Reflecting on Alma Ata 1978: forty years on

The European Journal of Public Health
Volume 28, Issue 4, 1 August 2018
https://academic.oup.com/eurpub/issue/28/4

Editorials
Reflecting on Alma Ata 1978: forty years on
Kairat Davletov; Talgat Nurgozhin; Martin McKee
European Journal of Public Health, Volume 28, Issue 4, 1 August 2018, Pages 587, https://doi.org/10.1093/eurpub/cky094
Extract
The Alma Ata declaration was a product of its time. It came about from a recognition that, in an increasingly prosperous world, many people were being left behind. In the world’s poorest countries, tens of thousands of people were dying every year from entirely avoidable conditions, lacking access to even the most basic health services. At the same time, those in the richest countries were benefiting from pharmaceutical and technological advances that would have been undreamed of even a decade earlier.
Forty years on, much of what it said is now taken for granted, such as health being a human right, that inequality of health status between rich and…

Good practices and challenges in addressing poliomyelitis and measles in the European Union

The European Journal of Public Health
Volume 28, Issue 4, 1 August 2018
https://academic.oup.com/eurpub/issue/28/4

Infectious diseases
Good practices and challenges in addressing poliomyelitis and measles in the European Union
John Kinsman; Svenja Stöven; Fredrik Elgh; Pilar Murillo; Michael Sulzner
European Journal of Public Health, Volume 28, Issue 4, 1 August 2018, Pages 730–734, https://doi.org/10.1093/eurpub/cky056

Association between vaccination coverage decline and influenza incidence rise among Italian elderly

The European Journal of Public Health
Volume 28, Issue 4, 1 August 2018
https://academic.oup.com/eurpub/issue/28/4

Association between vaccination coverage decline and influenza incidence rise among Italian elderly
Lamberto Manzoli; Giovanni Gabutti; Roberta Siliquini; Maria Elena Flacco; Paolo Villari
European Journal of Public Health, Volume 28, Issue 4, 1 August 2018, Pages 740–742, https://doi.org/10.1093/eurpub/cky053

Compulsory licensing of pharmaceuticals reconsidered: Current situation and implications for access to medicines

Global Public Health
Volume 13, 2017   Issue 10
http://www.tandfonline.com/toc/rgph20/current

Article
Compulsory licensing of pharmaceuticals reconsidered: Current situation and implications for access to medicines
Kyung-Bok Son & Tae-Jin Lee
Pages: 1430-1440
Published online: 28 Nov 2017
ABSTRACT
To examine patterns and trends in attempts, distinguished from issuance, to issue compulsory licensing of pharmaceuticals and to assess related implications in the era of high-cost medicines. Documents from various civil society organisations were primarily used to search attempts, as well as published literature. The identified attempts were analysed by pharmaceutical level, national level, claimers, and the outcomes of the attempts. There have been 108 attempts to issue compulsory licensing for 40 pharmaceuticals in 27 countries since 1995. Most of the attempts were in Asian, Latin American, and African countries and mainly for HIV/AIDS medicines. Moreover, when the claimer was the government, the likelihood of approval and positive outcomes increased. Compulsory licensing, which was devised to cope with the HIV/AIDS pandemic in low-income countries, became a practical measure in several Asian and Latin American countries, even for non-HIV/AIDS medicines. Resurgent compulsory licensing in 2012 and 2014, influenced by the global justice movement, might represent a policy window in the near future as the Doha Declaration did in the 2000s. In this context, various experiences should be circulated and analysed at the global level to better understand the circumstances under which successful issuance has been achieved at the country level.

Strengthening health research capacity in sub-Saharan Africa: mapping the 2012–2017 landscape of externally funded international postgraduate training at institutions in the region

Globalization and Health
http://www.globalizationandhealth.com/
[Accessed 18 Aug 2018]

Research
Strengthening health research capacity in sub-Saharan Africa: mapping the 2012–2017 landscape of externally funded international postgraduate training at institutions in the region
The objective was to guide key stakeholders on future directions of external funding of international postgraduate training (Master’s and PhD) of health research students at institutions in sub-Saharan Africa by mapping the numbers and characteristics of students, the location of institutions, and sources of external support.
Authors: Terra Morel, Dermot Maher, Thomas Nyirenda and Ole F. Olesen
Citation: Globalization and Health 2018 14:77
Published on: 31 July 2018

Encouraging Participation And Transparency In Biobank Research

Health Affairs
Vol. 37 , No. 8  August 2018
https://www.healthaffairs.org/toc/hlthaff/current
Medicaid, Markets & More

Research Article  Ethics
Encouraging Participation And Transparency In Biobank Research
Kayte Spector-Bagdady, Raymond G. De Vries, Michele G. Gornick, Andrew G. Shuman
Abstract
Medical biobanks often struggle to obtain sustainable funding. Commercialization of specimens is one solution, but disclosure of commercial interests to potential contributors can be dissuasive. Recent revisions to the federal human subjects research regulations will soon mandate such commercialization disclosure in some circumstances, which raises questions about implications for practice. In this nationally representative, probability-based survey sample of the US adult population, we found that 67 percent of participants agreed that clear notification of potential commercialization of biospecimens is warranted, but only 23 percent were comfortable with such use. Sixty-two percent believed that profits should be used only to support future research, and 41 percent supported sharing profits with the public. We also considered other factors related to disclosure in our analysis and argue for a “disclosure plus” standard: informing potential contributors that their biospecimens might be accessed by commercial organizations and explaining how profits would be used to both enhance transparency and facilitate contributors’ altruistic motivations.

The reporting of funding in health policy and systems research: a cross-sectional study

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 18 Aug 2018]

Research
The reporting of funding in health policy and systems research: a cross-sectional study
Major research-reporting statements, such as PRISMA and CONSORT, require authors to provide information about funding. The objectives of this study were (1) to assess the reporting of funding in health policy …
Authors: Assem M. Khamis, Lama Bou-Karroum, Maram B. Hakoum, Mounir Al-Gibbawi, Joseph R. Habib, Fadi El-Jardali and Elie A. Akl
Citation: Health Research Policy and Systems 2018 16:83
Published on: 17 August 2018

Public involvement in health research systems: a governance framework

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 18 Aug 2018]

Research
Public involvement in health research systems: a governance framework
Growing interest in public involvement in health research has led to organisational and policy change. Additionally, an emerging body of policy-oriented scholarship has begun to identify the organisational and…
Authors: Fiona Alice Miller, Sarah J. Patton, Mark Dobrow and Whitney Berta
Citation: Health Research Policy and Systems 2018 16:79
Published on: 6 August 2018

Developing the latest framework to measure and incentivise pharmaceutical industry contributions to health research and development

Health Research Policy and Systems
http://www.health-policy-systems.com/content
[Accessed 18 Aug 2018]

Commentary
Developing the latest framework to measure and incentivise pharmaceutical industry contributions to health research and development
Major pharmaceutical companies contribute important expertise to health research and development (R&D), particularly in their ability to develop and bring pharmaceuticals to market. The Access to Medicine Index…
Authors: Clarke B. Cole, Stine Trolle and Danny J. Edwards
Citation: Health Research Policy and Systems 2018 16:73
Published on: 2 August 2018

Climate drivers of vector-borne diseases in Africa and their relevance to control programmes

Infectious Diseases of Poverty
http://www.idpjournal.com/content
[Accessed 18 Aug 2018]

Research Article
Climate drivers of vector-borne diseases in Africa and their relevance to control programmes
Climate-based disease forecasting has been proposed as a potential tool in climate change adaptation for the health sector. Here we explore the relevance of climate data, drivers and predictions for vector-bor…
Authors: Madeleine C. Thomson, Ángel G. Muñoz, Remi Cousin and Joy Shumake-Guillemot
Citation: Infectious Diseases of Poverty 2018 7:81
Published on: 10 August 2018

Antimicrobial resistance in the context of the Syrian conflict: Drivers before and after the onset of conflict and key recommendations

International Journal of Infectious Diseases
August 2018 Volume 73, p1-118
https://www.ijidonline.com/issue/S1201-9712(18)X0007-1

Reviews
Antimicrobial resistance in the context of the Syrian conflict: Drivers before and after the onset of conflict and key recommendations
Aula Abbara, Timothy M. Rawson, Nabil Karah, Wael El-Amin, James Hatcher, Bachir Tajaldin, Osman Dar, Omar Dewachi, Ghassan Abu Sitta, Bernt Eric Uhlin, Annie Sparrow
p1–6
Published online: May 21, 2018

New Nonprofit Biotech From Bill and Melinda Gates

JAMA
August 14, 2018, Vol 320, No. 6, Pages 519-612
http://jama.jamanetwork.com/issue.aspx

Biotech Innovations
August 14, 2018
New Nonprofit Biotech From Bill and Melinda Gates
Jennifer Abbasi
JAMA. 2018;320(6):539. doi:10.1001/jama.2018.11253
A new nonprofit biotech organization funded by the Bill and Melinda Gates Foundation will take on infectious diseases that disproportionately affect the world’s poorest populations: malaria, tuberculosis, and enteric and diarrheal diseases in children. Together these diseases cause 5 deaths every minute, according to the new organization, the Bill and Melinda Gates Medical Research Institute.
Officially open since January, the institute—known as Gates MRI—recently announced details about its mission. Penny M. Heaton, MD, will serve as the institute’s chief executive officer. Heaton previously directed the foundation’s vaccine development program. Immunizations are on the docket at the new institute, too, which aims to speed the development of novel vaccine, drug, and biologic candidates for its target diseases.
Headquartered in Cambridge, Massachusetts, the institute will focus on translational medicine, moving research from late preclinical studies to proof-of-concept phase 1 trials. Later-stage development will involve partnerships with pharmaceutical and biotech companies, nonprofit product developers, and low- and middle-income country manufacturers.
According to the announcement, Gates MRI researchers’ first project will test if a booster shot of the bacille Calmette-Guérin (BCG) vaccine, which is usually given to infants but wanes in efficacy over time, protects at-risk adolescents from tuberculosis.

Return of Research Results to Study Participants – Uncharted and Untested

JAMA
August 14, 2018, Vol 320, No. 6, Pages 519-612
http://jama.jamanetwork.com/issue.aspx

JAMA
August 7, 2018, Vol 320, No. 5, Pages 419-516
Return of Research Results to Study Participants – Uncharted and Untested
Charlene A. Wong, MD, MSHP; Adrian F. Hernandez, MD, MHS; Robert M. Califf, MD
JAMA. 2018;320(5):435-436. doi:10.1001/jama.2018.7898
Research data may be of great utility to study participants and their clinicians in understanding and managing the health of patients who participate in research, depending on the clinical context and nature of results. In addition, increasing amounts of digital data are generated by commercial health products, such as accelerometers and smart watches, and in clinical care. With increasing digitization and data availability, researchers, clinicians, developers, and patients encounter the issue of how to consume, analyze, and make sense of those data. The return of individual results in the context of research studies provides a useful, structured environment to develop an empirical framework, and lessons learned may be applicable to other cases of health information consumerism.

The Influenza Vaccine Mess

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 3, September 2018
https://academic.oup.com/jpids/issue

On Vaccination
The Influenza Vaccine Mess
Stanley A Plotkin
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 3, 17 August 2018, Pages 178–180, https://doi.org/10.1093/jpids/piy057
Extract
By and large, we think of vaccines as highly efficacious, as has been shown in placebo-controlled trials and also by the decreasing incidence of the disease against which a vaccine has been developed. Not so with inactivated influenza vaccine, which we recommend each year for both children and adults but without expecting high efficacy. Indeed, we hope only for moderate efficacy under the conditions of a circulating influenza virus that has not changed substantially from the related strain that was included in the vaccine [1]. Moreover, the failure rate is augmented by the fact that current vaccines are aimed…

Randomized Trial of 2 Versus 1 Dose of Measles Vaccine: Effect on Hospital Admission of Children After 9 Months of Age

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 3, September 2018
https://academic.oup.com/jpids/issue

Randomized Trial of 2 Versus 1 Dose of Measles Vaccine: Effect on Hospital Admission of Children After 9 Months of Age
Marie Brønd; Cesario L Martins; Stine Byberg; Christine S Benn; Hilton Whittle
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 3, 17 August 2018, Pages 226–233, https://doi.org/10.1093/jpids/pix042
Within a randomized trial of measles vaccine (MV) given at 4½ and 9 months versus at 9 months only, boosting with MV reduced the risk of hospital admissions among children between 9 and 18 months of age who had not received vitamin A at birth.

Immunization Completion in Infants Born at Low Birth Weight

Journal of the Pediatric Infectious Diseases Society (JPIDS)
Volume 7, Issue 3, September 2018
https://academic.oup.com/jpids/issue

Original Articles and Commentaries
Immunization Completion in Infants Born at Low Birth Weight
Matt Nestander; Jay Dintaman; Apryl Susi; Gregory Gorman; Elizabeth Hisle-Gorman
Journal of the Pediatric Infectious Diseases Society, Volume 7, Issue 3, 17 August 2018, Pages e58–e64, https://doi.org/10.1093/jpids/pix079
Low birth weight significantly affects immunization completion, even after controlling for prematurity, neonatal illness, provider consistency, access to care, well-child care, and outpatient visits. Complete well-child care visits are associated with immunization completion.

On the road to universal health care in Indonesia, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

The Lancet
https://www.thelancet.com/journals/lancet/issue/current
Aug 18, 2018 Volume 392 Number 10147 p531-612

Articles
On the road to universal health care in Indonesia, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
Nafsiah Mboi, Indra Murty Surbakti, Indang Trihandini, Iqbal Elyazar, Karen Houston Smith, Pungkas Bahjuri Ali, Soewarta Kosen, Kristin Flemons, Sarah E Ray, Jackie Cao, Scott D Glenn, Molly K Miller-Petrie, Meghan D Mooney, Jeffrey L Ried, Dina Nur Anggraini Ningrum, Fachmi Idris, Kemal N Siregar, Pandu Harimurti, Robert S Bernstein, Tikki Pangestu, Yuwono Sidharta, Mohsen Naghavi, Christopher J L Murray, Simon I Hay

On reducing the risk of vaccine-associated paralytic poliomyelitis in the global transition from oral to inactivated poliovirus vaccine

The Lancet
https://www.thelancet.com/journals/lancet/issue/current
Aug 18, 2018 Volume 392 Number 10147 p531-612

Viewpoint
On reducing the risk of vaccine-associated paralytic poliomyelitis in the global transition from oral to inactivated poliovirus vaccine
Xiangdong Peng, Xiaojiang Hu, Miguel A Salazar
Owing to the concerted efforts of countries worldwide, the incidence of paralytic poliomyelitis due to wild poliovirus infection has been reduced to its lowest on record. Wild poliovirus type 2 has not been detected since 1999 and was certified to have been eradicated in 2015.  No case of paralytic poliomyelitis caused by wild poliovirus type 3 has been reported since 2012, and all cases detected since 2013 have been due to wild poliovirus type 1.  In 2016, only 37 cases of paralytic poliomyelitis caused by wild poliovirus infection were reported, and that number decreased to 22 in 2017. Global eradication of wild poliovirus—the long-awaited outcome of decades of effort—is finally in sight.

Vaccine scandal and confidence crisis in China

The Lancet
https://www.thelancet.com/journals/lancet/issue/current
Aug 04, 2018 Volume 392 Number 10145 p359-450  e6

Editorial
Vaccine scandal and confidence crisis in China
The Lancet
In July, China experienced its “worst public health crisis in years” as stated by South China Morning Post. Chinese vaccine maker Changsheng Biotechnology was found to have fabricated production and inspection records and to have arbitrarily changed process parameters and equipment during its production of freeze-dried human rabies vaccines. Furthermore, substandard diphtheria, pertussis, and tetanus (DPT) vaccines produced by Changsheng Biotechnology were administered to 215 184 Chinese children; and 400 520 substandard DPT vaccines produced by Wuhan Institute of Biological Products were sold in Hebei and Chongqing. On July 25, China’s drug regulator launched an investigation into all vaccine producers across the country. 15 people from Changsheng Biotechnology, including the chairman, have been detained by Chinese authorities.

This latest vaccine scandal follows on from a series of fake and substandard food and drugs issues in China. As a result, many parents have lost faith in the vaccine system. Although no cases of death or other severe consequences relevant to the substandard rabies and DPT vaccines have been documented as of July 31, the substandard vaccines have been reported as being poisonous in social media and on the internet.

The immediate action to investigate the national vaccine industry is crucial to deal with the vaccine scandal. However, such action alone will not end public distrust and dissent towards vaccines. The national immunisation programme has helped China achieve tremendous health gains. However, the current vaccine confidence crisis seriously threatens this programme.

Above all, it is the government’s responsibility to ensure that the vaccines produced and used in China are effective and safe. To restore and sustain the public’s confidence in China’s vaccine quality and safety, it is urgent for the government to reflect on and reform where necessary the country’s vaccine regulatory system. A better understanding of the concerns of the public and more transparent and open regulation are essential to protect millions of children from preventable illnesses.

Monitoring equity in universal health coverage with essential services for neglected tropical diseases: an analysis of data reported for five diseases in 123 countries over 9 years

Lancet Global Health
Sep 2018 Volume 6 Number 9 e933-e1044
http://www.thelancet.com/journals/langlo/issue/current

Articles
Monitoring equity in universal health coverage with essential services for neglected tropical diseases: an analysis of data reported for five diseases in 123 countries over 9 years
Christopher Fitzpatrick, Mathieu Bangert, Pamela Sabina Mbabazi, Alexei Mikhailov, Honorat Zouré, Maria Polo Rebollo, Magda Robalo Correia e Silva, Gautam Biswas

Long-term effectiveness of one and two doses of a killed, bivalent, whole-cell oral cholera vaccine in Haiti: an extended case-control study

Lancet Global Health
Sep 2018 Volume 6 Number 9 e933-e1044
http://www.thelancet.com/journals/langlo/issue/current

Long-term effectiveness of one and two doses of a killed, bivalent, whole-cell oral cholera vaccine in Haiti: an extended case-control study
Molly F Franke, Ralph Ternier, J Gregory Jerome, Wilfredo R Matias, Jason B Harris, Louise C Ivers
No study of long-term protection following killed oral cholera vaccination has been done outside of the historically cholera-endemic areas of south Asia, or has examined protection after a single-dose vaccination regimen. To address this, we examined the duration of protection of the standard two-dose regimen and an incomplete regimen of one dose up to 4 years after vaccination in Haiti…In a setting of epidemic and newly endemic cholera in Haiti, single-dose vaccination with killed, bivalent, whole-cell oral cholera vaccination provided short-term protection; however, vaccination with two doses was required for long-term protection, which lasted up to 4 years after vaccination. These results add to the evidence in support of the use of killed, bivalent, whole-cell oral cholera vaccination as part of comprehensive cholera control plans.

Impact of monovalent rotavirus vaccine on diarrhoea-associated post-neonatal infant mortality in rural communities in Malawi: a population-based birth cohort study

Lancet Global Health
Sep 2018 Volume 6 Number 9 e933-e1044
http://www.thelancet.com/journals/langlo/issue/current

Impact of monovalent rotavirus vaccine on diarrhoea-associated post-neonatal infant mortality in rural communities in Malawi: a population-based birth cohort study
Naor Bar-Zeev, Carina King, Tambosi Phiri, James Beard, Hazzie Mvula, Amelia C Crampin, Ellen Heinsbroek, Sonia Lewycka, Jacqueline E Tate, Umesh D Parashar, Anthony Costello, Charles Mwansambo, Robert S Heyderman, Neil French, Nigel A Cunliffe for the VacSurv Consortium

Keep off-target effects in focus

Nature Medicine
Volume 24 Issue 8, August 2018
https://www.nature.com/nm/volumes/24/issues/8

Editorial | 06 August 2018
Keep off-target effects in focus
Concerns about potential unintended DNA changes that might accidentally arise from CRISPR gene editing have emerged to varying degrees with the advent of the technology. As new therapies move from bench to bedside, scientists need to redouble their efforts to document the spectrum of these off-target effects while also acknowledging the reality that a certain degree of risk is embedded in many promising and successful medical therapies.

Accreditation of Clinical Research Sites — Moving Forward

New England Journal of Medicine
http://www.nejm.org/toc/nejm/medical-journal
August 2, 2018  Vol. 379 No. 5

Perspective
Accreditation of Clinical Research Sites — Moving Forward
Greg Koski, Ph.D., M.D., Larry Kennedy, Ph.D., Mary F. Tobin, Ph.D., and Matthew Whalen, Ph.D.
An initiative to design a system of accreditation that would improve and ensure the quality, performance, and safety of clinical trial sites is now coming to fruition. An initial set of quality standards is being made available by request.

Pediatricians and Global Health: Opportunities and Considerations for Meaningful Engagement

Pediatrics
August 2018, VOLUME 142 / ISSUE 2
http://pediatrics.aappublications.org/content/142/2?current-issue=y

State-of-the-Art Review Article
Pediatricians and Global Health: Opportunities and Considerations for Meaningful Engagement
Gitanjli Arora, Emily Esmaili, Michael B. Pitt, Andrea Green, Lisa Umphrey, Sabrina M. Butteris, Nicole E. St Clair, Maneesh Batra, Cliff O’Callahan, on behalf of the Global Health Task Force of the American Board of Pediatrics
Pediatrics Aug 2018, 142 (2) e20172964; DOI: 10.1542/peds.2017-2964
In this review, we describe opportunities, resources, and important personal and professional considerations for US-based pediatric practitioners who are engaged in GCH.

Research Consent at the Age of Majority: Preferable but not Obligatory

Pediatrics
August 2018, VOLUME 142 / ISSUE 2
http://pediatrics.aappublications.org/content/142/2?current-issue=y

Ethics Rounds
Research Consent at the Age of Majority: Preferable but not Obligatory
Kyle B. Brothers, Benjamin S. Wilfond
Pediatrics Aug 2018, 142 (2) e20173038; DOI: 10.1542/peds.2017-3038
There are important reasons for researchers to seek consent when participants turn 18 years old, but these must be balanced with scientific priorities.

Reconsidering the Need for Reconsent at 18

Pediatrics
August 2018, VOLUME 142 / ISSUE 2
http://pediatrics.aappublications.org/content/142/2?current-issue=y

Reconsidering the Need for Reconsent at 18
Benjamin E. Berkman, Dana Howard, David Wendler
Pediatrics Aug 2018, 142 (2) e20171202; DOI: 10.1542/peds.2017-1202
In this article, we challenge the prevailing view that researchers must attempt to obtain consent at 18 years of age to continue doing research with stored samples.
 

An Evaluation of Global Hazard Communication with Ethical Considerations

PLOS Currents: Disasters
http://currents.plos.org/disasters/
[Accessed 18 Aug 2018]

An Evaluation of Global Hazard Communication with Ethical Considerations
August 7, 2018 · Review
Introduction: Despite the large number of hazards occurring every year, it is often only the most catastrophic and rapidly occurring hazards that are covered in detail by major news outlets. This can result in an under-reporting of smaller or slowly evolving hazards such as drought. Furthermore, the type or country in which the hazard occurs may have a bearing on whether it receives media coverage. The Public Health England (PHE) global weekly hazards bulletin is designed to inform subscribers of hazards occurring in the world in a given week regardless of location or type of natural hazard. This paper will aim to examine whether the bulletin is reporting these events in a way that matches a number of international disaster databases.  It will also seek to answer if biases within media outlets reporting of an event is impacting on the types of hazards and events being covered.  Through the analysis of data collected, it is hoped to be able to consider the ethical implications of such a bulletin service and provide recommendations on how the service might be improved in the future.
Methods: The study used a year’s worth of global hazards bulletins sent by Public Health England.  These bulletins aim to communicate hazards in the form of compiled articles from news outlets around the world. Data from these bulletins was collected and analysed by hazard type and the country in which hazards occurred.  It was then compared to recognised hazard databases to assess similarities and differences in the hazards being reported via media or through dedicated hazard databases. The recognised hazard databases were those run by the Emergency Events Database (EM-DAT), European Civil Protection and Humanitarian Aid Operations (ECHO) and National Aeronautics and Space Administration (NASA) respectively.
Results: The PHE bulletin overall was found to be comparable to other global hazard or disaster databases in terms of hazards included by both country and type of hazard. The PHE bulletin covered a greater number of unique hazard events than the other databases and also covered more types of hazard. It also gave more frequent coverage to the United Kingdom and Canada than the other databases, with other countries appearing less frequently. More generally, the PHE bulletin and the databases it was compared to appear to focus more on hazards either occurring in developed countries or fast-onset ones such as landslides or floods. On the other hand, slow-onset hazards such as drought or those occurring in developing countries appear to be under-reported and are given less importance in both the bulletin and databases.
Discussion and recommendations” We recommend that the resources compared review their inclusion criteria and assess whether the discrepancies in hazard type and country can be ratified through changes in how hazards are assessed for inclusion. More research should be undertaken to assess whether similar findings arise when comparing databases in other areas within the remit of public health.

The 2015 Outbreak of Severe Influenza in Kashmir, North India: Emergence of a New Clade of A/H1n1 Influenza Virus

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
[Accessed 18 Aug 2018]

The 2015 Outbreak of Severe Influenza in Kashmir, North India: Emergence of a New Clade of A/H1n1 Influenza Virus
August 8, 2018 · Research Article
Introduction: Following the initial outbreak of A/H1N1pdm09, periodic resurgences of the virus, with variable morbidity and mortality, have been reported from various parts of India including the temperate Kashmir region of northern India. An outbreak of A/H1N1 with high morbidity and mortality was reported in early 2015 across India with a high morbidity and mortality. We studied patients during the outbreak in Kashmir.
Methods: Patients (n=1780, age 1 month to 90 years, median 35 years) presenting with acute respiratory illness to a tertiary care hospital in Srinagar, Kashmir from October 2014 to April 2015 were recruited. After clinical data recording, combined throat and nasal swabs were collected in viral transport medium and tested by real-time RT-PCR for influenza viruses. All influenza A positive samples were further subtyped using primers and probes for A/H1N1pdm09 and A/H3 whereas influenza B samples were further subtyped into B/Yamagata and B/Victoria lineages. Virus isolation, hemagglutination inhibition testing, sequencing and phylogenetic analysis was carried out using standard procedures. Testing for H275Y mutation was done to determine sensitivity to oseltamivir. All patients received symptomatic therapy and influenza positive patients were administered oseltamivir.
Results: Of the 1780 patients, 540 (30%) required hospitalization and 533 tested positive for influenza [influenza A=517(A/H1N1pdm09=437, A/H3N2=78 with co-infection of both in 2 cases); influenza B=16 (B/Yamgata=15)]. About 14% (n=254) had been vaccinated against influenza, having received the NH 2014-15 vaccine, 27 (11.3%) of these testing positive for influenza.  Sixteen patients, including 4 pregnant females, died due to multi-organ failure. HA sequencing depicted that 2015 isolates belonged to Clade 6B.1. No H275Y mutation was reported from A/H1N1 positives.
Conclusion: Resurgent outbreak of A/H1N1pdm09, with emergence of clade 6B.1, in 2014-15 resulted in high rate of hospitalizations, morbidity and mortality. Periodic resurgences and appearance of mutants emphasize continued surveillance so as to identify newer mutations with potential for outbreaks and severe outcomes.

The 2016-2017 Chikungunya Outbreak in Karachi

PLoS Currents: Outbreaks
http://currents.plos.org/outbreaks/
[Accessed 18 Aug 2018]

The 2016-2017 Chikungunya Outbreak in Karachi
August 7, 2018 · Research Article
Introduction: Chikungunya is an incipient disease, caused by Chikungunya virus (CHKV) that belongs to genus alphavirus of the family Togaviridae.
Materials and Methods: In this study, during an outbreak of CHKV in Dec 2016 in Karachi, Pakistan, samples were collected from patients presenting with fever, tiredness and pain in muscles and joints. Total 126 sera were tested for the presence of Chikungunya infection through ELISA and Real-time Reverse Transcriptase PCR assay.
Results and Discussion: This study showed that approx 79.4% samples were positive for CHKV. To our knowledge, this is the first reported outbreak from last decades in which the presence of CHKV is confirmed in Karachi while affecting such large no. of individuals.. Conclusion: CHKV diagnosis should be considered by the scientists and clinicians as a differential diagnosis in febrile patients, and appropriate control strategies must be adopted for its surveillance.

Choices in vaccine trial design in epidemics of emerging infections

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 18 Aug 2018)

Policy Forum
Choices in vaccine trial design in epidemics of emerging infections
Rebecca Kahn, Annette Rid, Peter G. Smith, Nir Eyal, Marc Lipsitch
| published 07 Aug 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002632
Summary points
:: The 2014–2016 Ebola epidemic highlighted variations in the design of randomized trials to evaluate investigational vaccines in an emergency setting. Here, we summarize scientific, ethical, and feasibility considerations relevant to different trial designs.
:: We focus on four fundamental choices in designing a trial of an experimental vaccine in the setting of an emerging infectious disease for which no proven vaccines exist: randomization unit, trial population, comparator intervention, and trial implementation. We also consider three ethical issues relevant to trial design: the social and scientific value of the trial, its risk–benefit profile, and the fairness of participant selection.
:: We believe that individual rather than cluster randomization is better suited for estimating the direct protective effect of a vaccine, a measure of great intrinsic interest. Individual randomization should therefore be the default strategy for evaluating investigational vaccines during epidemics.
:: Trial participants may be selected either from the general population or from a group at high risk of exposure to infection, depending on the characteristics of the infection together with statistical, fairness, and feasibility considerations.
:: Use of a placebo control, rather than an active control or delayed intervention, is likely to maximize the social and scientific value of the trial because it facilitates double-blinding and removes concerns that the comparison intervention may affect the incidence of the disease under study.
:: Starting the trial at approximately the same time for all participants should minimize the time required to obtain a result. Such a strategy will be facilitated when sufficient supplies of the investigational vaccine and control interventions (if any) are available at the start of a trial, when the geographic area for the trial is clearly identified (and anticipated to have continuing disease transmission throughout the trial), and when logistics permit rapid recruitment of the entire trial population. Otherwise, a stepped rollout may be necessary, in which recruitment to the trial is staggered over a period.

A collaborative translational research framework for evaluating and implementing the appropriate use of human genome sequencing to improve health

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 18 Aug 2018)

Essay
A collaborative translational research framework for evaluating and implementing the appropriate use of human genome sequencing to improve health
Muin J. Khoury, W. Gregory Feero, David A. Chambers, Lawrence E. Brody, Nazneen Aziz, Robert C. Green, A. Cecile J.W. Janssens, Michael F. Murray, Laura Lyman Rodriguez, Joni L. Rutter, Sheri D. Schully, Deborah M. Winn, George A. Mensah
| published 02 Aug 2018 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1002631
Summary points
:: There is currently insufficient scientific evidence to support routine nondiagnostic use of germline genome sequencing in healthcare settings and population screening, but an increasing number of health systems are piloting genomic sequencing projects for clinical care.
:: In principle, numerous diagnostic or prognostic tests based on genes or variants could be used for different purposes across the life span, and an evidence-based approach is urgently needed to evaluate their possible clinical utility and facilitate appropriate implementation.
:: We discuss a translational research framework that features collaboration among multiple health systems with already available genome sequencing data, intervention information, and clinical outcomes. The framework is based on evaluating the impact of genetic information on improving health outcomes with study designs that depend on the evolving level of evidence for specific intended clinical uses.
:: In addition to observational studies, randomized controlled trials will be needed to assess health benefits, harms, and costs based on returning or not returning the results of selected genes/variants to patients, providers, or both, for specific clinical scenarios.
:: The proposed approach will allow learning health systems to collect clinical utility evidence in a research environment and develop the necessary capacity for appropriate integration of sequencing alongside other medical services.

 

Hajj, Umrah, and the neglected tropical diseases

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 18 Aug 2018)

Viewpoints
Hajj, Umrah, and the neglected tropical diseases
Mashal M. Almutairi, Waleed Saleh Alsalem, Mazen Hassanain, Peter J. Hotez
| published 16 Aug 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006539
… In this report, we focus on the major NTDs that have either been introduced into the Middle East through Hajj and Umrah pilgrimages from tropical disease–endemic countries of Asia and Africa or where importation from Saudi Arabia to other parts of the world are possible. In some cases, these diseases have now become endemic in Saudi Arabia and elsewhere in the MENA region. Our report emphasizes the recent scientific literature published within the last five years….

Is the priority review voucher program stimulating new drug development for tropical diseases?

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 18 Aug 2018)

Research Article
Is the priority review voucher program stimulating new drug development for tropical diseases?
Kirk W. Kerr, Thomas C. Henry, Kathleen L. Miller
| published 09 Aug 2018 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0006695

Exploring the risk of severe outcomes and the role of seasonal influenza vaccination in pregnant women hospitalized with confirmed influenza, Spain, 2010/11-2015/16

PLoS One
http://www.plosone.org/
[Accessed 18 Aug 2018]

Research Article
Exploring the risk of severe outcomes and the role of seasonal influenza vaccination in pregnant women hospitalized with confirmed influenza, Spain, 2010/11-2015/16
Clara Mazagatos, Concepción Delgado-Sanz, Jesús Oliva, Alin Gherasim, Amparo Larrauri, the Spanish Influenza Surveillance System
Research Article | published 08 Aug 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0200934

Direct, indirect and total effectiveness of bivalent HPV vaccine in women in Galicia, Spain

PLoS One
http://www.plosone.org/
[Accessed 18 Aug 2018]

Direct, indirect and total effectiveness of bivalent HPV vaccine in women in Galicia, Spain
Jesus Purriños-Hermida, María Isolina Santiago-Pérez, Mercedes Treviño, Rafaela Dopazo, Angelina Cañizares, Isolina Bonacho, Matilde Trigo, M. Eva Fernández, Ana Cid, David Gómez, Patricia Ordóñez, Amparo Coira, M. J. Armada, Magdalena Porto, Sonia Perez, Alberto Malvar-Pintos, on behalf of the HPV Vaccine Impact Surveillance Working Group of Galicia
Research Article | published 03 Aug 2018 PLOS ONE
https://doi.org/10.1371/journal.pone.0201653

The challenge of HPV vaccination uptake and opportunities for solutions: Lessons learned from Alabama

Preventive Medicine
Volume 113  Pages 1-156 (August 2018)
https://www.sciencedirect.com/journal/preventive-medicine/vol/113/suppl/C

Regular Articles
The challenge of HPV vaccination uptake and opportunities for solutions: Lessons learned from Alabama
Original research article
Pages 124-131
Sarah E. Dilley, Sylvia Peral, J. Michael Straughn, Isabel C. Scarinci
Abstract
The human papillomavirus (HPV) vaccine is an important tool for cancer prevention. However, vaccination rates in Alabama, a state with high rates of HPV-related cancers, remain below the national average. Our objective was to develop a comprehensive assessment of HPV vaccination in our state, with the goal to make recommendations for tailored multilevel interventions. A multimodal approach with quantitative and qualitative data was used to determine barriers and facilitators to HPV vaccination in Alabama. This included a survey of pediatric care providers and structured interviews with pediatricians, parents, nurses and community stakeholders. Two separate investigators evaluated the interview transcripts for major themes that occurred in 65% or more interviews. Major barriers included lack of knowledge, concerns about vaccine safety, and the link between the HPV vaccine and sexuality. Qualitative interviews further revealed barriers such as misinformation received from the internet and parental vaccine hesitancy. Opportunities for increasing vaccination include parental education, establishment of a reminder system, increasing access to HPV vaccine providers, and education for providers. Additional facilitators revealed through interviews included: trust in physicians, using the internet or social media to propagate positive messaging, physicians and clinical staff education, utilizing existing technology more effectively, highlighting nurses’ roles as partners in HPV prevention, and the potential of schools as a venue for promotion of the vaccine. Our data are consistent with prior research showing major barriers to HPV vaccination. Several recommendations for optimizing HPV vaccination uptake in Alabama on the patient, provider and system level are given.

 

 

Thematic issue: Economics of NCDs

Revista Panamericana de Salud Pública/Pan American Journal of Public Health (RPSP/PAJPH)

http://www.paho.org/journal/index.php?option=com_content&view=featured&Itemid=101
Thematic issue: Economics of NCDs
The global health burden of noncommunicable diseases (NCDs) is large and growing, as this group of diseases already accounts for 70% of total deaths. Global evidence indicates that the high health burden of NCDs translates into significant economic and social costs that threaten to diminish the quality of life of millions of individuals, impoverish families, jeopardize universal health coverage, and increase health disparities within and between countries. Evidence consistently shows that the NCD epidemic cannot be tackled through interventions and policies in the health sector alone. In particular, prevention measures that address NCD risk factors involve a range of sectors including finance, trade, education, agriculture, and transportation. As economics has become the common language among decision makers across sectors, it is imperative that health authorities leverage economic information to more effectively communicate the urgency of tackling NCDs and related risk factors.

This thematic issue of the Pan American Journal of Public Health is part of a continued collaboration between the Public Health Agency of Canada (PHAC) and PAHO/WHO to fa­cilitate intragovernmental dialogue for a better understanding of NCD issues by making economic evidence available in the Americas, and to assist countries in integrating economic approaches into their NCD prevention and control policies.

[Reviewed earlier]

 

The Ethical Foundations of Risk Analysis

Risk Analysis          
Volume 38, Issue 8  Pages: 1519-1761  August 2018
https://onlinelibrary.wiley.com/toc/15396924/current

Perspectives
The Ethical Foundations of Risk Analysis
Daniel J. Rozell
Pages: 1529-1533
First Published: 19 January 2018
Abstract
In the field of risk analysis, the normative value systems underlying accepted methodology are rarely explicitly discussed. This perspective provides a critique of the various ethical frameworks that can be used in risk assessments and risk management decisions. The goal is to acknowledge philosophical weaknesses that should be considered and communicated in order to improve the public acceptance of the work of risk analysts.