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  1. Article ; Online: Breaking the cycle of malaria treatment failure.

    Boni, Maciej F

    Frontiers in epidemiology

    2022  Volume 2, Page(s) 1041896

    Abstract: Treatment of symptomatic malaria became a routine component of the clinical and public health response to malaria after the second world war. However, all antimalarial drugs deployed against malaria eventually generated enough drug resistance that they ... ...

    Abstract Treatment of symptomatic malaria became a routine component of the clinical and public health response to malaria after the second world war. However, all antimalarial drugs deployed against malaria eventually generated enough drug resistance that they had to be removed from use. Chloroquine, sulfadoxine-pyrimethamine, and mefloquine are well known examples of antimalarial drugs to which resistance did and still does ready evolve. Artemisinin-based combination therapies (ACTs) are currently facing the same challenge as artemisinin resistance is widespread in Southeast Asia and emerging in Africa. Here, I review some aspects of drug-resistance management in malaria that influence the strength of selective pressure on drug-resistant malaria parasites, as well as an approach we can take in the future to avoid repeating the common mistake of deploying a new drug and waiting for drug resistance and treatment failure to arrive. A desirable goal of drug-resistance management is to reduce selection pressure without reducing the overall percentage of patients that are treated. This can be achieved by distributing multiple first-line therapies (MFT) simultaneously in the population for the treatment of uncomplicated falciparum malaria, thereby keeping treatment levels high but the overall selection pressure exerted by each individual therapy low. I review the primary reasons that make MFT a preferred resistance management option in many malaria-endemic settings, and I describe two exceptions where caution and additional analyses may be warranted before deploying MFT. MFT has shown to be feasible in practice in many endemic settings. The continual improvement and increased coverage of genomic surveillance in malaria may allow countries to implement custom MFT strategies based on their current drug-resistance profiles.
    Language English
    Publishing date 2022-12-14
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2674-1199
    ISSN (online) 2674-1199
    DOI 10.3389/fepid.2022.1041896
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mathematical epidemiology for a later age.

    Rosenberg, Noah A / Boni, Maciej F

    Theoretical population biology

    2022  Volume 144, Page(s) 81–83

    Language English
    Publishing date 2022-03-02
    Publishing country United States
    Document type Editorial
    ZDB-ID 3948-2
    ISSN 1096-0325 ; 0040-5809
    ISSN (online) 1096-0325
    ISSN 0040-5809
    DOI 10.1016/j.tpb.2022.02.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Influenza vaccination allocation in tropical settings under constrained resources.

    Servadio, Joseph L / Choisy, Marc / Thai, Pham Quang / Boni, Maciej F

    medRxiv : the preprint server for health sciences

    2024  

    Abstract: Influenza virus seasonality, synchronicity, and vaccine supply differ substantially between temperate and tropical settings, and optimal vaccination strategy may differ on this basis. Most national vaccine recommendations focus on high-risk groups, ... ...

    Abstract Influenza virus seasonality, synchronicity, and vaccine supply differ substantially between temperate and tropical settings, and optimal vaccination strategy may differ on this basis. Most national vaccine recommendations focus on high-risk groups, elderly populations, and healthcare workers despite previous analyses demonstrating broad benefits to vaccinating younger high-contact age groups. Here, we parameterized an age-structured non-seasonal asynchronous epidemiological model of influenza virus transmission for a tropical low-income setting. We evaluated timing and age allocation of vaccines across vaccine supplies ranging from 10% to 90% using decade-based age groups. Year-round vaccination was beneficial when comparing to vaccination strategies focused on a particular time of year. When targeting a single age-group for vaccine prioritization, maximum vaccine allocation to the 10-19 high-contact age group minimized annual influenza mortality for all but one vaccine supply. When evaluating across all possible age allocations, optimal strategies always allocated a plurality of vaccines to school-age children (10-19). The converse however was not true as not all strategies allocating a plurality to children aged 10-19 minimized mortality. Allocating a high proportion of vaccine supply to the 10-19 age group is necessary but not sufficient to minimize annual mortality as distribution of remaining vaccine doses to other age groups also needs to be optimized. Strategies focusing on indirect benefits (vaccinating children) showed higher variance in mortality outcomes than strategies focusing on direct benefits (vaccinating the elderly). However, the indirect benefit approaches showed lower mean mortality and lower minimum mortality than vaccination focused on the elderly.
    Language English
    Publishing date 2024-02-09
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2024.02.08.24302551
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Assessing emergence risk of double-resistant and triple-resistant genotypes of Plasmodium falciparum.

    Li, Eric Zhewen / Nguyen, Tran Dang / Tran, Thu Nguyen-Anh / Zupko, Robert J / Boni, Maciej F

    Nature communications

    2024  Volume 15, Issue 1, Page(s) 1390

    Abstract: Delaying and slowing antimalarial drug resistance evolution is a priority for malaria-endemic countries. Until novel therapies become available, the mainstay of antimalarial treatment will continue to be artemisinin-based combination therapy (ACT). ... ...

    Abstract Delaying and slowing antimalarial drug resistance evolution is a priority for malaria-endemic countries. Until novel therapies become available, the mainstay of antimalarial treatment will continue to be artemisinin-based combination therapy (ACT). Deployment of different ACTs can be optimized to minimize evolutionary pressure for drug resistance by deploying them as a set of co-equal multiple first-line therapies (MFT) rather than rotating therapies in and out of use. Here, we consider one potential detriment of MFT policies, namely, that the simultaneous deployment of multiple ACTs could drive the evolution of different resistance alleles concurrently and that these resistance alleles could then be brought together by recombination into double-resistant or triple-resistant parasites. Using an individual-based model, we compare MFT and cycling policies in malaria transmission settings ranging from 0.1% to 50% prevalence. We define a total risk measure for multi-drug resistance (MDR) by summing the area under the genotype-frequency curves (AUC) of double- and triple-resistant genotypes. When prevalence ≥ 1%, total MDR risk ranges from statistically similar to 80% lower under MFT policies than under cycling policies, irrespective of whether resistance is imported or emerges de novo. At 0.1% prevalence, there is little statistical difference in MDR risk between MFT and cycling.
    MeSH term(s) Humans ; Antimalarials/pharmacology ; Antimalarials/therapeutic use ; Drug Resistance/genetics ; Folic Acid Antagonists/therapeutic use ; Genotype ; Malaria/parasitology ; Malaria, Falciparum/drug therapy ; Malaria, Falciparum/epidemiology ; Malaria, Falciparum/parasitology ; Plasmodium falciparum/genetics
    Chemical Substances Antimalarials ; Folic Acid Antagonists
    Language English
    Publishing date 2024-02-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-024-45547-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Repeatability and timing of tropical influenza epidemics.

    Servadio, Joseph L / Thai, Pham Quang / Choisy, Marc / Boni, Maciej F

    PLoS computational biology

    2023  Volume 19, Issue 7, Page(s) e1011317

    Abstract: Much of the world experiences influenza in yearly recurring seasons, particularly in temperate areas. These patterns can be considered repeatable if they occur predictably and consistently at the same time of year. In tropical areas, including southeast ... ...

    Abstract Much of the world experiences influenza in yearly recurring seasons, particularly in temperate areas. These patterns can be considered repeatable if they occur predictably and consistently at the same time of year. In tropical areas, including southeast Asia, timing of influenza epidemics is less consistent, leading to a lack of consensus regarding whether influenza is repeatable. This study aimed to assess repeatability of influenza in Vietnam, with repeatability defined as seasonality that occurs at a consistent time of year with low variation. We developed a mathematical model incorporating parameters to represent periods of increased transmission and then fitted the model to data collected from sentinel hospitals throughout Vietnam as well as four temperate locations. We fitted the model for individual (sub)types of influenza as well as all combined influenza throughout northern, central, and southern Vietnam. Repeatability was evaluated through the variance of the timings of peak transmission. Model fits from Vietnam show high variance (sd = 64-179 days) in peak transmission timing, with peaks occurring at irregular intervals and throughout different times of year. Fits from temperate locations showed regular, annual epidemics in winter months, with low variance in peak timings (sd = 32-57 days). This suggests that influenza patterns are not repeatable or seasonal in Vietnam. Influenza prevention in Vietnam therefore cannot rely on anticipation of regularly occurring outbreaks.
    MeSH term(s) Humans ; Influenza, Human/prevention & control ; Seasons ; Vietnam/epidemiology ; Models, Theoretical ; Epidemics
    Language English
    Publishing date 2023-07-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2193340-6
    ISSN 1553-7358 ; 1553-734X
    ISSN (online) 1553-7358
    ISSN 1553-734X
    DOI 10.1371/journal.pcbi.1011317
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Role of seasonal importation and genetic drift on selection for drug-resistant genotypes of

    Zupko, Robert J / Servadio, Joseph L / Nguyen, Tran Dang / Tran, Thu Nguyen-Anh / Tran, Kien Trung / Somé, Anyirékun Fabrice / Boni, Maciej F

    Journal of the Royal Society, Interface

    2024  Volume 21, Issue 212, Page(s) 20230619

    Abstract: ... ...

    Abstract Historically
    MeSH term(s) Plasmodium falciparum/genetics ; Seasons ; Genetic Drift ; Clone Cells ; Genotype
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2156283-0
    ISSN 1742-5662 ; 1742-5689
    ISSN (online) 1742-5662
    ISSN 1742-5689
    DOI 10.1098/rsif.2023.0619
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Using compartmental models and Particle Swarm Optimization to assess Dengue basic reproduction number

    Navarro Valencia, Vicente Alonso / Díaz, Yamilka / Pascale, Jose Miguel / Boni, Maciej F / Sanchez-Galan, Javier E

    Heliyon

    2023  Volume 9, Issue 4, Page(s) e15424

    Abstract: Nowadays, the ability to make data-driven decisions in public health is of utmost importance. To achieve this, it is necessary for modelers to comprehend the impact of models on the future state of healthcare systems. Compartmental models are a valuable ... ...

    Abstract Nowadays, the ability to make data-driven decisions in public health is of utmost importance. To achieve this, it is necessary for modelers to comprehend the impact of models on the future state of healthcare systems. Compartmental models are a valuable tool for making informed epidemiological decisions, and the proper parameterization of these models is crucial for analyzing epidemiological events. This work evaluated the use of compartmental models in conjunction with Particle Swarm Optimization (PSO) to determine optimal solutions and understand the dynamics of Dengue epidemics. The focus was on calculating and evaluating the rate of case reproduction,
    Language English
    Publishing date 2023-04-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835763-2
    ISSN 2405-8440
    ISSN 2405-8440
    DOI 10.1016/j.heliyon.2023.e15424
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  8. Article ; Online: National-scale simulation of human movement in a spatially coupled individual-based model of malaria in Burkina Faso.

    Zupko, Robert J / Nguyen, Tran Dang / Wesolowski, Amy / Gerardin, Jaline / Boni, Maciej F

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 321

    Abstract: Malaria due to the Plasmodium falciparum parasite remains a threat to human health despite eradication efforts and the development of anti-malarial treatments, such as artemisinin combination therapies. Human movement and migration have been linked to ... ...

    Abstract Malaria due to the Plasmodium falciparum parasite remains a threat to human health despite eradication efforts and the development of anti-malarial treatments, such as artemisinin combination therapies. Human movement and migration have been linked to the propagation of malaria on national scales, highlighting the need for the incorporation of human movement in modeling efforts. Spatially couped individual-based models have been used to study how anti-malarial resistance evolves and spreads in response to drug policy changes; however, as the spatial scale of the model increases, the challenges associated with modeling of movement also increase. In this paper we discuss the development, calibration, and validation of a movement model in the context of a national-scale, spatial, individual-based model used to study the evolution of drug resistance in the malaria parasite.
    MeSH term(s) Humans ; Antimalarials/pharmacology ; Antimalarials/therapeutic use ; Burkina Faso/epidemiology ; Malaria/drug therapy ; Malaria/epidemiology ; Plasmodium falciparum ; Drug Therapy, Combination ; Drug Resistance ; Malaria, Falciparum/drug therapy ; Malaria, Falciparum/epidemiology ; Malaria, Falciparum/parasitology
    Chemical Substances Antimalarials
    Language English
    Publishing date 2023-01-06
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-26878-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Benefits of near-universal vaccination and treatment access to manage COVID-19 burden in the United States.

    Yang, Fuhan / Tran, Thu Nguyen-Anh / Howerton, Emily / Boni, Maciej F / Servadio, Joseph L

    medRxiv : the preprint server for health sciences

    2023  

    Abstract: Background: As we enter the fourth year of the COVID-19 pandemic, SARS-CoV-2 infections still cause high morbidity and mortality in the United States. During 2020-2022, COVID-19 was one of the leading causes of death in the United States and by far the ... ...

    Abstract Background: As we enter the fourth year of the COVID-19 pandemic, SARS-CoV-2 infections still cause high morbidity and mortality in the United States. During 2020-2022, COVID-19 was one of the leading causes of death in the United States and by far the leading cause among infectious diseases. Vaccination uptake remains low despite this being an effective burden reducing intervention. The development of COVID-19 therapeutics provides hope for mitigating severe clinical outcomes. This modeling study examines combined strategies of vaccination and treatment to reduce the burden of COVID-19 epidemics over the next decade.
    Methods: We use a validated mathematical model to evaluate the reduction of incident cases, hospitalized cases, and deaths in the United States through 2033 under various levels of vaccination and treatment coverage. We assume that future seasonal transmission patterns for COVID-19 will be similar to those of influenza virus. We account for the waning of infection-induced immunity and vaccine-induced immunity in a future with stable COVID-19 dynamics. Due to uncertainty in the duration of immunity following vaccination or infection, we consider two exponentially-distributed waning rates, with means of 365 days (one year) and 548 days (1.5 years). We also consider treatment failure, including rebound frequency, as a possible treatment outcome.
    Results: As expected, universal vaccination is projected to eliminate transmission and mortality. Under current treatment coverage (13.7%) and vaccination coverage (49%), averages of 89,000 annual deaths (548-day waning) and 120,000 annual deaths (365-day waning) are expected by the end of this decade. Annual mortality in the United States can be reduced below 50,000 per year with >81% annual vaccination coverage, and below 10,000 annual deaths with >84% annual vaccination coverage. Universal treatment reduces hospitalizations by 88% and deaths by 93% under current vaccination coverage. A reduction in vaccination coverage requires a comparatively larger increase in treatment coverage in order for hospitalization and mortality levels to remain unchanged.
    Conclusions: Adopting universal vaccination and universal treatment goals in the United States will likely lead to a COVID-19 mortality burden below 50,000 deaths per year, a burden comparable to that of influenza virus.
    Language English
    Publishing date 2023-02-10
    Publishing country United States
    Document type Preprint
    DOI 10.1101/2023.02.08.23285658
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Benefits of near-universal vaccination and treatment access to manage COVID-19 burden in the United States.

    Yang, Fuhan / Tran, Thu Nguyen-Anh / Howerton, Emily / Boni, Maciej F / Servadio, Joseph L

    BMC medicine

    2023  Volume 21, Issue 1, Page(s) 321

    Abstract: Background: As we continue the fourth year of the COVID-19 epidemic, SARS-CoV-2 infections still cause high morbidity and mortality in the United States. During 2020-2022, COVID-19 was one of the leading causes of death in the United States and by far ... ...

    Abstract Background: As we continue the fourth year of the COVID-19 epidemic, SARS-CoV-2 infections still cause high morbidity and mortality in the United States. During 2020-2022, COVID-19 was one of the leading causes of death in the United States and by far the leading cause among infectious diseases. Vaccination uptake remains low despite this being an effective burden reducing intervention. The development of COVID-19 therapeutics provides hope for mitigating severe clinical outcomes. This modeling study examines combined strategies of vaccination and treatment to reduce the burden of COVID-19 epidemics over the next decade.
    Methods: We use a validated mathematical model to evaluate the reduction of incident cases, hospitalized cases, and deaths in the United States through 2033 under various levels of vaccination and treatment coverage. We assume that future seasonal transmission patterns for COVID-19 will be similar to those of influenza virus and account for the waning of infection-induced immunity and vaccine-induced immunity in a future with stable COVID-19 dynamics. Due to uncertainty in the duration of immunity following vaccination or infection, we consider three exponentially distributed waning rates, with means of 365 days (1 year), 548 days (1.5 years), and 730 days (2 years). We also consider treatment failure, including rebound frequency, as a possible treatment outcome.
    Results: As expected, universal vaccination is projected to eliminate transmission and mortality. Under current treatment coverage (13.7%) and vaccination coverage (49%), averages of 81,000-164,600 annual reported deaths, depending on duration of immunity, are expected by the end of this decade. Annual mortality in the United States can be reduced below 50,000 per year with 52-80% annual vaccination coverage and below 10,000 annual deaths with 59-83% annual vaccination coverage, depending on duration of immunity. Universal treatment reduces hospitalizations by 88.6% and deaths by 93.1% under current vaccination coverage. A reduction in vaccination coverage requires a comparatively larger increase in treatment coverage in order for hospitalization and mortality levels to remain unchanged.
    Conclusions: Adopting universal vaccination and universal treatment goals in the United States will likely lead to a COVID-19 mortality burden below 50,000 deaths per year, a burden comparable to that of influenza virus.
    MeSH term(s) United States/epidemiology ; Humans ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Vaccination ; Vaccination Coverage ; Epidemics
    Language English
    Publishing date 2023-08-24
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 2131669-7
    ISSN 1741-7015 ; 1741-7015
    ISSN (online) 1741-7015
    ISSN 1741-7015
    DOI 10.1186/s12916-023-03025-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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