158 results on '"Tini G"'
Search Results
2. Arrhythmic risk stratification in patients with left ventricular ring-like scar
- Author
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Parisi, V, primary, Graziosi, M, additional, Lopes, R L, additional, Pasquale, F, additional, De Luca, A, additional, Targetti, M, additional, Tini, G, additional, Torlasco, C, additional, Ditaranto, R, additional, Chiti, C, additional, Crotti, L, additional, Olivotto, I, additional, Merlo, M, additional, Elliott, P, additional, and Biagini, E, additional
- Published
- 2023
- Full Text
- View/download PDF
3. Diagnostic pathways to wild-type transthyretin amyloid cardiomyopathy: a multicentre network study
- Author
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Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., Canepa M., Tini, G, Milani, P, Zampieri, M, Caponetti, A, Fabris, F, Foli, A, Argiro, A, Mazzoni, C, Gagliardi, C, Longhi, S, Saturi, G, Vergaro, G, Aimo, A, Russo, D, Varra, G, Serenelli, M, Fabbri, G, De Michieli, L, Palmiero, G, Ciliberti, G, Carigi, S, Sessarego, E, Mandoli, G, Ricci Lucchi, G, Rella, V, Monti, E, Gardini, E, Bartolotti, M, Crotti, L, Merli, E, Mussinelli, R, Vianello, P, Cameli, M, Marzo, F, Guerra, F, Limongelli, G, Cipriani, A, Perlini, S, Obici, L, Perfetto, F, Autore, C, Porto, I, Rapezzi, C, Sinagra, G, Merlo, M, Musumeci, B, Emdin, M, Biagini, E, Cappelli, F, Palladini, G, Canepa, M, Tini G., Milani P., Zampieri M., Caponetti A. G., Fabris F., Foli A., Argiro A., Mazzoni C., Gagliardi C., Longhi S., Saturi G., Vergaro G., Aimo A., Russo D., Varra G. G., Serenelli M., Fabbri G., De Michieli L., Palmiero G., Ciliberti G., Carigi S., Sessarego E., Mandoli G. E., Ricci Lucchi G., Rella V., Monti E., Gardini E., Bartolotti M., Crotti L., Merli E., Mussinelli R., Vianello P. F., Cameli M., Marzo F., Guerra F., Limongelli G., Cipriani A., Perlini S., Obici L., Perfetto F., Autore C., Porto I., Rapezzi C., Sinagra G., Merlo M., Musumeci B., Emdin M., Biagini E., Cappelli F., Palladini G., and Canepa M.
- Abstract
Aim: Epidemiology of wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) remains poorly defined. A better characterization of pathways leading to ATTRwt-CA diagnosis is of key importance, and potentially informative of disease course and prognosis. The aim of this study was to describe the characteristics of contemporary pathways leading to ATTRwt-CA diagnosis, and their potential association with survival. Methods and results: This was a retrospective study of patients diagnosed with ATTRwt-CA at 17 Italian referral centres for CA. Patients were categorized into different ‘pathways’ according to the medical reason that triggered the diagnosis of ATTRwt-CA (hypertrophic cardiomyopathy [HCM] pathway, heart failure [HF] pathway, incidental imaging or incidental clinical pathway). Prognosis was investigated with all-cause mortality as endpoint. Overall, 1281 ATTRwt-CA patients were included in the study. The diagnostic pathway leading to ATTRwt-CA diagnosis was HCM in 7% of patients, HF in 51%, incidental imaging in 23%, incidental clinical in 19%. Patients in the HF pathway, as compared to the others, were older and had a greater prevalence of New York Heart Association (NYHA) class III–IV and chronic kidney disease. Survival was significantly worse in the HF versus other pathways, but similar among the three others. In multivariate model, older age at diagnosis, NYHA class III–IV and some comorbidities but not the HF pathway were independently associated with worse survival. Conclusions: Half of contemporary ATTRwt-CA diagnoses occur in a HF setting. These patients had worse clinical profile and outcome than those diagnosed either due to suspected HCM or incidentally, although prognosis remained primarily related to age, NYHA functional class and comorbidities rather than the diagnostic pathway itself.
- Published
- 2023
4. From the phenotype to precision medicine: An update on the cardiomyopathies diagnostic workflow
- Author
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Autore, C, Bariani, R, Bauce, B, Biagini, E, Canepa, M, Castelletti, S, Crotti, L, Limongelli, G, Merlo, M, Monda, E, Pio Loco Detto Gava, C, Parisi, V, Tini, G, Imazio, M, Autore C., Bariani R., Bauce B., Biagini E., Canepa M., Castelletti S., Crotti L., Limongelli G., Merlo M., Monda E., Pio Loco Detto Gava C., Parisi V., Tini G., Imazio M., Autore, C, Bariani, R, Bauce, B, Biagini, E, Canepa, M, Castelletti, S, Crotti, L, Limongelli, G, Merlo, M, Monda, E, Pio Loco Detto Gava, C, Parisi, V, Tini, G, Imazio, M, Autore C., Bariani R., Bauce B., Biagini E., Canepa M., Castelletti S., Crotti L., Limongelli G., Merlo M., Monda E., Pio Loco Detto Gava C., Parisi V., Tini G., and Imazio M.
- Abstract
Cardiomyopathies are disease of the cardiac muscle largely due to genetic alterations of proteins with 'structural' or 'functional' roles within the cardiomyocyte, going from the regulation of contraction-relaxation, metabolic and energetic processes to ionic fluxes. Modifications occurring to these proteins are responsible, in the vast majority of cases, for the phenotypic manifestations of the disease, including hypertrophic, dilated, arrhythmogenic and restrictive cardiomyopathies. Secondary nonhereditary causes to be excluded include infections, toxicity from drugs or alcohol or medications, hormonal imbalance and so on. Obtaining a phenotypic definition and an etiological diagnosis is becoming increasingly relevant and feasible, thanks to the availability of new tailored treatments and the diagnostic advancements made particularly in the field of genetics. This is, for example, the case for transthyretin cardiac amyloidosis, Fabry disease or dilated cardiomyopathies due to laminopathies. For these diseases, specific medications have been developed, and a more tailored arrhythmic risk stratification guides the implantation of a defibrillator. In addition, new medications directly targeting the altered protein responsible for the phenotype are becoming available (including the myosin inhibitors mavacantem and aficamten, monoclonal antibodies against Ras-MAPK, genetic therapies for sarcoglycanopathies), thus making a precision medicine approach less unrealistic even in the field of cardiomyopathies. For these reasons, a contemporary approach to cardiomyopathies must consider diagnostic algorithms founded on the clinical suspicion of the disease and developed towards a more precise phenotypic definition and etiological diagnosis, based on a multidisciplinary methodology putting together specialists from different disciplines, facilities for advanced imaging testing and genetic and anatomopathological competencies.
- Published
- 2023
5. Recommendations for pre-symptomatic genetic testing for hereditary transthyretin amyloidosis in the era of effective therapy: a multicenter Italian consensus
- Author
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Grandis, M., Obici, L., Luigetti, M., Briani, C., Benedicenti, F., Bisogni, G., Canepa, M., Cappelli, F., Danesino, C., Fabrizi, G. M., Fenu, S., Ferrandes, G., Gemelli, C., Manganelli, F., Mazzeo, A., Melchiorri, L., Perfetto, F., Pradotto, L. G., Rimessi, P., Tini, G., Tozza, S., Trevisan, L., Pareyson, D., and Mandich, P.
- Published
- 2020
- Full Text
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6. P278 A RARE CASE OF RECURRENT SARS–COV–2 MRNA VACCINE–INDUCED PERICARDITIS
- Author
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Mistrulli, R, primary, Orellana, S, additional, Cittadini, E, additional, Ricci, M, additional, Tini, G, additional, Musumeci, M, additional, Autore, C, additional, Tocci, G, additional, and Pagannone, E, additional
- Published
- 2023
- Full Text
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7. Acute Myocarditis Associated With Desmosomal Gene Variants
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Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., Cooper L. T., Ammirati, E, Raimondi, F, Piriou, N, Sardo Infirri, L, Mohiddin, S, Mazzanti, A, Shenoy, C, Cavallari, U, Imazio, M, Aquaro, G, Olivotto, I, Pedrotti, P, Sekhri, N, Van de Heyning, C, Broeckx, G, Peretto, G, Guttmann, O, Dellegrottaglie, S, Scatteia, A, Gentile, P, Merlo, M, Goldberg, R, Reyentovich, A, Sciamanna, C, Klaassen, S, Poller, W, Trankle, C, Abbate, A, Keren, A, Horowitz-Cederboim, S, Cadrin-Tourigny, J, Tadros, R, Annoni, G, Bonoldi, E, Toquet, C, Marteau, L, Probst, V, Trochu, J, Kissopoulou, A, Grosu, A, Kukavica, D, Trancuccio, A, Gil, C, Tini, G, Pedrazzini, M, Torchio, M, Sinagra, G, Gimeno, J, Bernasconi, D, Valsecchi, M, Klingel, K, Adler, E, Camici, P, Cooper, L, Ammirati E., Raimondi F., Piriou N., Sardo Infirri L., Mohiddin S. A., Mazzanti A., Shenoy C., Cavallari U. A., Imazio M., Aquaro G. D., Olivotto I., Pedrotti P., Sekhri N., Van de Heyning C. M., Broeckx G., Peretto G., Guttmann O., Dellegrottaglie S., Scatteia A., Gentile P., Merlo M., Goldberg R. I., Reyentovich A., Sciamanna C., Klaassen S., Poller W., Trankle C. R., Abbate A., Keren A., Horowitz-Cederboim S., Cadrin-Tourigny J., Tadros R., Annoni G. A., Bonoldi E., Toquet C., Marteau L., Probst V., Trochu J. N., Kissopoulou A., Grosu A., Kukavica D., Trancuccio A., Gil C., Tini G., Pedrazzini M., Torchio M., Sinagra G., Gimeno J. R., Bernasconi D., Valsecchi M. G., Klingel K., Adler E. D., Camici P. G., and Cooper L. T.
- Abstract
Background: The risk of adverse cardiovascular events in patients with acute myocarditis (AM) and desmosomal gene variants (DGV) remains unknown. Objectives: The purpose of this study was to ascertain the risk of death, ventricular arrhythmias, recurrent myocarditis, and heart failure (main endpoint) in patients with AM and pathogenic or likely pathogenetic DGV. Methods: In a retrospective international study from 23 hospitals, 97 patients were included: 36 with AM and DGV (DGV[+]), 25 with AM and negative gene testing (DGV[−]), and 36 with AM without genetics testing. All patients had troponin elevation plus findings consistent with AM on histology or at cardiac magnetic resonance (CMR). In 86 patients, CMR changes in function and structure were re-assessed at follow-up. Results: In the DGV(+) AM group (88.9% DSP variants), median age was 24 years, 91.7% presented with chest pain, and median left ventricular ejection fraction (LVEF) was 56% on CMR (P = NS vs the other 2 groups). Kaplan-Meier curves demonstrated a higher risk of the main endpoint in DGV(+) AM compared with DGV(−) and without genetics testing patients (62.3% vs 17.5% vs 5.3% at 5 years, respectively; P < 0.0001), driven by myocarditis recurrence and ventricular arrhythmias. At follow-up CMR, a higher number of late gadolinium enhanced segments was found in DGV(+) AM. Conclusions: Patients with AM and evidence of DGV have a higher incidence of adverse cardiovascular events compared with patients with AM without DGV. Further prospective studies are needed to ascertain if genetic testing might improve risk stratification of patients with AM who are considered at low risk.
- Published
- 2022
8. 83P The Immune-related adverse event (IRAE) Likelihood Score (ILS) identifies “pure” IRAEs strongly associated with outcome in a phase I-II trial population
- Author
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Mazzarella, L., primary, Nicolo, E., additional, Esposito, A., additional, Crimini, E., additional, Tini, G., additional, Uliano, J., additional, Corti, C., additional, Trillo Aliaga, P.M., additional, Valenza, C., additional, Repetto, M., additional, Antonarelli, G., additional, Minchella, I., additional, Belli, C., additional, Locatelli, M.A., additional, Criscitiello, C., additional, and Curigliano, G., additional
- Published
- 2022
- Full Text
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9. Incidence and factors associated with de novo atrial fibrillation in patients with wild-type transthyretin cardiac amyloidosis
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Fumagalli, C, primary, Zampieri, M, additional, Argiro', A, additional, Musumeci, B, additional, Tini, G, additional, Di Bella, G, additional, Cipriani, A, additional, Porcari, A, additional, Canepa, M, additional, Merlo, M, additional, Sinagra, G, additional, Rapezzi, C, additional, Perfetto, F, additional, and Cappelli, F, additional
- Published
- 2022
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10. Prognostic implications of biventricular uptake of bone tracers at planar scintigraphy in transthyretin cardiac amyloidosis
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Porcari, A, primary, Pagura, L, additional, Canepa, M, additional, Biagini, E, additional, Cappelli, F, additional, Tini, G, additional, Dore, F, additional, Longhi, S, additional, Sciagra', R, additional, Fontana, M, additional, Gillmore, J, additional, Rapezzi, C, additional, Merlo, M, additional, and Sinagra, G, additional
- Published
- 2022
- Full Text
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11. Incidence and risk factors for pacemaker implantation in light chain and transthyretin cardiac amyloidosis
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Porcari, A, primary, Rossi, M, additional, Cappelli, F, additional, Canepa, M, additional, Musumeci, B, additional, Cipriani, A, additional, Tini, G, additional, Varra', G G, additional, Argiro', A, additional, Sessarego, E, additional, Sinigiani, G, additional, Di Bella, G, additional, Rapezzi, C, additional, Sinagra, G, additional, and Merlo, M, additional
- Published
- 2022
- Full Text
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12. Current patterns of beta-blocker prescription in cardiac amyloidosis: an Italian nationwide survey
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Tini, G, Cappelli, F, Biagini, E, Musumeci, B, Merlo, M, Crotti, L, Cameli, M, Di Bella, G, Cipriani, A, Marzo, F, Guerra, F, Forleo, C, Gagliardi, C, Zampieri, M, Carigi, S, Vianello, P, Mandoli, G, Ciliberti, G, Lichelli, L, Mariani, D, Porcari, A, Russo, D, Licordari, R, Ponziani, A, Porto, I, Perfetto, F, Autore, C, Rapezzi, C, Sinagra, G, Canepa, M, Tini G., Cappelli F., Biagini E., Musumeci B., Merlo M., Crotti L., Cameli M., Di Bella G., Cipriani A., Marzo F., Guerra F., Forleo C., Gagliardi C., Zampieri M., Carigi S., Vianello P. F., Mandoli G. E., Ciliberti G., Lichelli L., Mariani D., Porcari A., Russo D., Licordari R., Ponziani A., Porto I., Perfetto F., Autore C., Rapezzi C., Sinagra G., Canepa M., Tini, G, Cappelli, F, Biagini, E, Musumeci, B, Merlo, M, Crotti, L, Cameli, M, Di Bella, G, Cipriani, A, Marzo, F, Guerra, F, Forleo, C, Gagliardi, C, Zampieri, M, Carigi, S, Vianello, P, Mandoli, G, Ciliberti, G, Lichelli, L, Mariani, D, Porcari, A, Russo, D, Licordari, R, Ponziani, A, Porto, I, Perfetto, F, Autore, C, Rapezzi, C, Sinagra, G, Canepa, M, Tini G., Cappelli F., Biagini E., Musumeci B., Merlo M., Crotti L., Cameli M., Di Bella G., Cipriani A., Marzo F., Guerra F., Forleo C., Gagliardi C., Zampieri M., Carigi S., Vianello P. F., Mandoli G. E., Ciliberti G., Lichelli L., Mariani D., Porcari A., Russo D., Licordari R., Ponziani A., Porto I., Perfetto F., Autore C., Rapezzi C., Sinagra G., and Canepa M.
- Abstract
Aims: The use of beta-blocker therapy in cardiac amyloidosis (CA) is debated. We aimed at describing patterns of beta-blocker prescription through a nationwide survey. Methods and results: From 11 referral centres, we retrospectively collected data of CA patients with a first evaluation after 2016 (n = 642). Clinical characteristics at first and last evaluation were collected, with a focus on medical therapy. For patients in whom beta-blocker therapy was started, stopped, or continued between first and last evaluation, the main reason for beta-blocker management was requested. Median age of study population was 77 years; 81% were men. Arterial hypertension was found in 58% of patients, atrial fibrillation (AF) in 57%, and coronary artery disease in 16%. Left ventricular ejection fraction was preserved in 62% of cases, and 74% of patients had advanced diastolic dysfunction. Out of the 250 CA patients on beta-blockers at last evaluation, 215 (33%) were already taking this therapy at first evaluation, while 35 (5%) were started it, in both cases primarily because of high-rate AF. One-hundred-nineteen patients (19%) who were on beta-blocker at first evaluation had this therapy withdrawn, mainly because of intolerance in the presence of heart failure with advanced diastolic dysfunction. The remaining 273 patients (43%) had never received beta-blocker therapy. Beta-blockers usage was similar between CA aetiologies. Patients taking vs. not taking beta-blockers differed only for a greater prevalence of arterial hypertension, coronary artery disease, AF, and non-restrictive filling pattern (P < 0.01 for all) in the former group. Conclusions: Beta-blockers prescription is not infrequent in CA. Such therapy may be tolerated in the presence of co-morbidities for which beta-blockers are routinely used and in the absence of advanced diastolic dysfunction.
- Published
- 2021
13. Proof of stability of an RSV Controlled Human Infection Model challenge agent
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Sandra Verstraelen, Dirk Roymans, An Jacobs, Karen Hollanders, Sylvie Remy, Dirk Jochmans, Jelle Klein, and Tini Grauwet
- Subjects
RSV-NICA ,CHIM ,TCID50 ,Plaque ,Titration ,MucilAir™ ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract In 2018, SGS Belgium NV developed RSV-NICA (Respiratory Syncytial Virus-Nasobronchial Infective Challenge Agent), an RSV type A challenge agent for use in RSV Controlled Human Infection Model (CHIM) studies. It is widely recognized that the stability of RSV can be influenced by a variety of environmental parameters, such as temperature and pH. Consequently, our objective was to evaluate the stability of the viral titer of RSV-NICA following five years of controlled storage and to determine the uniformity of the viral titers across different vials of a GMP-qualified batch of RSV-NICA. In addition, we examined the capacity of RSV-NICA to infect human primary airway epithelial cells (MucilAir™), the principal target cells of RSV, and evaluated the influence of single and recurrent freeze–thaw cycles on the infectious viral titer of the challenge agent. The aliquoted RSV-NICA virus stock was subjected to standard virological and molecular methods to gather data on the titer and consistency of the viral titer contained within 24 representative vials of the stock. Our findings illustrate that over a span of five years of cryo-storage, the infectious viral titer in 75% of the tested vials exhibited a comparable average infectious viral titer (4.75 ± 0.06 vs 4.99 ± 0.11; p-value = 0.14). A considerable reduction down to an undetectable level of infectious virus was observed in the remaining vials. RSV-NICA demonstrated its capacity to effectively infect differentiated human airway epithelial cells, with active virus replication detected in these cells through increasing RSV genome copy number over time. Virus tropism for ciliated cells was suggested by the inhibition of cilia beating coupled with an increase in viral RNA titers. No discernable impact on membrane barrier function of the epithelial lung tissues nor cytotoxicity was detected. Pooling of vials with infectious titers > 4.0 log10 TCID50/ml and freeze-thawing of these combined vials showed no deterioration of the infectious titer. Furthermore, pooling and re-aliquoting of vials spanning the entire range of viral titers (including vials with undetectable infectious virus) along with subjecting the vials to three repeated freeze–thaw cycles did not result in a decrease of the infectious titers in the tested vials. Taken together, our findings indicate that long-term cryo-storage of vials containing RSV-NICA challenge agent may influence the infectious viral titer of the virus, leading to a decrease in the homogeneity of this titer throughout the challenge stock. However, our study also demonstrates that when heterogeneity of the infectious titer of an RSV stock is observed, rounds of pooling, re-aliquoting and subsequent re-titration serve as an effective method not only to restore the homogeneity of the infectious titer of an RSV-A stock, but also to optimize patient-safety, scientific and operational aspects of viral inoculation of study participants during at least the period of one RSV CHIM trial. RSV-NICA is a stable, suitable CHIM challenge agent that can be utilized in efficacy trials for RSV vaccines and antiviral entities.
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- 2024
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14. Radiomic analysis for prediction of nodal status in lung cancer simulated data: comparison of machine learning methods
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Presti, G. Lo, primary, Corso, F., additional, Tini, G., additional, Garau, N., additional, De Angelis, S., additional, Bellerba, F., additional, Botta, F., additional, Rinaldi, L., additional, Rizzo, S., additional, Origgi, D., additional, Rampinelli, C., additional, Bellomi, M., additional, Gandini, S., additional, and Raimondi, S., additional
- Published
- 2021
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15. Hepatitis From Spiroplasma sp. in an Immunocompromised Patient
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Mueller, N. J., Tini, G. M., Weber, A., Gaspert, A., Husmann, L., Bloemberg, G., Boehler, A., and Benden, C.
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- 2015
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16. Comparison of cardiovascular risk scores to predict anthracycline-induced cardiotoxicity in early breast cancer patients
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Solfanelli, G, Bianchini, G, Petrungaro, M, Reale, S, Lanza, O, Ferrera, A, Tini, G, Piras, M, Pellegrini, P, Tocci, G, Battistoni, A, and Volpe, M
- Published
- 2021
17. Cancer Patient With Unusual Dyspnea in the COVID-19 Era. Challenging Management of a Rare Cardiac Tumor
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La Malfa, G., Spallarossa, P., Tini, G., Sarocchi, M., Salsano, A., Parolari, G., Guadagno, A., Sciallero, S., Porto, I., and Santini, F.
- Subjects
shortness of breath ,cancer ,echocardiography ,imaging ,computed tomography ,right ventricle - Published
- 2021
18. I poligoni stellati: origini storiche ed implicazioni didattiche
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Palladino, N., Tini, G., Vaccaro, M. A., Casolaro, F, Sessa, S, Palladino N, Tini G, and Vaccaro M.A.
- Subjects
storia della matematica ,Star polygons, Euclidean geometry, History of Mathematics, Mathematics Education ,didattica della matematica ,concezioni operativa e strutturale ,storia della matematica, didattica della matematica, concezioni operativa e strutturale ,Settore MAT/04 - Matematiche Complementari - Abstract
The genesis of mathematical concepts in the evolutionary line of human thought in the long story and the genesis in individual optics possess evident analogies. Starting from this assumption, we describe an activity presented to 15-year-old students; the aim was to consolidate fundamental concepts of Euclidean geometry related to regular polygons. The experimentation has used a didactic approach based on the historical evolution of the formal definition of regular star polygon through the centuries. The activity and the results obtained in terms of internalization of the concepts in the students are showed.
- Published
- 2019
19. Temporal trend of age at diagnosis in hypertrophic cardiomyopathy: an analysis of the international SHaRe Registry
- Author
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Canepa, M, Fumagalli, C, Tini, G, Vincent-Tompkins, J, Day, SM, Ashley, EA, Mazzarotto, F, Ware, J, Michels, M, Jacoby, M, Ho, CY, Olivotto, I, The SHaRe Investigators, Wellcome Trust, and British Heart Foundation
- Subjects
SHaRe Investigators ,Cardiovascular System & Hematology ,phenotype ,genotype ,1116 Medical Physiology ,prevalence ,heart failure ,1103 Clinical Sciences ,0601 Biochemistry and Cell Biology ,cardiomyopathy, hypertrophic ,1102 Cardiorespiratory Medicine and Haematology ,1117 Public Health and Health Services - Abstract
BACKGROUND Over the last 50 years, the epidemiology of hypertrophic cardiomyopathy (HCM) has changed due to increased awareness and availability of advanced diagnostic tools. We aim to describe the temporal trends in age, gender and clinical characteristics at HCM diagnosis over >4 decades. METHODS We retrospectively analyzed records from the ongoing multinational SHaRe registry. Overall, 7,286 HCM patients diagnosed at an age ≥18 years between 1961 and 2019 were included in the analysis and divided into three eras of diagnosis (2010). RESULTS Age at diagnosis increased markedly over time (40±14 vs. 47±15 vs. 51±16 years, p30 mmHg: 31.9% vs. 39.3% vs. 39.0%, p=0.001). Consistent with decreasing phenotypic severity, yield of pathogenic/likely-pathogenic variants at genetic testing decreased over time (57.7% vs. 45.6% vs. 38.4%, p
- Published
- 2020
20. Temporal Trend of Age at Diagnosis in Hypertrophic Cardiomyopathy: An Analysis of the International Sarcomeric Human Cardiomyopathy Registry
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Canepa, M, Fumagalli, C, Tini, G, Vincent-Tompkins, J, Day, S M, Ashley, E A, Mazzarotto, F, Ware, JS, Michels, Michelle, Jacoby, D, Ho, CY, Olivotto, I, Canepa, M, Fumagalli, C, Tini, G, Vincent-Tompkins, J, Day, S M, Ashley, E A, Mazzarotto, F, Ware, JS, Michels, Michelle, Jacoby, D, Ho, CY, and Olivotto, I
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- 2020
21. Low Sensitivity of Bone Scintigraphy in Detecting Phe64Leu Mutation-Related Transthyretin Cardiac Amyloidosis
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Musumeci, M. B., Cappelli, F., Russo, D., Tini, G., Canepa, M., Milandri, A., Bonfiglioli, R., Di Bella, G., My, F., Luigetti, Marco, Grandis, M., Autore, C., Perlini, S., Perfetto, F., Rapezzi, C., Luigetti M. (ORCID:0000-0001-7539-505X), Musumeci, M. B., Cappelli, F., Russo, D., Tini, G., Canepa, M., Milandri, A., Bonfiglioli, R., Di Bella, G., My, F., Luigetti, Marco, Grandis, M., Autore, C., Perlini, S., Perfetto, F., Rapezzi, C., and Luigetti M. (ORCID:0000-0001-7539-505X)
- Abstract
Objectives: The aim of this study was to assess the diagnostic accuracy of bone scintigraphy in a large multicenter cohort of patients with cardiac amyloidotic involvement and Phe64Leu transthyretin (TTR) mutation. Background: Diagnostic accuracy of bone scintigraphy for transthyretin-related cardiac amyloidosis (TTR-CA) is considered extremely high, enabling this technique to be the noninvasive diagnostic standard for TTR-CA. Nevertheless, this approach has not been systematically validated across the entire spectrum of TTR mutations. Methods: A total of 55 patients with Phe64Leu TTR mutation were retrospectively analyzed and evaluated between 1993 and 2018 at 7 specialized Italian tertiary centers. Cardiac involvement was defined as presence of an end-diastolic interventricular septum thickness ≥12 mm, without other possible causes of left ventricular hypertrophy (i.e., arterial hypertension or valvulopathies). A technetium-99m (99mTc)–diphosphonate (DPD) or 99mTc–hydroxyl-methylene-diphosphonate (HMDP) bone scintigraphy was reviewed, and visual scoring was evaluated according to Perugini's method. Results: Among 26 patients with definite cardiac involvement, 19 underwent 99mTc-DPD or 99mTc-HMDP bone scintigraphy. Of them, 17 (89.5%) patients had low or absent myocardial bone tracer uptake, whereas only 2 (10.5%) showed high-grade myocardial uptake. The sensitivity and the accuracy of bone scintigraphy in detecting TTR-CA were 10.5% and 37%, respectively. Patients with cardiac involvement and low or absent bone tracer uptake were similar to those with high-grade myocardial uptake in terms of age, sex, and electrocardiographic and echocardiographic findings. Conclusions: The sensitivity of bone scintigraphy (DPD and HMDP) in detecting TTR-CA is extremely low in patients with Phe64Leu TTR mutation, suggesting the need to assess diagnostic accuracy of bone scintigraphy to identify cardiac involvement across a wider spectrum of TTR mutations.
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- 2020
22. Temporal Trend in Age at Diagnosis of Hypertrophic Cardiomyopathy: An Analysis of the Share Registry
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Canepa, M, Fumagalli, C, Tini, G, Mazzarotto, F, Vincent-Tompkins, J, Day, S, Ashley, E, Michels, M, Colan, Sd, Jacoby, D, Ho, C, and Olivotto, I
- Published
- 2019
23. OD168 - Radiomic analysis for prediction of nodal status in lung cancer simulated data: comparison of machine learning methods
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Presti, G. Lo, Corso, F., Tini, G., Garau, N., De Angelis, S., Bellerba, F., Botta, F., Rinaldi, L., Rizzo, S., Origgi, D., Rampinelli, C., Bellomi, M., Gandini, S., and Raimondi, S.
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- 2021
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24. How can the public health impact of vaccination be estimated?
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Susy Echeverria-Londono, Xiang Li, Jaspreet Toor, Margaret J. de Villiers, Shevanthi Nayagam, Timothy B. Hallett, Kaja Abbas, Mark Jit, Petra Klepac, Kévin Jean, Tini Garske, Neil M. Ferguson, and Katy A. M. Gaythorpe
- Subjects
Vaccine ,Impact ,Modelling ,Hepatitis ,Measles ,Yellow fever ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Deaths due to vaccine preventable diseases cause a notable proportion of mortality worldwide. To quantify the importance of vaccination, it is necessary to estimate the burden averted through vaccination. The Vaccine Impact Modelling Consortium (VIMC) was established to estimate the health impact of vaccination. Methods We describe the methods implemented by the VIMC to estimate impact by calendar year, birth year and year of vaccination (YoV). The calendar and birth year methods estimate impact in a particular year and over the lifetime of a particular birth cohort, respectively. The YoV method estimates the impact of a particular year’s vaccination activities through the use of impact ratios which have no stratification and stratification by activity type and/or birth cohort. Furthermore, we detail an impact extrapolation (IE) method for use between coverage scenarios. We compare the methods, focusing on YoV for hepatitis B, measles and yellow fever. Results We find that the YoV methods estimate similar impact with routine vaccinations but have greater yearly variation when campaigns occur with the birth cohort stratification. The IE performs well for the YoV methods, providing a time-efficient mechanism for updates to impact estimates. Conclusions These methods provide a robust set of approaches to quantify vaccination impact; however it is vital that the area of impact estimation continues to develop in order to capture the full effect of immunisation.
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- 2021
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25. Seasonality of agricultural exposure as an important predictor of seasonal yellow fever spillover in Brazil
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Arran Hamlet, Daniel Garkauskas Ramos, Katy A. M. Gaythorpe, Alessandro Pecego Martins Romano, Tini Garske, and Neil M. Ferguson
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Science - Abstract
Yellow fever virus (YFV) is an arbovirus affecting humans and non-human primates (NHPs) with seasonal transmission. Here Hamlet et al. model the monthly occurrence of YF in humans and NHPs across Brazil and show that seasonality of agriculture is an important predictor of seasonal YF transmission.
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- 2021
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26. Risk of yellow fever virus importation into the United States from Brazil, outbreak years 2016–2017 and 2017–2018
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Ilaria Dorigatti, Stephanie Morrison, Christl A. Donnelly, Tini Garske, Sarah Bowden, and Ardath Grills
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Medicine ,Science - Abstract
Abstract Southeast Brazil has experienced two large yellow fever (YF) outbreaks since 2016. While the 2016–2017 outbreak mainly affected the states of Espírito Santo and Minas Gerais, the 2017–2018 YF outbreak primarily involved the states of Minas Gerais, São Paulo, and Rio de Janeiro, the latter two of which are highly populated and popular destinations for international travelers. This analysis quantifies the risk of YF virus (YFV) infected travelers arriving in the United States via air travel from Brazil, including both incoming Brazilian travelers and returning US travelers. We assumed that US travelers were subject to the same daily risk of YF infection as Brazilian residents. During both YF outbreaks in Southeast Brazil, three international airports—Miami, New York-John F. Kennedy, and Orlando—had the highest risk of receiving a traveler infected with YFV. Most of the risk was observed among incoming Brazilian travelers. Overall, we found low risk of YFV introduction into the United States during the 2016–2017 and 2017–2018 outbreaks. Decision makers can use these results to employ the most efficient and least restrictive actions and interventions.
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- 2019
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27. Practical approach to emergencies in lung transplant recipients: how we do it
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Schuurmans, M M, Tini, G M, Zuercher, A, Hofer, M, Benden, C, Boehler, A, Schuurmans, M M, Tini, G M, Zuercher, A, Hofer, M, Benden, C, and Boehler, A
- Abstract
Lung transplant recipients (LTRs) are prone to medical complications and emergencies due to the transplanted organ being in constant direct contact with the environment and the need for life-long profound immunosuppression (IS). As a result of these specific circumstances, the medical and surgical management of LTRs frequently differs from usual standard care. Therefore, we outline here some of the principles we take into account when dealing with the most frequent medical emergencies encountered in our lung transplant cohort in Zurich. The main topics dealt with are: diagnostics and treatment of infections, gastrointestinal emergencies, IS and other medication issues as well as work-up of unclear inflammatory signs and peri-operative precautions in LTRs. Early post-operative transplant complications, rare medical emergencies and surgical problems are not covered. Our report is intended to help internists and pulmonologists new to the field to obtain a better understanding of the peculiarities of LTRs and their management.
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- 2012
28. Mapping the baseline prevalence of lymphatic filariasis across Nigeria
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Obiora A. Eneanya, Claudio Fronterre, Ifeoma Anagbogu, Chukwu Okoronkwo, Tini Garske, Jorge Cano, and Christl A. Donnelly
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Lymphatic filariasis ,Machine learning ,Antigenaemia ,Microfilaraemia ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Introduction The baseline endemicity profile of lymphatic filariasis (LF) is a key benchmark for planning control programmes, monitoring their impact on transmission and assessing the feasibility of achieving elimination. Presented in this work is the modelled serological and parasitological prevalence of LF prior to the scale-up of mass drug administration (MDA) in Nigeria using a machine learning based approach. Methods LF prevalence data generated by the Nigeria Lymphatic Filariasis Control Programme during country-wide mapping surveys conducted between 2000 and 2013 were used to build the models. The dataset comprised of 1103 community-level surveys based on the detection of filarial antigenemia using rapid immunochromatographic card tests (ICT) and 184 prevalence surveys testing for the presence of microfilaria (Mf) in blood. Using a suite of climate and environmental continuous gridded variables and compiled site-level prevalence data, a quantile regression forest (QRF) model was fitted for both antigenemia and microfilaraemia LF prevalence. Model predictions were projected across a continuous 5 × 5 km gridded map of Nigeria. The number of individuals potentially infected by LF prior to MDA interventions was subsequently estimated. Results Maps presented predict a heterogeneous distribution of LF antigenemia and microfilaraemia in Nigeria. The North-Central, North-West, and South-East regions displayed the highest predicted LF seroprevalence, whereas predicted Mf prevalence was highest in the southern regions. Overall, 8.7 million and 3.3 million infections were predicted for ICT and Mf, respectively. Conclusions QRF is a machine learning-based algorithm capable of handling high-dimensional data and fitting complex relationships between response and predictor variables. Our models provide a benchmark through which the progress of ongoing LF control efforts can be monitored.
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- 2019
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29. Guidelines for multi-model comparisons of the impact of infectious disease interventions
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Saskia den Boon, Mark Jit, Marc Brisson, Graham Medley, Philippe Beutels, Richard White, Stefan Flasche, T. Déirdre Hollingsworth, Tini Garske, Virginia E. Pitzer, Martine Hoogendoorn, Oliver Geffen, Andrew Clark, Jane Kim, and Raymond Hutubessy
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Model comparisons ,Policy ,Decision-making ,Impact modelling ,Cost-effectiveness ,Infectious diseases ,Medicine - Abstract
Abstract Background Despite the increasing popularity of multi-model comparison studies and their ability to inform policy recommendations, clear guidance on how to conduct multi-model comparisons is not available. Herein, we present guidelines to provide a structured approach to comparisons of multiple models of interventions against infectious diseases. The primary target audience for these guidelines are researchers carrying out model comparison studies and policy-makers using model comparison studies to inform policy decisions. Methods The consensus process used for the development of the guidelines included a systematic review of existing model comparison studies on effectiveness and cost-effectiveness of vaccination, a 2-day meeting and guideline development workshop during which mathematical modellers from different disease areas critically discussed and debated the guideline content and wording, and several rounds of comments on sequential versions of the guidelines by all authors. Results The guidelines provide principles for multi-model comparisons, with specific practice statements on what modellers should do for six domains. The guidelines provide explanation and elaboration of the principles and practice statements as well as some examples to illustrate these. The principles are (1) the policy and research question – the model comparison should address a relevant, clearly defined policy question; (2) model identification and selection – the identification and selection of models for inclusion in the model comparison should be transparent and minimise selection bias; (3) harmonisation – standardisation of input data and outputs should be determined by the research question and value of the effort needed for this step; (4) exploring variability – between- and within-model variability and uncertainty should be explored; (5) presenting and pooling results – results should be presented in an appropriate way to support decision-making; and (6) interpretation – results should be interpreted to inform the policy question. Conclusion These guidelines should help researchers plan, conduct and report model comparisons of infectious diseases and related interventions in a systematic and structured manner for the purpose of supporting health policy decisions. Adherence to these guidelines will contribute to greater consistency and objectivity in the approach and methods used in multi-model comparisons, and as such improve the quality of modelled evidence for policy.
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- 2019
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30. The social, physical and economic impact of lymphedema and hydrocele: a matched cross-sectional study in rural Nigeria
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Obiora A. Eneanya, Tini Garske, and Christl A. Donnelly
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Lymphatic filariasis ,Lymphedema ,Hydrocele ,Psychosocial impacts ,Mental health ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Lymphatic filariasis (LF) is a mosquito-borne parasitic disease and a major cause of disability worldwide. To effectively plan morbidity management programmes, it is important to estimate disease burden and evaluate the needs of patients. This study aimed to estimate patient numbers and characterise the physical, social and economic impact of LF in in rural Nigeria. Methods This is a matched cross-sectional study which identified lymphedema and hydrocele patients with the help of district health officers and community-directed distributors of mass drug administration programmes. A total of 52 cases were identified and matched to 52 apparently disease-free controls, selected from the same communities and matched by age and sex. Questionnaires and narrative interviews were used to characterise the physical, social and economic impact of lymphedema and hydrocele. Results Forty-eight cases with various stages of lower limb lymphedema, and 4 with hydrocele were identified. 40% of all cases reported feeling stigma and were 36 times (95% CI: 5.18–1564.69) more likely to avoid forms of social participation. Although most cases engaged in some form of income-generating activity, these were low paid employment, and on average cases spent significantly less time than controls working. The economic effects of lower income were exacerbated by increased healthcare spending, as cases were 86 times (95% CI: 17.48–874.90) more likely to spend over US $125 on their last healthcare payment. Conclusion This study highlights the importance of patient-search as a means of estimating the burden of LF morbidity in rural settings. Findings from this work also confirm that LF causes considerable psychosocial and economic suffering, all of which adversely affect the mental health of patients. It is therefore important to incorporate mental health care as a major component of morbidity management programmes.
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- 2019
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31. The global burden of yellow fever
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Katy AM Gaythorpe, Arran Hamlet, Kévin Jean, Daniel Garkauskas Ramos, Laurence Cibrelus, Tini Garske, and Neil Ferguson
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yellow fever ,mathematical modelling ,vaccine impact ,vector-borne ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Yellow fever (YF) is a viral, vector-borne, haemorrhagic fever endemic in tropical regions of Africa and South America. The vaccine for YF is considered safe and effective, but intervention strategies need to be optimised; one of the tools for this is mathematical modelling. We refine and expand an existing modelling framework for Africa to account for transmission in South America. We fit to YF occurrence and serology data. We then estimate the subnational forces of infection for the entire endemic region. Finally, using demographic and vaccination data, we examine the impact of vaccination activities. We estimate that there were 109,000 (95% credible interval [CrI] [67,000–173,000]) severe infections and 51,000 (95% CrI [31,000–82,000]) deaths due to YF in Africa and South America in 2018. We find that mass vaccination activities in Africa reduced deaths by 47% (95% CrI [10%–77%]). This methodology allows us to evaluate the effectiveness of vaccination and illustrates the need for continued vigilance and surveillance of YF.
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- 2021
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32. Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study.
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Kévin Jean, Hanaya Raad, Katy A M Gaythorpe, Arran Hamlet, Judith E Mueller, Dan Hogan, Tewodaj Mengistu, Heather J Whitaker, Tini Garske, and Mounia N Hocine
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Medicine - Abstract
BackgroundThe Eliminate Yellow fever Epidemics (EYE) strategy was launched in 2017 in response to the resurgence of yellow fever in Africa and the Americas. The strategy relies on several vaccination activities, including preventive mass vaccination campaigns (PMVCs). However, to what extent PMVCs are associated with a decreased risk of outbreak has not yet been quantified.Methods and findingsWe used the self-controlled case series (SCCS) method to assess the association between the occurrence of yellow fever outbreaks and the implementation of PMVCs at the province level in the African endemic region. As all time-invariant confounders are implicitly controlled for in the SCCS method, this method is an alternative to classical cohort or case-control study designs when the risk of residual confounding is high, in particular confounding by indication. The locations and dates of outbreaks were identified from international epidemiological records, and information on PMVCs was provided by coordinators of vaccination activities and international funders. The study sample consisted of provinces that were both affected by an outbreak and targeted for a PMVC between 2005 and 2018. We compared the incidence of outbreaks before and after the implementation of a PMVC. The sensitivity of our estimates to a range of assumptions was explored, and the results of the SCCS method were compared to those obtained through a retrospective cohort study design. We further derived the number of yellow fever outbreaks that have been prevented by PMVCs. The study sample consisted of 33 provinces from 11 African countries. Among these, the first outbreak occurred during the pre-PMVC period in 26 (79%) provinces, and during the post-PMVC period in 7 (21%) provinces. At the province level, the post-PMVC period was associated with an 86% reduction (95% CI 66% to 94%, p < 0.001) in the risk of outbreak as compared to the pre-PMVC period. This negative association between exposure to PMVCs and outbreak was robustly observed across a range of sensitivity analyses, especially when using quantitative estimates of vaccination coverage as an alternative exposure measure, or when varying the observation period. In contrast, the results of the cohort-style analyses were highly sensitive to the choice of covariates included in the model. Based on the SCCS results, we estimated that PMVCs were associated with a 34% (95% CI 22% to 45%) reduction in the number of outbreaks in Africa from 2005 to 2018. A limitation of our study is the fact that it does not account for potential time-varying confounders, such as changing environmental drivers of yellow fever and possibly improved disease surveillance.ConclusionsIn this study, we provide new empirical evidence of the high preventive impact of PMVCs on yellow fever outbreaks. This study illustrates that the SCCS method can be advantageously applied at the population level in order to evaluate a public health intervention.
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- 2021
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33. Hepatitis-C-Infektion mit falsch negativer Serologie bei gemischter kryoglobulinämischer Vaskulitis
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Tini, G, primary, Wüscher, V, additional, and Jeker, R, additional
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- 2007
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34. Seasonal and inter-annual drivers of yellow fever transmission in South America.
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Arran Hamlet, Katy A M Gaythorpe, Tini Garske, and Neil M Ferguson
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
In the last 20 years yellow fever (YF) has seen dramatic changes to its incidence and geographic extent, with the largest outbreaks in South America since 1940 occurring in the previously unaffected South-East Atlantic coast of Brazil in 2016-2019. While habitat fragmentation and land-cover have previously been implicated in zoonotic disease, their role in YF has not yet been examined. We examined the extent to which vegetation, land-cover, climate and host population predicted the numbers of months a location reported YF per year and by each month over the time-period. Two sets of models were assessed, one looking at interannual differences over the study period (2003-2016), and a seasonal model looking at intra-annual differences by month, averaging over the years of the study period. Each was fit using hierarchical negative-binomial regression in an exhaustive model fitting process. Within each set, the best performing models, as measured by the Akaike Information Criterion (AIC), were combined to create ensemble models to describe interannual and seasonal variation in YF. The models reproduced the spatiotemporal heterogeneities in YF transmission with coefficient of determination (R2) values of 0.43 (95% CI 0.41-0.45) for the interannual model and 0.66 (95% CI 0.64-0.67) for the seasonal model. For the interannual model, EVI, land-cover and vegetation heterogeneity were the primary contributors to the variance explained by the model, and for the seasonal model, EVI, day temperature and rainfall amplitude. Our models explain much of the spatiotemporal variation in YF in South America, both seasonally and across the period 2003-2016. Vegetation type (EVI), heterogeneity in vegetation (perhaps a proxy for habitat fragmentation) and land cover explain much of the trends in YF transmission seen. These findings may help understand the recent expansions of the YF endemic zone, as well as to the highly seasonal nature of YF.
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- 2021
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35. The effect of climate change on yellow fever disease burden in Africa
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Katy AM Gaythorpe, Arran Hamlet, Laurence Cibrelus, Tini Garske, and Neil M Ferguson
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yellow fever ,climate change ,mathematical model ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Yellow Fever (YF) is an arbovirus endemic in tropical regions of South America and Africa and it is estimated to cause 78,000 deaths a year in Africa alone. Climate change may have substantial effects on the transmission of YF and we present the first analysis of the potential impact on disease burden. We extend an existing model of YF transmission to account for rainfall and a temperature suitability index and project transmission intensity across the African endemic region in the context of four climate change scenarios. We use these transmission projections to assess the change in burden in 2050 and 2070. We find disease burden changes heterogeneously across the region. In the least severe scenario, we find a 93.0%[95%CI(92.7, 93.2%)] chance that annual deaths will increase in 2050. This change in epidemiology will complicate future control efforts. Thus, we may need to consider the effect of changing climatic variables on future intervention strategies.
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- 2020
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36. Eliminating yellow fever epidemics in Africa: Vaccine demand forecast and impact modelling.
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Kévin Jean, Arran Hamlet, Justus Benzler, Laurence Cibrelus, Katy A M Gaythorpe, Amadou Sall, Neil M Ferguson, and Tini Garske
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundTo counter the increasing global risk of Yellow fever (YF), the World Health Organisation initiated the Eliminate Yellow fever Epidemics (EYE) strategy. Estimating YF burden, as well as vaccine impact, while accounting for the features of urban YF transmission such as indirect benefits of vaccination, is key to informing this strategy.Methods and findingsWe developed two model variants to estimate YF burden in sub-Saharan Africa, assuming all infections stem from either the sylvatic or the urban cycle of the disease. Both relied on an ecological niche model fitted to the local presence of any YF reported event in 34 African countries. We calibrated under-reporting using independent estimates of transmission intensity provided by 12 serological surveys performed in 11 countries. We calculated local numbers of YF infections, deaths and disability-adjusted life years (DALYs) lost based on estimated transmission intensity while accounting for time-varying vaccination coverage. We estimated vaccine demand and impact of future preventive mass vaccination campaigns (PMVCs) according to various vaccination scenarios. Vaccination activities conducted in Africa between 2005 and 2017 were estimated to prevent from 3.3 (95% CI 1.2-7.7) to 6.1 (95% CI 2.4-13.2) millions of deaths over the lifetime of vaccinees, representing extreme scenarios of none or maximal herd effects, respectively. By prioritizing provinces based on the risk of urban YF transmission in future PMVCs, an average of 37.7 million annual doses for PMVCs over eight years would avert an estimated 9,900,000 (95% CI 7,000,000-13,400,000) infections and 480,000 (180,000-1,140,000) deaths over the lifetime of vaccinees, corresponding to 1.7 (0.7-4.1) deaths averted per 1,000 vaccine doses.ConclusionsBy estimating YF burden and vaccine impact over a range of spatial and temporal scales, while accounting for the specificity of urban transmission, our model can be used to inform the current EYE strategy.
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- 2020
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37. Environmental suitability for lymphatic filariasis in Nigeria
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Obiora A. Eneanya, Jorge Cano, Ilaria Dorigatti, Ifeoma Anagbogu, Chukwu Okoronkwo, Tini Garske, and Christl A. Donnelly
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Lymphatic filariasis ,Ensemble modelling ,Machine learning ,Generalised boosted model (GBM) ,Random forest (RF) ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Lymphatic filariasis (LF) is a mosquito-borne parasitic disease and a major cause of disability worldwide. It is one of the neglected tropical diseases identified by the World Health Organization for elimination as a public health problem by 2020. Maps displaying disease distribution are helpful tools to identify high-risk areas and target scarce control resources. Methods We used pre-intervention site-level occurrence data from 1192 survey sites collected during extensive mapping surveys by the Nigeria Ministry of Health. Using an ensemble of machine learning modelling algorithms (generalised boosted models and random forest), we mapped the ecological niche of LF at a spatial resolution of 1 km2. By overlaying gridded estimates of population density, we estimated the human population living in LF risk areas on a 100 × 100 m scale. Results Our maps demonstrate that there is a heterogeneous distribution of LF risk areas across Nigeria, with large portions of northern Nigeria having more environmentally suitable conditions for the occurrence of LF. Here we estimated that approximately 110 million individuals live in areas at risk of LF transmission. Conclusions Machine learning and ensemble modelling are powerful tools to map disease risk and are known to yield more accurate predictive models with less uncertainty than single models. The resulting map provides a geographical framework to target control efforts and assess its potential impacts.
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- 2018
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38. A simple approach to measure transmissibility and forecast incidence
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Pierre Nouvellet, Anne Cori, Tini Garske, Isobel M. Blake, Ilaria Dorigatti, Wes Hinsley, Thibaut Jombart, Harriet L. Mills, Gemma Nedjati-Gilani, Maria D. Van Kerkhove, Christophe Fraser, Christl A. Donnelly, Neil M. Ferguson, and Steven Riley
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Infectious and parasitic diseases ,RC109-216 - Abstract
Outbreaks of novel pathogens such as SARS, pandemic influenza and Ebola require substantial investments in reactive interventions, with consequent implementation plans sometimes revised on a weekly basis. Therefore, short-term forecasts of incidence are often of high priority. In light of the recent Ebola epidemic in West Africa, a forecasting exercise was convened by a network of infectious disease modellers. The challenge was to forecast unseen “future” simulated data for four different scenarios at five different time points. In a similar method to that used during the recent Ebola epidemic, we estimated current levels of transmissibility, over variable time-windows chosen in an ad hoc way. Current estimated transmissibility was then used to forecast near-future incidence. We performed well within the challenge and often produced accurate forecasts. A retrospective analysis showed that our subjective method for deciding on the window of time with which to estimate transmissibility often resulted in the optimal choice. However, when near-future trends deviated substantially from exponential patterns, the accuracy of our forecasts was reduced. This exercise highlights the urgent need for infectious disease modellers to develop more robust descriptions of processes – other than the widespread depletion of susceptible individuals – that produce non-exponential patterns of incidence. Keywords: Forecasting, Rapid response, Branching process, Renewal equation, MCMC
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- 2018
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39. Hepatitis From Spiroplasmasp. in an Immunocompromised Patient
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Mueller, N. J., Tini, G. M., Weber, A., Gaspert, A., Husmann, L., Bloemberg, G., Boehler, A., and Benden, C.
- Abstract
A 70‐year‐old lung transplant recipient patient was admitted with fever, nausea, abdominal pain, peripheral edema and pronounced weakness. An initial work‐up for presumed infection revealed cholestatic hepatitis, leukocytosis and thrombocytopenia, but failed to detect a pathogen. An increased glucose uptake exclusively in the liver was demonstrated by positron emission tomography. Liver biopsy showed basophilic inclusions in the cytoplasm of hepatocytes. Broad‐ range 16S rRNA gene PCR followed by sequence analysis yielded Spiroplasmasp. in two independent blood samples and the liver biopsy, confirming Spiroplasmasp. as the causative agent. Antibiotic treatment with doxycycline and azithromycin led to complete recovery. This report presents the first description of hepatitis by Spiroplasma sp. in a transplant recipient, highlighting the value of an unbiased diagnostic approach and the role of transplant patients as sentinels for new infections.
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- 2015
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40. Quantifying model evidence for yellow fever transmission routes in Africa.
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Katy A M Gaythorpe, Kévin Jean, Laurence Cibrelus, and Tini Garske
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Biology (General) ,QH301-705.5 - Abstract
Yellow fever is a vector-borne disease endemic in tropical regions of Africa, where 90% of the global burden occurs, and Latin America. It is notoriously under-reported with uncertainty arising from a complex transmission cycle including a sylvatic reservoir and non-specific symptom set. Resulting estimates of burden, particularly in Africa, are highly uncertain. We examine two established models of yellow fever transmission within a Bayesian model averaging framework in order to assess the relative evidence for each model's assumptions and to highlight possible data gaps. Our models assume contrasting scenarios of the yellow fever transmission cycle in Africa. The first takes the force of infection in each province to be static across the observation period; this is synonymous with a constant infection pressure from the sylvatic reservoir. The second model assumes the majority of transmission results from the urban cycle; in this case, the force of infection is dynamic and defined through a fixed value of R0 in each province. Both models are coupled to a generalised linear model of yellow fever occurrence which uses environmental covariates to allow us to estimate transmission intensity in areas where data is sparse. We compare these contrasting descriptions of transmission through a Bayesian framework and trans-dimensional Markov chain Monte Carlo sampling in order to assess each model's evidence given the range of uncertainty in parameter values. The resulting estimates allow us to produce Bayesian model averaged predictions of yellow fever burden across the African endemic region. We find strong support for the static force of infection model which suggests a higher proportion of yellow fever transmission occurs as a result of infection from an external source such as the sylvatic reservoir. However, the model comparison highlights key data gaps in serological surveys across the African endemic region. As such, conclusions concerning the most prevalent transmission routes for yellow fever will be limited by the sparsity of data which is particularly evident in the areas with highest predicted transmission intensity. Our model and estimation approach provides a robust framework for model comparison and predicting yellow fever burden in Africa. However, key data gaps increase uncertainty surrounding estimates of model parameters and evidence. As more mathematical models are developed to address new research questions, it is increasingly important to compare them with established modelling approaches to highlight uncertainty in structures and data.
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- 2019
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41. Impact of seasonal variations in Plasmodium falciparum malaria transmission on the surveillance of pfhrp2 gene deletions
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Oliver John Watson, Robert Verity, Azra C Ghani, Tini Garske, Jane Cunningham, Antoinette Tshefu, Melchior K Mwandagalirwa, Steven R Meshnick, Jonathan B Parr, and Hannah C Slater
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radid diagnostic tests ,pfhrp2-deletion ,mapping ,mathematical modelling ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Ten countries have reported pfhrp2/pfhrp3 gene deletions since the first observation of pfhrp2-deleted parasites in 2012. In a previous study (Watson et al., 2017), we characterised the drivers selecting for pfhrp2/3 deletions and mapped the regions in Africa with the greatest selection pressure. In February 2018, the World Health Organization issued guidance on investigating suspected false-negative rapid diagnostic tests (RDTs) due to pfhrp2/3 deletions. However, no guidance is provided regarding the timing of investigations. Failure to consider seasonal variation could cause premature decisions to switch to alternative RDTs. In response, we have extended our methods and predict that the prevalence of false-negative RDTs due to pfhrp2/3 deletions is highest when sampling from younger individuals during the beginning of the rainy season. We conclude by producing a map of the regions impacted by seasonal fluctuations in pfhrp2/3 deletions and a database identifying optimum sampling intervals to support malaria control programmes.
- Published
- 2019
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42. A graph-based evidence synthesis approach to detecting outbreak clusters: An application to dog rabies.
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Anne Cori, Pierre Nouvellet, Tini Garske, Hervé Bourhy, Emmanuel Nakouné, and Thibaut Jombart
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Biology (General) ,QH301-705.5 - Abstract
Early assessment of infectious disease outbreaks is key to implementing timely and effective control measures. In particular, rapidly recognising whether infected individuals stem from a single outbreak sustained by local transmission, or from repeated introductions, is crucial to adopt effective interventions. In this study, we introduce a new framework for combining several data streams, e.g. temporal, spatial and genetic data, to identify clusters of related cases of an infectious disease. Our method explicitly accounts for underreporting, and allows incorporating preexisting information about the disease, such as its serial interval, spatial kernel, and mutation rate. We define, for each data stream, a graph connecting all cases, with edges weighted by the corresponding pairwise distance between cases. Each graph is then pruned by removing distances greater than a given cutoff, defined based on preexisting information on the disease and assumptions on the reporting rate. The pruned graphs corresponding to different data streams are then merged by intersection to combine all data types; connected components define clusters of cases related for all types of data. Estimates of the reproduction number (the average number of secondary cases infected by an infectious individual in a large population), and the rate of importation of the disease into the population, are also derived. We test our approach on simulated data and illustrate it using data on dog rabies in Central African Republic. We show that the outbreak clusters identified using our method are consistent with structures previously identified by more complex, computationally intensive approaches.
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- 2018
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43. The seasonal influence of climate and environment on yellow fever transmission across Africa.
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Arran Hamlet, Kévin Jean, William Perea, Sergio Yactayo, Joseph Biey, Maria Van Kerkhove, Neil Ferguson, and Tini Garske
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Yellow fever virus (YFV) is a vector-borne flavivirus endemic to Africa and Latin America. Ninety per cent of the global burden occurs in Africa where it is primarily transmitted by Aedes spp, with Aedes aegypti the main vector for urban yellow fever (YF). Mosquito life cycle and viral replication in the mosquito are heavily dependent on climate, particularly temperature and rainfall. We aimed to assess whether seasonal variations in climatic factors are associated with the seasonality of YF reports.We constructed a temperature suitability index for YFV transmission, capturing the temperature dependence of mosquito behaviour and viral replication within the mosquito. We then fitted a series of multilevel logistic regression models to a dataset of YF reports across Africa, considering location and seasonality of occurrence for seasonal models, against the temperature suitability index, rainfall and the Enhanced Vegetation Index (EVI) as covariates alongside further demographic indicators. Model fit was assessed by the Area Under the Curve (AUC), and models were ranked by Akaike's Information Criterion which was used to weight model outputs to create combined model predictions. The seasonal model accurately captured both the geographic and temporal heterogeneities in YF transmission (AUC = 0.81), and did not perform significantly worse than the annual model which only captured the geographic distribution. The interaction between temperature suitability and rainfall accounted for much of the occurrence of YF, which offers a statistical explanation for the spatio-temporal variability in transmission.The description of seasonality offers an explanation for heterogeneities in the West-East YF burden across Africa. Annual climatic variables may indicate a transmission suitability not always reflected in seasonal interactions. This finding, in conjunction with forecasted data, could highlight areas of increased transmission and provide insights into the occurrence of large outbreaks, such as those seen in Angola, the Democratic Republic of the Congo and Brazil.
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- 2018
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44. Exposure Patterns Driving Ebola Transmission in West Africa: A Retrospective Observational Study.
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International Ebola Response Team, Junerlyn Agua-Agum, Archchun Ariyarajah, Bruce Aylward, Luke Bawo, Pepe Bilivogui, Isobel M Blake, Richard J Brennan, Amy Cawthorne, Eilish Cleary, Peter Clement, Roland Conteh, Anne Cori, Foday Dafae, Benjamin Dahl, Jean-Marie Dangou, Boubacar Diallo, Christl A Donnelly, Ilaria Dorigatti, Christopher Dye, Tim Eckmanns, Mosoka Fallah, Neil M Ferguson, Lena Fiebig, Christophe Fraser, Tini Garske, Lice Gonzalez, Esther Hamblion, Nuha Hamid, Sara Hersey, Wes Hinsley, Amara Jambei, Thibaut Jombart, David Kargbo, Sakoba Keita, Michael Kinzer, Fred Kuti George, Beatrice Godefroy, Giovanna Gutierrez, Niluka Kannangarage, Harriet L Mills, Thomas Moller, Sascha Meijers, Yasmine Mohamed, Oliver Morgan, Gemma Nedjati-Gilani, Emily Newton, Pierre Nouvellet, Tolbert Nyenswah, William Perea, Devin Perkins, Steven Riley, Guenael Rodier, Marc Rondy, Maria Sagrado, Camelia Savulescu, Ilana J Schafer, Dirk Schumacher, Thomas Seyler, Anita Shah, Maria D Van Kerkhove, C Samford Wesseh, and Zabulon Yoti
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Medicine - Abstract
BackgroundThe ongoing West African Ebola epidemic began in December 2013 in Guinea, probably from a single zoonotic introduction. As a result of ineffective initial control efforts, an Ebola outbreak of unprecedented scale emerged. As of 4 May 2015, it had resulted in more than 19,000 probable and confirmed Ebola cases, mainly in Guinea (3,529), Liberia (5,343), and Sierra Leone (10,746). Here, we present analyses of data collected during the outbreak identifying drivers of transmission and highlighting areas where control could be improved.Methods and findingsOver 19,000 confirmed and probable Ebola cases were reported in West Africa by 4 May 2015. Individuals with confirmed or probable Ebola ("cases") were asked if they had exposure to other potential Ebola cases ("potential source contacts") in a funeral or non-funeral context prior to becoming ill. We performed retrospective analyses of a case line-list, collated from national databases of case investigation forms that have been reported to WHO. These analyses were initially performed to assist WHO's response during the epidemic, and have been updated for publication. We analysed data from 3,529 cases in Guinea, 5,343 in Liberia, and 10,746 in Sierra Leone; exposures were reported by 33% of cases. The proportion of cases reporting a funeral exposure decreased over time. We found a positive correlation (r = 0.35, p < 0.001) between this proportion in a given district for a given month and the within-district transmission intensity, quantified by the estimated reproduction number (R). We also found a negative correlation (r = -0.37, p < 0.001) between R and the district proportion of hospitalised cases admitted within ≤4 days of symptom onset. These two proportions were not correlated, suggesting that reduced funeral attendance and faster hospitalisation independently influenced local transmission intensity. We were able to identify 14% of potential source contacts as cases in the case line-list. Linking cases to the contacts who potentially infected them provided information on the transmission network. This revealed a high degree of heterogeneity in inferred transmissions, with only 20% of cases accounting for at least 73% of new infections, a phenomenon often called super-spreading. Multivariable regression models allowed us to identify predictors of being named as a potential source contact. These were similar for funeral and non-funeral contacts: severe symptoms, death, non-hospitalisation, older age, and travelling prior to symptom onset. Non-funeral exposures were strongly peaked around the death of the contact. There was evidence that hospitalisation reduced but did not eliminate onward exposures. We found that Ebola treatment units were better than other health care facilities at preventing exposure from hospitalised and deceased individuals. The principal limitation of our analysis is limited data quality, with cases not being entered into the database, cases not reporting exposures, or data being entered incorrectly (especially dates, and possible misclassifications).ConclusionsAchieving elimination of Ebola is challenging, partly because of super-spreading. Safe funeral practices and fast hospitalisation contributed to the containment of this Ebola epidemic. Continued real-time data capture, reporting, and analysis are vital to track transmission patterns, inform resource deployment, and thus hasten and maintain elimination of the virus from the human population.
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- 2016
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45. Potential Biases in Estimating Absolute and Relative Case-Fatality Risks during Outbreaks.
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Marc Lipsitch, Christl A Donnelly, Christophe Fraser, Isobel M Blake, Anne Cori, Ilaria Dorigatti, Neil M Ferguson, Tini Garske, Harriet L Mills, Steven Riley, Maria D Van Kerkhove, and Miguel A Hernán
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Arctic medicine. Tropical medicine ,RC955-962 ,Public aspects of medicine ,RA1-1270 - Abstract
Estimating the case-fatality risk (CFR)-the probability that a person dies from an infection given that they are a case-is a high priority in epidemiologic investigation of newly emerging infectious diseases and sometimes in new outbreaks of known infectious diseases. The data available to estimate the overall CFR are often gathered for other purposes (e.g., surveillance) in challenging circumstances. We describe two forms of bias that may affect the estimation of the overall CFR-preferential ascertainment of severe cases and bias from reporting delays-and review solutions that have been proposed and implemented in past epidemics. Also of interest is the estimation of the causal impact of specific interventions (e.g., hospitalization, or hospitalization at a particular hospital) on survival, which can be estimated as a relative CFR for two or more groups. When observational data are used for this purpose, three more sources of bias may arise: confounding, survivorship bias, and selection due to preferential inclusion in surveillance datasets of those who are hospitalized and/or die. We illustrate these biases and caution against causal interpretation of differential CFR among those receiving different interventions in observational datasets. Again, we discuss ways to reduce these biases, particularly by estimating outcomes in smaller but more systematically defined cohorts ascertained before the onset of symptoms, such as those identified by forward contact tracing. Finally, we discuss the circumstances in which these biases may affect non-causal interpretation of risk factors for death among cases.
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- 2015
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46. Estimated risk of placental infection and low birthweight attributable to Plasmodium falciparum malaria in Africa in 2010: a modelling study
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Dr. Patrick G T Walker, PhD, Prof. Feiko O ter Kuile, PhD, Tini Garske, PhD, Clara Menendez, PhD, and Prof. Azra C Ghani, PhD
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Public aspects of medicine ,RA1-1270 - Abstract
Background: Plasmodium falciparum infection during pregnancy leads to adverse outcomes including low birthweight; however, contemporary estimates of the potential burden of malaria in pregnancy in Africa (in the absence of interventions) are poor. We aimed to estimate the need to protect pregnant women from malaria across Africa. Methods: Using a mathematical model applied to estimates of the geographical distribution of P falciparum across Africa in 2010, we estimated the number of pregnant women who would have been exposed to infection that year in the absence of pregnancy-specific intervention. We then used estimates of the parity-dependent acquisition of immunity to placental infection and associated risk of low birthweight to estimate the number of women who would have been affected. Findings: We estimate that, without pregnancy-specific protection, 12·4 million pregnant women (44·9% of all 27·6 million livebirths in malaria endemic areas in Africa in 2010) would have been exposed to infection, with 11·4 million having placental infection (41·2% of all livebirths). This infection leads to an estimated 900 000 (95% credible interval [CrI] 530 000–1 240 000) low birthweight deliveries per year. Around the end of the first trimester, when the placenta becomes susceptible to infection, is a key period during which we estimate that 65·2% (95% CrI 60·9–70·0) of placental infections first occur. Interpretation: Our calculations are the only contemporary estimates of the geographical distribution of placental infection and associated low birthweight. The risk of placental infection across Africa in unprotected women is high. Prevention of malaria before conception or very early in pregnancy is predicted to greatly reduce incidence of low birthweight, especially in primigravidae. The underlying lifetime risk of low birthweight changes slowly with decreasing transmission, drawing attention to the need to maintain protection as transmission falls. Funding: Malaria in Pregnancy Consortium and the Bill & Melinda Gates Foundation.
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- 2014
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47. Yellow Fever in Africa: estimating the burden of disease and impact of mass vaccination from outbreak and serological data.
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Tini Garske, Maria D Van Kerkhove, Sergio Yactayo, Olivier Ronveaux, Rosamund F Lewis, J Erin Staples, William Perea, Neil M Ferguson, and Yellow Fever Expert Committee
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Medicine - Abstract
Yellow fever is a vector-borne disease affecting humans and non-human primates in tropical areas of Africa and South America. While eradication is not feasible due to the wildlife reservoir, large scale vaccination activities in Africa during the 1940s to 1960s reduced yellow fever incidence for several decades. However, after a period of low vaccination coverage, yellow fever has resurged in the continent. Since 2006 there has been substantial funding for large preventive mass vaccination campaigns in the most affected countries in Africa to curb the rising burden of disease and control future outbreaks. Contemporary estimates of the yellow fever disease burden are lacking, and the present study aimed to update the previous estimates on the basis of more recent yellow fever occurrence data and improved estimation methods.Generalised linear regression models were fitted to a dataset of the locations of yellow fever outbreaks within the last 25 years to estimate the probability of outbreak reports across the endemic zone. Environmental variables and indicators for the surveillance quality in the affected countries were used as covariates. By comparing probabilities of outbreak reports estimated in the regression with the force of infection estimated for a limited set of locations for which serological surveys were available, the detection probability per case and the force of infection were estimated across the endemic zone. The yellow fever burden in Africa was estimated for the year 2013 as 130,000 (95% CI 51,000-380,000) cases with fever and jaundice or haemorrhage including 78,000 (95% CI 19,000-180,000) deaths, taking into account the current level of vaccination coverage. The impact of the recent mass vaccination campaigns was assessed by evaluating the difference between the estimates obtained for the current vaccination coverage and for a hypothetical scenario excluding these vaccination campaigns. Vaccination campaigns were estimated to have reduced the number of cases and deaths by 27% (95% CI 22%-31%) across the region, achieving up to an 82% reduction in countries targeted by these campaigns. A limitation of our study is the high level of uncertainty in our estimates arising from the sparseness of data available from both surveillance and serological surveys.With the estimation method presented here, spatial estimates of transmission intensity can be combined with vaccination coverage levels to evaluate the impact of past or proposed vaccination campaigns, thereby helping to allocate resources efficiently for yellow fever control. This method has been used by the Global Alliance for Vaccines and Immunization (GAVI Alliance) to estimate the potential impact of future vaccination campaigns.
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- 2014
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48. Estimating air temperature and its influence on malaria transmission across Africa.
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Tini Garske, Neil M Ferguson, and Azra C Ghani
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Medicine ,Science - Abstract
Malaria transmission is strongly influenced by climatic conditions which determine the abundance and seasonal dynamics of the Anopheles vector. In particular, water temperature influences larval development rates whereas air temperature determines adult longevity as well as the rate of parasite development within the adult mosquito. Although data on land surface temperature exist at a spatial resolution of approximately 1 km globally with four time steps per day, comparable data are not currently available for air temperature. In order to address this gap and demonstrate the importance of using the right type of temperature data, we fitted simple models of the relationship between land-surface and air temperature at lower resolution to obtain a high resolution estimate of air temperature across Africa. We then used these estimates to calculate some crucial malaria transmission parameters that strongly depend on air temperatures. Our results demonstrate substantial differences between air and surface temperatures that impact temperature-based maps of areas suitable for transmission. We present high resolution maps of the malaria transmission parameters driven by air temperature and their seasonal variation. The fitted air temperature datasets are made publicly available alongside this publication.
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- 2013
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49. Travel patterns in China.
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Tini Garske, Hongjie Yu, Zhibin Peng, Min Ye, Hang Zhou, Xiaowen Cheng, Jiabing Wu, and Neil Ferguson
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Medicine ,Science - Abstract
The spread of infectious disease epidemics is mediated by human travel. Yet human mobility patterns vary substantially between countries and regions. Quantifying the frequency of travel and length of journeys in well-defined population is therefore critical for predicting the likely speed and pattern of spread of emerging infectious diseases, such as a new influenza pandemic. Here we present the results of a large population survey undertaken in 2007 in two areas of China: Shenzhen city in Guangdong province, and Huangshan city in Anhui province. In each area, 10,000 randomly selected individuals were interviewed, and data on regular and occasional journeys collected. Travel behaviour was examined as a function of age, sex, economic status and home location. Women and children were generally found to travel shorter distances than men. Travel patterns in the economically developed Shenzhen region are shown to resemble those in developed and economically advanced middle income countries with a significant fraction of the population commuting over distances in excess of 50 km. Conversely, in the less developed rural region of Anhui, travel was much more local, with very few journeys over 30 km. Travel patterns in both populations were well-fitted by a gravity model with a lognormal kernel function. The results provide the first quantitative information on human travel patterns in modern China, and suggest that a pandemic emerging in a less developed area of rural China might spread geographically sufficiently slowly for containment to be feasible, while spatial spread in the more economically developed areas might be expected to be much more rapid, making containment more difficult.
- Published
- 2011
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50. Correction: Travel Patterns in China.
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Tini Garske, Hongjie Yu, Zhibin Peng, Min Ye, Hang Zhou, Xiaowen Cheng, Jiabing Wu, and Neil Ferguson
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Medicine ,Science - Published
- 2011
- Full Text
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