., Mezerji N.M.G., Mohammed A.S., Mohammed S., Mokdad A.H., Molokhia M., Monasta L., Moodley Y., Moosazadeh M., Moradi G., Moradi M., Moradi Y., Moradi-Lakeh M., Moradinazar M., Moraga P., Morawska L., Mosapour A., Mousavi S.M., Mueller U.O., Muluneh A.G., Mustafa G., Nabavizadeh B., Naderi M., Nagarajan A.J., Nahvijou A., Najafi F., Nangia V., Ndwandwe D.E., Neamati N., Negoi I., Negoi R.I., Ngunjiri J.W., Thi Nguyen H.L., Nguyen L.H., Nguyen S.H., Nielsen K.R., Ningrum D.N.A., Nirayo Y.L., Nixon M.R., Nnaji C.A., Nojomi M., Noroozi M., Nosratnejad S., Noubiap J.J., Motlagh S.N., Ofori-Asenso R., Ogbo F.A., Oladimeji K.E., Olagunju A.T., Olfatifar M., Olum S., Olusanya B.O., Oluwasanu M.M., Onwujekwe O.E., Oren E., Ortega-Altamirano D.D.V., Ortiz A., Osarenotor O., Osei F.B., Osgood-Zimmerman A.E., Otstavnov S.S., Owolabi M.O., Mahesh P.A., Pagheh A.S., Pakhale S., Panda-Jonas S., Pandey A., Park E.-K., Parsian H., Pashaei T., Patel S.K., Pepito V.C.F., Pereira A., Perkins S., Pickering B.V., Pilgrim T., Pirestani M., Piroozi B., Pirsaheb M., Plana-Ripoll O., Pourjafar H., Puri P., Qorbani M., Quintana H., Rabiee M., Rabiee N., Radfar A., Rafiei A., Rahim F., Rahimi Z., Rahimi-Movaghar V., Rahimzadeh S., Rajati F., Raju S.B., Ramezankhani A., Ranabhat C.L., Rasella D., Rashedi V., Rawal L., Reiner Jr R.C., Renzaho A.M.N., Rezaei S., Rezapour A., Riahi S.M., Ribeiro A.I., Roever L., Roro E.M., Roser M., Roshandel G., Roshani D., Rostami A., Rubagotti E., Rubino S., Sabour S., Sadat N., Sadeghi E., Saeedi R., Safari Y., Safari-Faramani R., Safdarian M., Sahebkar A., Salahshoor M.R., Salam N., Salamati P., Salehi F., Zahabi S.S., Salimi Y., Salimzadeh H., Salomon J.A., Sambala E.Z., Samy A.M., Santric Milicevic M.M., Jose B.P.S., Saraswathy S.Y.I., Sarmiento-Suarez R., Sartorius B., Sathian B., Saxena S., Sbarra A.N., Schaeffer L.E., Schwebel D.C., Sepanlou S.G., Seyedmousavi S., Shaahmadi F., Shaikh M.A., Shams-Beyranvand M., Shamshirian A., Shamsizadeh M., Sharafi K., Sharif M., Sharif-Alhoseini M., Sharifi H., Sharma J., Sharma R., Sheikh A., Shields C., Shigematsu M., Shiri R., Shiue I., Shuval K., Siddiqi T.J., Silva J.P., Singh J.A., Sinha D.N., Sisay M.M., Sisay S., Sliwa K., Smith D.L., Somayaji R., Soofi M., Soriano J.B., Sreeramareddy C.T., Sudaryanto A., Sufiyan M.B., Sykes B.L., Sylaja P.N., Tabares-Seisdedos R., Tabb K.M., Tabuchi T., Taveira N., Temsah M.-H., Terkawi A.S., Tessema Z.T., Thankappan K.R., Thirunavukkarasu S., To Q.G., Tovani-Palone M.R., Tran B.X., Tran K.B., Ullah I., Usman M.S., Uthman O.A., Vahedian-Azimi A., Valdez P.R., van Boven J.F.M., Vasankari T.J., Vasseghian Y., Veisani Y., Venketasubramanian N., Violante F.S., Vladimirov S.K., Vlassov V., Vos T., Vu G.T., Vujcic I.S., Waheed Y., Wakefield J., Wang H., Wang Y., Wang Y.-P., Ward J.L., Weintraub R.G., Weldegwergs K.G., Weldesamuel G.T., Westerman R., Wiysonge C.S., Wondafrash D.Z., Woyczynski L., Wu A.-M., Xu G., Yadegar A., Yamada T., Yazdi-Feyzabadi V., Yilgwan C.S., Yip P., Yonemoto N., Lebni J.Y., Younis M.Z., Yousefifard M., Yousof H.-A.S.A., Yu C., Yusefzadeh H., Zabeh E., Moghadam T.Z., Bin Zaman S., Zamani M., Zandian H., Zangeneh A., Zerfu T.A., Zhang Y., Ziapour A., Zodpey S., Murray C.J.L., and Hay S.I.

Subjects
Survival, RJ101, Mortalidad Infantil, HB, UNDER-5 MORTALITY, Global Health, Pediatrics, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Child death, Infant Mortality, Epidemiology, Global health, Middle income country, Nacimiento vivo, 030212 general & internal medicine, 10. No inequality, Child, POPULATION, Developing world, education.field_of_study, Public health, Multidisciplinary, Geography, Mortality rate, wa_900, 1. No poverty, SUCCESS, Pediatrik, A900 Others in Medicine and Dentistry, 3142 Public health care science, environmental and occupational health, 3. Good health, Child Mortality, Death children, VACCINATION, HEALTH, ws_100, INTERVENTIONS, AFRICA, medicine.medical_specialty, United Nations, General Science & Technology, 030231 tropical medicine, Population, Developing country, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], ITC-HYBRID, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Social Justice, Recién nacido, Neonatal deaths, medicine, SYSTEMATIC ANALYSIS, Organizational Objectives, Humans, education, Developing Countries, business.industry, Infant, Newborn, Infant, CIVIL REGISTRATION, Paediatrics, Child survival, Newborn, PREVENTION, Infant mortality, wa_320, ws_200, Child mortality, Socioeconomic Factors, ITC-ISI-JOURNAL-ARTICLE, Human medicine, Paediatrics, Public health, Developing world, business, Demography
Abstract

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations., A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.

Published
2019
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29. Predicting the environmental suitability for onchocerciasis in Africa as an aid to elimination planning

Author

Fereshteh Ansari, Richard C. Franklin, Naznin Hossain, Rodrigo Sarmiento-Suárez, Mahdi Bohluli, Irena Ilic, Anwar Faraj, Soosanna Kumary Chattu, Sanni Yaya, Hagos Degefa Hidru, Morteza Shamsizadeh, Ehsan Sadeghi, Bach Xuan Tran, Leila Zaki, Mohammad Miri, Maha El Tantawi, Maciej Banach, Hasan Yusefzadeh, Kira A Barbre, Chigozie Jesse Uneke, Mehdi Naderi, Behzad Karami Matin, Yunquan Zhang, Vahid Yazdi-Feyzabadi, Emma Elizabeth Spurlock, Zahid A Butt, Nuruzzaman Khan, Robert L. Thompson, Mehdi Hosseinzadeh, Rovshan Khalilov, Usman Iqbal, K M Shivakumar, Leili Tapak, Chris A Schmidt, Priya Rathi, Shanshan Li, Bhaskaran Unnikrishnan, Chuanhua Yu, Elizabeth A. Cromwell, Davood Anvari, Hoa Thi Do, Abdullah Al Mamun, Obinna Onwujekwe, Serge Resnikoff, Majid Fasihi Harandi, Joshua C. P. Osborne, Farahnaz Joukar, Aso Mohammad Darwesh, Rohollah Kalhor, Turki Alanzi, Katie M Donkers, Amir Kasaeian, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Paul S. F. Yip, Tomislav Mestrovic, Zhi-Jiang Zhang, Katherine Gass, Cuong Tat Nguyen, Gurudatta Naik, Joshua Longbottom, Somayeh Bohlouli, Aziz Rezapour, Huong Lan Thi Nguyen, Khaled Khatab, Mohammed Ibrahim Mohialdeen Gubari, Ahmed Omar Bali, Temesgen Yihunie Akalu, Paul H. Lee, Vahid Alipour, Kebede Deribe, Megan F. Schipp, Ziyad Al-Aly, Biagio Simonetti, Masoud Moradi, Jalal Arabloo, Reza Rawassizadeh, Saif Ullah, Seth Christopher Yaw Appiah, Demelash Abewa Elemineh, Abedin Saghafipour, Fakher Rahim, Tinuke O Olagunju, Kimberly B. Johnson, Souranshu Chatterjee, Salvatore Rubino, Nataliya Foigt, Olayinka Stephen Ilesanmi, Taras Kavetskyy, Carlo La Vecchia, Eduarda Fernandes, Mohsen Mazidi, Claudiu Herteliu, Sojib Bin Zaman, Aziz Sheikh, Yong Yu, David Laith Rawaf, Hassan Magdy Abd El Razek, Natalie V S Vinkeles Melchers, Samath D Dharmaratne, Enrico Rubagotti, Fahad Alanezi, Masood Ali Shaikh, Masoud Foroutan, B. Suresh Kumar Shetty, Milena Ilic, Melese Abate Reta, Dian Kusuma, Ali Manafi, Krittika Bhattacharyya, Giovanni Damiani, Kanaan Hamagharib Abdullah, Desalegn Tadese Mengistu, Van C. Lansingh, Till Bärnighausen, Benjamin F. Arnold, Natalie Maria Cormier, Zulfiqar A Bhutta, Ahmad Daryani, Ali Bijani, Jae Il Shin, Samer Hamidi, Jasvinder A. Singh, Mohsen Bayati, Tomohide Yamada, Zubair Kabir, Muhammed Magdy Abd El Razek, Jonathan F. Mosser, Gbenga A. Kayode, Martin Amogre Ayanore, Shahin Soltani, Arvin Haj-Mirzaian, Mohammad Ali Mansournia, Salah Eddin Karimi, Alan J Thomson, Daniel Diaz, Ahamarshan Jayaraman Nagarajan, Adrian Pana, Salman Rawaf, Oliver J. Brady, Birhanu Geta Meharie, Yousef Fatahi, Sadia Bibi, Bogdan Oancea, Masoud Moghadaszadeh, Kelemu Tilahun Kibret, Valery L. Feigin, Saad M.A. Dahlawi, Ted R. Miller, Nicola Luigi Bragazzi, Atif Amin Baig, Maryam Zamanian, Kate E. LeGrand, Salahuddin Mohammed, Yuming Guo, Irfan Ullah, Hebat Allah Salah A. Yousof, Mowafa Househ, Ionut Negoi, Naohiro Yonemoto, Reza Mohammadpourhodki, Hadi Pourjafar, Navid Manafi, Neda Kianipour, Abraham Getachew Kelbore, Victor Adekanmbi, Seid Tiku Mereta, Olalekan A. Uthman, Arash Ziapour, Olatunji O. Adetokunboh, Trang Huyen Nguyen, Seyed Sina Naghibi Irvani, Francesco Saverio Violante, Monika Sawhney, Paula Moraga, Rahmatollah Moradzadeh, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, María-Gloria Basáñez, Vijay Kumar Chattu, Mustafa Geleto Ansha, Mona M. Khater, Andrew T Olagunju, Ejaz Ahmad Khan, Davide Guido, Kiomars Sharafi, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Tarig B. Higazi, Afshin Maleki, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Amin Soheili, Félix Carvalho, Yun Jin Kim, Catalina Liliana Andrei, Ali Kazemi Karyani, Ehsan Ahmadpour, Thomas R. Unnasch, Mohsen Afarideh, Takahiro Tabuchi, Shreya Shirude, Marcel Ausloos, Maysaa El Sayed Zaki, Haileab Fekadu Wolde, Amira Shaheen, Shafiu Mohammed, Rajan Nikbakhsh, Tewodros Eshete Wonde, Endalkachew Worku Mengesha, Jacek Jerzy Jozwiak, Muktar Beshir Ahmed, Eugenio Traini, Leila R Kalankesh, Kris J. Krohn, Colm McAlinden, Walter Mendoza, Maryam Keramati, Ravi Prakash Jha, David M. Pigott, Elex Hill, Abdallah M. Samy, Farah Daoud, Wanji, Samuel, Public Health, Bill & Melinda Gates Foundation, Medical Research Council (Reino Unido), Department for International Development (Reino Unido), Unión Europea, Cromwell E.A., Osborne J.C.P., Unnasch T.R., Basanez M., Gass K.M., Barbre K.A., Hill E., Johnson K.B., Donkers K.M., Shirude S., Schmidt C.A., Adekanmbi V., Adetokunboh O.O., Afarideh M., Ahmadpour E., Beshir Ahmed M., Yihunie Akalu T., Al-Aly Z., Alanezi F.M., Alanzi T.M., Alipour V., Andrei C.L., Ansari F., Ansha M.G., Anvari D., Yaw Appiah S.C., Arabloo J., Arnold B.F., Ausloos M., Ayanore M.A., Amin Baig A., Banach M., Barac A., Barnighausen T.W., Bayati M., Bhattacharyya K., Bhutta Z.A., Bibi S., Bijani A., Bohlouli S., Bohluli M., Brady O.J., Bragazzi N.L., Butt Z.A., Carvalho F., Chatterjee S., Chattu V.K., Chattu S.K., Cormier N.M., Dahlawi S.M.A., Damiani G., Daoud F., Darwesh A.M., Daryani A., Deribe K., Dharmaratne S.D., Diaz D., Do H.T., El Sayed Zak M., El Tantawi M., Elemineh D.A., Faraj A., Harandi M.F., Fatahi Y., Feigin V.L., Fernandes E., Foigt N.A., Foroutan M., Franklin R.C., Mohialdeen Gubari M.I., Guido D., Guo Y., Haj-Mirzaian A., Abdullah K.H., Hamidi S., Herteliu C., De Hidru H.D., Higazi T.B., Hossain N., Hosseinzadeh M., Househ M., Ilesanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Naghibi Irvani S.S., Jha R.P., Joukar F., Jozwiak J.J., Kabir Z., Kalankesh L.R., Kalhor R., Matin B.K., Karimi S.E., Kasaeian A., Kavetskyy T., Kayode G.A., Karyani A.K., Kelbore A.G., Keramati M., Khalilov R., Khan E.A., Nuruzzaman Khan M.N., Khatab K., Khater M.M., Kianipour N., Kibret K.T., Kim Y.J., Kosen S., Krohn K.J., Kusuma D., Vecchia C.L., Lansingh Van C., Lee P.H., Legrand K.E., Li S., Longbottom J., Abd El Razek H.M., Abd El Razek M.M., Maleki A., Mamun A.A., Manafi A., Manafi N., Mansournia M.A., Martins-Melo F.R., Mazidi M., McAlinden C., Meharie B.G., Mendoza W., Mengesha E.W., Mengistu D.T., Mereta S.T., Mestrovic T., Miller T.R., Miri M., Moghadaszadeh M., Hafshejani A.M., Mohammadpourhodki R., Mohammed S., Moradi M., Moradzadeh R., Moraga P., Mosser J.F., Naderi M., Nagarajan A.J., Naik G., Negoi I., Nguyen C.T., Nguyen H.L.T., Nguyen T.H., Nikbakhsh R., Oancea B., Olagunju T.O., Olagunju A.T., Bali A.O., Onwujekwe O.E., Pana A., Pourjafar H., Rahim F., Ur Rahman M.H., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Resnikoff S., Reta M.A., Rezapour A., Rubagotti E., Rubino S., Sadeghi E., Saghafipour A., Sajadi S.M., Samy A.M., Sarmiento-Suarez R., Sawhney M., Schipp M.F., Shaheen A.A., Shaikh M.A., Shamsizadeh M., Sharafi K., Sheikh A., Kumar Shetty B.S., Shin J.I., Shivakumar K.M., Simonetti B., Singh J.A., Skiadaresi E., Soheili A., Soltani S., Spurlock E.E., Sufiyan M.B., Tabuchi T., Tapak L., Thompson R.L., Thomson A.J., Traini E., Tran B.X., Ullah I., Ullah S., Uneke C.J., Unnikrishnan B., Uthman O.A., Melchers N.V.S.V., Violante F.S., Wolde H.F., Wonde T.E., Yamada T., Yaya S., Yazdi Feyzabadi V., Yip P., Yonemoto N., Yousof H.-A.S.A., Yu C., Yu Y., Yusefzadeh H., Zaki L., Zaman S.B., Zamanian M., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Pigott D.M., and Cuidado de la Salud y Desarrollo Sostenible

Subjects
Oncocercosis, Decision Analysis, RC955-962, Onchocerciasis, law.invention, Geographical Locations, Medical Conditions, 0302 clinical medicine, law, Arctic medicine. Tropical medicine, Medicine and Health Sciences, 030212 general & internal medicine, Onchocerca, 11 Medical and Health Sciences, Data Management, biology, Pharmaceutics, wc_695, Enfermedades Parasitarias, Onchocerciasi, 3. Good health, Infectious Diseases, Geography, Transmission (mechanics), Helminth Infections, Engineering and Technology, Mass Drug Administration, Public aspects of medicine, RA1-1270, Management Engineering, Cartography, Human, Research Article, Neglected Tropical Diseases, Computer and Information Sciences, Drug Administration, 030231 tropical medicine, Decision tree, wa_395, Dermatology, wc_765, Environment, wc_885, Research and Analysis Methods, Skin Diseases, 03 medical and health sciences, Drug Therapy, SDG 3 - Good Health and Well-being, Diagnostic Medicine, Tropical Medicine, Parasitic Diseases, medicine, Humans, Disease Eradication, Spatial analysis, Ivermectin, Data collection, Receiver operating characteristic, Data Visualization, Decision Trees, Public Health, Environmental and Occupational Health, 06 Biological Sciences, Elimination planning, Africa, Implementation units, Public health, Tropical Diseases, medicine.disease, biology.organism_classification, Health Care, ROC Curve, People and Places, Health Statistics, Morbidity, Scale (map), Forecasting
Abstract

Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify., Author summary As of 2018, it was unknown if onchocerciasis transmission occurred among approximately 2 400 implementation units (IUs; typically, second administrative-level units, such as districts) considered potentially endemic. These IUs have either never been surveyed for onchocerciasis or historical data are not sufficient to define contemporary endemicity status. Given the large number of IUs for which baseline data collection is likely required to achieve continental elimination, there is a need to prioritise areas for surveys to ensure that those suitable for endemic transmission, and therefore potentially eligible for mass drug administration, are able to initiate interventions as soon as possible. We used boosted regression trees to predict environmental suitability for onchocerciasis, with corresponding measures of uncertainty. We summarized the fine scale spatial predictions at the IU level by using receiver operating characteristic (ROC) curve analysis to identify a threshold that maximized agreement with the occurrence locations to identify IUs that may warrant prioritisation for mapping surveys. This analysis suggests that approximately half of the IUs considered for surveys could be classified as environmentally suitable for onchocerciasis. In order to develop an elimination strategy, many national onchocerciasis elimination programmes (NOEPs) need a mechanism to synthesise historical data to define priority areas for surveys.

Published
2021
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30. Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis

Author

Freya M, Shearer, Catherine L, Moyes, David M, Pigott, Oliver J, Brady, Fatima, Marinho, Aniruddha, Deshpande, Joshua, Longbottom, Annie J, Browne, Moritz U G, Kraemer, Kathleen M, O'Reilly, Joachim, Hombach, Sergio, Yactayo, Valdelaine E M, de Araújo, Aglaêr A, da Nóbrega, Jonathan F, Mosser, Jeffrey D, Stanaway, Stephen S, Lim, Simon I, Hay, Nick, Golding, and Robert C, Reiner

Subjects
Vaccination, Yellow Fever, Yellow Fever Vaccine, Humans, Global Health, Article, Retrospective Studies, Disease Outbreaks
Abstract

Summary Background Substantial outbreaks of yellow fever in Angola and Brazil in the past 2 years, combined with global shortages in vaccine stockpiles, highlight a pressing need to assess present control strategies. The aims of this study were to estimate global yellow fever vaccination coverage from 1970 through to 2016 at high spatial resolution and to calculate the number of individuals still requiring vaccination to reach population coverage thresholds for outbreak prevention. Methods For this adjusted retrospective analysis, we compiled data from a range of sources (eg, WHO reports and health-service-provider registeries) reporting on yellow fever vaccination activities between May 1, 1939, and Oct 29, 2016. To account for uncertainty in how vaccine campaigns were targeted, we calculated three population coverage values to encompass alternative scenarios. We combined these data with demographic information and tracked vaccination coverage through time to estimate the proportion of the population who had ever received a yellow fever vaccine for each second level administrative division across countries at risk of yellow fever virus transmission from 1970 to 2016. Findings Overall, substantial increases in vaccine coverage have occurred since 1970, but notable gaps still exist in contemporary coverage within yellow fever risk zones. We estimate that between 393·7 million and 472·9 million people still require vaccination in areas at risk of yellow fever virus transmission to achieve the 80% population coverage threshold recommended by WHO; this represents between 43% and 52% of the population within yellow fever risk zones, compared with between 66% and 76% of the population who would have required vaccination in 1970. Interpretation Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling. Funding The Rhodes Trust, Bill & Melinda Gates Foundation, the Wellcome Trust, the National Library of Medicine of the National Institutes of Health, the European Union's Horizon 2020 research and innovation programme.

Published
2017

31. Vulnerability to snakebite envenoming: a global mapping of hotspots

Author

Joshua, Longbottom, Freya M, Shearer, Maria, Devine, Gabriel, Alcoba, Francois, Chappuis, Daniel J, Weiss, Sarah E, Ray, Nicolas, Ray, David A, Warrell, Rafael, Ruiz de Castañeda, David J, Williams, Simon I, Hay, and David M, Pigott

Subjects
Antivenins, Geographic Mapping, Neglected Diseases, Snake Bites, Snakes, Vulnerable Populations, Health Services Accessibility, Africa, Northern, Indonesia, Animals, Health Resources, Humans, Public Health, Quality of Health Care
Abstract

Snakebite envenoming is a frequently overlooked cause of mortality and morbidity. Data for snake ecology and existing snakebite interventions are scarce, limiting accurate burden estimation initiatives. Low global awareness stunts new interventions, adequate health resources, and available health care. Therefore, we aimed to synthesise currently available data to identify the most vulnerable populations at risk of snakebite, and where additional data to manage this global problem are needed.We assembled a list of snake species using WHO guidelines. Where relevant, we obtained expert opinion range (EOR) maps from WHO or the Clinical Toxinology Resources. We also obtained occurrence data for each snake species from a variety of websites, such as VertNet and iNaturalist, using the spocc R package (version 0.7.0). We removed duplicate occurrence data and categorised snakes into three groups: group A (no available EOR map or species occurrence records), group B (EOR map but5 species occurrence records), and group C (EOR map and ≥5 species occurrence records). For group C species, we did a multivariate environmental similarity analysis using the 2008 WHO EOR maps and newly available evidence. Using these data and the EOR maps, we produced contemporary range maps for medically important venomous snake species at a 5 × 5 km resolution. We subsequently triangulated these data with three health system metrics (antivenom availability, accessibility to urban centres, and the Healthcare Access and Quality [HAQ] Index) to identify the populations most vulnerable to snakebite morbidity and mortality.We provide a map showing the ranges of 278 snake species globally. Although about 6·85 billion people worldwide live within range of areas inhabited by snakes, about 146·70 million live within remote areas lacking quality health-care provisioning. Comparing opposite ends of the HAQ Index, 272·91 million individuals (65·25%) of the population within the lowest decile are at risk of exposure to any snake for which no effective therapy exists compared with 519·46 million individuals (27·79%) within the highest HAQ Index decile, showing a disproportionate coverage in reported antivenom availability. Antivenoms were available for 119 (43%) of 278 snake species evaluated by WHO, while globally 750·19 million (10·95%) of those living within snake ranges live more than 1 h from population centres. In total, we identify about 92·66 million people living within these vulnerable geographies, including many sub-Saharan countries, Indonesia, and other parts of southeast Asia.Identifying exact populations vulnerable to the most severe outcomes of snakebite envenoming at a subnational level is important for prioritising new data collection and collation, reinforcing envenoming treatment, existing health-care systems, and deploying currently available and future interventions. These maps can guide future research efforts on snakebite envenoming from both ecological and public health perspectives and better target future estimates of the burden of this neglected tropical disease.BillMelinda Gates Foundation.

Published
2018

32. Mapping local variation in educational attainment across Africa

Author

Aniruddha Deshpande, Joseph Friedman, Peter W. Gething, Lucas Earl, Samir Bhatt, Joshua Longbottom, Roy Burstein, Daniel J. Weiss, Daniel C Casey, Stephen S Lim, Nancy Fullman, Aubrey J. Levine, Emmanuela Gakidou, Sarah E Ray, Nicholas Graetz, Ali H. Mokdad, Jonathan F. Mosser, Christopher J L Murray, Annie J. Browne, Robert Reiner, Molly H Biehl, Simon I. Hay, Aaron Osgood-Zimmerman, Chloe Shields, Rebecca W. Stubbs, and Benjamin K. Mayala

Subjects
0301 basic medicine, Male, Internationality, SUSTAINABLE DEVELOPMENT GOALS, ECONOMIC-DEVELOPMENT, 0302 clinical medicine, 030212 general & internal medicine, Young adult, Reproductive health, media_common, Multidisciplinary, PLASMODIUM-FALCIPARUM, Middle Aged, Multidisciplinary Sciences, GENDER INEQUALITY, Geography, Science & Technology - Other Topics, MATERNAL EDUCATION, GROWTH, Educational Status, Female, CHILD-MORTALITY, HEALTH, Goals, COUNTRIES, Adult, Inequality, Adolescent, General Science & Technology, media_common.quotation_subject, Fertility, World Health Organization, Article, 03 medical and health sciences, Young Adult, Sex Factors, Kilometer, MD Multidisciplinary, SYSTEMATIC ANALYSIS, Humans, Probability, Sustainable development, Science & Technology, business.industry, Local variation, Educational attainment, 030104 developmental biology, Africa, Demographic economics, business
Abstract

Educational attainment for women of reproductive age is linked to reduced child and maternal mortality, lower fertility and improved reproductive health. Comparable analyses of attainment exist only at the national level, potentially obscuring patterns in subnational inequality. Evidence suggests that wide disparities between urban and rural populations exist, raising questions about where the majority of progress towards the education targets of the Sustainable Development Goals is occurring in African countries. Here we explore within-country inequalities by predicting years of schooling across five by five kilometre grids, generating estimates of average educational attainment by age and sex at subnational levels. Despite marked progress in attainment from 2000 to 2015 across Africa, substantial differences persist between locations and sexes. These differences have widened in many countries, particularly across the Sahel. These high-resolution, comparable estimates improve the ability of decision-makers to plan the precisely targeted interventions that will be necessary to deliver progress during the era of the Sustainable Development Goals., Local-level analyses show that, despite marked progress in educational attainment from 2000 to 2015 across Africa, substantial differences persist between locations and sexes that have widened in many countries.

Published
2018

33. Mapping child growth failure in Africa between 2000 and 2015

Author

Aaron Osgood-Zimmerman, Puja Rao, David M. Pigott, Chloe Shields, Nancy Fullman, Rebecca W. Stubbs, Nathaniel J Henry, Abdisalan M. Noor, Jonathan F. Mosser, Peter W. Gething, Roy Burstein, Ewan Cameron, Daniel C Casey, Annie J. Browne, Mario Herrero, Nicholas Graetz, Lutz Krause, Stephen S Lim, Sarah E Ray, Robert Reiner, Daniel J. Weiss, Damaris K. Kinyoki, Ian D. Letourneau, Aubrey J. Levine, Rahul Rawat, Samir Bhatt, Harry S. Gibson, Ali H. Mokdad, Joshua Longbottom, Anoushka Millear, Brandon V. Pickering, Kirsten E. Wiens, Simon I. Hay, Benjamin K. Mayala, Murray Cjl., P. Liu, Aniruddha Deshpande, Nicholas J Kassebaum, Lucas Earl, Ellen Piwoz, David L. Smith, and Medical Research Council (MRC)

Subjects
medicine.medical_specialty, General Science & Technology, 030231 tropical medicine, SUSTAINABLE DEVELOPMENT GOALS, MODELS, Psychological intervention, GLOBAL HEALTH, Article, 03 medical and health sciences, 0302 clinical medicine, Environmental health, HEALTH SYSTEM PERFORMANCE, MD Multidisciplinary, Medicine, 030212 general & internal medicine, NIGERIA, Wasting, 2. Zero hunger, Sustainable development, Multidisciplinary, Science & Technology, PLASMODIUM-FALCIPARUM, business.industry, Public health, 1. No poverty, MALNUTRITION, medicine.disease, Child development, Health equity, 3. Good health, Multidisciplinary Sciences, Malnutrition, PUBLIC-HEALTH, SURVIVAL, Science & Technology - Other Topics, Public Health, Underweight, medicine.symptom, business, INTERVENTIONS
Abstract

Insufficient growth during childhood is associated with poor health outcomes and an increased risk of death. Between 2000 and 2015, nearly all African countries demonstrated improvements for children under 5 years old for stunting, wasting, and underweight, the core components of child growth failure. Here we show that striking subnational heterogeneity in levels and trends of child growth remains. If current rates of progress are sustained, many areas of Africa will meet the World Health Organization Global Targets 2025 to improve maternal, infant and young child nutrition, but high levels of growth failure will persist across the Sahel. At these rates, much, if not all of the continent will fail to meet the Sustainable Development Goal target—to end malnutrition by 2030. Geospatial estimates of child growth failure provide a baseline for measuring progress as well as a precision public health platform to target interventions to those populations with the greatest need, in order to reduce health disparities and accelerate progress., Geospatial estimates of child growth failure in Africa provide a baseline for measuring progress and a precision public health platform to target interventions to those populations with the greatest need.

Published
2018

34. Mapping under-5 and neonatal mortality in Africa, 2000-15: a baseline analysis for the Sustainable Development Goals

Author

Nick, Golding, Roy, Burstein, Joshua, Longbottom, Annie J, Browne, Nancy, Fullman, Aaron, Osgood-Zimmerman, Lucas, Earl, Samir, Bhatt, Ewan, Cameron, Daniel C, Casey, Laura, Dwyer-Lindgren, Tamer H, Farag, Abraham D, Flaxman, Maya S, Fraser, Peter W, Gething, Harry S, Gibson, Nicholas, Graetz, L Kendall, Krause, Xie Rachel, Kulikoff, Stephen S, Lim, Bonnie, Mappin, Chloe, Morozoff, Robert C, Reiner, Amber, Sligar, David L, Smith, Haidong, Wang, Daniel J, Weiss, Christopher J L, Murray, Catherine L, Moyes, Simon I, Hay, and Medical Research Council (MRC)

Subjects
Male, Conservation of Natural Resources, Age Factors, Infant, Newborn, Infant, Bayes Theorem, 11 Medical And Health Sciences, Risk Assessment, Article, Africa, Western, Sex Factors, Predictive Value of Tests, Cause of Death, Child, Preschool, Population Surveillance, General & Internal Medicine, Child Mortality, Infant Mortality, Humans, Female, Developing Countries, Goals
Abstract

Summary Background During the Millennium Development Goal (MDG) era, many countries in Africa achieved marked reductions in under-5 and neonatal mortality. Yet the pace of progress toward these goals substantially varied at the national level, demonstrating an essential need for tracking even more local trends in child mortality. With the adoption of the Sustainable Development Goals (SDGs) in 2015, which established ambitious targets for improving child survival by 2030, optimal intervention planning and targeting will require understanding of trends and rates of progress at a higher spatial resolution. In this study, we aimed to generate high-resolution estimates of under-5 and neonatal all-cause mortality across 46 countries in Africa. Methods We assembled 235 geographically resolved household survey and census data sources on child deaths to produce estimates of under-5 and neonatal mortality at a resolution of 5 × 5 km grid cells across 46 African countries for 2000, 2005, 2010, and 2015. We used a Bayesian geostatistical analytical framework to generate these estimates, and implemented predictive validity tests. In addition to reporting 5 × 5 km estimates, we also aggregated results obtained from these estimates into three different levels—national, and subnational administrative levels 1 and 2—to provide the full range of geospatial resolution that local, national, and global decision makers might require. Findings Amid improving child survival in Africa, there was substantial heterogeneity in absolute levels of under-5 and neonatal mortality in 2015, as well as the annualised rates of decline achieved from 2000 to 2015. Subnational areas in countries such as Botswana, Rwanda, and Ethiopia recorded some of the largest decreases in child mortality rates since 2000, positioning them well to achieve SDG targets by 2030 or earlier. Yet these places were the exception for Africa, since many areas, particularly in central and western Africa, must reduce under-5 mortality rates by at least 8·8% per year, between 2015 and 2030, to achieve the SDG 3.2 target for under-5 mortality by 2030. Interpretation In the absence of unprecedented political commitment, financial support, and medical advances, the viability of SDG 3.2 achievement in Africa is precarious at best. By producing under-5 and neonatal mortality rates at multiple levels of geospatial resolution over time, this study provides key information for decision makers to target interventions at populations in the greatest need. In an era when precision public health increasingly has the potential to transform the design, implementation, and impact of health programmes, our 5 × 5 km estimates of child mortality in Africa provide a baseline against which local, national, and global stakeholders can map the pathways for ending preventable child deaths by 2030. Funding Bill & Melinda Gates Foundation.

Published
2017

36. Department of Error

Author

Maziar Moradi-Lakeh, Krishna K. Aryal, Mohamad-Hani Temsah, Ahmad Daryani, Claudio Alberto Davila, Achala Upendra Jayatilleke, David L. Smith, Chinwe Juliana Iwu, Kavumpurathu Raman Thankappan, Ibrahim Abdollahpour, Mehdi Fazlzadeh, Robert C. Reiner, Bineyam Taye, Dadi Marami, Ghulam Mustafa, Manasi Kumar, Mostafa Leili, Mehdi Sharif, Mohsen Naghavi, Maarten J. Postma, Chhabi Lal Ranabhat, Oluchi Okpala, Shivakumar K.M. Kondlahalli, Nihal Thomas, Man Mohan Mehndiratta, Ebrahim Babaee, Tsegaye Lolaso Lenjebo, Miliva Mozaffor, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Meysam Behzadifar, Carlos Miguel Rios González, Pallab K. Maulik, Ali H. Mokdad, Mehran Alijanzadeh, Florian Fischer, Lalit Dandona, Aso Mohammad Darwesh, Alemayehu Toma Mena, Jennifer Rickard, Benjamin K. Mayala, Seyed Mostafa Mir, Moslem Soofi, Bhaskaran Unnikrishnan, Boris Bikbov, Bereket Duko Adema, Jagdish Khubchandani, Sachin R Atre, Rafael Moreira Claro, Sandra B. Munro, Carlos Zambrana-Torrelio, Kassawmar Angaw Bogale, Soraya Siabani, Muluken Azage Yenesew, Birhan Tamene Alemnew, Anwar E. Ahmed, Morteza Shamsizadeh, Masresha Tessema Anegago, Muluken Bekele Sorrie, Vivekanand Jha, Gebrekiros Gebremichael Meles, Andre M. N. Renzaho, Muhammad Aziz Rahman, Hebat Allah Salah A. Yousof, Naohiro Yonemoto, Ahmad Ghashghaee, Kebede Embaye Gezae, Hadi Pourjafar, Junaid Khan, Farnam Mohebi, Marcel Ausloos, Manisha Dubey, Quynh Anh P. Nguyen, Assefa Desalew, Vera Marisa Costa, Mohammad Fareed, Ronny Westerman, Maciej Banach, Paul S. F. Yip, Kala M. Mehta, Mehdi Yaseri, Quique Bassat, Amir Almasi-Hashiani, Fatemeh Rajati, Irina Filip, Gelin Xu, Derrick A Bennett, Atalay Goshu Muluneh, Leeberk Raja Inbaraj, Edgar Denova-Gutiérrez, Fariba Ghassemi, Behzad Karami Matin, David C. Schwebel, Syed Ather Hussain, Milena Ilic, Xiu Ju Zhao, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Mostafa Hosseini, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Santosh Varughese, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Aubrey J. Levine, Jacqueline Elizabeth Alcalde Rabanal, Hesham M. Al-Mekhlafi, Rufus A. Adedoyin, Gudlavalleti Vs Murthy, Amir Khater, Olufemi Ajumobi, Seth Christopher Yaw Appiah, Mehdi Ahmadi, Lorenzo Monasta, Mohammad Hossein Khosravi, Rizwan Suliankatchi Abdulkader, Richard C. Franklin, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Shai Linn, Fisaha Haile Tesfay, Abdullah Al Mamun, Yoshan Moodley, Amjad Mohamadi-Bolbanabad, Hajer Elkout, Mohammad Zamani, Yousef Mohammad, Yousef Veisani, Iman El Sayed, Asmamaw Bizuneh Demis, Alex Yeshaneh, Sharath Burugina Nagaraja, Segun Emmanuel Ibitoye, Charles Shey Wiysonge, Pushpendra Kumar, Engida Yisma, Maysaa El Sayed Zaki, Kebede Deribe, Ali Akbar Fazaeli, Moritz U. G. Kraemer, Ayele Geleto Bali, Platon D. Lopukhov, Paula Moraga, Giovanni Damiani, Alebachew Fasil Ashagre, Hossein Farzam, Amir Kasaeian, Taye Abuhay Zewale, Ben Lacey, Mika Shigematsu, Bryan L. Sykes, Abdur Razzaque Sarker, Ali Kabir, Lal B. Rawal, Juan Sanabria, Ehsan Khodamoradi, Saeed Amini, Hasan Yusefzadeh, Josephine W. Ngunjiri, Aberash Abay Tassew, Sezer Kisa, Biruck Desalegn Yirsaw, Hosni Salem, Ayman Grada, Jean Jacques Noubiap, Mina Anjomshoa, Gebre Teklemariam Demoz, Sharareh Eskandarieh, Maryam Adabi, Nuworza Kugbey, Rahman Shiri, Melkamu Merid Mengesha, Zemenu Tadesse Tessema, Amir Radfar, Girmay Teklay Weldesamuel, Sahel Valadan Tahbaz, Nader Jahanmehr, Yuming Guo, Roghiyeh Faridnia, Mehdi Naderi, Ziad A. Memish, Adnan Kisa, Gbenga A. Kayode, Yafeng Wang, Ehsan Sadeghi, Behnam Heidari, Apurba Shil, Kamarul Imran Musa, Jagadish Rao Padubidri, Farshad Pourmalek, Saravanan Muthupandian, Navid Rabiee, Mario Poljak, Nima Hafezi-Nejad, Hagos Degefa Hidru, Jemal Abdu Mohammed, MohammadBagher Shamsi, Mohsen Asadi-Lari, Sameh Magdeldin, Berhe Etsay Tesfay, Khanh Bao Tran, James A Platts-Mills, Jan-Walter De Neve, Maria Jesus Rios-Blancas, Hedley Quintana, Félix Carvalho, Yun Jin Kim, Eric L. Ding, Noushin Mohammadifard, Saeed Safari, Addisu Melese, Rakesh Lodha, Reza Shirkoohi, Itamar S. Santos, Alireza Khatony, Mohammad Khazaei, Mekdes Tigistu Yilma, Taweewat Wiangkham, Hamed Kalani, Mayowa O. Owolabi, Mohammad Reza Sobhiyeh, Frank B. Osei, Narayan Bahadur Mahotra, Zewdie Aderaw Alemu, Konrad Pesudovs, Kewal Krishan, Samath D Dharmaratne, Ayalew Jejaw Zeleke, Osayomwanbo Osarenotor, Tina Beyranvand, Yahya Salimi, Winfried März, Sheikh Mohammed Shariful Islam, Azmeraw T. Amare, Julio Cesar Campuzano Rincon, Maha El Tantawi, Anusha Ganapati Bhat, Susanna Dunachie, Shymaa Enany, Anelisa Jaca, Desalegn Tadese Mengistu, Salvatore Rubino, Nelson J. Alvis-Zakzuk, Indang Trihandini, Bartosz Miazgowski, Huda Basaleem, Zahid A Butt, Vijay Kumar Chattu, Navid Manafi, Si Si, Joan B. Soriano, Victor Adekanmbi, Andrea Farioli, Masoud Moradi, Joseph Frostad, Collins Chansa, Enrico Rubagotti, Edward J Mills, Senbagam Duraisamy, Foad Abd-Allah, Moses K. Muriithi, Elias Merdassa Roro, Netsanet Fentahun, Kenji Shibuya, Amira Hamed Darwish, Ai-Min Wu, Tomohide Yamada, Lauren E. Schaeffer, Sonia Lewycka, Catalina Liliana Andrei, Ali Kazemi Karyani, Beyene Meressa Adhena, Shaimaa I. El-Jaafary, Francisco Rogerlandio Martins-Melo, Faris Lami, Aziz Eftekhari, Naser Mohammad Gholi Mezerji, André Karch, Suraj Bhattarai, Mona M. Khater, Paulina A. Lindstedt, Marcos Roberto Tovani-Palone, Kedir Hussein Abegaz, Padukudru Anand Mahesh, Alexandre C. Pereira, Ammas Siraj Mohammed, Mehdi Hosseinzadeh, Reta Tsegaye Gayesa, In-Hwan Oh, Dietrich Rothenbacher, Margaret Kosek, Yunquan Zhang, Ketema Bizuwork Gebremedhin, Rahul Gupta, Claudiu Herteliu, Nicole Davis Weaver, Dawit Zewdu Wondafrash, Oliver J. Brady, Samad Azari, Ebrahim M Yimer, Andrew T Olagunju, Ana Laura Manda, Ali Rostami, Aniruddha Deshpande, Ninuk Hariyani, Gulfaraz Khan, Narinder Pal Singh, Dabere Nigatu, Jae Il Shin, Preeti Dhillon, Duduzile Ndwandwe, Michelle L. Bell, Rakhi Dandona, Mojtaba Hoseini-Ghahfarokhi, Obinna Onwujekwe, Olatunji O. Adetokunboh, Tanuj Kanchan, Suleman Atique, Rovshan Khalilov, Ai Koyanagi, Ejaz Ahmad Khan, Jalal Arabloo, Ahmed Abdelalim, Van C. Lansingh, Ali Almasi, Catherine A. Welgan, Surendra Karki, Eirini Skiadaresi, Aleksandra Barac, Simon I. Hay, Hamid Yimam Hassen, Mohammad Ali Sahraian, Akram Pourshams, Mowafa Househ, Dilaram Acharya, Getnet Mengistu, Arya Haj-Mirzaian, Salman Khazaei, Bahram Armoon, Emerito Jose Aquino Faraon, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, David Laith Rawaf, Ali S. Akanda, Till Bärnighausen, Veincent Christian Filipino Pepito, Ahmed Omar Bali, Norberto Perico, Sergio I. Prada, Mohammad Moradi-Joo, Helen Derara Diro, Gebremicheal Gebreslassie Kasahun, Andre Rodrigues Duraes, Ajay Patle, Simin Mouodi, Yuan-Pang Wang, Alireza Esteghamati, Paramjit Gill, Ahamarshan Jayaraman Nagarajan, Meghnath Dhimal, Hafiz Ansar Rasul Suleria, Saleh Salehi Zahabi, Nader Jafari Balalami, Lucas Earl, Haileab Fekadu Wolde, Doris D. V. Ortega-Altamirano, Beatriz Paulina Ayala Quintanilla, Franz Castro, Deborah Carvalho Malta, Desta Haftu Hayelom, Sebastian Vollmer, Getinet Ayano, Arianna Maever L. Amit, Bárbara Niegia Garcia de Goulart, John S. Ji, Raaj Kishore Biswas, Michael R.M. Abrigo, Arash Etemadi, Andrey Nikolaevich Briko, Nefsu Awoke, Anton Sokhan, Daniel Adane Endalew, Ibrahim Abdelmageed Ginawi, Jacek Jóźwiak, Mihajlo Jakovljevic, Degu Abate, Ali S. Shalash, Hamidreza Haririan, Lucas Guimarães Abreu, Davide Guido, Masoud Foroutan, Karzan Abdulmuhsin Mohammad, Niranjan Kissoon, Farkhonde Salehi, Ashish Awasthi, Hosein Shabaninejad, Trang Huyen Nguyen, Anthony Masaka, Getenet Dessie, Fakher Rahim, Aklilu Endalamaw, Kiana Ramezanzadeh, Farzad Manafi, Olayinka Stephen Ilesanmi, Vahid Alipour, Neeraj Bedi, Kimberly B. Johnson, Laurie B. Marczak, Mehran Shams-Beyranvand, Amira Shaheen, Zubair Kabir, Saleem Muhammad Rana, Marzieh Nojomi, Peter Njenga Keiyoro, Yared Asmare Aynalem, Tissa Wijeratne, Fiseha Wadilo Wada, Giuseppe Remuzzi, Carlo La Vecchia, Chuanhua Yu, Pascual R. Valdez, Senthilkumar Balakrishnan, Phetole Walter Mahasha, Liliana Preotescu, Tewodros Eshete Wonde, Keivan Ahmadi, Masood Ali Shaikh, Leticia Avila-Burgos, Ken Lee Chin, Dinh-Toi Chu, Francesco Saverio Violante, Yasir Waheed, Daniel Diaz, Rosario Cárdenas, Ibrahim A Khalil, Ernoiz Antriyandarti, Adrian Pana, Salman Rawaf, Nauman Khalid, Nejimu Biza Zepro, Turki Alanzi, Amir Jalali, Chukwudi A Nnaji, Kebadnew Mulatu Mihretie, Demelash Woldeyohannes Handiso, Nuruzzaman Khan, Takeshi Fukumoto, Christiane Dolecek, Melese Abate Reta, Vinay Nangia, Soumyadeep Bhaumik, Ravi Mehrotra, Seyed-Mohammad Fereshtehnejad, Brigette F. Blacker, Savita Lasrado, Seifadin Ahmed Shallo, Arash Ziapour, Krittika Bhattacharyya, Praveen Hoogar, Nicola Luigi Bragazzi, Mahdi Safdarian, Seyed Sina Naghibi Irvani, Chi Linh Hoang, Boikhutso Tlou, Manfred Accrombessi, Christopher J L Murray, Dragos Virgil Davitoiu, Hossein Poustchi, Farid Najafi, Sathish Thirunavukkarasu, Daniel Bekele Ketema, Dharmesh Kumar Lal, Vafa Rahimi-Movaghar, Christopher Troeger, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Paul H. Lee, Genet Melak Alamene, George C Patton, Andem Effiong, André Faro, Rushdia Ahmed, Colm McAlinden, Parvaneh Mirabi, Joshua Longbottom, Hagos Tasew Atalay, Alireza Rafiei, Somayeh Bohlouli, Temesgen Yihunie Akalu, Syed Mohamed Aljunid, Javad Nazari, Ismael R. Campos-Nonato, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Arvin Haj-Mirzaian, Sanghamitra Pati, Bakhtiar Piroozi, Rafael Alves Guimarães, Khaled Khatab, Evanson Z. Sambala, Mohsen Afarideh, Nelson Alvis-Guzman, Koku Sisay Tamirat, Mustafa Z. Younis, Hamed Zandian, Aparna Lal, Tamer H. Farag, Tahereh Pashaei, Benn Sartorius, Kidane Tadesse Gebremariam, Demelash Abewa Elemineh, Marwa Rashad Salem, Davide Rasella, Hedayat Abbastabar, Manu Raj Mathur, Peng Jia, Natalie Maria Cormier, Olatunde Aremu, Mohammad Reza Salahshoor, Kirsten E. Wiens, Ghobad Moradi, Srinivas Goli, Ruth W Kimokoti, Aliasghar Ahmad Kiadaliri, Khalid A Altirkawi, Ritesh G. Menezes, Molly K. Miller-Petrie, Alaa Badawi, Beriwan Abdulqadir Ali, Ensiyeh Jenabi, Getnet Azeze Gedefaw, Ahmed I. Hasaballah, Arash Tehrani-Banihashemi, Govinda Prasad Dhungana, Eleonora Dubljanin, Amir Hasanzadeh, Jasvinder A. Singh, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Feleke Mekonnen Demeke, Agus Sudaryanto, Muhammad Ali, Yilma Chisha Dea Geramo, Leonardo Roever, Gebreamlak Gebremedhn Gebremeskel, Maheswar Satpathy, Asnakew Achaw Ayele, Seyyed Meysam Mousavi, Devasahayam J. Christopher, Malede Mequanent Sisay, Yibeltal Alemu Bekele, Tamirat Tesfaye Dasa, Gessessew Bugssa Hailu, Luca Ronfani, James Albright, Nathaniel J. Henry, Ionut Negoi, Dessalegn Ajema Berbada, Brijesh Sathian, Yousef Khader, Bal Govind Chauhan, Nikolay Ivanovich Briko, Hamideh Salimzadeh, Ali Bijani, Irfan Ullah, Shirin Djalalinia, Shanshan Li, Kebreab Paulos, Mohsen Bayati, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Fatemeh Heydarpour, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Ireneous N. Soyiri, Mathew M. Baumann, Mehedi Hasan, Vishnu Renjith, Nuno Taveira, Getaneh Alemu Abebe, Pranab Chatterjee, Shafiu Mohammed, Dongyu Zhang, Abbas Mosapour, Muki Shey, Rajat Das Gupta, Muktar Beshir Ahmed, Satar Rezaei, Wondimeneh Shibabaw Shiferaw, Kenean Getaneh Tlaye, Eugenio Traini, Oladimeji Adebayo, Aisha Elsharkawy, David M. Pigott, Hadi Hassankhani, Anas M. Saad, Mohammad Rabiee, Sivan Yegnanarayana Iyer Saraswathy, Abdallah M. Samy, Ali Talha Khalil, Nelson G.M. Gomes, Afsaneh Arzani, Ayesha Humayun, Michael Tamene Haile, Huyen Phuc Do, Maryam Khayamzadeh, Rajeev Gupta, Davoud Adham, Farah Daoud, Jai K Das, Ana Isabel Ribeiro, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Brian J. Hall, Ravi Prakash Jha, David Teye Doku, Guoqing Hu, Erkin M. Mirrakhimov, Seyed Hossein Yahyazadeh Jabbari, S. Mohammad Sajadi, Shankar M Bakkannavar, Ali Yadollahpour, Masoud Behzadifar, and G Anil Kumar

Subjects
Burden of disease, 030219 obstetrics & reproductive medicine, business.industry, Low income and middle income countries, General Medicine, Specific mortality, 030204 cardiovascular system & hematology, Article, 3. Good health, 03 medical and health sciences, Geography, 0302 clinical medicine, Environmental health, Medicine, 030212 general & internal medicine, Geographical inequalities, business, Demography
Abstract

Reiner RC Jr, Hay SI. Mapping geographical inequalities in childhood diarrhoeal morbidity and mortality in low-income and middle-income countries, 2000–17: analysis for the Global Burden of Disease Study 2017. Lancet 2020; 395: 1779–801—In this Article, the author byline has been amended to Local Burden of Disease Diarrhoea Collaborators. This correction has been made to the online version as of June 4, 2020, and the printed version is correct. © 2020 Elsevier Ltd

Published
2018
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37. Mapping the zoonotic niche of Lassa fever in Africa

Author

Adrian Q N, Mylne, David M, Pigott, Joshua, Longbottom, Freya, Shearer, Kirsten A, Duda, Jane P, Messina, Daniel J, Weiss, Catherine L, Moyes, Nick, Golding, and Simon I, Hay

Subjects
Original Articles, Disease Outbreaks, Rodent Diseases, Lassa Fever, Mastomys natalensis, LASV, Population Surveillance, Zoonoses, Animals, Cluster Analysis, Humans, Topography, Medical, Boosted regression trees, Murinae, Species distribution models, Lassa virus, Viral haemorrhagic fever, Disease Reservoirs
Abstract

Background Lassa fever is a viral haemorrhagic illness responsible for disease outbreaks across West Africa. It is a zoonosis, with the primary reservoir species identified as the Natal multimammate mouse, Mastomys natalensis. The host is distributed across sub-Saharan Africa while the virus' range appears to be restricted to West Africa. The majority of infections result from interactions between the animal reservoir and human populations, although secondary transmission between humans can occur, particularly in hospital settings. Methods Using a species distribution model, the locations of confirmed human and animal infections with Lassa virus (LASV) were used to generate a probabilistic surface of zoonotic transmission potential across sub-Saharan Africa. Results Our results predict that 37.7 million people in 14 countries, across much of West Africa, live in areas where conditions are suitable for zoonotic transmission of LASV. Four of these countries, where at-risk populations are predicted, have yet to report any cases of Lassa fever. Conclusions These maps act as a spatial guide for future surveillance activities to better characterise the geographical distribution of the disease and understand the anthropological, virological and zoological interactions necessary for viral transmission. Combining this zoonotic niche map with detailed patient travel histories can aid differential diagnoses of febrile illnesses, enabling a more rapid response in providing care and reducing the risk of onward transmission.

Published
2015

38. High Spatial Resolution Mapping of Changing Inequalities in Child Mortality Across Africa between 2000 and 2015

Author

Aaron Osgood-Zimmerman, Haidong Wang, Lucas Earl, Chloe Morozoff, Laura Dwyer-Lindgren, Tamer H. Farag, Samir Bhatt, Catherine L. Moyes, Scott F. Dowell, Nick Golding, Simon I. Hay, Abraham D. Flaxman, Joshua Longbottom, Lutz Krause, Stephen S Lim, Roy Burstein, D. Weiss, Christopher J L Murray, P. Gething, and Annie J. Browne

Subjects
Child mortality, Geography, Inequality, media_common.quotation_subject, High spatial resolution, Infectious and parasitic diseases, RC109-216, General Medicine, Public aspects of medicine, RA1-1270, Cartography, media_common
Published
2017
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