scholarly journals Intestinal helminth co-infection is an unrecognised risk factor for increased pneumococcal carriage density and invasive disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alice E. Law ◽  
Rebecca K. Shears ◽  
Andrea A. Lopez Rodas ◽  
Richard K. Grencis ◽  
Philip J. Cooper ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cost Effective ◽  
Invasive Disease ◽  
Intestinal Helminth ◽  
Infection Model ◽  
Pneumococcal Carriage ◽  
Helminth Infections ◽  
Cost Effective Method ◽  
Lower Income Countries ◽  
The Impact

AbstractInfection with Streptococcus pneumoniae is the leading cause of death in children and burden of disease is greatest where helminth infections are also common. We investigated the impact of intestinal helminth co-infection on pneumococcal carriage; a risk factor for invasive disease. We used a mouse co-infection model and clinical data to assess the impact of co-infection on carriage density. Co-infection in mice was associated with increased pneumococcal carriage density and dissemination into lungs. Helminth-infected children also exhibited increased carriage density as compared to uninfected children. Anthelmintic treatment may be a cost-effective method of reducing pneumococcal disease burden in lower-income countries.

scholarly journals Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Panatto ◽  
P Landa ◽  
D Amicizia ◽  
P L Lai ◽  
E Lecini ◽  
...  
Keyword(s):  
Large Scale ◽  
Public Health Problem ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Dose Schedule ◽  
Developed Countries ◽  
Invasive Disease ◽  
International Setting ◽  
The Impact

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.

scholarly journals A pneumococcal controlled human infection model in Malawi: Transfer of an established pneumococcal carriage model from Liverpool, UK to Blantyre, Malawi – A feasibility study

2020 ◽  
Vol 5 ◽  
pp. 25
Author(s):  
Ben Morton ◽  
Sarah Burr ◽  
Kondwani Jambo ◽  
Jamie Rylance ◽  
Marc Y.R. Henrion ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Feasibility Study ◽  
Invasive Disease ◽  
Community Acquired Pneumonia ◽  
Human Infection ◽  
Infection Model ◽  
Endpoint Detection ◽  
Pneumococcal Carriage ◽  
Sampling Protocols ◽  
Classical Culture

Streptococcus pneumoniae is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis and bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive to manufacture, limited in serotype coverage, associated with serotype replacement and demonstrate reduced effectiveness against mucosal colonisation.  As asymptomatic colonisation of the human nasopharynx is a prerequisite for pneumococcal disease, this is proposed as a marker for novel vaccine efficacy. Our team established a safe and reproducible pneumococcal controlled human infection model at Liverpool School of Tropical Medicine (LSTM). This has been used to test vaccine induced protection against nasopharyngeal carriage for ten years in over 1000 participants. We will transfer established standardised operating procedures from LSTM to Malawi and test in up to 36 healthy participants. Primary endpoint: detection of the inoculated pneumococci by classical culture from nasal wash recovered from the participants after pneumococcal challenge. Secondary endpoints: confirmation of robust clinical and laboratory methods for sample capture and processing. Tertiary endpoints: participant acceptability of study and methods. We will test three doses of pneumococcal inoculation (20,000, 80,000 and 160,000 colony forming units [CFUs] per naris) using a parsimonious study design intended to reduce unnecessary exposure to participants. We hypothesise that 80,000 CFUs will induce nasal colonisation in approximately half of participants per established LSTM practice. The aims of the feasibility study are: 1) Establish Streptococcus pneumoniae experimental human pneumococcal carriage in Malawi; 2) Confirm optimal nasopharyngeal pneumococcal challenge dose; 3) Confirm safety and measure potential symptoms; 4) Confirm sampling protocols and laboratory assays; 5) Assess feasibility and acceptability of consent and study procedures. Confirmation of pneumococcal controlled human infection model feasibility in Malawi will enable us to target pneumococcal vaccine candidates for an at-risk population who stand the most to gain from new and improved vaccine strategies.

scholarly journals Improving Maternal and Child Health in Bangladesh: The Integration of Midwives in Conjunction With the United Nations Millenium Development Goals Initiative

2015 ◽  
Vol 3 ◽  
Author(s):  
Elizabeth Casto
Keyword(s):  
Child Health ◽  
United Nations ◽  
Maternal And Child Health ◽  
Millennium Development Goals ◽  
Cost Effective ◽  
Cost Effective Method ◽  
Development Goals ◽  
The United Nations ◽  
The Impact ◽  
And Child Health

As the United Nations Millennium Development Goals initiative comes to a close, it is important to examine what has been effective in combating disparities in developing nations. In this paper I explore the impact midwives have on improving maternal and child health in Bangladesh by focusing on how the United Nations Millennium Development Goals initiative has helped to change societal views on women and birth as midwives become more integrated into improving maternal and child health. It is a quantitative and qualitative approach analyzing the statistics of implementing midwives as these impact cost-effectiveness and change in mortality rates in addition to social changes that have occurred in the culture towards maternal and child health. The paper further analyzes programs implemented by countries such as India and Sri Lanka comparatively. Data have been collected from published United Nations and governmental reports, media, and research articles. The paper concludes that the implementation of midwives has provided a cost-effective method of reducing maternal and child health in Bangladesh, and will be increasingly efficient as governmental programs continue to improve various aspects and laws of the country. It is important to analyze what is working in order to further improve maternal and child health on both a regional and global level. The use of midwives can provide a fundamental framework in communities that can aid in reducing health disparities as well as all improve all facets of reproductive wellness, providing the support needed at all stages to improve maternal and child health.

scholarly journals A pneumococcal controlled human infection model in Malawi: Transfer of an established pneumococcal carriage model from Liverpool, UK to Blantyre, Malawi – A feasibility study

2020 ◽  
Vol 5 ◽  
pp. 25
Author(s):  
Ben Morton ◽  
Sarah Burr ◽  
Kondwani Jambo ◽  
Jamie Rylance ◽  
Marc Y.R. Henrion ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Feasibility Study ◽  
Invasive Disease ◽  
Community Acquired Pneumonia ◽  
Human Infection ◽  
Infection Model ◽  
Endpoint Detection ◽  
Pneumococcal Carriage ◽  
Sampling Protocols ◽  
Classical Culture

Streptococcus pneumoniae is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis and bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive to manufacture, limited in serotype coverage, associated with serotype replacement and demonstrate reduced effectiveness against mucosal colonisation.  As asymptomatic colonisation of the human nasopharynx is a prerequisite for pneumococcal disease, this is proposed as a marker for novel vaccine efficacy. Our team established a safe and reproducible pneumococcal controlled human infection model at Liverpool School of Tropical Medicine (LSTM). This has been used to test vaccine induced protection against nasopharyngeal carriage for ten years in over 1000 participants. We will transfer established standardised operating procedures from LSTM to Malawi and test in up to 36 healthy participants. Primary endpoint: detection of the inoculated pneumococci by classical culture from nasal wash recovered from the participants after pneumococcal challenge. Secondary endpoints: confirmation of robust clinical and laboratory methods for sample capture and processing. Tertiary endpoints: participant acceptability of study and methods. We will test three doses of pneumococcal inoculation (20,000, 80,000 and 160,000 colony forming units [CFUs] per naris) using a parsimonious study design intended to reduce unnecessary exposure to participants. We hypothesise that 80,000 CFUs will induce nasal colonisation in approximately half of participants per established LSTM practice. The aims of the feasibility study are: 1) Establish Streptococcus pneumoniae experimental human pneumococcal carriage in Malawi; 2) Confirm optimal nasopharyngeal pneumococcal challenge dose; 3) Confirm safety and measure potential symptoms; 4) Confirm sampling protocols and laboratory assays; 5) Assess feasibility and acceptability of consent and study procedures. Confirmation of pneumococcal controlled human infection model feasibility in Malawi will enable us to target pneumococcal vaccine candidates for an at-risk population who stand the most to gain from new and improved vaccine strategies.

Impact of intestinal helminthes infections on malnutrition and haematological indices of school-age children in Gondar town, Ethiopia.

2019 ◽  
Author(s):  
Wossenseged Lemma ◽  
Daniel Tarekegn ◽  
Meseret Birhanie
Keyword(s):  
School Children ◽  
School Age Children ◽  
Intestinal Helminth ◽  
School Age ◽  
Helminth Infections ◽  
Gondar Town ◽  
Z Scores ◽  
Hook Worm ◽  
The Impact ◽  
Haematological Indices

Abstract Abstract Background: Ethiopia, the second populous nation in Africa, has been grouped under low income countries. Stunting, underweight and wasting in school children are very common. The aim of this research was to evaluate the impact of intestinal helminthesand schistosomiasison malnutrition, anaemiaand haematological indices in the school age children of Azezo Elementary School in Gondar town. Methods:Kato Katz technique was performed todetermine infection and intensity of intestinal helminthinfections. AnthroPlus software version 1.04 (WHO, Geneva, Switzerland) was used to get malnutrition indiceswhile fully-automated hematologicalcell counter (Mindray BC-3200) andMindray BS-200E chemistry analyser were used to determine haematological and biochemical parametrs. Results: Atotal of 384 school childrenwere recruited in this study.The overall prevalence of helminthes infections was 45.8% (178/384) with the leading Ascarislumbericoides infection (20.6%) compared to the second leading Schistosomamansoni(17.4%)and third leading hook worm infections (13.3%).The prevalencesof body mass indexes for age Z-scores (BAZ) indices were 9.6% (37) wasting, 17.2%(66) sever thinness, 38.5%(148) thinness, 34.1% (131) normal and 0.5%(2) overweight. On the other hand, the prevalences of height for age Z-scores (HAZ) indices were 12.2%(47) stunt, 87%(334) normal and 0.8%(3) over height.Of the total 384 school age children, 335(87.2%) had normal blood glucose level (70 – 110 mg/dL) while the remaining 49 (12.8%) school age children were hypoglycemic. The number of the school children with normal total protein level (6.6 – 8 g/dL) was 259(67.4%) while the remaining 125(32.6%) school children were hypo-proteinaemic. The prevalence of anemia in the school age children was 33.1%(127).Intestinal helminthes infections were statistically significantly associated (p = 0.000) with hypo-glycemia, hypo-proteinaemia and anemia compared with non-infected school children. The likelihood of anemia in intestinal helminth infected school children, when it was compared with uninfected was 148 times higher for both Ascarislumbericoides-Schistosomamansoni co-infection, 38 times for Hook worm, 20 times for Schistosomamansoni and 3 times for Ascarislumbericoidesmono-infection. Conclusion: Intestinal helminth infections in school age children aggravate malnutrition. Prolonged malnutrition and intestinal helminth infections could result in stunting in school-age children.

scholarly journals Human Onchocerciasis and Tetanus Vaccination: Impact on the Postvaccination Antitetanus Antibody Response

1999 ◽  
Vol 67 (11) ◽  
pp. 5951-5957 ◽  
Author(s):  
Philip J. Cooper ◽  
Ivan Espinel ◽  
Moira Wieseman ◽  
Wilson Paredes ◽  
Mauricio Espinel ◽  
...  
Keyword(s):  
Strongyloides Stercoralis ◽  
Intestinal Helminth ◽  
Antibody Isotype ◽  
Helminth Infections ◽  
Specific Igg4 ◽  
Vaccine Antigens ◽  
Tetanus Vaccination ◽  
The Impact ◽  
Group Stratification ◽  
Isotype Igg1

ABSTRACT To investigate whether helminth infections may affect the efficacy of vaccines by impairing the immune response to nonparasite vaccine antigens, we compared the antibody responses to tetanus toxoid (TT) after tetanus vaccination in 193 subjects with Onchocerca volvulus infection with 85 comparable noninfected controls. After vaccination, the proportions of subjects in each group attaining protective levels of antitetanus antibodies were similar (96.9% infected versus 97.6% noninfected). Postvaccination increases in antitetanus immunoglobulin G (IgG) and the predominant IgG isotype, IgG1, were equivalent in both groups, as were increases in specific IgG4 and IgE; however, significantly greater increases in specific IgG2 (P < 0.05) and IgG3 (P < 0.001) were observed in the noninfected group. Stratification of the O. volvulus-infected group into two groups representing light and heavy infections revealed a significantly impaired antitetanus IgG response in those with heavy infections compared to those with light infections (P < 0.01) or no infection (P < 0.05). The impact of concurrent intestinal helminth infections on the antitetanus response was also examined; an increased IgG4/IgE ratio was seen in those infected withStrongyloides stercoralis (P < 0.05) and when all helminth infections were combined as a single group (P < 0.05). These findings indicate that concurrent infection with O. volvulus does not prevent the development of a protective antitetanus response, although heavier O. volvulus infections are able to alter the magnitude of this response, and concurrent helminth infections (O. volvulusand intestinal helminths) may alter TT-specific antibody isotype responses.

scholarly journals Improvement of semen parameters after coil embolization of varicoceles: a systematic review

2021 ◽  
Vol 20 ◽  
Author(s):  
Sergio Quilici Belczak ◽  
Vanessa Stefaniak ◽  
Leonardo Garcia Góes ◽  
Felipe Coelho Neto ◽  
Walter Jr. Boim de Araújo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Studies ◽  
Cost Effective ◽  
Semen Parameters ◽  
Semen Parameter ◽  
Cost Effective Method ◽  
Prisma Statement ◽  
Meta Analyses ◽  
The Impact

Abstract This systematic review was conducted in accordance with the 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, including clinical studies in which one of the outcomes was semen parameter improvement after varicocele embolization using coils only. The objective of the review was to assess the evidence on the role of embolization using coils alone for semen parameter improvement in men with varicocele, since embolization using coils is the most cost-effective method of varicocele repair. Study quality was assessed using the methodological index for non-randomized studies (MINORS). Out of six retrospective and two prospective observational or comparative clinical studies involving 701 patients, semen concentration improved significantly in all five studies that assessed this parameter. Mean semen motility improved significantly in seven studies. The impact of embolization on semen density could not be analyzed.

SUSTAINABLE IMPACT OF BUILDING ENERGY RETROFIT MEASURES

2017 ◽  
Vol 12 (3) ◽  
pp. 69-84 ◽  
Author(s):  
Amirhosein Jafari ◽  
Vanessa Valentin
Keyword(s):  
Social Impact ◽  
Cost Effective ◽  
Building Energy ◽  
Economic Benefits ◽  
Environmental Benefits ◽  
Energy Retrofit ◽  
Cost Effective Method ◽  
Impact Index ◽  
The Impact

Energy retrofitting is argued to be the most feasible and cost-effective method for improving existing buildings' energy efficiency. As a sustainable development, building energy retrofits require the consideration and integration of all three sustainability dimensions: environmental, economic and social. The objective of this study is to estimate and compare the sustainable impact of building energy retrofits to determine the maximum sustainable benefit when implementing different energy-related measures. The proposed analysis consists of integrating three approaches for evaluating these benefits. Economic benefits are measured by estimating the payback period of energy-related measures, environmental benefits are measured by estimating the CO2 equivalent saving per year due to the implementation of energy-related measures, and social benefits are measured by defining a “social impact index” that establishes the impact of energy-related measures on buildings' users. A case study is used to demonstrate the framework for four potential scenarios. The results show that for the case study, energy-related “controlling” and “upgrading mechanical system” measures have the highest sustainable impact among the identified energy retrofitting measures.

scholarly journals Locating microseismic sources with a single seismometer channel using coda wave interferometry

Geophysics ◽  
2017 ◽  
Vol 82 (3) ◽  
pp. A19-A24 ◽  
Author(s):  
Youqian Zhao ◽  
Andrew Curtis ◽  
Brian Baptie
Keyword(s):  
Single Channel ◽  
Cost Effective ◽  
Coda Wave ◽  
Probabilistic Framework ◽  
Data Set ◽  
Cost Effective Method ◽  
Potential Applications ◽  
The Impact ◽  
Coda Wave Interferometry ◽  
Selection Of

A novel source location method based on coda wave interferometry (CWI) was applied to a microseismic data set of mining-induced events recorded in Nottinghamshire, England. CWI uses scattered waves in the coda of seismograms to estimate the differences between two seismic states. We used CWI to estimate the distances between pairs of earthquake locations, which are then used jointly to determine the relative location of a cluster of events using a probabilistic framework. We evaluated two improvements to this location technique: These account for the impact of a large difference in the dominant wavelength of a recording made on different instruments, and they standardize the selection of parameters to be used when implementing the method. Although the method has been shown to produce reasonable estimates on larger earthquakes, we tested the method for microseismic events with shorter distinguishable codas in recorded waveforms, and hence, fewer recorded scattered waves. The earthquake location results are highly consistent when using different individual seismometer channels, showing that it is possible to locate event clusters with a single-channel seismometer. We thus extend the potential applications of this cost-effective method to seismic events over a wider range of magnitudes.

The Effectiveness of Dynamic Compaction Under Various Water Levels

2009 ◽  
Author(s):  
Jing-Wen Chen ◽  
Fu-Cheng Chen
Keyword(s):  
Boundary Effect ◽  
Single Point ◽  
Cost Effective ◽  
Soil Liquefaction ◽  
Water Levels ◽  
Dynamic Compaction ◽  
Cost Effective Method ◽  
Compaction Energy ◽  
Soil Densification ◽  
The Impact

Dynamic compaction is currently regarded as one of the quick but cost-effective method for soil densification to resist the potential of soil liquefaction during earthquake. Most practices and studies reveal the depth of densification is mainly limited by the compaction energy without considering the effect of water table. In this experimental study, the impact performances under both presence and absence of water level without changing the compaction energy were presented. The Single-point Impact Test is developed to perform a series of tests on soils under different water levels and drained conditions. Meanwhile, an automatic cone penetrometer is also developed to evaluate the effectiveness. The boundary effect of soil container used in the test is also discussed. The impact-induced pore pressures and dissipation periods are measured and compared with a field measurement. The relationship between the effective dynamic stresses and corresponding cone resistances in soils is highlighted. The performance of dynamic impacts is evaluated by a term of improvement ratio.

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